1 About ehr and Meaningful Use in DR Systems Unity

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1 For: Release: Release 8.2 Updated: April 11, 2012 Reading physicians, technologists, front desk staff, back office staff, system administrators Contents 1 About ehr and Meaningful Use in DR Systems Unity Accessing ehr Creating User Accounts in ehr Assigning ehr Access Rights to Roles Meaningful Use Stage 1 Requirements Getting Help and Information About ehr and Meaningful Use in DR Systems Unity About ehr The term ehr is used in two ways: EHR refers to patient data that is kept on-line as an electronic health record. ehr is also the name of a DR Systems product that helps providers comply with the federal regulations for using electronic health records called meaningful use. About meaningful use Meaningful use is a specification that the federal government created to describe how providers should use electronic health records. It was formally written and added to federal regulations, mostly under title 42, Public Health, section Meaningful use consists of objectives, measures and exclusions: An objective is usually a record keeping activity that used to be done by hand, but which can now be done using computers. For example, one of the meaningful use objectives is to encourage physicians to write prescriptions electronically (495.6.d.1). The measure specifies what you must do to comply with an objective. For example, if a doctor writes 100 or more prescriptions during a certain time period, the government would like 30% of the Page 1 of 8

2 prescriptions to be written electronically. If you met that measure, you would be considered in compliance with the objective. Exclusion. The government recognized that not every objective applies to every physician, so for every meaningful use objective there can be an exclusion statement. For example, if a doctor writes fewer than 100 prescriptions during a certain time period, they are exempt from the objective of writing prescriptions electronically. The meaningful use regulations are being rolled out in stages. Stage 1 has fifteen "core" requirements and ten "menu" requirements. ehr and compliance with meaningful use In 2009, the federal government created an incentive program to encourage providers to comply with the meaningful use objectives. Providers that comply with meaningful use receive some funds from the government. Providers that do not comply may receive financial penalties. The ehr program does the work of tracking and proving your compliance with meaningful use. The ehr program can be reached through DR Systems workstations or directly through any Internet connection. Because ehr is an Internet cloud application, physicians can use it from any location. The ehr application can be updated by DR Systems without putting any burden on the physician or their staff. This is particularly important because the meaningful use requirements are being rolled out in stages, and each stage may include a change in compliance. The meaningful use requirements are tracked and organized in the ehr application. 2 Accessing ehr You can start the ehr application in several ways: To connect directly to the ehr program from a browser, you must have an ehr account already set up. See Creating User Accounts in ehr. To reach the ehr program from ehr tab, you must have a DR Systems Unity login and user name, and your role must have ehr access. See Assigning ehr Access Rights to Roles. Connecting directly to ehr You can connect directly to ehr anywhere you have a browser and an Internet connection. 1. Open a browser. 2. In the address bar, enter the ehr web address that was created for your site. If you don't know what web address to use, please contact your system administrator. 3. The ehr application will open. In the Login screen, enter your user name and password. Page 2 of 8

3 Accessing ehr from the workstation main grid In Unity you can access ehr by selecting the ehr tab, which appears in the tab list and the View menu. The ehr program opens and you are automatically logged in with your Unity user name and password. If you do not see this tab, your computer may not be configured for ehr access or you may not have the correct user permissions. See Assigning ehr Access Rights to Roles or contact your system administrator. Accessing ehr from the Patient Properties dialog box 1. Select the Patients tab. 2. Right-click a patient and select Properties. 3. At the bottom of the Patient Properties dialog box, click the ehr button. If you do not see this button, your computer may not be configured for ehr access or you may not have the correct user permissions. See Accessing Rights to Roles or contact your system administrator. The ehr program opens in a new window. You are automatically logged in with your user name and password. The ehr program displays the patient record that you selected. Accessing ehr from the Exam Properties dialog box 1. Select the Scheduled tab. 2. Right-click a scheduled exam and select Properties. 3. At the bottom of the Exam Properties dialog box, click the ehr button. If you do not see this button, your computer may not be configured for ehr access or you may not have the correct user permissions. See Assigning ehr Access Rights to Roles or contact your system administrator. The ehr program opens in a new window. You are automatically logged in with your user name and password. ehr displays the exam record that you selected. Accessing ehr from the Electronic Requisition 1. Select any tab where you can view exam images and the Electronic Requisition, such as In-Progress, Work List, Online, or the Transcription tabs. 2. Right-click an exam and select View Images. 3. At the top of the Electronic Requisition, select the ehr tab. If you do not see this tab, your computer may not be configured for ehr access or you may not have the correct user permissions. See Assigning ehr access Rights to Roles or contact your system administrator. The ehr program opens. You are automatically logged in with your user name and password. The ehr program displays the exam record that you selected. Page 3 of 8

4 3 Creating User Accounts in ehr User accounts in ehr are separate from accounts in Unity. Users can have accounts in either program or both, but they are separate accounts. User accounts can be created: Automatically Manually Automatic account creation System administrators 1. Create a user name and login in Unity for the user. 2. Restrict a user account if needed. Users You can restrict a user's account in ehr by editing the user account and re-assigning the user to a more restricted ehr group. 1. Log in to Unity. 2. Click the ehr tab. For detail, see Accessing ehr. An account is automatically created for the user in ehr with the same user name and password that they used to login to Unity. After you go through automatic account creation one time, you can access the ehr application directly though a browser. (See Connecting directly to ehr.) Note: when you use this method to automatically create ehr accounts, the new account is added to a group in ehr that has all rights to all features in ehr. It does not change the user's rights in Unity. Please contact DR Systems support if you would like to change this default. Manual account creation in ehr If you have admin rights in the ehr application, you can manually create user accounts. The user does not need to have an account in Unity. Please note that manually creating a user account in ehr does not automatically create an account for that user in Unity. If the user already has a user account, you may want to create their ehr account with the same user name and password. 1. Log into ehr with an admin account. 2. In the Meaningful Use Administration menu, select Site Administration. 3. Select the Users and Groups tab. Page 4 of 8

5 4. In the Users and Groups tab, click the group where you want to add a user. 5. The User Details panel will appear. Enter the information for the new account and click the Add New User button. 4 Assigning ehr Access Rights to Roles Before users can reach the ehr program from within Unity, the user must belong to a role with ehr rights. If a user logs into Unity and doesn't see an ehr tab or see ehr listed in the View menu, their current role does not have ehr rights. You can either create a new role with ehr rights, or add ehr rights to an existing role. To view a user's current role 1. Log into Unity as an administrator. 2. Select the Users tab. 3. Select a user, right-click, and select Properties. The Role field shows the role that the user is currently assigned to. To add ehr rights to the user's role 1. Log in to Unity as admin. 2. Select the Users tab. 3. Click Roles. 4. Select the role that the user is currently assigned to and click the Properties button. 5. In the Role Properties dialog box, select the Tab - ehr right and click OK. The next time that the user logs into Unity, they can access ehr. For details, see Accessing ehr. 5 Meaningful Use Stage 1 Requirements For Stage 1, there are 15 core requirements and 10 menu requirements. An eligible professional (EP) must comply with and report: All 15 core requirements Five of the 10 menu requirements EPs may qualify for exclusions for some core and menu requirements, and the excluded items count toward compliance. For example, an EP might have exclusions for five menu requirements. Since an exclusion counts, this EP would be in compliance with the menu requirements without taking any further action. Page 5 of 8

6 Core requirements Objective Exclusion Measure 495.6(d)(1) Computerized Order Entry 495.6(d)(2) Drug/Drug, Drug/Allergy interaction checks (d)(3) Maintain problem list of current and active diagnoses (d)(4) Generate and transmit permissible prescriptions electronically (erx) 495.6(d)(5) Maintain active medication list 495.6(d)(6) Maintain active medication allergy list 495.6(d)(7) Record demographics 495.6(d)(8) Record changes in vital signs 495.6(d)(9) Record smoking status 495.6(d)(10) Report clinical quality measures 495.6(d)(11) Clinical decision support 495.6(d)(12) Provide patient with electronic copy of their health information (d)(13) Provide clinical summaries for patients for each visit Any eligible professional (EP) who writes fewer than 100 prescriptions during the EHR reporting period 30% 80% Any EP who writes fewer than one hundred prescriptions during the EHR reporting period The EP performs drugdrug and drug-allergy interaction checks for the entire EHR reporting period. 40% 80% 80% Any EP who sees only patients 2 years old or younger or who believes that all three vital signs of height, weight and blood pressure have no relevance to their scope of practice may attest and be excluded Any EP who sees only patients younger than 13 years old Any EP that has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period Any EPs who have no office visits during the EHR reporting period Must report to CMS or the state the measures that they require. Implement one clinical decision support rule. Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days. Page 6 of 8

7 Objective Exclusion Measure 495.6(d)(14) Capability to exchange key clinical information 495.6(d)(15) Conduct Annual Security Risk Analysis Performed at least one test of a certified EHR technology's capacity to electronically exchange key clinical information. Conduct a security risk analysis (45 CFR a.1). Implement security updates as necessary. Menu requirements Objective Exclusion Measure 495.6(e)(1) Any EP who writes fewer than 100 The EP has access to at Drug formulary prescriptions during the EHR least one internal or checks reporting period. external formulary for the entire EHR reporting period (e)(2) Incorporate clinical lab test results into EHR 495.6(e)(3) Generate patient lists by specific conditions 495.6(e)(4) Send reminders to patients for follow up care 495.6(e)(5) Provide patients with timely electronic access 495.6(e)(6) Identify patientspecific educational resources via EHR 495.6(e)(7) Medication reconciliation 495.6(e)(8) Provide summary of care for patients referred to another provider Any EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period. Any EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology. Any EP that neither orders nor creates lab tests or information that would be contained in the problem list, medication list, medication allergy list (or other information as listed at 45 CFR (g)) during the EHR reporting period 40% Generate at least one report listing patients of the EP with a specific condition. 20% for patients that are >65yrs or <5yrs 10% 10% An EP who was not the recipient of any transitions of care during the EHR reporting period Any EP that does not transfer a patient to another setting or refer a patient to another provider during the EHR reporting period Page 7 of 8

8 Objective Exclusion Measure 495.6(e)(9) Submit electronic data to immunization registries 495.6(e)(10) Submit electronic syndromic data An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries. Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies. 6 Getting Help and Information Displaying Online Help Press F1 or click Help Topics from the Help menu. Contacting DR Systems Mesa Rim Road San Diego, CA Phone: Fax: Sales Info Support Customer Support Online: Click Customer Support Login Accessing the Resource Center Review white papers, user guides, TechNotes, technical specifications and other documents: Go to Click the Resource Center button. Copyright and Notice Copyright All rights reserved. Various DR Systems product modules are protected by one or more of U.S. Patent # 5,452,416; 7,660,488; 7,885,440; 7,787,672; 7,953,614; 7,970,625; 8,019,138; 8,094,901 and other patents pending. Specifications are subject to change without notice. Other trademarks used herein are the property of their respective owners. Template: TCP D Page 8 of 8

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