Objective Data Dashboard Metrics Overview

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1 Objective Data Dashboard Metrics Overview Document Purpose: To improve understanding of the Objective Data Dashboard s (ODD) function, intent, and measures by providing simple descriptions of each ODD metric. What is the ODD and how does it work? The Objective Data Dashboard is a module within the physician s EMR that provides feedback on 14 common EMR (patient chart) data elements, which were established by a panel of 12 physicians. Using the ODD, the physician will be able to identify any gaps or issues in how data is being recorded in the EMR. Possible areas for consideration include: the problem list, patient history, lifestyle, allergies, encounters, medications, and other data elements that are important to enabling proactive practice and quality of care. Meaningful Use Level 3 is determined by meeting or exceeding the threshold for each of the 14 data elements. The thresholds are not targets, nor clinical guidelines, but are minimum levels that indicate capture of the data elements. The physician may determine that a higher or lower rate of capture is suitable to the nature of their practice. The intent is to determine basic capture of data in different areas of the EMR, not clinical usage. In addition to the dashboard display, the ODD produces a summative PDF report confirming that the physician has achieved EMR MU3, which can be submitted for eligibility of the $3,000 sessional funding. Data never leaves the physician s EMR The physician maintains complete autonomy over their EMR data. The details of metric scores should not be submitted, only the summative PDF report confirming MU3 achievement without divulging any specific metric values. How does the ODD relate to Post Implementation Support and funding? Achievement of Meaningful Use Level 3 (MU3) is determined by an objective assessment using the ODD. Physicians who demonstrate (via the ODD) that they have achieved MU3 will submit the PDF report to be eligible for a one- time sessional payment of $3,000 in recognition of the time out of practice required to achieve this level of EMR use, minus any reimbursement they received in advance for participation in post implementation support program. This report should be ed to with the attached ODD declaration form 1. The ODD should include at minimum: patients with at least one visit in the previous 6 months 5 of a physician s patient panel and; patients for whom the physician is the MRP most responsible provider. A physician may want to request an exception due to the unique nature of the patient population or clinic services (e.g. pediatric focus). In these cases, all reasons for an 1 ODD Declaration form is a guideline; please note exception with reason on the declaration if your minimum number is less than 500

2 exception should be outlined in the confirming achievement of MU3, along with an image/copy of the particular dashboard measure. A clinical working group will review requested exceptions at the end of each month. Definitions: Metric: The measure which is displayed on the ODD. This is an automatically calculated ratio comprised of a numerator and a denominator, whose values are pulled from data within the physician s EMR database. Numerator: The value above the line in a fraction (e.g. in ¾, the numerator is 3). In the ODD, the numerator represents the data elements relevant to the metric in question. Denominator: The value below the line in a fraction (e.g. in ¾, the denominator is 4). In the ODD, the denominator represents the portion of the physician s patient population to be measured against (e.g. all active patients of a certain age group). Threshold: The minimum % that must be achieved for a particular metric in order to indicate meaningful use of that aspect of the EMR (e.g. 5 of patients in the denominator population have the data in the numerator recorded). Thresholds are NOT targets, nor clinical guidelines; they are indicators that the data elements are being captured with baseline consistency for complete patient charts. Metrics where coding is required but a standard coding system is not yet consistently available are assigned thresholds of representing that they are important metrics, but not yet applicable for MU3. NOTE: The Threshold is neither a target, nor a clinical guideline. It is an indicator that there is at least regular capture of the relevant data element occurring. For example, hypothetically it may be typical to capture blood pressure during all visits, but the threshold would be set at 5 in recognition that it isn t always relevant, with 5 presence indicating that the physician knows how to capture blood pressure in the EMR and is doing so with some consistency. The physician must determine if a higher rate of capture is suitable to the nature of their practice.

3 Quick Reference: All metrics are calculated for the physician as the most responsible physician (MRP), meaning the primary care provider for the patient population. Category Metric Numerator value Denominator (population) MU3 Threshold Demographics Patient identification Identifying demographics: name, gender, DOB, PHN 95% Patient contact information Contact fields: Address, phone, postal code 9 Patient status with at least one visit who are not marked within 36 months inactive Chart summary Problems/health concerns Problems/health concerns documented in problem list 4 Problems coded Coded problems documented in problem list 3 Allergies/Intolerances Allergies/intolerances documented 3 Allergies coded Coded allergies documented Encounter notes Encounter notes for visits documented 8 Vaccinations/Immunizations Vaccinations documented 2 Procedures Procedures documented (e.g. surgical, endoscopy) 3 Procedures coded Coded procedures documented Measures Smoking status Smoking status documented with 1 visit in 6 mo. Age 2 13 y.o. Height/weight (BMI) Height and weight documented with 1 visit in 6 mo. Age 3 Blood pressure Systolic and diastolic blood pressure documented 21 y.o. 5 Medication Prescriptions Prescriptions documented 4 Communications Recall reminders Recall reminders set up 2 Referrals Referrals made 2

4 Detailed Description of ODD Metrics: Category Metric Numerator value Denominator Demographics Chart summary Patient identification Patient contact information Patient status Problems/health concerns Problems coded Allergies/Intoleran ces Allergies coded Number of patients with ID fields: Patient name Patient gender Patient DOB Patient ID (e.g. PHN) Number of patients with contact fields: Postal code Geo- ID Contact information (e.g. phone number) with one or more visit within 36 months documented problem or health concern documented problem using a code (e.g. ICD9 or SNOMED) documented allergy or intolerance documented allergy using a code (population) who are not marked inactive MU3 Threshold 95% Simple explanation (example) 95% or more of my active patients have recorded ID fields such as name, PHN, DOB so I can properly identify them. 9 or more of my patients have completed demographic fields so I can locate them. E.g. phone numbers, postal codes etc. Ideally this should be close to 8 or more of my patients who have had a visit within the past 36 months are marked as active Demonstrates accuracy of active patient panel 4 or more of my patients have a documented problem in the problem list Indicates presence of data (any text) in the problem list 3 or more of my patients have a coded problem documented in their problem list Indicates presence of coded data (ICD9 code) in problem list 3 or more of my patients have a documented allergy Indicates presence of data in the allergies section of EMR, should include NKA What % of my patients have documented coded allergies? Indicates presence of coded data in the allergies section of EMR Related Post Implementation Support Assessment Workflow Descriptions Reg 1- Our practice records all patient demographics in the EMR, using discrete (searchable) data where possible Reg 1- Our practice records all patient demographics in the EMR, using discrete (searchable) data where possible Reg2- Our practice ensures patients are indicated as having a primary provider and are assigned a status MS2a- Recording/maintaining patient 'problem' lists using consistent and accurate diagnostic (e.g. ICD- 9 or SNOMED codes) MS2f- Allergies/adverse events Encounter notes Number of encounter notes documented for active patients with one of more visits in 36 months 8 For 8 or more of visits with a patient I have documented an encounter Indicates documentation of encounter notes for patient visits MS1- I record all encounter notes in my EMR

5 Vaccinations/Imm unizations n immunization or vaccination documented 2 2 or more of my patients have a documented vaccination or immunization Indicates presence of data in the immunizations section of the EMR MS2g- Immunizations; where possible including historical, source (e.g. public health, pharmacy) and BCCDC guideline- based information such as lot #, batch #, expiry, manufacturer, etc. Measures Medication Procedures Procedures coded Smoking status Height/weight (BMI) Blood pressure Prescriptions documented procedure documented coded procedure documented smoking status documented blood pressure measure (sys/dia) documented height and weight or BMI documented prescription with 1 visit in 6 mo. Age 13 y.o. with 1 visit in 6 mo. Age 21 y.o or more of my patients have a documented procedure Indicates presence of data in the procedures area of EMR (e.g. surgical procedures) What % of my patients have a documented coded procedure? Coded procedures would be for example a surgical procedure such as hysterectomy coded with an ICD9 code 68 2 or more of my patients above the age of 13.y.o have a documented smoking status Indicates documented smoking status, in whichever way the EMR records it 3 or more of my patients above the age of 13.y.o have a documented height and weight Indicates presence of discrete measures (data) for height and weight. BMI is a calculated measure using height and weight. 5 or more of my adult patients have a recorded blood pressure Indicates presence of discrete measures (data) for blood pressure 4 or more of my patients have a documented prescription Indicates presence of coded prescription selected from the formulary using the prescription writer of the EMR MS2b- History: medical, surgical MS2d- Social & lifestyle details entered in a consistent manner MS4- Our practice enters patient clinical information such as measures (e.g. blood pressure, height, weight etc.) in our EMR in a consistent manner using discrete (searchable) data Med 1- I create all new point- of- care formulary- based prescriptions, including renewals, in my EMR as discrete (searchable) data Communications Recall reminders Referrals documented recall reminder documented referral 2 2 For 2 or more of my patients, I am using recall reminders Indicates the use of recall reminders. For 2 or more of my patients, I am using the referral function Indicates documented referrals. Prev 1 - Our practice uses an EMR- based recall system for routine screening Ref 1- I create all my referrals in the EMR, which are pre- populated with and/or attach clinical data from the patient s chart

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