I'm coming to this party late, but I would like to post a "devil's advocate" response. The fact that the CPOE measure dropped out of the objectives (you would expect to see it in the "Advancing Care Initiatives") category may not be because it is no longer important, but because the measure is no longer meaningful to track because anyone that is doing CPOE is assumed to have some kind of clinical certification. This is not unlike the quality metrics that CMS considers "topped out." Just because something is topped out shouldn't mean you stop doing them (but I have had several conversations with physicians that want to do just that). A "topped out" objective is simply one that should be so ingrained in your workflow, there is no longer any point in trying to incentivize anyone to do it (i.e. it's become universally adopted as a best practice).
I could be mistaken, but I believe that any EHR that is certified to 2014 and above must have the capability of limiting a user's privileges so that only individuals with the proper certification can perform CPOE. Centricity has this feature. Whether or not you use it is up to you, but until CMS clearly spells out that some form of certification is no longer required, I think you are opening yourself up to potential risks (e.g. malpractice risks).
If you do choose to allow non-certified people to enter orders into Centricity to reduce the administrative burden on physicians, then I would recommend the system be configured to require the physician to sign off on all those orders. Personally it seems pointless; if the provider knows how to use the system, they could probably enter the orders or order sets themselves vs. tasking someone else to do it and then signing off on them later.
I don't want to read into anyone's situation, but I have a strong suspicion the desire to move away from this prior rule is out of convenience. I'm not saying I support everything CMS does, but their intent is to protect the patient and improve the quality of the outcome. So, if you move away from the CPOE certification requirement, I would highly recommend you document why doing so is in the best interest of the patient.
If anyone can find anything official from CMS that would indicate this requirement has been rescinded, please post the reference here for everyone's benefit.
#feelingyourpain
Greg
Posted : July 24, 2018 10:04 am
