Electronic Medical Records Meaningful Use Guide TABLE OF CONTENTS. Master Files to Update...2. Prepare Superbill Encounter Forms...

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1 AMS Electronic Medical Records Meaningful Use Guide TABLE OF CONTENTS Master Files to Update...2 Prepare Superbill Encounter Forms...3 Patient Presents to Check In...3 Clinical Staff is Ready for Next Patient...4 Provider is Ready for Next Patient...15 Patient Presents to Check Out...23 EMR Daily Functions (not outlined above) Core and Menu Set Measures (not outlined above) Reports and Lists (Clinical Quality Measures /NQF Reports)...27 Please note that meeting meaningful use measures are the responsibility of the practice, not your certified EHR alone. The purpose of this guide is to show you how to document in a meaningful way but does not necessarily mean that each measure will be met simply because you are using a certified product. This guide will address the 15 Core Measures, the 10 Menu Set Measures and NQF reports. For additional information, refer to the Meaningful Use page of our website: Revised 04/06/2012 Page 1

2 Master Files to Update: The following master files will need updated with their assigned codes before your attestation date: Allergy Master Update SNOMED CT (Substance), Rx CUI (Drug), and UNII (Food) codes For example: Allergy: Latex Type: Substance SNOMED: Medication Master Update RxCUI For Example: Medication Name: Vicodin 5/500 RxCUI: Description (optional): Acetaminophen 500 MG / Hydrocodone Bitartrate 5 MG Routine Healthcare Maintenance (RHCM Other Master Update) ICD, CPT, and SNOMED: For Example: RHCM Item: Breast Cancer Screening Diagnosis Code: V70.0 Procedure Code: SNOMED: NOTE: Diagnosis Codes, Procedure Codes and/or SNOMED Codes may not be required unless RHCM items are being used for NQF Reporting. Social History Type Update Tobacco Use For Example: Social History Type: Tobacco Use Units: Cigarette(s), Pack(s), Carton(s), Cigar(s) Vaccine Master Update CVX and Procedure Codes relevant to the vaccines administered: For Example: Vaccine Type: Hepatitis A, Pediatric\Adolescent, 2 dose CVX: 83 Procedure Code: NOTE: CVX and Procedure codes must be setup to upload immunizations administered to your state. Definition of Terms: SNOMED - The Systematized Nomenclature of Medicine is a standardized, multilingual vocabulary of clinical terminology that is used by physicians and other health care providers for the electronic exchange of clinical health information. RxCUI - a standardized nomenclature for clinical drugs and drug delivery devices. UNII - Unique ingredient identifier assigned by the US Food & Drug Administration. CVX a numeric string which represents the type of product used in an immunization. Revised 04/06/2012 Page 2

3 To prepare superbill encounter forms for the appointments scheduled the following day: 1. Choose View Open Encounters from the top toolbar. 2. Choose Add Encounters. 3. Choose By Appointment Date and enter the date of appointments you want to queue encounters for. 4. Check mark the All Providers box and choose Add. 5. From the View Open Encounter window, filter your display to ENC TYPE: APT. 6. Click the checkmark (located in the middle of the screen) to select all encounters then choose PRINT. Patient presents to Check In: 1. Choose View Open Encounters from the top toolbar. 2. Right click on the patient s encounter and Change Type to WR Waiting Room. OPTIONAL: If this is an established patient, you can quickly access the Patient Inquiry screen by right clicking on the encounter to verify a patient s demographic info, insurance info, etc. Revised 04/06/2012 Page 3

4 Objective: Record demographics including preferred language, gender, race, ethnicity and DOB. Core Measure 7: More than 50% of all unique patients seen by the EP have demographics recorded as structured data. Exclusion: No exclusion. 3. Right click on the patients encounter and Enter/Update Copay. 4. Enter the appropriate payment code (CC credit card, CK check, CS cash, MO money order), check number if applicable, the total amount of the payment and include remarks as needed. 5. Before saving this payment, a Receipt can be printed for the patient. Clinical Staff is ready for next patient: 1. View Open Encounters will serve as a work list for the clinical staff to determine who is in the waiting room, which patient arrived first and what time the appointment was scheduled for. Right click on the selected encounter to quickly access the patient s chart. Revised 04/06/2012 Page 4

5 2. Perform a chart overview for items that may affect or need to be addressed during today s visit (ex. RHCM Alerts, Test Tracking Records, Allergies, Medications, Problems, etc), making changes as necessary. 3. Verify that the patient s Supplementary file is accurate and complete. Upon rooming the patient, document/review the details of your supplementary tabs. For example: a. Past Medical History Type PMH and choose F9 on your keyboard (or click on the blue label) to make the appropriate selections. Choose F10 once selections are made to remove all choices not selected. Otherwise, free text is acceptable. NOTE: Templates will not be used during follow up visits. Simply note changes by deleting/free typing. Revised 04/06/2012 Page 5

6 b. Family History Type FHX and choose F9 on your keyboard (or click on the blue label) to make the appropriate selections. Choose F10 once selections are made to remove all choices not selected. Otherwise, free text is acceptable. NOTE: Templates will not be used during follow up visits. Simply note changes by deleting/free typing. c. Social History Type SHX and choose F9 on your keyboard (or click on the blue label) to make the appropriate selections. Choose F10 once selections are made to remove all choices not selected. Otherwise, free text is acceptable. Indicate Smoking Status and add records for future reporting purposes of a patient s tobacco use. NOTE: Templates Revised 04/06/2012 Page 6

7 will not be used during follow up visits. Simply note changes by deleting/free typing. Objective: Record smoking status for patients 13 years old and older. Core Measure 9: More than 50% of all unique patients 13 years old and older seen by the EP have smoking status recorded as structured data. Exclusion: Any EP who sees no patients 13 years or older. d. Problems Add the patient s problems by diagnosis code or search for the code by description. When reviewing a Problem List during a follow up visit, add problems, move active problems to inactive problems OR click Reviewed if there is no change to be made. NOTE: Hyperlinks to disease management/patient education are attached to diagnosis codes from the Diagnosis Master Update and are accessible from here to print by clicking it. Objective: Maintain an up-to-date problem list of current and active diagnoses. Core Measure 3: More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data. Exclusion: No exclusion. Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice. Menu Set Measure 10: Performed at least one test of certified EHR technology s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information has the capacity to receive the information electronically). Revised 04/06/2012 Page 7

8 Exclusion: 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. NQF Reports: All quality reports that relate to a particular diagnosis require a relevant diagnosis code(s) be reported in the problem list. e. Medication Add the patient s medications prescribed by an outside doctor and/or taken over the counter. Populate medications by searching your medication master (F4) or your common script master file (F5). When reviewing a Medication List during a follow up visit, add or edit medications or mark as Reviewed if there is no change to be made. This list can be printed. Objective: Maintain active medication list. Core Measure 5: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data. Exclusion: No exclusion. Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. Menu Set Measure 7: The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP. Exclusion: An EP who was not the recipient of any transitions of care during the EHR reporting period. NQF Reports: All quality reports that relate to a particular medication require the medication(s) be reported in the medication list. Revised 04/06/2012 Page 8

9 f. Allergies Add the patient s allergies by name. When reviewing an Allergy List during a follow up visit, add or edit allergies or mark as reviewed if there is no change. This list can be printed. Objective: Maintain active medication allergy lists. Core Measure 6: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data. Exclusion: No Exclusion NQF Reports: All quality reports that have exclusions based on allergies require the allergy be reported in the allergy list. Revised 04/06/2012 Page 9

10 g. Immunizations Add immunizations as administered to the patient (including a history of). If there are scheduled vaccines showing due, double click it to document the date it was done so that it will show due again appropriately. NOTE: Hyperlinks to Vaccine Information Statements/patient education are attached to vaccines from the Vaccine Type Master Update and are accessible from here to print by clicking it. NQF Reports: All quality reports that relate to a particular vaccine require the vaccine(s) be reported in the immunization history list. h. Injections Add injections as administered to the patient (if applicable). Revised 04/06/2012 Page 10

11 NOTE: Hyperlinks to disease management/patient education are attached to injections from the Injection Types Master Update and are accessible from here to print by clicking it. i. RHCM Add a history of the patient s routine healthcare maintenance. If there are scheduled items showing due, double click it to document the date it was done/ordered so that it will show due again appropriately. To change the date the item is due manually, choose Adjust Date. Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule. Core Measure 11: Implement on clinical decision support rule. Exclusion: No exclusion. NQF Reports: All quality reports that relate to routine healthcare not otherwise specified above or below require the item(s) be reported in the RHCM items due/history list. Measure Note: Problems, Medications, Allergies, Immunizations, Injections and/or RHCM items can be addressed from the patient s chart view. Revised 04/06/2012 Page 11

12 j. Growth Charts Objective: Record and chart changes in vital signs that include Height, Weight, Blood pressure, Calculate and display body mass index, Plot and display growth charts for children 2-20 years, including BMI. Core Measure 8: For more than 50% of all unique patients age 2 and over seen by the EP; height, weight and blood pressure are recorded as structured data. Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight and blood pressure of their patients have no relevance to their scope of practice. 4. Enter/Update Vitals: BMI is automatically calculated upon entering a patient s height and weight. Objective: Record and chart changes in vital signs that include Height, Weight, Blood pressure, Calculate and display body mass index, Plot and display growth charts for children 2-20 years, including BMI. Revised 04/06/2012 Page 12

13 Core Measure 8: For more than 50% of all unique patients age 2 and over seen by the EP; height, weight and blood pressure are recorded as structured data. Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight and blood pressure of their patients have no relevance to their scope of practice. NQF Reports: All quality reports for Weight Screenings/Assessments require a height and weight be recorded in the Enter/Update Vitals window. NQF Reports: All quality reports for Hypertension and Diabetes Management/Control require a blood pressure be recorded in the Enter/Update Vitals window. 5. Encounter Note Entry (if the clinical staff will be starting the Encounter Note for the provider): 6. Complete the Chief Complaint or paste (F2) from what was previously entered in the vital record. If the patient was referred to your provider, enter who referred in the Referral field as an Inbound Type (I). Revised 04/06/2012 Page 13

14 7. Paste appropriate Medical History from the supplementary file by choosing F4: 8. Paste Vitals by choosing F2: 9. Save the Encounter Note and Exit the patient s chart. 10. From View Open Encounters (see page 4); right click on the patient s encounter and Change Type to RM#. Revised 04/06/2012 Page 14

15 Provider is ready for next patient: 1. Choose View Open Encounters from the top toolbar. View Open Encounters will serve as a work list to determine who is in an exam room, which patient was roomed first and what time the appointment was scheduled for. 2. Right Click (or F2) on the patient s encounter to quickly access the patient chart. 3. Perform a chart overview for items that may affect or need to be addressed during today s visit (ex. RHCM Alerts, Test Tracking Records, Allergies, Medications, Problems, etc), making changes as necessary. Measure Note: Problems, Medications, Allergies, Immunizations, Injections and/or RHCM items can be addressed from the supplementary view. Revised 04/06/2012 Page 15

16 4. If the clinical staff has started the encounter for the provider, double click it. Otherwise, see steps 5-8 above. 5. The provider will document time and make appropriate selections for this patient s exam details using templates if previously created. Otherwise, free typing is acceptable. NOTE: Supplementary Information can be pasted into the Encounter Note at anytime (F4): Revised 04/06/2012 Page 16

17 6. From the Problems Tab; Add New Problems found during this visit, Add checked items to the Patient s Active Problems, and/or Add the Patients Active Problems already noted to associate to this visit. 7. Order Tests when applicable from the Tests Ordered tab and print/fax the requisition. Revised 04/06/2012 Page 17

18 8. Choose Write Prescription to write /refill a medication. a. Click the Electronic Rx option on the prescription writing screen to load the Compose Rx page with the patient s information. b. When prescribing new; medications will be searched for by name (or picked from a list once your Doctors Drug List has been created) and the appropriate name and strength will be selected. When refilling; click on the medication from the existing list. c. When prescribing new; complete the sig (selecting to add this medication strength and sig to your Doctor s list before continuing if applicable). d. Once the sig is completed, you will then proceed to transmit with the medications selected that will be sent to the same pharmacy from the Route Rx page. e. When refilling a medication as previously written, checkmark it and choose Instant Renewal. f. Once the pharmacy is selected, choose Transmit Rx. Objective: Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. Core Measure 1: More than 30% of all unique patients with at least one medication in their medication list seen by the EP have at least on medication order entered using CPOE. Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period. Objective: Implement drug-drug and drug-allergy interaction checks. Core Measure 2: The EP has enabled this functionality for the entire EHR reporting period. Exclusion: No exclusion Revised 04/06/2012 Page 18

19 Objective: Generate and transmit permissible prescriptions electronically (erx). Core Measure 4: More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period. Objective: Implement drug formulary checks. Menu Set Measure 1: The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period. Exclusion: Any EP who writes fewer than 100 prescriptions during and EHR reporting period. 9. Link images to this encounter from the Linked Image tab by check marking the appropriate one. Double click one to see it returned on the screen or to manipulate it by adding text, circling areas of concern, etc. 10. Choose the Medical Decision Making (MDM) Risk appropriate for this encounter to suggest the level of code to be used (see above). E&M coding conditions must be defined within the templates used during this visit for codes to be suggested. Revised 04/06/2012 Page 19

20 11. Code the encounter by double clicking it to add diagnosis (select ICD1) and procedure codes (Add Procedure Line, Select from Procedure Code List). Search results will be limited to the suggested procedure codes and associated problems but can also be manually entered: Notes can be attached to the encounter (ex. Follow Up in 3 months). Before saving, Change Type appropriately (ex. FIN Finished) which will now be the default for all encounters coded during a visit at this workstation. Measures Note: All Core and Alternate Objectives as well as NQF reports require coding the electronic charge encounter. This is the ONLY indication that a service was rendered!! If paper superbills are used, this can be done at the time of check out/billing by right clicking on the encounter and choosing Code Encounter. 12. Queue a work/school excuse, a letter to the in or out bound referring physician indicated at the top of the encounter note entry window, etc. Revised 04/06/2012 Page 20

21 13. The Encounter Note is complete. Choose Sign and Save opting to close the note at this time. (If templates were used, it is the close process that will remove the conditionals that were not selected.) NOTE: If your encounter note is not complete (or your notes require a supervising physician s signature before they are closed), do not close the note. See Process Daily Records. 14. If applicable, process the letter from the Patient Chart Letter icon ( ). Queued Letters can also be merged from the Letter List located on the main menu in an instance where this is part of a staff members check out/daily routine. Revised 04/06/2012 Page 21

22 15. From the Patient s Chart, verify/update Patient Measures for any of the following reasons: Select Update if a box was checked manually. To see previously recorded measures for this patient choose Recorded Measures. Measure Note: Some Patient Measures are automatic and will be checked and updated for you based on the patient s visit. However, providing electronic copies of health information, sending reminders to the patient, summary of care plans provided, etc must be checked manually. It is highly recommended that the Patient Measure window is reviewed for updating at the end of every visit. Objective: Report ambulatory clinical quality measures to CMS. Core Measure 10: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS. Exclusion: No exclusion. Revised 04/06/2012 Page 22

23 Patient Presents to Check-Out: 1. Choose View Open Encounters from the top toolbar. 2. If the encounter type indicates this patient is in an exam room, right click on the patient s encounter and Change Type to CKO Checked Out. NOTE: If the encounter type indicates FIN Finished, do not change the type. 3. If there are notes attached to the patient s encounter, there will be Pencil and Note icon next to the encounter type. Rest your mouse on it to see the details of the note. (Ex. Follow Up in 3 months.) EMR Daily Functions (not outlined above): Import Lab Results/Test Tracking Records: Double click the patient s name when the Alert icon indicates this patient could not be found based on the patient number, name or social security number that was returned with the results. The star indicates there is an outstanding order(s) on this patient s chart. Click it to result the previously ordered test with the results received. If no Lab Interface is setup, manually enter your test results from the Enter Tracking Records menu option of Daily Data Entry found on the main menu of Electronic Medical Records. Revised 04/06/2012 Page 23

24 Objective: Incorporate clinical lab test results into EHR as structured data. Menu Set Measure 2: More than 40% of all clinical lab test results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data. Exclusion: An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period. Measure Note: Scanning lab results to save to a patient s chart will not satisfy this measure. Process Daily Records An end of day work list to review/complete encounter notes: Double click the note from this display to finish it then Sign and Save as described previously. The bottom half of this window will display test results that need to be closed once signed by the provider. NOTE: Additional software features are available but are not required for meaningful use. Core and Menu Set Measures (not outlined above): Print the patient s Encounter Note (or an Encounter Note Title, subtitle): Objective: Provide clinical summaries for patients for each office visit. Core Measure 13: Clinical summaries provided to patients for more than 50% of all office visits within 3 business days. Exclusion: Any EP who has no office visits during the EHR reporting period. Print an Encounter Note, a Letter, or a C32 document: Objective: The EP who transitions their patient to another setting of care or provider of care or refers to their patient to another provider of care should provide summary care record for each transition of care or referral. Menu Set Measure 8: The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals. Exclusions: An EP who neither transfers a patent to another setting nor refers a patient to another provider during the EHR reporting period. Revised 04/06/2012 Page 24

25 Export a C32 document from the patient s chart and send it to an electronic media (CD, flash drive, etc) or as a message to the patient s portal account: Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and medication allergies) upon request. Core Measure 12: More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days. Exclusion: Any EP that has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period. Export a C32 document from the patient s chart and send it as a message to the patient s portal account: Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP. Menu Set Measure 5: At least 10% of all unique patients seen by the EP are provided timely (available to the patient within 4 business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP s discretion to withhold certain information. Exclusion: 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. Export a C32 document to save on electronic media (CD, flash drive, etc), or upload to a provider s portal to exchange clinical information: Objective: Capability to exchange key clinical information (for example, problem list, medication list, medication allergies and diagnostic test results), among provider of care and patient authorized entities electronically. Menu Set Measure 14: Performed at least one test of certified EHR technology s capacity to electronically exchange key clinical information. Exclusion: No exclusion. File Links attached to diagnoses, injections, vaccines, medications, and tests provide quick access to patient specific education resources: Objective: Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. Menu Set Measure 6: More than 10% of all unique patients seen by the EP are provided patient-specific education resources. Exclusion: No exclusion. Revised 04/06/2012 Page 25

26 Export Immunizations administered to immunization registries (additional setup/programming may be required): Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice. Menu Set Measure 9: Performed at least one test of certified EHR technology s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically). Exclusion: An EP who administers no immunization during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically. RHCM Items Due Report or Query Medical Records Data: Objective: Send reminders to patients per patient preference for preventive/follow-up care. Menu Set Measure 4: More than 20% of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period. Exclusion: An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology. Query Medical Records Data for specific problems: Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. Menu Set Measure 3: Generate at least on report listing patients of the EP with a specific condition. Exclusion: No exclusion. Security updates including software updates or any other necessary corrective action that needs to take place in order to eliminate security deficiencies: Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities. Core Measure 15: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process. Exclusion: No exclusion. Measure Note: Refer to the American Medical Software Technical Manual and your IT professional for assistance with security risk analysis in accordance with the requirements. Revised 04/06/2012 Page 26

27 Reports and Lists: Clinical Quality Measures: Objective: Report ambulatory clinical quality measures to CMS. Core Measure 10: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS. Exclusion: No exclusion. Measure Note: The Denominator includes all patients who have an electronic charge encounter during the date range specified. The Numerator includes the patients who have an electronic charge encounter and a recorded Patient Measure of the above per the report selected and the specified date range. Quality Reports (NQF): Choose from 3 of the Core Reports: NQF Adult Weight Screening NQF Hypertension: Blood Pressure Measurement NQF Preventative Care: Tobacco Use Assessment and Cessation If any of the Core Reports are not within your scope of care, choose from the Alternate Reports list: NQF Influenza Immunization NQF Youth Weight Assessment NQF Childhood Immunization Status If none of the Core or Alternate Reports is within the scope of your care, clarify with CMS or the specialty organization you belong to if 0 is acceptable when attesting. You still must choose 3 additional reports from the below list: NQF Asthma Assessment NQF Pharyngitis- Children NQF Alcohol and Drug Dependence NQF Prenatal Care: HIV Screening NQF Prenatal Care: Anti-D immune Globulin NQF Controlling High Blood Pressure NQF Tobacco Use Cessation NQF Breast Cancer Screening NQF Cervical Cancer Screening NQF Chlamydia Screening for Women NQF Colorectal Cancer Screening NQF Appropriate Medications for Asthma NQF Pneumonia Vaccination NQF Asthma Pharmacologic Therapy NQF Use of Imaging Study: Low Back Pain NQF Diabetes: Eye Exam NQF Diabetes: Foot Exam NQF Diabetes Control: Hemoglobin A1C >9.0% NQF Diabetic Patients who elevated mmhg V140/90 NQF Nephropathy Screening- Urine NQF Diabetes Control: LDL < 100mg/dl Revised 04/06/2012 Page 27

28 NQF Antiplatelet Therapy NQF Ischemic Vascular Disease: Aspirin or other Antithrombotic NQF Coronary Artery Disease: Beta Blocker Therapy Post Myocardial Infarction NQF Blood Pressure Management: Ischemic Valve Disease NQF Coronary Artery Disease: Lipid Lowering Therapy NQF IVD: Complete Lipid Panel and LDL Control NQF Heart Failure: ACE/ ARB Therapy For LVSD (LVEF <40%) NQF Heart Failure: Beta Blocker for LVSD NQF Heart Failure: Warfarin Therapy NQF Primary Open Angle Glaucoma NQF Diabetic Retinopathy: Macular Edema NQF Diabetes Management: Retinopathy Screening NQF Depression Management NQF Colon Cancer: Chemotherapy NQF Breast Cancer: Hormonal Therapy NQF Prostate Cancer: Avoid overuse of Bone Scan NQF Diabetes Control: Hemoglobin A1C <8.0% NOTE: If there is a report in the above list that you would like to attest to but it is not in the Quality Reports that have been programmed previously, contact Technical Support with the NQF number. NQF report guides can be found on the Meaningful Use page of our website: Revised 04/06/2012 Page 28

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