Home Forums Discussions MACRA/MIPS 21st Century CURES, 11.3 vs 11.4? (and other ?'s)

Hey everyone, figured I'd dust off the MACRA forum. Been a VERY long time since I posted a question, so thanks in advance.

I updated to 11.3 a few months back, but I got that popup a few weeks ago saying should upgrade to 11.4 to stay compliant with 21st Century CURES.

Our hospital PHO (using EPIC, and actively asking us to spend literally 10x more/month to switch to EPIC) has been hounding us to prove our current EHR is compliant with CURES act. I actually just submitted to them the CURES certification ID (as of 11/17/2022) for version 11.3. If I remember the pop-up, the 11.4 upgrade may allow for bi-directional communication with state registries for vaccination. And I believe the pop-up was advising doing by Oct.2.

I was planning on doing the update myself this weekend, but now I'm a little freaked out by ITFACTOR posts about bugs (see 11.4 Database tuner thread). I'm not typically an "early adopter" with these updates... I'm more like a 11.4.2 or 11.4.3 kinda guy. But I have to admit I think someone in the PHO would relish finding we were not compatible with CURES.

But in your opinions...

1) Do you think we need/should upgrade to 11.4 to stay CURES compatible?

2) Does anyone have any experience with 11.4, with regards to the bidirectional. Easy?

3) My understanding that part of 21st Century CURES involves patients having access to see their notes. Please correct me if I'm mistaken, but does anyone have experience with this (other than if a patient specifically requests and we send a "fax" to their portal?)

4) Any other CURES act need-to-knows, with regards to Amazing Charts, that I might be missing?

I'm not at office right now, so I can't remember the exact wording of that pop-up in the corner of main page encouraging the upgrade, but I'm sure everyone's seen it...

Thank you!

Well, I was about to just pre-download from the AC Portal site, and finally was able to find the release notes (wasn't able to google them), and some answers are there.

If my understanding is correct, 11.3 is technically CURES compatible, but there is a specific added 2023 reporting year requirement to attest to Electronic Case Reporting, that requires 11.4 upgrade.

Here's the release notes from portal:

Click here to learn more about the new features in 11.4
https://help.amazingcharts.com/ac/R...4978808.1696105283-1800883530.1590502492

still curious about everyone's opinion on the other questions.

here's more from the Release Notes:

"Version 11.4 contains Electronic Case Reporting (eCR) to a Public Health Agency which
is required for participation in MIPS for the 2023 reporting year.

What is eCR?

Electronic case reporting (eCR) is the automated, real-time exchange of case report information between
electronic health records (EHRs) and public health agencies. These timely data are more complete than
manual reporting and include patient demographics (such as race and ethnicity), diagnoses, comorbidities,
occupation, travel history, immunizations, medications, pregnancy status, and other treatments. eCR runs
securely and seamlessly behind the scenes in the EHR to automatically capture and report required
information, reducing provider burden. eCR also enables immediate feedback from public health agencies
to healthcare providers about reportable conditions and possible outbreaks. eCR uses a centralized
platform that allows systems to communicate with each other in real time. eCR runs behind the scenes in
the EHR to automatically capture and report required information. If information entered in the EHR
matches codes of interest to public health, the data necessary for a public health report are sent to the
platform. If the data meet jurisdictional reporting requirements, the report is sent to the appropriate
public health agencies for investigation and follow-up.

eCR is a joint effort of the Association of Public Health Laboratories, the Council of State and Territorial
Epidemiologists, and CDC. These organizations play key roles in leading, implementing, and operating eCR
with healthcare organizations, EHR vendors, and public health agencies."

...and it looks like the download says 11.4.2.

Looks like some good fixes notably erx and med history speed ups. Also Chris note the 2 rxs not sent inactivates med fix.

Anyone try 11.4.x?

Beagle I hope you are right, I am going to be looking at updating to 11.4 soon and crossing my fingers the prescription Gremlins are evicted!

My concern, call me a conspiracy theorist, is that the eCR sure is a lot of Big Brother monitoring and all done in the background where neither us nor the pt knows what they are getting. I already feel that the insurance companies coming in to get chart information to make sure we are jumping through all of the Medicare hoops is an invasion of the pt's privacy.

What exactly are we CURING with the CURES ACT?

Hi Everyone. I will answer some questions here.

11.3.2 is CURES certified, so if you do not need Electronic Case Reporting (which is part of the Promoting Interoperability section of MIPS), then there is no big rush to upgrade. Most AC practices are actually excluded from the PI section of MIPS due to being a small practice (under 15 providers). If you are working with an ACO, however, I would check with them on their specific requirements.

As far as the CURES act itself and what it is "Curing", as Chris put it (clever, BTW)... What the CURES act is focusing on is how patient's are able to get their medical records, and what they have access to. In short, The CURES act will allow patients to request the medical record at any time, and have it sent to any device/app of their choosing (where previously medical records were generally just faxed or printed.. maybe put on a CD or flash drive). The idea is to move the sharing of medical records into a more modern "app based" economy. It gets a little more detailed and complicated than that (about 1100 pages worth), but that is the general idea.

Yeah, eClinicalWorks lawsuit really created a shockwave regarding data access.

Still feeling it to this day.

JamesNT

Elaborate please? What should we be wary of.

Hey just looking over posts and saw this, wondering what electropura2 did? I did not go to version 11.4...... but am Beta Testing 11.5. So far I am happy with 11.5 and will say AC tech support has been very receptive to any ideas and issues!

The eRX gremlins of disappearing meds does seem to be fixed, I am trying to watch for this problem. I do not see that pulling a medication history has really sped up, it is painfully slow. I am not sure if this is an AC issue or New Crop but have will continue to monitor.

I am still wondering what JamesNT was eluding regarding eClinicalworks!

@ChrisFNP,

A few years back, eClinicalWorks was sued for several millions of dollars because a medical firm asked for all their data out of the eClinicalWorks "cloud". ECW said, "We don't do exports of data. If you want access you have to keep paying us mega bucks every month otherwise we DELETE."

The medical firmed sued because the P in HIPAA does stand for PORTABILITY. eCW lost, handedly, and had to come up with the export they have today. Suddenly, almost all the other online EMRs had their own export features as well. Note: I said almost. There are still a few holdouts that will either not export at all or give you some half-assed export. And, of course, there are those medical facilities that cannot get their data because they are still on some old version of the software, never upgraded, and the export feature was done way after.

JamesNT

Thanks for the update, what a story. It is interesting sometimes with old records.