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Frequently Asked Questions About Meaningful Use: General (Questions 14–27)

  1. What are the reporting requirements for a physician who is 100% employed by a hospital and all of his or her patients are in the hospital?
  2. How is CDC coordinating so that vendors have only one format?
  3. How is CDC coordinating across other MU public health programs?
  4. Will the encounter records come with a condensed edit set?
  5. Will only physician encounters trigger submission of a cancer report, or will nurses’ encounters, X-rays, and lab encounters trigger a report to be sent?
  6. Are electronic laboratory reporting (EHR) vendors going to be ready?
  7. What should a state cancer registry do if a vendor asks if they are ready?
  8. Does CDC recommend that state cancer registries focus on certain specialties?
  9. At what point in the six months of reporting do you decide whether it is a meaningfully useful report?
  10. CDC asked states to review the Cancer Reporting Implementation Guide for Meaningful Use (MU) Stage 2 and create a list of any data their cancer registry requires that are not included. What was the purpose of this request?
  11. How can states resolve difficulties in getting help from their state MU coordinators and colleagues in other public health programs?
  12. Does CDC map the results of the cancer registry data to look for areas of concentration for cancer?
  13. What type of providers do you expect to report to state cancer registries?
  14. If providers are working on MU Stage 1 objectives, can they also do cancer reporting?
  1. What are the reporting requirements for a physician who is 100% employed by a hospital and all of his or her patients are in the hospital?

With regard to Medicaid and Medicare incentive payments, the provider is either part of a hospital and the hospital receives these payments as an eligible hospital, or the provider is an eligible professional (EP) and receives these payments directly. Cancer reporting requirements apply only to EPs. If they do not receive the payment themselves, there is no incentive for them to do cancer reporting.

  1. How is CDC coordinating so that vendors have only one format?

The Cancer Implementation Guide was developed with the North American Association of Central Cancer Registries (NAACCR), which represents all state cancer registries, and with individual state cancer registries to ensure that required data elements were included. We have worked to minimize the variability between registries, and we are asking all state cancer registries to identify additional data requirements so we can standardize them as well.

  1. How is CDC coordinating across other MU public health programs?

The Stage 2 Meaningful Use Public Health Reporting Task Force is made up representatives from CDC, all of the public health programs in MU Stages 1 and 2, and public health organizations representing all of the public health areas covered in the MU reporting objectives. CDC’s MU Technical Assistance Team consists of representatives from each program, and CDC’s MU Project Lead facilitates communication across all programs.

  1. Will the encounter records come with a condensed edit set?

There is no plan to change the edits. Instead, CDC plans to use the same model as ePath reporting in eMaRC Plus, which is to default missing information so the exported physician abstracts pass EDITS.

  1. Will only physician encounters trigger submission of a cancer report, or will nurses’ encounters, X-rays, and lab encounters trigger a report to be sent?

This depends on how electronic laboratory reporting (EHR) vendors implement their systems. The Cancer Implementation Guide defines an encounter as “an interaction between a patient and care provider(s) for the purpose of providing healthcare-related service(s). Healthcare services include health assessment. Examples: outpatient visit to multiple departments, home health support (including physical therapy), emergency room visit, field visit (e.g., traffic accident), office visit, chemotherapy and radiation therapy, occupational therapy, or telephone call” (page 7). In current pilots, only physician encounters have triggered reports.

  1. Are electronic laboratory reporting (EHR) vendors going to be ready?

As of July 17, 2013, 5 vendors have been certified for cancer reporting: BuildYourEMR; athenahealth, Inc; Glenwood Systems LLC; Epic Systems Corporation and LSS Data Systems. As CDC becomes aware of other EHR vendors’ plans for cancer reporting, we will inform states. Vendor certification information can be found on the ONC Certified HIT Product List.

  1. What should a state cancer registry do if a vendor asks if they are ready?

We encourage state cancer registries to let vendors and providers know that they plan to receive cancer reports for MU Stage 2 and that they will provide more information as they get further along.

  1. Does CDC recommend that state cancer registries focus on certain specialties?

The National Program of Cancer Registries (NPCR) requires cancer registries to focus on urologists, dermatologists, gastroenterologists, medical oncologists, radiation oncologists, hematologists, and independent surgeons. For MU specifically, there are no requirements.

  1. At what point in the six months of reporting do you decide whether it is a meaningfully useful report?

MU regulations indicate that providers can meet the cancer reporting and public health objectives by (1) achieving ongoing submission of data, (2) being engaged with the PHA in testing and validation of data, or (3) waiting for an invitation from the PHA to begin testing and validation.

The PHA determines when a provider has achieved ongoing submission. State cancer registries are encouraged to consider ongoing submission achieved when providers are sending valid documents and able to begin production. Providers are required to respond to any written communication from the PHA within 30 days.

  1. CDC asked states to review the Cancer Reporting Implementation Guide for Meaningful Use (MU) Stage 2 and create a list of any data their cancer registry requires that are not included. What was the purpose of this request?

The cancer community cannot change the data elements that vendors and physicians are required to report as part of MU Stage 2. We may be able to add MU Stage 2 reporting requirements, but EHR vendors aren’t required to make any changes. The cancer community will have an opportunity to change the Cancer Implementation Guide for MU Stage 3. CDC needs to know what changes need to be made, so that we can coordinate them across all cancer registries.

  1. How can states resolve difficulties in getting help from their state MU coordinators and colleagues in other public health programs?

CDC is exploring ways to help registries with these communications, including a conference call with state MU coordinators to discuss cancer reporting requirements as part of MU Stage 2. CDC also can provide transport documents to the state PHA MU coordinator.

  1. Does CDC map the results of the cancer registry data to look for areas of concentration for cancer?

Yes. CDC and the National Cancer Institute (NCI), in collaboration with NAACCR, produce the United States Cancer Statistics (USCS): Incidence and Mortality Web-based Report. CDC’s Interactive Cancer Atlas (InCA) shows USCS data in a dynamic format. NCI provides state cancer profiles. You can also find more granular geographic information on state cancer registry Web sites.

  1. What type of providers do you expect to report to state cancer registries?

In addition to oncologists, registries are particularly interested in receiving reports from dermatologists, urologists, gastroenterologists, hematologists, ambulatory surgical centers, and radiation oncology centers. Many other provider types may diagnose or treat cancer cases, such as cardiologists, colorectal surgeons, endocrinologists, family practice physicians, gynecologists, internal medicine specialists, neurosurgeons, and otolaryngologists.

  1. If providers are working on MU Stage 1 objectives, can they also do cancer reporting?

Cancer reporting is not available as a menu option until Stage 2, so providers cannot implement reporting to a cancer registry to receive MU Stage 1 incentives. However, if the providers’ EHR vendor includes cancer reporting functionality in the version that providers implement, they may use that functionality to report to their state cancer registry as soon as the registry is ready to receive the data, even though they would not qualify for incentive payments for doing so until Stage 2.

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