Care360 Guide for CMS Meaningful Use Audit

Transcription

1 Care360 Guide for CMS Meaningful Use Audit The Centers for Medicare and Medicaid Services (CMS) has contracted with third parties to conduct Meaningful Use audits of certified Electronic Health Record (EHR) technologies. Utilize the guide below to prepare for and/or respond to such an audit. The audits for the Medicare and Medicaid programs may vary. Year 1 participation for the Medicaid program requires providers to Adopt, Implement, or Upgrade an EHR. Subsequent audits will require proof of such EHR technology. Year 2 participation for the Medicaid program requires demonstration of the Meaningful Use Measures, similar to Year 1 of the Medicare program. Below is an example of a Year 1 Medicare Audit Request. It may not be a comprehensive listing, and your audit items may vary. It is recommended that the material provided to you by CMS (or contracted third party) be considered your master reference. If there are requests that require assistance from Care360 Support that are not listed in this document please call (option 6; option 2 for EHR) with the specifics. Part I General Information CMS Audit Request List Source: CMS 1 As proof of possession of a certified Electronic Health Record technology system, provide a copy of the Office of the National Coordinator of Health Information Technology (ONC) certification as well as licensing agreements with the vendor or invoices from time system was purchased. Care360 Recommendations 1. A copy of Care360 s CCHIT Certificate can be downloaded from the Care360 EHR login page. 2. A copy of your EHR Contract can be provided by Care360 Support at (option 6; option 2 for EHR). 3. The Care360 EHR CMS Certification IDs reference document may also be helpful in satisfying this request. To download follow these steps: Access the "Help" menu located at the top right of Care360 EHR. Support Center window opens, select Online Training. Care360 Online Training Center appears, select the "Menu" icon located at the bottom left. From the Care360 EHR training list select "Understanding Meaningful Use." From within the training, navigate to page 2. A Course Objectives drop down will appear at the top. Select Course Summary from the drop down menu. From this location, the Care360 EHR CMS Certification IDs document and other MU supporting documentation is available for download.

2 2 Please provide a response to the following questions: At how many offices/facilities do you see your patients? Do you utilize EHR software in all of these facilities? 3 Could you please supply documentation which proves that 50% or more of your patient encounters during the EHR reporting period have been entered into your Certified Electronic Health Record Technology system (i.e., an appointment log demonstrating all appointments that took place during the reporting period as well as a list of patient encounters from your EHR system). Note: CMS has requested this percentage be as high as 80% in some instances. No assistance needed from Care Appointment List: If fully utilizing Care360 PMS s scheduling functionality, a report can be generated by going to: Reports Appointments Appointment Details. Adjust the date range to match the date range of the reporting period, and then click Refresh. If you are not using Care360 PMS for scheduling or have another method for scheduling follow the appropriate steps to generate an appointment list. 2. Patient Encounter List: Contact Care360 Support at (option 6; option 2 for EHR) for a report that lists the encounters entered into Care360, for which you are primary provider. Please provide Care360 Support the date range for the report (e.g. the 90 day period you attested), Account Number, and User Name. 2

3 Part II CORE Set Objectives/Measures CMS Audit Request List Source: CMS 4 Provide the supporting documentation (in either paper or electronic format) used in the completion of the Attestation Module responses (i.e. a report from your EHR system that ties to your attestation). Please Note: If you are providing a summary report from your EHR system as support for your numerators/ denominators, please ensure that we can identify that the report has actually been generated by your EHR (i.e. your EHR logo is displayed on the report, or step by step screenshots which demonstrate how the report is generated by your EHR are provided.)to support Y/N attestation measures, please supply documentation such as screenshots from your EHR system.* Steps for generating these screen shots can be found below. Care360 Recommendations From within Care360 Provider, Clinician, and Delegated Admin Roles can: 1. Go to Reports Meaningful Use. 2. Click on the Report History tab. 3. Locate name in Provider drop down 4. Click checkbox to the left of the Core Usage (10) and Quality (6) measures submitted for attestation. 5. Once all reports are selected, click on the printer icon located to the top right and choose Print Selected. 6. PDF file will open to print. For Yes/No measures follow the steps below to generate screen shots from within Care360. Generating Screen Shots for Yes/No Core Measures: Core: Implement drug to drug allergy interaction checks: 1. Login into Care360 and search for a patient. 2. Ensure patient has active allergy and/or medication. 3. Click Write a prescription from Patient Summary or from within a SOAP note. 4. Search for a medication that will interact with the active allergy and/or medication. a. For example, a drug-to-drug interaction would generate if the patient is currently taking Amoxicillin and a prescription is written for Ambien. b. For example, a drug-to-allergy interaction would generate if the patient is allergic to eggs and a prescription is written for the MMR vaccine. 5. An Interaction or Contraindication Detected warning message displays in red when a medication is selected from search or added to the prescription that interacts with an active allergy or med. a. These interactions can be addressed by clicking the red warning message. 6. To capture a screen shot of this functionality click the PrtScn button on your keyboard. Then open up a Word document, right click on your mouse in the area you would like the image to appear, and then select Paste. The image should display. 3

4 Core: Implement one clinical decision support rule (CDS): 1. Login to Care360, click on the Admin menu, and then select Configure CDS Alerts sub menu. 2. The Care Recommendation Preferences will display, click the green arrows to the left of the category you selected to activate for attestation. Active alerts will display with a checkmark (these checkmarks will be grey unless you have a role of Delegated Admin or Provider). 3. To capture a screen shot of this functionality click the PrtScn button on your keyboard. Then open up a Word document, right click on your mouse in the area you would like the image to appear, and then select Paste. The image should display. * In some instances, screen shots have not been sufficient for CMS Auditors due to the lack of date/time information. In those cases, it is recommended that you contact Care360 Support at (option 6; option 2 for EHR) to request custom audit reports from the Care360 production database. 4

5 Part III MENU Set Objectives/Measures CMS Audit Request List Source: CMS 5 Provide the supporting documentation (in either paper or electronic format) used in the completion of the Attestation Module responses (i.e., a report from your EHR system that ties to your attestation). Please Note: If you are providing a summary report from your EHR system as support for your numerators/ denominators, please ensure that we can identify that the report has actually been generated by your EHR (i.e., your EHR logo is displayed on the report, or step by step screenshots which demonstrate how the report is generated by your EHR are provided.) To support Y/N attestation measures, please supply documentation such as screenshots from your EHR system.* Steps for generating these screen shots can be found below. Care360 Recommendations From within Care360 Provider, Clinician, and Delegated Admin Roles can: 1. Go to Reports Meaningful Use. 2. Click on the Report History tab. 3. Locate name in Provider drop down 4. Click checkbox to the left of the Menu Usage (up to 6) measures submitted for attestation. 5. Once all reports are selected, click on the printer icon located to the top right and choose Print Selected. 6. A PDF file will open in a new window to print. For Yes/No measures follow the steps below to generate screen shots from within Care360. Generating Screen Shots for Yes/No Menu Measure: Menu: Implement drug to drug-formulary checks: 1. Login into Care360 and search for a patient. 2. Ensure the following demographic information is populated: a. First Name, Last Name, Date of Birth, Gender, City, and Zip b. If any items are missing enter them (into Practice Management if utilized) so formulary data can be pulled over from the Pharmacy Benefit Management system. 3. Click Write a prescription from Patient Summary or from within a SOAP note. 4. Once patient eligibility is verified, formulary data will appear in two locations: a. On the Favorite Meds list ( ) b. On the script pad once a medication is selected from a search or favorites list 5. To capture a screen shot of this functionality click the PrtScn button on your keyboard. Then open up a Word document, right click on your mouse in the area you would like the image to appear, and then select Paste. The image should display. 5

6 * In some instances, screen shots have not been sufficient for CMS Auditors due to the lack of date/time information. In those cases, it is recommended that you contact Care360 Support at (option 6; option 2 for EHR) to request custom audit reports from the Care360 production database. Other Potential Audit Request Item: Security Risk Assessment In a couple of instances Providers have been asked for additional information related to the Protect Electronic Health Information measure (Security Risk Analysis task). Quest Diagnostics will supply a reference checklist for this measure. It lists the security features of Care360 and provides a list of other recommended actions outside Care360 to assist offices in meeting the measure. However, Quest cannot guarantee that CMS will not ask for additional items. The checklist serves as a guide and reference document. This document can be downloaded via Care360 by following these steps: Access the "Help" menu located at the top right of Care360 EHR. Support Center window opens, select Online Training. Care360 Online Training Center appears, select the "Menu" icon located at the bottom left. From the Care360 EHR training list select "Understanding Meaningful Use." From within the training, navigate to page 2. A Course Objectives drop down will appear at the top. Select Course Summary from the drop down menu. From this location, MU supporting documentation, including the Security of Care360 EHR and Electronic Protected Health Information checklist, is available for download. 6