Objective Data Dashboard Metrics Overview Document Purpose: What is the ODD and how does it work?

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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 reporting function 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 common or frequent capture of the data elements. The physician may determine that a higher rate of capture is suitable to the nature of their practice. In addition to the dashboard, the ODD produces a summative PDF report confirming that the physician has achieved EMR MU3, which will 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. 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. 50% 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

2 complete patient charts. Metrics where coding is required but a standard coding system is not yet consistently available are assigned thresholds of 0% representing that they are important metrics, but not yet applicable for MU3. 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 Values (data elements of focus) Denominator (population) MU3 Threshold Demographics Patient identification Identifying demographics: name, gender, DOB, PHN 95% Number of active patients with 1visit in 36 mo. Patient contact information Contact fields: Address, phone, postal code 90% Patient status Number of active patients with at least one visit within 36 months Number of active patients who are not marked inactive 80% Problems/health concerns Problems/health concerns documented in problem list Problems coded Coded problems documented in problem list 30% Allergies/Intolerances Allergies/intolerances documented 30% Allergies coded Coded allergies documented 0%* 40% Chart Summary Key Measure Number of active patients with 1 visit in 36 mo. Encounter notes Encounter notes for visits documented 80% Vaccinations/Immunizations Vaccinations documented 20% Procedures Procedures documented (e.g. surgical, endoscopy) 30% Procedures coded Coded procedures documented 0%* Smoking status Smoking status documented Number of active patients with 1 visit in 36 mo. Age 13 y.o. 20% Height/weight (BMI) Height and weight documented Number of active patients with 1 visit in 36 mo. Age 21 y.o. Blood pressure Systolic and diastolic blood pressure documented 50% 30% Medications Prescriptions Prescriptions documented Number of active patients with 1 visit in 36 mo. 40% Communication Recall reminders Recall reminders set up Number of active patients with 1visit in 36 mo. 20%

3 Referrals Referrals made 20% * Set at 0% until a standard coding system is consistently available 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 eye colour during all visits, but the threshold would be set at 80% in recognition that it isn t always relevant, with 80% presence indicating that the physician knows how to capture eye colour 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. Detailed of ODD Metrics: Category Metric Numerator (discrete data elements of focus) Denominator (population) MU3 Threshold Simple Explanation (example): Related Post Implementation Support Assessment Workflow Patient identification Number of patients with ID fields: Patient name Patient gender 95% 95% or more of my active patients have recorded ID fields such as name, PHN, DOB so I can properly identify them. Reg 1 - Our practice records all patient demographics in the EMR, using discrete (searchable) data where possible Patient contact information Number of patients with contact fields: 90% 90% or more of my patients have completed Postal code demographic fields so I can locate them. Geo-ID E.g. phone numbers, postal codes etc. Contact information (e.g. phone number) 36 mo. Reg 1 - Our practice records all patient demographics in the EMR, using discrete (searchable) data where possible Patient status Number of active patients with one or more visit within 36 months Number of active patients who are not marked inactive 80% 80% 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 Reg 2 - Our practice ensures patients are indicated as having a primary provider and are assigned a status

4 Problem List/health concerns Problem List coded Number of patients with a documented problem or health concern Number of patients with a documented problem using a code (ICD9 or SNOMED) 40% 40% or more of my patients have a documented problem in the problem list Indicates presence of data (any text) in the problem list 30% 30% or more of my patients have a coded problem documented in their problem list Indicates presence of coded data (ICD9 code) in problem list MS 2a - Recording/maintaining patient problem lists using consistent and accurate diagnostic (e.g. ICD-9 or SNOMED codes) Allergies/Intolerances Number of patients with a documented allergy or intolerance 30% 30% or more of my patients have a documented Number of active patients with 1 visit in 36 mo. allergy Indicates presence of data in the allergies section of EMR, does not include NKA (no known allergies) Allergies coded Number of patients with a documented allergy using a code 0%* What % of my patients have documented coded allergies? Indicates presence of coded data in the allergies section of EMR MS 2f - Allergies/adverse events Encounter notes Number of encounter notes documented for active patients with one of more visits in 36 months 80% For 80% or more of visits with a patient I have documented an encounter Indicates documentation of encounter notes for patient visits MS 1 - I record all encounter notes in my EMR Category Metric Numerator (discrete data elements of focus) Denominator (population) MU3 Threshold Simple Explanation (example): Related Post Implementation Support Assessment Workflow

5 Vaccinations/Immunizations Number of patients with an immunization or vaccination documented a documented procedure Number of patients with 20% 20% or more of my patients have a documented vaccination or immunization Indicates presence of data in the immunizations section of the EMR Procedures 30% 30% or more of my patients have a documented procedure Indicates presence of data in the procedures area of EMR (e.g. surgical procedures) 36 mo. Procedures coded Number of patients with a documented coded procedure 0%* 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 Smoking status Number of patients with a documented smoking status Number of active patients with 1 visit in 36 mo. Age 13 y.o. Height/weight (BMI) Number of patients with a documented height and weight or BMI a documented blood pressure measure (sys/dia) Number of patients with 20% 20% 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 30% 30% 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 Blood pressure 50% 50% or more of my adult patients have a recorded blood pressure Indicates presence of discrete measures (data) 36 mo. Age 21 y.o. for blood pressure MS 2g - Immunizations; where possible including historical, source (e.g. public health, pharmacy) and BCCDC guideline-based information such as lot #, batch #, expiry, manufacturer, etc. MS 2b - History: medical, surgical MS 2d - Social & lifestyle details entered in a consistent manner MS 4 - 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

6 Prescriptions Number of patients with a documented prescription Number of active patients with 1 visit in 36 mo. 40% 40% 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 Med 1 - I create all new pointofcare formulary-based prescriptions, including renewals, in my EMR as discrete (searchable) data Category Metric Numerator (discrete data elements of focus) Denominator (population) MU3 Threshold Simple Explanation (example): Related Post Implementation Support Assessment Workflow Recall reminders Number of patients with a documented recall reminder 20% For 20% or more of my patients, I am using recall reminders Indicates the use of recall reminders Number of active Referrals Number of patients with a documented referral patients with 1visit in 20% For 20% or more of my patients, I am using the referral 36 mo. function Indicates documented referrals Prev 1 - Our practice uses an EMRbased 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