Maine Medicine Weekly Update - 07/30/2018  (Plain Text Version)

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In this issue:
•  Maine Medical Center and Tufts Continue Collaboration for Medical Education
•  MICIS 3-hour Opioid CME Presentations - registration open for August 21 in Brewer
•  CMS Releases Proposed 2019 Medicare Payment Rule
•  Licensing Boards Discuss Nursing Home Exception to Opioid Requirements
•  MMA Board of Directors Meets Friday for Summer Board Meeting
•  Prescription Monitoring Program User Survey
•  Time to Volunteer for an MMA Committee
•  Computerized Provider Order Entry (CPOE) Myth
•  Azar: HHS to rewrite health care privacy rules
•  Correction of Last Week's Update
•  MMA Presentation on Healthcare Issues Considered by 128th Legislature Now Available
•  Childhood Development and Behavior Conference At Colby August 2-3
•  Maine Quality Counts Offers Project ECHO Medication Assisted Treatment Course
•  17th Annual Downeast Ophthalmology Symposium - September 21-23, 2018
•  Hanley Center Offers New PELI Course Beginning in October
•  Northern New England Society of Addiction Medicine 2018 Annual Conference & Meeting - Nov 2-3
•  Hanley Center Offers Next Level Leadership Seminar Series and Advanced Practice Provider Leadership Institute
•  Advanced Hanley Center Training Available for PELI and HLD Alumni
•  Behavioral Health Consultant
•  Clinical Cardiology Opportunity
•  Internal Medicine Outpatient Physician
•  Nurse Practitioner - Nasson Health Care
•  Medical Board Physician
•  Medical Director/Family Practice Physician - Relocate to Beautiful Southwestern Maine
•  Outpatient Internal Medicine Physician Bangor, Maine
•  Psychiatry Faculty, Division of Child & Adolescent Psychiatry
•  Maine's Largest FQHC in need of Physician for Geriatric Program
•  Multiple Family Med Opportunities in Beloved Community Health Centers
•  Opportunities at the VA for Volunteer Physicians


Computerized Provider Order Entry (CPOE) Myth

The Myth: Only physicians can pend, or enter, orders in the EHR (e.g., lipid profile, urinalysis, ear wash). This process is commonly referred to as Computerized Provider Order Entry (CPOE). What is the reality?


[from AMA Morning Rounds]

Computerized provider order entry (CPOE) is a process of electronic entry of medical practitioner instructions for the treatment of patients under the physician’s care. Physicians use CPOE to increase efficiency and reduce errors by submitting orders in the EHR.

Debunking the Myth

All members of the care team, including nurses, certified medical assistants (MAs), or non-credentialed staff, can enter orders in the EHR.  Additionally, there is no Medicare EHR incentive program that requires CPOE.  Clinical and clerical staff can pend or send orders per the physician’s instruction (i.e. as conveyed verbally or through written checklist), as long as this is consistent with state and institutional policies.

Regulatory Clarification

New guidance was issued from the Centers for Medicare and Medicaid Services in 2017.

“In the 2017 OPPS rule, we finalized the elimination of the CPOE and CDS objectives and associated measures for eligible hospitals and Critical Access Hospitals (CAHs). The elimination of the CPOE and CDS objectives and associated measures also applies to dual-eligible hospitals that are attesting to CMS for both the Medicare and Medicaid EHR Incentive Programs.

However, the CPOE and CDS objectives and measures are still required for the Medicaid EHR Incentive Program to successfully attest to meaningful use.

Please also note we did not include CPOE and CDS objectives and associated measures as part of the advancing care information performance category, thus, they are not required for reporting by MIPS eligible clinicians.”*

CPOE objectives remain in the Medicaid EHR Incentive program.  Within this program, “any licensed health care provider or a medical staff person who is a credentialed medical assistant or is credentialed to and performs the duties equivalent to a credentialed medical assistant can enter orders in the medical record, per state, local and professional guidelines.”**

Sources: *Medicare: Objectives Measures FAQs, Medicare FAQ #22349; **Medicaid: Eligible Professional Objectives & Measures