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New Jersey urologist passes stage 2 attestation

A New Jersey urologist and athenahealth customer negotiates the meaningful use stage 2 attestation maze without undue pain.

This is the latest in an occasional series of meaningful use stage 2 attestation success stories. This installment features an athenahealth customer.

All healthcare providers who take part in the Centers for Medicaid and Medicare Services' (CMS) meaningful use program must legally swear to and be able to prove in an audit that they have passed a series of tests for using medical information electronically.

That can be tougher on specialists than primary care providers, as they often must twist workflows in odd ways to meet the incentive program's criteria. But it was not so tough for specialist Alan Strumeyer, M.D., a New Jersey urologist who recently completed stage 2 attestation.

Strumeyer works for Urology Group of New Jersey, a practice with about 25 specialists. His colleagues are following the same path he is on by starting to adopt more sophisticated procedures for using and sharing electronic health data -- which is what stage 2 is all about. Stage 1, which took place last year, was mostly about collecting information, and the next step, stage 3, scheduled for next year, will be about outcomes.

Cloud vendor automates process

For now, Strumeyer is depending heavily on the meaningful use attestation expertise -- and firepower -- of his EHR vendor, athenahealth Inc.

For us, if we did things correctly on a daily basis, it was not difficult to achieve. It was as painless as it could be.
Alan StrumeyerM.D.

The Watertown, Mass.-based company has positioned itself in the healthcare IT marketplace as a sort of meaningful use think tank, intermingling experiences and best practices among its customer base to inform its cloud-based software and service-based approach. Athenahealth does most of the attestation "paperwork" and audit trail for doctors at its Belfast, Maine and Chennai, India offices.

"It's one of the reasons why we have [athenahealth]," Strumeyer said. "The way they have it set up, it's almost a no-brainer. All the data is tracked."

As a specialist, though, Strumeyer can exclude himself from one of the criteria that many generalists have found somewhat vexing, and for which they often need to lean on vendor support: the "transitions of care" measure, which requires doctors to prove they can send referrals to other providers electronically.

In the case of specialists -- because they are usually the receivers rather than the authors of referrals -- they are excluded from the transitions of care measure. They also are excluded from maintaining an electronic immunization registry.

View, download, attest

That doesn't mean, though, that Strumeyer could avoid other tough stage 2 tasks. He still had some significant challenges.

While athenahealth takes care of a lot of the attestation details -- such as providing evidence to CMS that providers have met the 20 objectives of stage 2 meaningful use for doctors -- Strumeyer and his staff had to invest time and effort in the item that bedevils many physicians the most: getting patients to view, download and transmit secure messages through a software portal.

Because many of the urology practice's patients are older, a lot of them are not as conversant with technology as younger people, Strumeyer noted. So it was harder to get the patients to buy into the idea.

The campaign started with front desk employees educating patients about the portal, and extended to the doctor and clinical staff.

"It required a campaign to get them to sign on. It did require a lot of push," Strumeyer said. "No one can force anyone to sign on."

In the end, though, Strumeyer succeeded in getting at least 50% of his patients to sign up.
That satisfied that stage 2 measure.

"For me, it was worth it," the urologist said of the effort to establish and sell the portal to his patients. "For patient communication, it's a huge benefit. It definitely saves time."

Athenahealth takes stake in customer incentive payments

Because of athenahealth's partnership approach to attesting, the company takes a stake in the process. The attesting physician, medical group or hospital must succeed and receive federal incentive payments for the company to collect. If the provider isn't paid, neither is athenahealth.

Casey Johnson, a product marketing associate at athenahealth, said it is practically unknown for any of the company's customers not to successfully attest.

As for potential audits, the firm documents and tracks all the client's data in athenahealth's own system and stores it for up to six years, as per CMS' requirements. If a provider is audited, athenahealth can provide an electronic record or a hard copy printout.

Also, Johnson said that because athenahealth has been pre-certified for meaningful use by the Office of the National Coordinator (ONC) for Healthcare Information Technology, there is a level of trust on the part of federal regulators -- and little customers have to prove on their own other than ensuring data security.

"It's a minimal lift for the customers," Johnson said.

Strumeyer agreed, saying the whole stage process wasn't that difficult, even though it has earned a reputation in some quarters for being difficult to navigate.

"For us, if we did things correctly on a daily basis, it was not difficult to achieve," he said. "It was as painless as it could be."

Editor's note: The story has been updated to correct the urology group name.

Let us know what you think about the story; email Shaun Sutner, news and features writer or contact @SSutner on Twitter.

Next Steps

Another provider walks through meaningful use steps

Stage 2 vendor data provides look into meaningful use

EHR Association loses athenahealth as a member

This was first published in August 2014

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