The Department of Health and Senior Services provided an update on the status of the Missouri Immunization Information System (IIS) during an educational session for the Missouri Health Information Technology (MO HIT) Assistance Center on June 15.  The MO HIT Assistance Center is sharing this updated information with providers.

The Missouri Department of Health and Senior Services (DHSS) is developing electronic interfaces that will allow providers to exchange immunization data directly with the state from their certified electronic health record (EHR.)  Enabling transmission of data (as opposed to manually entering data as is now required through “ShowMeVax”) holds the best promise for building a comprehensive statewide database. This electronic exchange will also allow providers to meet the meaningful use requirement, “Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice.”  Providers are required to select one of the two public health measures from the menu set of meaningful use objectives.  (The other public health measure concerns submission of syndromic surveillance data—currently, Missouri is only capable of accepting syndromic surveillance data from hospitals.)  The state is using funds provided through the Health Care Reform law to make the Missouri Immunization Information Systems HL7-compliant.   

The State began this work with providers who contacted them to enable HL7 data messaging with their EHR systems and has successfully enabled HL7 data messaging with the first two providers.  The EHR systems used by these providers are Insight (used by a Public Health Service) and Cerner (being built as a custom interface by a Kansas City hospital).  An additional provider using Epic is beginning work on an interface, and a practice in Joplin is testing an interface using e-MDs.   More than 40 applicants, representing various EHRs, are “in the cue” waiting for assistance with the development of an interface between their systems and DHSS.  DHSS is looking for providers willing to work with DHSS and their vendor to develop and test interfaces.

Providers must “perform at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow-up with submission if the test is successful” to meet meaningful use criteria. To meet this requirement, providers should do the following:

1. Contact Lori Sprock, MSN, APRN, Missouri Public Health Information Exchange (MoPHIE) Project, Missouri Department of Health and Senior Services at  lori.sprock@oa.mo.gov  (573) 526-3021. This request must come from the provider, not the vendor. 
2. The provider should state they are preparing to apply for Meaningful Use and want to test an exchange with the Immunization Information System.
3. Lori will provide information on conducting the test.
4. The provider will need to contact their vendor to enable their system to transmit HL7 messages.  The vendor should be able to provide instructions on how to do this.
5. The test should then be conducted with the vendor and DHSS assistance.
6. It is highly unlikely that the test will be successful.  However, DHSS will send a letter to the provider stating they completed the test.  This should satisfy the Meaningful Use requirements for 2011.
7. DHSS will continue working with providers and their vendors to eventually get everyone participating in successful IIS exchange.

If you have any questions, please feel free to contact either Lori Sprock, as listed above, or your implementation specialist.

For information on the Medicaid and Medicare EHR incentive programs, EHR adoption, or how the MO HIT Assistance Center helps health care providers adopt and achieve meaningful use of certified EHRs, please visit the Missouri Health Information Technology Assistance Center Website, E-mail us, or call us toll-free 1-877-882-9933.

Providers striving for meaningful use of an EHR may be able to participate easily in the Physician Quality Reporting System (PQRS—formerly PQRI) with just a little help from Primaris.  Physicians may be unaware that several quality measures, including six preventative measures, are consistent between the meaningful use and PQRS programs, and some EHRs are capable of submitting data for both programs. The PQRS Incentive Program offers payments of 1.0 percent of allowable Medicare Part B Professional Fee Schedule charges in 2011 and 0.5 percent during 2012-2014.  Furthermore, providers who do not report PQRS will face payment reductions of 1.5 percent beginning in 2015.  Also, performance on quality measures will be publicly reported on the “Physician Compare” website beginning in 2013.  All are good reasons to take PQRS seriously—now!

Primaris, a partner of the Missouri Health Information Technology (MO HIT) Assistance Center and Missouri’s Quality Improvement Organization, is offering onsite, individualized assistance with PQRS reporting at no charge to 100 Missouri providers, as part of an initiative funded by the Centers for Medicare and Medicaid Services (CMS).  To be eligible for this program, providers must be: (a) eligible for the PQRS Incentive Program, as defined by CMS; (b) willing to report at least three of six specific PQRS preventive care measures, including:   influenza immunization, pneumonia vaccination, screening mammography, colorectal cancer screening, tobacco use-screening and cessation, and hypertension–blood pressure measurement; and (c) using an EHR that is “qualified” to submit PQRS data directly to CMS.

Only 28 EHRs are “qualified” to report PQRS directly to CMS in 2011, click here to view the entire list of qualified EHRs.  Primaris assistance will include one-on-one services, such as enabling EHR functionality for PQRS reporting, identifying where and how to record data elements for each measure, establishing workflows for consistent data capture, developing routine reports to monitor performance, implementing a continuous quality improvement program, and sharing best practices and expertise from topic experts.  Sandy Pogones, program manager for Primaris, says PQRS reporting using the EHR option is easier than reporting using the traditional “claims” option, as data only has to be submitted once to CMS following the close of the reporting period.

Primaris will also offer wide-scale assistance to eligible providers that do not have a qualified EHR, but wish to improve their performance on PQRS preventive measures as reported through claims.  Services will include tools for accurate data capture, sharing of best practices for improving performance on the six measures, information and updates from CMS and vendors regarding PQRS reporting, and e-mail and telephone support.

Routinely measuring and reviewing care allows providers to identify potential issues, such as missing or inconsistent documentation, overdue prevention services, and missed revenue-producing opportunities.  When public reporting begins in 2013, providers that are experienced with PQRS will be confident their reports reflect an accurate picture of their health care operation.

If you would like more information about Primaris’ free PQRS support, email Sandy Pogones at Primaris. For information on the Medicaid and Medicare EHR incentive programs, EHR adoption, or how the MO HIT Assistance Center helps health care providers adopt and achieve meaningful use of certified EHRs, please visit the Missouri Health Information Technology Assistance Center Website, E-mail us, or call us toll-free 1-877-882-9933.