Stage 2 Meaningful Use
Cancer Reporting in Stage 2 Meaningful Use (MU2)
The Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs provide financial incentives for the “meaningful use” of certified EHR technology to improve patient care. Stage 2 Meaningful Use (MU2) includes a menu objective for Eligible Professionals (EP)’s EHRs to have the capability to identify and report cancer cases to a state cancer registry, effective 1/1/2014. Successful ongoing submission of cancer data to the PCR using certified EHR technology will assist EPs in receiving Medicare and Medicaid incentive funds.
The use of certified electronic health record (EHR) technology to transmit cancer cases to the state cancer registry provides a secure, automated, and unobtrusive reporting method for physicians. Physicians benefit by removing the burden to manually identify and report required information to the state cancer registry. State cancer registries benefit by improving cancer case reporting from providers treating cancer patients in outpatient settings resulting in more comprehensive data for epidemiology and public health activities.
Declaration of Readiness
In support of physician cancer reporting and MU2, the Pennsylvania Cancer Registry (PCR) is implementing electronic reporting from certified electronic health record (EHR) technology. While cancer reporting is a “menu” option under Stage 2, all eligible professionals (EPs) are encouraged to participate in this important public health activity.
Registration of Intent
Eligible Professional (EPs) seeking to meet MU2 public health objectives by reporting cancer data to the PCR must register their intent to do so with the PCR. The PCR will provide confirmation when the EP successfully registers, an invitation to the EP to begin on-boarding, and a description of next steps.
To register intent, the meaningful use contact for the practice should send their name, phone number, email address and the name of the physician practice to the PCR by e-mail. PCR staff will call to obtain additional information. A confirmation email will be sent after registration information has been received.
On-boarding refers to the testing and validation process that EPs engage in to integrate clinical electronic data into the public health surveillance system. After registering with the PCR, EPs begin the on-boarding process by sending data from the EP’s certified electronic health record (EHR) to the PCR for evaluation of format and content and for correction of data that fails during the testing process. On-boarding ends when the EP is routinely submitting actual data that passes PCR validation.
Upon successful completion of the on-boarding process, the PCR will provide a written communication to the EP acknowledging they have achieved ongoing submission of actual cancer data relevant to public health. Written communications sent by the PCR are used by EPs to substantiate attestation to CMS (Centers for Medicare and Medicaid Services) that MU2 public health measures have been met and for CMS audit purposes.
Helpful Resources for Certified EHR Reporting
Certified Electronic Health Record (EHR) Products – For a list of EHR products certified for cancer reporting, visit the Certified Health IT Product List. Once on the web site, select “2014 Edition,” then select “search by criteria met.” In the list of certification criteria, scroll down and check “(f)(5) cancer case information” and “(f)(6) transmission to cancer registries,” then select “search matching products.” A list of EHR products certified for cancer reporting will be displayed. If your EHR system is not listed, contact your EHR vendor to determine if and when the cancer reporting option will be added to the software. If the vendor is not certified or is not planning to certify for this criteria, the EP must find a module certified for this objective.
Standardized Cancer Data Specifications – The Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, August 2012 (referred to as the Cancer Implementation Guide) and additional documentation/clarifications found in the Cancer Reporting Clarification Document for Electronic Health Record (EHR) Technology Certification assist EHR vendors in the implementation of standardized electronic cancer reporting. It includes both business rules and standardized specifications for HL7 CDA reportable cancer documents.
Case Report Selection – A standard list of reportable diagnoses is described in the Cancer Implementation Guide. The first-listed ICD-9 (International Classification of Diseases, Ninth Revision) diagnosis code in an outpatient (ambulatory) setting is used to trigger the EHR to generate and transmit the cancer record to the PCR.
Cancer Data Transport – Transport is the method or protocol used to transmit clinical information from a sending CEHRT (Certified Electronic Health Record Technology) to a receiving system (PCR) for consumption. The PCR is currently developing transport options. More information will be posted when these options have been fully developed.
Meaningful Use Resources – The Office of the National Coordinator (ONC) for Health IT (HIT) offers web-based interoperability training on Public Health Reporting, including state cancer reporting. The Centers for Disease Control's National Program of Cancer Registries (NPCR) Meaningful Use website contains numerous guidance documents for EHR/EMR vendors and providers.
Questions – Questions about the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program registration, attestation, eligibility, and other Meaningful Use criteria should be directed to the CMS EHR Incentive Program or the Pennsylvania MA HIT EHR Program
Other Public Health Reporting – PA Dept. of Health Registry Information provides details about the PA Dept. of Health Immunization, Syndromic Surveillance, Cancer, Lab and Kids Phila registries. This document will be updated periodically to include the most up-to-date information.