Speakers: Meaningful use may eventually be universally required

LAS VEGAS – Two practicing optometrists offered tips to help attendees navigate stages 1 and 2 of the meaningful use objectives, in a continuing education symposium here at Vision Expo West.

“You don’t have to do this if you don’t take Medicare and Medicaid,” Jay Henry, OD, said. “However, insurers are saying they’re going to decrease reimbursement if you don’t do this in the future. We have heard rumblings it will be a 50% decrease in reimbursement if you’re not a meaningful user.

“We feel if you don’t do meaningful use,” he added, “you’re going to go away as a practitioner.”

Henry and Philip Gross, OD, explained that a practitioner will be in stage 1 of meaningful use for at least 2 years, then move on to stage 2, then eventually stage 3. For the first year, you must demonstrate meaningful use for any continuous 90-day reporting period. For all subsequent years, except 2014, it needs to be done for an entire calendar year.

Practitioners must meet all core objectives, of which there are 15 for stage 1 and 17 for stage 2. For menu objectives, clinicians choose five of 10 in stage one and three of six in stage 2.

Several core objectives for which there are no exclusions include patient demographics, active medication list, active medication allergy list and changes in vital signs, which drew much discussion among attendees.

In stage 1, for more than 50% of patients age 2 and older, practitioners must record height, weight and blood pressure. The only exclusion is if you see no patients older than 2 years or you believe all three vital signs are not relevant to your specialty, Gross said.

“They are tracking who is taking an exclusion on this, and ophthalmology and optometry are leading the pack,” he said. “It’s a fairly high incidence that puts us under the microscope. You could set yourself up for an audit.”

In stage 2, the requirement increases to 80%, but you can take an exclusion for height and weight only or blood pressure only, Gross said.

“We know that an increased risk of conditions such as age-related macular degeneration, glaucoma and cataract is related to body mass index,” he said.

“We collect height and weight in the patient questionnaire, and we also scan the patient’s driver’s license, which indicates that,” Gross said. “Patients can self report.

“For blood pressure, we feel we should really be doing this on patients,” he continued. “It’s amazing to us to have patients with very high pressure, and once or twice a month we may see someone with critically high pressure that necessitates us sending them to the emergency room.”

Gross clarified that “you can ask the patient their height and weight, but you have to take their blood pressure.”

Disclosure: Gross and Henry are affiliated with www.ehrguru.net.