Guide to Meaningful Use Stage 2

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1 Guide to Meaningful Use Stage 2 September, 2013 Introduction This document describes the following Core Measure requirements that are needed in order to be compatible with Meaningful Use Stage 2. Meaningful Use Clinical Quality Measures for 2014 and Beyond (page 1) Core Measure 7: Patient Electronic Access (page 2) Core Measure 8: Clinical Summaries (page 8) Core Measure 12: Preventive Care (page 9) Core Measure 15: Summary of Care (page 9) Core Measure 17: Secure Messaging (page 11) Meaningful Use Clinical Quality Measures for 2014 and Beyond All providers are required to report on CQMs in order to demonstrate meaningful use. Beginning in 2014, all providers regardless of their stage of meaningful use will report on CQMs in the same way. EPs must report on 9 out of 64 total CQMs. EHs and CAHs must report on 16 out of 29 total CQMs. In addition, all providers must select CQMs from at least 3 of the 6 key health care policy domains recommended by HHS's National Quality Strategy: Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes/Effectiveness A complete list of the 2014 CQMs, along with their associated National Quality Strategy domains, usage guides, release notes, fact sheets, etc. are available at: Guidance/Legislation/EHRIncentivePrograms/2014_ClinicalQualityMeasures.html Copyright 2013 by Kryptiq Corporation. All rights reserved.

2 Core Measure 7: Patient Electronic Access Core Measure 7: Patient Electronic Access Secure Messaging and Patient Portal now complies with Core Measure 7, which is to provide patients with the ability to electronically view, download, and transmit their health information online within four business days of the information being available to the eligible professional (EP). Also referred to as view, download, transfer (VDT), Core Measure 7 requires that patients are enabled to access their records using Consolidated Clinical Document Architecture (CCDA) standard, which includes the following: The Qualifying action for "access": PIN tab, which tells the patient who has accessed her Chart Summary page. This could be herself or her family members, depending on how access is set up. This is issued to patient or portal account linked to chart. The Chart Summary page in the Portal supports the new CCDA-based Chart Summary. The Chart Summary page has a Send button, which allows a patient to transmit the Chart Summary to someone else. The Chart Summary page has an Activity History. For more information on how these core measures are defined, refer to the specific core measure documentation found in the Secure Messaging & Patient Portal > Meaningful Use Stage 2 area of the Kryptiq support site (http://support.kryptiq.com/). 2

3 Guide to Meaningful Use Stage 2 The Patient Chart Summary Page This page is now compliant with Meaningful Use Stage 2, and can be set up to include the tabs shown below, which are described in the sections that follow. For patients with family managed accounts, family member names appear as their own tab across the top of each medical summary record. To select which category tabs you would like to have available for your patients, configure them from the Custom Configuration tab of the Portal Admin Chart Summary page, located in the Pages area. Immunizations and Insurance are available for patient access, but not required to be set up for MU2 compliance. 3

4 Core Measure 7: Patient Electronic Access Configuring the Chart Summary Page The Custom Configuration tab of the Portal Admin Chart Summary page has been updated to inform practices if their settings are MU2 Compliant. An asterisk (*) is placed next to each category to indicate that it is a required selection. The Display options selected on this tab correspond to the sections the patient will see when viewing the Chart Summary page. The options selected also determine which sections will be included in the CCDA. The CCDA viewed by the patient is identical to the CCDA when printed, downloaded, or transmitted. In order for patients to be able to send or transmit their chart summary, an applicable eform must be chosen from the Transmit Select eform list box in the Custom Configuration tab. The requirements for eligible eforms are listed at the bottom of the screen shown below. 4

5 Guide to Meaningful Use Stage 2 Chart Summary Tab The Complete Medical Record tab has been renamed to Chart Summary. From this tab, patients can View a complete report of their medical or ambulatory summary, Download the summary to their computer (PDF, HTML, and XML) as a zip file, or Send it as an attachment (XML and PDF). The Send button shown in the image below will not appear if a Send/Transfer eform is not set up for the Chart Summary. If the Send/Transfer eform is configured to Route by user-supplied address, make sure that Secure Messaging is set to automatically create user accounts for first-time message recipients in the SM PP Configuration Utility (located in Secure Messaging > Messages). The sections that are included in the chart summary (CCDA) match the tabs that have been selected to be available by the clinic on the Chart Summary configuration page. 5

6 Core Measure 7: Patient Electronic Access Configuring the Send Chart eform A special eform, routed as a Secure Message and including a chart attachment question, must be configured for clinics who wish to allow patients to send their chart summary documents to a third party. A preconfigured eform like the one shown below is available for download from the Kryptiq support site (http://support.kryptiq.com). The send eform is set to route by user-supplied address. This provides an address field at the top of the form for users to type in the recipient's . The eform also needs to specify how to route the address that is provided by the user. It can route the message as either a Direct address or a Secure Message address. If the Transmit option: Direct or Secure Messaging (user chooses) is selected, then a check box will appear next to the address field on the eform asking the user to specify if they are providing a direct address. For more information about direct, navigate to the Secure Messaging Patient Portal > Meaningful Use Stage 2 area of the Kryptiq support site (http://support.kryptiq.com). 6

7 Guide to Meaningful Use Stage 2 When setting up the attachment question, choose Chart from the Source list box, and then select Chart Summary from the Term list box. Since this attachment file type is predetermined, the allowed file types area is grayed out. 7

8 Core Measure 8: Clinical Summaries Core Measure 8: Clinical Summaries Secure Messaging and Patient Portal now complies with Core Measure 8, which is to provide patients with a clinical summary for each office visit. Also referred to as Visit Summaries, Core Measure 8 requires that clinical visit summary (CVS) documents can be attached to clinical messages. Although the measure does not mandate that a CVS be sent via secure messaging, an audit is created when a CVS is sent in this manner. For more information on how these core measures are defined, refer to the specific core measure documentation found in the Secure Messaging & Patient Portal > Meaningful Use Stage 2 area of the Kryptiq support site (http://support.kryptiq.com/). Workflow Auditing Criteria Secure Messaging and Patient Portal requires that the following criteria be met to fulfill Core Measure 8 requirements: The sender must be a provider and the recipient must be a patient. The sender must have a secure messaging account and is on the internal domain. The recipient must be a linked patient within a community. 8

9 Guide to Meaningful Use Stage 2 Core Measure 12: Preventive Care Secure Messaging and Patient Portal now complies with Core Measure 12, which is to enable practices to use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference. For more information on how these core measures are defined, refer to the specific core measure documentation found in the Secure Messaging & Patient Portal > Meaningful Use Stage 2 area of the Kryptiq support site (http://support.kryptiq.com/). Core Measure 15: Summary of Care Secure Messaging and Patient Portal now complies with Core Measure 15, which is to enable the eligible professional, who transitions their patient to another setting of care or provider of care, or refers their patient to another provider of care, to provide a summary care record for each transition of care or referral. Also referred to as Transition of Care (TOC), Core Measure 15 requires that a provider can select a new, CCDA-based TOC document and attach it to an outbound secure message to another provider. Also, an audit for this workflow is sent. For more information on how these core measures are defined, refer to the specific core measure documentation found in the Secure Messaging & Patient Portal > Meaningful Use Stage 2 area of the Kryptiq support site (http://support.kryptiq.com/). Workflow 9

10 Core Measure 15: Summary of Care Auditing Criteria Secure Messaging and Patient Portal requires that the following criteria be met to fulfill Core Measure 15 requirements: The sender and recipient must be a provider. The sender must have a secure messaging account and is on the internal domain. The recipient cannot be a linked patient. The Transition of Care document that is sent has to be a valid CCDA document that is both human and machine readable. A valid CCDA conforms to the approved format and contains the minimum required sections. If the message being sent is using Direct, the receiving HISP must respond to the message verifying that it has been received. 10

11 Guide to Meaningful Use Stage 2 Core Measure 17: Secure Messaging Secure Messaging and Patient Portal now complies with Core Measure 17, which requires the use of secure electronic messaging to communicate with patients on relevant health information. Also referred to as patient-to-provider messaging, Core Measure 17 requires that practices identify patient-to-provider messages and send the necessary audit information. For more information on how these core measures are defined, refer to the specific core measure documentation found in the Secure Messaging & Patient Portal > Meaningful Use Stage 2 area of the Kryptiq support site (http://support.kryptiq.com/). Workflow For MU2 compliance, make sure that patients can only compose messages through Portal eforms that have been set up to be routed as a Secure Message. If using Message Center, patients should only be allowed to reply to messages. Only messages sent to providers from an eform will be counted towards the Meaningful Use measures. 11

12 Core Measure 17: Secure Messaging Do not enable patients to compose messages from the Message Center. Only allow them to respond to their provider. Auditing Criteria Secure Messaging and Patient Portal requires that the following criteria be met to fulfill Core Measure 17 requirements: In the case of a reply to a secure message: Message must have provider and patient context, meaning that we know who the doctor was who sent the message, and we know who the patient was who replied. In the case of a patient initiating a message via an eform, we know the patient ID because it's a verified patient user in the portal. If the eform has a provider selector, and we can determine the recipient's provider ID, it will be used. If the recipient is part of the internal domain, but we are unable to determine the provider's ID, then the audit will use the patient's responsible provider ID. 12

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