2013 Meaningful Use Dashboard Calculation Guide

Transcription

1 2013 Meaningful Use Dashboard Calculation Guide Learn how to use Practice Fusion s Meaningful Use Dashboard to help you achieve Meaningful Use. For more information, visit the Meaningful Use Center. General Functionality How do I set up the Dashboard? Make sure you set the correct year and reporting period: o Select a 90 day reporting duration if you are participating in your first year of the Medicare program or second year of the Medicaid program. o Select a full year reporting duration each year after. You can update your 90 day start date at any time from January 1 October 3. Your status will update the following day. How does the Dashboard update? The Dashboard updates each night for visits during your reporting period (based on your start date). You need to sign your SOAP notes to get credit for patient visits. Criteria completed outside of the EHR (e.g. information exchange, Security Audit) are not calculated by the Dashboard. You must maintain documentation of these actions for your records. Both the Seen By and the Signed By providers get Dashboard credit for signed SOAP notes. How do I start completing criteria? Start charting patient visits using Practice Fusion during your reporting period. Meaningful Use applies to all patients you see, regardless of their insurance. Check the Start date in the Meaningful Use Dashboard to ensure you are in your active reporting period. What do I do if I have not met all the criteria? Use the Gap Report to see which patients need to be updated on specific measures. If you feel your numbers aren t accurate in the Dashboard, make sure you have signed all of your SOAP notes for visits during the reporting period. Other Tips Make sure you complete the criteria during your reporting period, not after. If you believe a specific measure does not apply to your scope of practice, you may be eligible for an exclusion learn more about qualifying for exclusions here.

2 Measure Calculations and Tips To achieve Meaningful Use, you should first make sure you understand how to meet all of the measures using Practice Fusion s EHR. Visit the Meaningful Use Center for full information on achieving the measures in your EHR. Each Core and Menu measure below contains a calculation (for workflow criteria) or an objective (for one-time actions). We also include Practice Fusion s recommended workflow and tips for ensuring that you get the right calculation in the Dashboard. If applicable, the CMSapproved exclusion is listed. Core 1: CPOE for Medication Orders Denominator: The number of unique patients seen during the EHR reporting period with at least one medication in their medication (Rx) list. Numerator: The number of patients in the denominator with at least one prescription entered. Exclusion: Providers who write fewer than 100 prescriptions during the EHR reporting period. Practice Fusion Workflow: From the Plan tab of your SOAP note, click Add Medication and find your medication. Be sure to include a SIG code, then click Print Rx, Record Rx or Send e-rx. Dashboard tip: Include a SIG code for medications that you prescribe. If you are not prescribing the medication, write the frequency in the Med comment field. Alternate CMS measure: You may attest to an alternate Core 1 measure for Visit the Help Forum to learn about this alternate measure. Core 2: Drug Interaction Checks Objective: Implement drug-drug and drug-allergy interaction checks for the entire EHR reporting period. Dashboard tip: You automatically meet this measure by using Practice Fusion. You can adjust your alert settings in the Permissions tab of the settings section (click the gear icon), but you must leave severe alerts on.

3 Core 3: Maintain Problem List Denominator: Number of unique patients seen during the EHR reporting period. Numerator: Number of patients in the denominator who have at least one diagnosis recorded in the diagnosis list (Dx History) or have the No Active Diagnosis box checked. Practice Fusion Workflow: From the Assessment tab of a SOAP note, click Add Diagnosis and search for a diagnosis. Click Save or Save and Prescribe. Dashboard tip: If the patient has no diagnoses, mark the "No Active Diagnoses" box in their Dx History to receive credit. Leaving the problem list empty does not satisfy this measure. Core 4: e-prescribing Denominator: Number of prescriptions written for drugs other than controlled substances during the EHR reporting period. Numerator: Number of prescriptions from the denominator that are generated and transmitted electronically. Exclusion: Providers who write fewer than 100 prescriptions during the EHR reporting period or if no pharmacies accept e-prescriptions within 10 miles of the practice location at the start of the reporting period. Practice Fusion Workflow: Click Add Medication from the Plan tab of a SOAP note or the New button from the Rx List. Find your medication, select a pharmacy, and click e-prescribe. Dashboard tip: Controlled substances, durable medical equipment and compound drugs cannot be e-prescribed and thus are not included in the Dashboard calculations. Core 5: Active Medication List Denominator: Number of unique patients seen during the EHR reporting period. Numerator: Number of patients in the denominator with at least one medication entered in the medication (Rx) list or the No Active Medications box checked. Practice Fusion Workflow: If you are prescribing, click Add Medication from the Plan tab of your SOAP note and search for a medication. If you are updating the patient's medication history, go their Rx List and click New. Find the medication and click Save. Dashboard tip: If the patient has no medications, check "No Active Medications" in their Rx List to receive credit. Leaving the medication list empty does not satisfy this measure.

4 Core 6: Medication Allergy List Denominator: Number of unique patients seen during the EHR reporting period. Numerator: Number of patients in the denominator with at least one drug allergy entered in the Allergies list or the No Known Drug Allergies box checked. Practice Fusion Workflow: In the Subjective tab of a SOAP note, click on Add Allergy and search for a drug allergy. If the patient is allergic to a drug group, select any individual drug from that group. Dashboard tip: If the patient has no drug allergies, mark the "No Known Drug Allergies" box on their Allergies list to receive credit. Food allergies, environmental allergies or any allergies entered in the PMH list does not satisfy this measure. Core 7: Record Demographics Denominator: Number of unique patients seen during the EHR reporting period. Numerator: Number of patients in the denominator who have the following demographics recorded in the Basic section: preferred language, gender, race, ethnicity, and date of birth. Practice Fusion Workflow: Enter all patient demographics in the Basic section of their chart. You can choose multiple races if applicable to the patient. Dashboard tip: Indicating that ethnicity is not specified does not satisfy this measure. Core 8: Vital Signs Denominator: Number of unique patients over two years of age seen during the EHR reporting period. Numerator: Number of patients in the denominator who have at least one entry of their height, weight and blood pressure recorded as structured data in a SOAP note. Exclusion: Providers who see no patients two years or older or providers for whom height, weight, and blood pressure have no relevance to their scope of practice. Practice Fusion Workflow: Click Start a chart note from the patient chart, choose 'SOAP note' and enter all their vitals on the following screen. Alternate CMS measure: You may attest to an alternate Core 8 measure for Visit the Help Forum to learn about this alternate measure.

5 Core 9: Smoking Status Denominator: Number of unique patients 13 years or older seen during the EHR reporting period. Numerator: Number of patients in the denominator who have smoking status recorded in the Lifestyle section. Exclusion: Providers who see no patients 13 years or older. Practice Fusion Workflow: From the Lifestyle section of a patient chart, click New and select the patient's current smoking status with an effective date. Enter multiple statuses to reflect a change in smoking habits over time. Dashboard tip: Even a status of 'Unknown' will give you Dashboard credit as long as it is recorded. Core 10: Clinical Quality Measures Not required for Stage 1 in 2013 This measure is no longer included in the core criteria. You still must report clinical quality measures (CQMs) to CMS during attestation as the last step, using the ONC Stage 1 - CQM report in the Reports section of your EHR. Learn more about CQMs. Core 11: Clinical Decision Support Objective: Implement one clinical decision support (CDS) rule and have this functionality enabled for the entire EHR reporting period. Dashboard tip: You automatically meet this measure by using Practice Fusion. Core 12: Electronic Copy of Health Information Denominator: Number of patients who request an electronic copy of their electronic health information Numerator: Number of patients who receive an electronic copy of their electronic health information within three business days. Exclusion: Providers who have no requests from patients for an electronic copy of patient health information during the EHR reporting period.

6 Practice Fusion Workflow: Enroll patients in the PHR under the Patient Actions drop-down menu in their chart. Make sure to grant your staff rights to give PHR access. Dashboard tip: Enroll all patients who request an electronic copy of their health information in the PHR. Core 13: Clinical Summaries Denominator: Number of office visits during the EHR reporting period. Numerator: Number of office visits in the denominator for which the patient is provided a clinical summary within three business days. Exclusion: Any provider who has no office visits during the EHR reporting period. Practice Fusion Workflow: Enroll patients in the PHR under the Patient Actions drop-down menu in their chart. Make sure to grant your staff rights to give PHR access. Dashboard tip: You can also print the patient chart (click on Summary) or the SOAP note to receive credit. Include diagnoses, medications, allergies and any relevant lab results in the clinical summary, at the minimum. Core 14: Exchange Clinical Information Not required for Stage 1 in 2013 Core 15: Protect Electronic Health Information Objective: Conduct a security risk analysis and implement security updates as necessary. Practice Fusion Workflow: Download the Privacy & Security Audit and follow the instructions. Be sure to save these documents and any other documents related to practice security (e.g. receipts for new security software) for your records. Dashboard tip: Manually indicate that you have completed the privacy and security audit, then click Save to receive credit for this measure.

7 Menu 1: Drug Formulary Checks Objective: Implement drug formulary checks and ensure that this functionality is enabled for your entire EHR reporting period. Exclusion: Providers who write fewer than 100 prescriptions during the EHR reporting period. Practice Fusion Workflow: Enroll in e-prescribing and enter a valid 10-digit NPI under your individual Identifiers section under Setup (click the gear icon) to enable Drug Formulary. Dashboard tip: In order to achieve this measure, your reporting period start date must be on or after the date you were enabled to e-prescribe. Download the erx signup form. Menu 2: Clinical Lab Test Results Denominator: Total number of lab tests ordered during the EHR reporting period. Numerator: Number of lab test results whose results are expressed as positive or negative or as a number and stored in the Labs section. Exclusion: Providers who order no lab tests with results that are either in positive/negative or numeric format during the EHR reporting period. Practice Fusion Workflow: Order labs for patients and sign the results in the Labs section to ensure you receive credit. Dashboard tip: Manually enter your total number of lab orders in the denominator, then click Save to receive credit. PDF results received in the Documents section do not count as structured data. Menu 3: Patient Lists Objective: Generate a report listing patients with a specific diagnosis. Practice Fusion Workflow: Run the Patient Lists Report for a specific problem in the Reports section. Dashboard tip: The provider qualifying for Meaningful Use must run this report under their own username to receive credit.

8 Menu 4: Send Patient Reminders Denominator: Number of unique patients over 65 and under 5 with records maintained in Practice Fusion. Numerator: Number of patients in the specified age range that are sent a HIPAA compliant reminder for preventative or follow-up care. Exclusion: Providers who have no patients 65 years old or older or 5 years old or younger with records maintained in the EHR. Practice Fusion Workflow: Identify patients in the age range using the Patient Lists report and send a reminder via , mail, or phone for preventative or follow-up care. Make sure to track the reminders sent for your records. Dashboard tip: Click on the Patient reminder sent button under the Appointments tab in the patient chart to receive Dashboard credit for the patients you have contacted. Menu 5: Patient Electronic Access Denominator: Number of unique patients seen during the EHR reporting period. Numerator: Number of patients in the denominator who receive electronic access to their health information within four business days of their visit. Exclusion: Providers that neither order nor create lab tests or information that would be contained in your problem list, medication list or medication allergy list during the EHR reporting period. Practice Fusion Workflow: Enroll patients in the PHR under the Patient Actions drop-down menu in their chart. Make sure to grant your staff rights to give PHR access. Menu 6: Patient-Specific Education Resources Denominator: Number of unique patients you see during the EHR reporting period. Numerator: Number of patients in the denominator who are provided patient-specific education resources using Practice Fusion. Practice Fusion Workflow: Click on the Patient Education button in any diagnosis or medication window and provide the resources to the patient.

9 Dashboard tip: Providers can share education materials with patients in any HIPAA compliant manner (i.e. printed or delivered verbally). Menu 7: Perform Medication Reconciliation Denominator: Number of transitions of care during the EHR reporting period for which you were the receiving party of the transition Numerator: Number of transitions of care in the denominator where medication reconciliation was performed Exclusion: Providers who do not receive any transitions of care during the EHR reporting period. Practice Fusion Workflow: Make sure to mark the "Med list reconciled" checkbox on the Finalization tab of the SOAP note to receive credit. Dashboard tip: The checkbox will only appear for the first SOAP note of a new patient or a SOAP note created after a CCR/CCD file is uploaded and linked to a patient. Menu 8: Transition of Care Summaries Denominator: Number of transitions of care and referrals made during the EHR reporting period. Numerator: Number of transitions of care and referrals where a summary of care record was provided. Exclusion: Providers who neither transfer a patient to another setting nor refer a patient to another provider during the EHR reporting period. Practice Fusion Workflow: Select the "Transition of Care" box under Visit Type(s) in the Finalization tab of the SOAP note, and then click Send referral/response letter. Choose the recipient and send the summary of care. Dashboard tip: If the receiving provider is unknown, you can receive Dashboard credit by sending the referral letter directly to the patient or by enrolling them in the PHR so they can access the summary of care record themselves.

10 Note: The following two measures are public health measures. You must attest to at least one public health measure. If you are excluded from one, you must attest to the alternate measure. If you are excluded from both, you will claim an exclusion to only one of these measures during attestation. Be prepared to prove that you were eligible for exclusions from both measures. Menu 9: Immunization Registry Data Submission Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice. Exclusion: Providers who administer no immunizations during the EHR reporting period or where your state immunization registry doesn't have the ability to receive the information electronically. Practice Fusion Workflow: Check if your state can accept Practice Fusion files. If necessary, call the state registry to confirm its ability to receive immunization data in HL format and ask what their process is for electronic transmission. If they don't accept the file, you qualify for an exclusion. If they can accept the file, but you are not successful in transmitting the electronic data, you will still receive credit for this measure. Under Patient Actions, export an immunization file for a test patient and attempt to transmit it to a local immunization registry. Dashboard tip: This measure is automatically checked in the Meaningful Use Dashboard after you export the immunization record. Be sure to maintain documentation of the exchange for your records, such as a copy of the that you sent and/or an from the receiving party. Menu 10: Syndromic Surveillance Data Submission Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice. Exclusion: Providers who do not collect any reportable syndromic surveillance information on their patients during the EHR reporting period or where your local public health agency does not have the capacity to receive the information electronically. Practice Fusion Workflow: Find your local public health department and call them to see if they can accept Practice Fusion files in HL format using SFTP or HTTPS. If they are unable to accept the file, you qualify for an exclusion. If they can accept the file, but you are not successful in transmitting the electronic data, you will still receive credit for this measure.

11 Under Patient Actions, select Public Health Surveillance Export and submit it to your public health agency. If you receive an error message upon export, then the patient does not have any reportable information available. Dashboard tip: This measure is automatically checked in the Meaningful Use Dashboard after you export the immunization record. Be sure to maintain documentation of the exchange for your records, such as a copy of the that you sent and/or an from the receiving party.