How to survive an EHR meaningful use audit.

Andrew Pasternak, MD, MS I 2011, the Centers for Medicare & Medicaid Services (CMS) implemented the meaningful use (MU) program to promote the use of electronic health records (EHRs) in hospitals and physician offices. If measured by how many physicians currently use EHRs, the program has been successful; the percentage of offices using an EHR has increased from 48 percent in 2009 to 72 percent in 2012. As background, MU Stage 1 offers financial incentives to independent physicians who can prove that they have completed 15 core objectives and five of 10 menu objectives for how they use EHRs as well as report certain clinical quality measures. Medicare-eligible physicians who are not MU compliant by 2015 will receive a penalty to their reimbursements. Our two-provider practice had used our EHR system (e-MDs Solution Series) since opening in 2005. We were excited when the MU program was announced because we felt that we were ahead of other offices with regards to EHR use, and one of our primary goals for 2011 was to become one of the first practices in Nevada to complete the attestation process for the MU program. Although the early focus was on larger health care systems, not independent practices, we wanted to demonstrate that small practices are the most adept at incorporating new technologies. We did realize, however, that we needed some outside support given our size. We worked very closely with our vendor and HealthInsight, the Medicare regional extension center (REC) that serves our state. Because MU was a new program, we were all at the same point on the learning curve. Part of the fun of reaching our goal was the collaborative learning between our office, our vendor, and HealthInsight. In February 2011, we began to run weekly reports on our MU criteria to measure our progress. Initially, we did have to make a few small adjustments to aspects of our workflow and documentation. Three months later, we ran our 90-day reports and submitted our documentation to CMS for Stage 1 MU attestation. Our only “glitch” was that we incorrectly entered the dates of attestation for one of our providers. We only noticed this during the attestation for the second provider, and we called the MU hotline immediately to notify them of this issue. In our recollection, we were told not to worry about it too much and that they really couldn’t make any changes on their end. ➤