Meaningful Use e-Referrals in 2015: What You Need to Know

For many practices and organizations demonstrating for Stage 2 Meaningful Use in 2014, Core 15 (Summary of Care) brought along the most frustration. There were various reasons for this frustration, including but not limited to: an inadequate understanding of what the measure requires, unsatisfactory EHR configuration efforts, difficulty obtaining outside Direct IDs, and implementing new workflows too late in the reporting period. Use the following tips to help ensure that you position yourself adequately for meeting this measure in 2015.

5 Tips for meeting Meaningful Use e-Referrals in 2015


1. Have an exact understanding of what the measure requires

If you’ve been working in the world of Meaningful Use for some time now, you probably have had the uncomfortable experience of not being able to sufficiently decipher exactly what exactly CMS is looking for. Not having a solid understanding of the measure makes almost everything more difficult as you make your way down the road to attestation. Be sure to spend some serious time verifying that your understanding of the measure is correct. Once you feel comfortable with the requirements, make sure that your whole team also has sturdy knowledge of the specifics of the measure.

2. Factor in the extension of the reporting period from 90 days to 1 year

Many providers were able to exclude themselves from this measure in 2014. The exclusion states that any provider who transitions or refers less than 100 times during the reporting period is exempt from all pieces of this measure. If you were able to meet this exclusion in 2014, don’t assume that 2015 will allow for the same strategy. While the exclusion number of 100 remains the same in 2015, the number of days in the reporting period has increased substantially from 90 to 365. Research how many total referrals you made in previous years to get an estimate for where you will stand in 2015. If you only refer 1 or 2 times per month, chances are you will still meet this exclusion. However, if you refer around 10 times per month, you will most likely pass the threshold for exclusion and be held responsible for meeting the measure. Plan ahead so you don’t get caught off-guard.

3. Start obtaining the Direct IDs of providers you refer to right now

Direct IDs are essentially secure email addresses that allow for the sending and receiving of electronic referrals. You will need these IDs stored in your EHR when the time comes to send an actual e-referral. Ideally, there will eventually be a national database of all available Direct IDs, similar to the national NPI directory. Unfortunately, this “yellow pages” style directory does not yet exist at this point in time. This means that your practice or organization will need to manually reach out to providers you refer to in an effort to obtain their Direct IDs. These Direct IDs will then need to be entered into your EHR so providers can select them when the time comes to send out an e-referral. Reach out to your system administrators to ensure that this effort is an established and ongoing process.

4. Implement e-referral workflows that sync up with your EHR sooner rather than later

While it may be tempting to wait for your EHR vendor to provide recommended workflows for e-referrals, you might save yourself some time and frustration by getting a head start. Reach out to your EHR vendor directly to find out what their approach to the e-referral workflow entails. There may be items that you can start addressing on your own, making any necessary implementation efforts down the road easier and more productive. Also, sit down with your system administrators, physician champions, and front-desk staff to do a close analysis of your current non-electronic referral workflows. If you don’t have them documented, this would be a good time to do so. This pro-active effort will make the transition to electronic go much more smoothly.

5. Focus on communication and teamwork

Keep in mind that the e-referral process is still very new to all stakeholders in the healthcare industry. Providers and staff are needing to learn or develop new workflows. EHR vendors are constantly tweaking their software coding to keep up with ever-changing CMS guidelines. System administrators are busy ensuring their virtual environments are secure and up-to-code with new technological requirements. The key to making sure all of these parties are successful is communication. Regardless of what category you find yourself a part of, make sure everyone on your team is on the same page and in constant communication with other relevant parties. From your newest front desk staff member to your highest-ranking physician to your go-to EHR vendor contact, approaching e-referrals as a team-based endeavor will help your efforts immensely.