Business Performance Services

Transcription

1 Title page Business Performance Services Release 11.0 July 2014 Produced in Cork, Ireland

2 Copyright notice Copyright notice Copyright 2014 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved. Publication date July 2014 Use of this documentation and related software is governed by a license agreement. This documentation and related software contain confidential, proprietary, and trade secret information of McKesson Corporation and/or one of its subsidiaries, and is protected under United States and international copyright and other intellectual property laws. Use, disclosure, reproduction, modification, distribution, or storage in a retrieval system in any form or by any means is prohibited without the prior express written permission of McKesson Corporation and/or one of its subsidiaries. This documentation and related software is subject to change without notice. Product Practice Partner, Release 11.0 Corporate address McKesson Business Performance Services 5995 Windward Parkway Alpharetta, GA Trademarks Practice Partner is a registered trademark of McKesson Corporation and/or one of its subsidiaries. All other product and company names may be trademarks or registered trademarks of their respective companies. ii Release 11.0 July 2014

3 Table of Contents Table of Contents Chapter 1 - Introduction Chapter 2 - Installing the Clinical Quality Measures Report Installing the Clinical Quality Reporting Tool Installation Notes Upgrade Instructions Installation Notes Chapter 3 - Running and Printing the Clinical Quality Measures Report Running the Clinical Quality Measures report Printing the Clinical Quality Measures report Fields and Buttons on the Clinical Quality Reporting screen Report Example Chapter 4 - Configuring the Clinical Quality Measures Report Chapter 5 - Building and Configuring the EHR Application Adding List Item Names and List Items Adding Clinical Element Names Adding clinical element names to templates Adding Health Maintenance Names Adding health maintenance procedure names to health maintenance templates. 37 Adding laboratory data test names Adding laboratory data test names to laboratory templates Adding order names Adding order names to order trees Appendix A - Diagnosis and Procedure Codes for Clinical Quality Measures Children Who Have Dental Decay or Cavities (CMS number 0075 v2) Functional Status Assessment for Complex Chronic Conditions (CMS number 0090 v3) 48 Use of Appropriate Medications for Asthma (Pediatric Core) (NQF 0036) (CMS number 0126 v2) Colorectal Cancer Screening (NQF 0034) (CMS number 0130 v2) Glossary Index July 2014 Release 11.0 iii

4 Table of Contents iv Release 11.0 July 2014

5 List of Figures List of Figures Figure 1 Login screen Figure 2 Clinical Quality Reporting screen Figure 3 Quality Measure Document screen Figure 4 Log Viewer screen Figure 5 Preview screen Figure 6 Reports screen Figure 7 Clinical Quality Measures Report example Figure 8 Report Settings screen Figure 9 Report Settings screen, with alternate name for the Asthma Control Test element Figure 10 List Names Select screen Figure 11 New List Name screen Figure 12 List Names Select screen Figure 13 List Items View screen Figure 14 List Item screen Figure 15 Clinical Element Names Select screen Figure 16 Clinical Elements Maintenance screen Figure 17 Flow/Lab/Clinical Templates screen Figure 18 Flow/Lab Templates screen Figure 19 Select Clinical Element Name screen Figure 20 Flow/Lab Templates screen Figure 21 Vital Sign Names Select screen Figure 22 Health Maintenance Procedure Name <New> screen Figure 23 Health Maintenance Templates screen Figure 24 Health Maintenance Template <Edit> screen Figure 25 Health Maintenance Procedures screen Figure 26 HM Procedure Rules <New> screen Figure 27 Health Maintenance Template <Edit> screen Figure 28 Lab Test Names screen Figure 29 Laboratory Test <New> screen Figure 30 Order Names Select screen Figure 31 Order Name <New> screen Figure 32 Order Tree screen July 2014 Release 11.0 v

6 List of Figures vi Release 11.0 July 2014

7 Chapter 1 - Introduction This guide offers step-by-step instructions on how to install, run, and configure the Practice Partner Clinical Quality Report for meaningful use. The Clinical Quality Measures report was created to help eligible professionals (EPs), hospitals, and critical access hospitals with their responses to particular measures required to qualify for meaningful use incentive payments. This guide includes the following chapters. Chapter Installing the Clinical Quality Measures Report Running and Printing the Clinical Quality Measures Report Configuring the Clinical Quality Measures Report Description This chapter explains how to install the Clinical Quality Reporting tool and update your Clinical Quality Reporting tool components. This chapter explains how to run and print the reports. This chapter explains how to change the values for the elements that print on the Clinical Quality Measures report to correspond to the values your practice is using. See the following guides for information on the requirements for the entry of clinical information that is necessary to populate the report, as well as information regarding the Meaningful Use Stage 1 and Stage 2 objectives and measures. Practice Partner EHR Meaningful Use Stage 1 Guide - Configuration and End User Training Practice Partner EHR Meaningful Use Stage 2 Guide - Configuration and End User Training 2014 and Beyond Product Documentation You can find the Practice Partner documentation referenced in this guide and the latest product documentation located on BPS Central. If you are a... customer VAR Then access the user manuals here... documentation practice%20partner July 2014 Release

8 Chapter 1 - Introduction 2 Release 11.0 July 2014

9 Chapter 2 - Installing the Clinical Quality Measures Report This chapter explains how to install or upgrade from a previous version of the Clinical Quality Measures report. In this chapter This chapter contains the following topics. Topic See page Installing the Clinical Quality Reporting Tool 4 Installation Notes 4 Upgrade Instructions 6 Installation Notes 6 July 2014 Release

10 Installing the Clinical Quality Reporting Tool Chapter 2 - Installing the Clinical Quality Measures Report Installing the Clinical Quality Reporting Tool Installation Notes Make sure that the version number of the Clinical Quality Reporting tool you are about to install exactly matches the version number of your Practice Partner server. For example, if you are using Practice Partner 11.0, you must install the Clinical Quality Reporting tool for The Clinical Quality Reporting tool is developed and configured to be run on the 32-bit version of Microsoft Office/Access. The 64-bit version of Microsoft Office is not supported. If your Practice Partner server is running the 64-bit edition of Microsoft Office, you must to uninstall it, install the 32-bit version of Microsoft Access, and then install the Clinical Quality Reporting tool. Install the Clinical Quality Reporting tool on the Practice Partner server or a client workstation. If your site uses c-tree server, longer extraction times may occur if you install the tool on a client workstation. NOTE: If you wish to install the Clinical Quality Reporting tool on a client workstation, contact Practice Partner Support for assistance. To install the Clinical Quality Reporting tool: 1. Refer to the following table for your first step. Do you have a Practice Partner - Server CD? Yes No Then... insert the CD into your server or workstation s CD-ROM drive. The License Agreement screen appears. If the License Agreement screen does not appear, complete the following steps. a. On the taskbar, click the Start button, and then click Run. The Run dialog box displays. b. Enter d:\clinical Quality Reporting\Clinical Quality Reporting v msi in Open, where d:\ is the drive letter the CD-ROM drive. c. Click the OK button. Copy the downloaded Clinical Quality Reporting.exe file to your Practice Partner server or workstation and double-click the.exe file. 2. If you don t have Microsoft Access Runtime 2010 installed on your machine, the installer will install it for you using the default location. 3. When the Microsoft Access Runtime 2010 installation is complete, click the Close button. The License Agreement screen appears. 4 Release 11.0 July 2014

11 Chapter 2 - Installing the Clinical Quality Measures Report Installation Notes 4. Select the I accept the terms in the License Agreement check box to indicate that you accept the agreement. Click the Print button to print the agreement. 5. Click the Install button. The Clinical Quality Reporting Setup screen displays the installation status. After successfully installing the tool, the Setup Wizard Complete screen appears. It displays the name and the location of the log file that is created after the installation is complete. If the installation was not successful, you can check the log file to see why it failed. 6. Click the Finish button. July 2014 Release

12 Upgrade Instructions Chapter 2 - Installing the Clinical Quality Measures Report Upgrade Instructions Installation Notes Run the CQM report for your 2011 measures (that is, the measures supported in Practice Partner 9.5.2) and retain copies of your existing CQM reports before upgrading. The CQM Report for Practice Partner 11.0 supports the new 2014 CQM measures. After upgrading, you will not be able to generate the report for 2011 measures. To retain copies of your existing reports, you must archive the following files prior to updating the Practice Partner Clinical Quality Reporting tool. PP Clinical Quality Reporting.accdb Cqm_Settings.accdb TMP_*.accdb (archive ALL files that start with TMP and end with.accdb) These files are located in your ppart folder (typically p:\ppart). Install the Clinical Quality Reporting tool on the Practice Partner server or a client workstation. If your site uses c-tree server, longer extraction times may occur if you install the tool on a client workstation. To upgrade the Clinical Quality Reporting tool from a previous version: 1. Upgrade your server to Practice Partner For procedural steps, see the Practice Partner Upgrade and Configuration Guide. 2. Upgrade your client workstation to Practice Partner For procedural steps, see the Practice Partner Upgrade and Configuration Guide. 3. Run a new installation of the Clinical Quality Reporting tool. For procedural steps, see To install the Clinical Quality Reporting tool: on page 4. 6 Release 11.0 July 2014

13 Chapter 3 - Running and Printing the Clinical Quality Measures Report This chapter explains how to run and print the Clinical Quality Measures report. In this chapter This chapter contains the following topics. Topic See page Running the Clinical Quality Measures report 8 Printing the Clinical Quality Measures report 15 Fields and Buttons on the Clinical Quality Reporting screen 16 Report Example 19 July 2014 Release

14 Running the Clinical Quality Measures report Chapter 3 - Running and Printing the Clinical Quality Measures Running the Clinical Quality Measures report RxNorm codes are required for measures that include medication lists as a part of their criteria. The first time you log in, a data file containing medications and their RxNorm codes will be downloaded and automatically imported into the Clinical Quality Reporting tool. The data file will be used to link your patients medications to RxNorm codes for reporting purposes. The clinical data extraction process will determine if recently extracted data can be reused for the selected measures. If data can be reused, you can select to reuse the data or extract new data. Reusing data from the previous extraction date can save time when generating the report. However changes made in Practice Partner since the previous extraction date will not be reflected in the measures scores. To run the Clinical Quality Measures report: 1. Click Start > All Programs > McKesson > Practice Partner > Clinical Quality Reporting. The Login screen appears. 2. Enter your Practice Partner user ID and password in the User ID and Password fields. Figure 1. Login screen 8 Release 11.0 July 2014

15 Chapter 3 - Running and Printing the Clinical Quality Measures Report Running the Clinical Quality Measures report 3. Click the OK button. The Clinical Quality Reporting screen appears. Figure 2. Clinical Quality Reporting screen July 2014 Release

16 Running the Clinical Quality Measures report Chapter 3 - Running and Printing the Clinical Quality Measures 4. Optionally, click the? icon next to a measure to view the Quality Measure Document screen that contains all the CMS requirements for the measure. Figure 3. Quality Measure Document screen 5. In the Measures area, select the check boxes for the clinical quality measures you want to include in the report. 6. In the Extract area, choose the desired settings for the patient clinical data that will be retrieved out of your Practice Partner database. a. Enter the dates for which you want to extract patient clinical data in the Extract From Date and Extract To Date fields, or click the calendar to select the desired time period. b. Leave the Automatically Summarize check box selected if you want the Clinical Quality Reporting tool to automatically summarize patient clinical data after extracting it from the Practice Partner database. Clear the check box to disable this functionality. c. Click the Extract Data button to start the extraction process. If any recently extracted data can be reused, the Reuse Extracted Data message appears. Click the... Yes button No button To... reuse the data. extract new data. 10 Release 11.0 July 2014

17 Chapter 3 - Running and Printing the Clinical Quality Measures Report Running the Clinical Quality Measures report The Log Viewer screen appears, displaying the progress of the data extraction. Figure 4. Log Viewer screen 5. After the data extraction, click the Close button to close the Log Viewer screen. 6. In the Summarize area, enter the dates for which you want to run the report in the Report From Date and Report To Date fields, or click the calendar to select the desired time period. 7. Click the Summarize Data button to summarize the extracted data based on the time range you selected for the report. You do not need to summarize data if you did not change the Report From or Report To dates after the original extraction was completed and the Automatically Summarize check box was selected. 8. In the Report area, choose the desired sort option for the report: Select the... All Providers Combined option button If you want to generate a... single list of the selected clinical quality measures for all providers in your database. July 2014 Release

18 Running the Clinical Quality Measures report Chapter 3 - Running and Printing the Clinical Quality Measures Select the... By Provider option button If you want to generate a... report for a specific provider or a selection of providers. Click the Providers button to open the Choose Providers screen. Use this screen to choose the desired providers or provider groups. To select providers: a. Select the appropriate check boxes, or click the Select All button to run a report for all available providers. b. Click the Close button when you have made your selections. 9. Optional: Click the Settings button to open the Report Settings screen and configure the report. For more information, see Configuring the Clinical Quality Measures Report on page Optional: Click the Export button to create a data file in any of the following formats: - QRDA1 XML - QRDA3 XML - PDF - MS Word - MS Excel Tip: Use the search area at the bottom of the Choose Providers screen to locate the provider you want to include in the report. Click the desired format, enter the name of the output file, and click the Save button. By default, output files are saved in your Practice Partner database folder (typically p:\ppart), but you can select another location, if required. 12 Release 11.0 July 2014

19 Chapter 3 - Running and Printing the Clinical Quality Measures Report Running the Clinical Quality Measures report 11. Click the Preview button to preview to open the Preview screen and subsequently print the output of the report. Figure 5. Preview screen 12. On the Preview screen, click the Numerator/Denominator link to view a list of the patients that meet the criteria of the respective clinical quality measure. The IPP, Denom, Numerator, Exclusion, and Exception option buttons indicate whether the patient was included in the calculation of the: - initial patient population, - numerator, - denominator, or both numerator and denominator, or - did not meet numerator criteria, and, therefore, was calculated as an exclusion, or July 2014 Release

20 Running the Clinical Quality Measures report Chapter 3 - Running and Printing the Clinical Quality Measures - are an exception to respective clinical quality measure, due to an allowable reason for nonperformance of a quality measure. Figure 6. Reports screen 14 Release 11.0 July 2014

21 Chapter 3 - Running and Printing the Clinical Quality Measures Report Printing the Clinical Quality Measures report Printing the Clinical Quality Measures report Print the Clinical Quality Measures report from the Preview or Print Preview screens. To print the report from the Preview screen: 1. With the Preview screen open, select File > Print. 2. Use the following table to determine your next step: Select the... Print option Quick Print option To... select a printer. The Print screen appears. a. Select a printer. b. Click the OK button. send the report directly to your default printer without making changes to the print settings. The report is printed. To print the report from the Print Preview screen: 1. With the Print Preview screen open, click the Print button on the toolbar. The Print screen appears. 2. Select a printer. 3. Click the OK button. The report is printed. July 2014 Release

22 Fields and Buttons on the Clinical Quality Reporting screen Chapter 3 - Running and Printing the Clinical Quality Measures Fields and Buttons on the Clinical Quality Reporting screen Fields/Buttons Measures Extract Extract From Date/Extract To Date Data Last Extracted Automatically Summarize Extract Data Summarize Report From Date/Report To Date Description Select the meaningful use measure(s) you want to include in the report. Selecting these will gather and report a total population for the category, the number in that population that qualified for the meaningful use measure, and the percentage that qualified. Click the Help buttons (to the right of the measure check boxes) to open files which explain the initial patient population, numerator, denominator, exclusions, and exceptions (if applicable) for each of the measures. Enter the range of dates for which you want to extract patient clinical data or click the calendar to select the desired dates. Practice Partner will extract data pertaining only to the clinical quality measures selected in the Measures area. This field reflects the date and time when the report data was last extracted from the Practice Partner database. Select this check box if you want the Clinical Quality Reporting tool to automatically summarize patient clinical data after extracting it from the Practice Partner database. This check box is selected by default. Click this button to start the data extraction process. Note that this process can take a considerable amount of time depending on the size of your database. Enter the range of dates for which you want to run the report or click the calendar to select the desired dates. Use these fields to narrow the date range of the report if you selected a broader range for the extract data in the Extract area. This way you can run multiple reports with different report parameters (providers, report period, and so on) without having to re-extract patient clinical data every time you change the report parameters. Make sure to enter a report date range that falls within the extract date range. When you select a From and To date, all data between those dates that meet the selected criteria will be included on the report. 16 Release 11.0 July 2014

23 Chapter 3 - Running and Printing the Clinical Quality Measures Report Fields and Buttons on the Clinical Quality Reporting screen Data Last Summarized Summarize Data Report All Providers Combined By Provider Providers Settings Export This field reflects the date and time when the report data was last summarized. Click this button to summarize the extracted data based on the time range you selected for the report. Select this option button to run the report for all providers. Select this option button to run the report for (a) selected provider(s) or provider group(s). The report will be broken out for each of the selected provider/provider group. For example, if you are running the report for five providers, there will be five denominator/numerator sets for each measure. Click this button to open the Choose Providers screen. Use this screen to select the provider(s) or provider group(s) for which you want to run the report. Select the appropriate check boxes or click the Select All button to include all providers in the report. Use the search area at the bottom of the screen to locate the provider you want to include in the report. Click this button to open the Report Settings screen. Use this screen to change the values for the elements that print on the report. For more information, see Configuring the Clinical Quality Measures Report on page 21. Click this button to create a data file in any of the following formats. Option QRDA1 XML QRDA3 XML PDF MS Word MS Excel Select this option to create... an individual-patient-level quality report using the QRDA format. The individual report(s) will be added to a.zip file and saved in the default location. an aggregate quality report using the QRDA format. The report will be added to a.zip file and saved in the default location. a PDF file. a Microsoft Word file. a Microsoft Excel file. Click the desired format, type the name of the output file, and click the Save button. By default, output files are saved in your Practice Partner database folder (typically p:\ppart) but you can select another location, if required. July 2014 Release

24 Fields and Buttons on the Clinical Quality Reporting screen Chapter 3 - Running and Printing the Clinical Quality Measures Preview Exit Click this button to run the report. Click this button to close the screen. 18 Release 11.0 July 2014

25 Chapter 3 - Running and Printing the Clinical Quality Measures Report Report Example Report Example The following diagram illustrates an example of the printed Clinical Quality Measure report. Figure 7. Clinical Quality Measures Report example July 2014 Release

26 Report Example Chapter 3 - Running and Printing the Clinical Quality Measures 20 Release 11.0 July 2014

27 Chapter 4 - Configuring the Clinical Quality Measures Report You can change the values for the elements that are included on the Clinical Quality Measures report to correspond to the values your practice is using. To configure the Clinical Quality Measures Report: 1. Click the Settings button on the Clinical Quality Reporting screen. The Report Settings screen appears. Figure 8. Report Settings screen 2. The Category pane lists the elements that you can configure for the report. Click the plus sign (+) to expand the desired item, and then enter the appropriate value in the Value pane. You can enter an unlimited number of values for the following elements: allergy codes clinical element results or user-entered values that go into a clinical element record (for example, you can define the following result values for clinical element Asthma Stage Element Result: Mild Persistent, Moderate Persistent, and Severe Persistent). July 2014 Release

28 Chapter 4 - Configuring the Clinical Quality Measures Report condition diagnosis codes encounters medications notes prenatal procedure codes vaccines Note: Values must be delimited by commas and surrounded individually by single quotes. You can enter only ONE name for the following elements: allergy names (with the exception of the Pneumococcal Vaccine and Influenza Vaccine Allergy names) clinical element names Health Maintenance names lab names procedure names vital signs 22 Release 11.0 July 2014

29 Chapter 4 - Configuring the Clinical Quality Measures Report Note: Do not surround names by quotes. Figure 9. Report Settings screen, with alternate name for the Asthma Control Test element 3. Click the Reset to Default button if you want to restore the default value for the selected item. 4. Click the Close button to apply the changes you made to the report settings. July 2014 Release

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31 Chapter 5 - Building and Configuring the EHR Application IMPORTANT: Calculations for the 11 Clinical Quality Measures described in this chapter have been tested in McKesson s internal test environments and appear to function correctly. This chapter will be updated as more information is obtained for the remainder of the Clinical Quality Measures. Some known defects exist in some of the measures and are being investigated. Resolutions will be released in the form of patches as and when available. The following table provides information on the elements that need to be built in order to print on the Clinical Quality Measures report. NOTE: Any clinical element listed below can be entered using any name of your choice as long as it is linked to the specific LOINC or SNOMED code listed. Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan (NQF 0418) (CMS number 0002 v3) Numerator Value of Positive or Negative in clinical element field ADULT DEPRESSION SCREEN or ADOLESCENT DEPRESSION SCREEN entered on same date as that of the visit. If Positive, then the patient must have either of the following: a suicide risk assessment (procedure linked to SNOMED code ) within a day OR an anti-depressant prescription (in the current medication list). Denominator All patients 12 years of age and older with a clinical encounter type of Office Visit. Exclusion Patients who already have been diagnosed with Major Depression and/ or Bipolar Disorder. Build and Configuration Clinical elements: ADULT DEPRESSION SCREEN linked to LOINC code and ADOLESCENT DEPRESSION SCREEN linked to LOINC code List item: DEPRESSION SCREENING RESULTS with a drop-down list with the following values: Negative and Positive. Negative linked to SNOMED code and Positive linked to SNOMED code Closing the Referral Loop: Receipt of Specialist Report (CMS number 050 v2) Numerator An entry for clinical element Consultant Report with any value during the measurement period. July 2014 Release

32 Chapter 5 - Building and Configuring the EHR Application Closing the Referral Loop: Receipt of Specialist Report (CMS number 050 v2) Denominator Build and Configuration All patients with one or more clinical encounter during the measurement period with a completed order for REFERRAL TO PROVIDER. Order name: REFERRAL TO PROVIDER and clinical element: Consultant Report linked to SNOMED code Functional Status Assessment for Hip Replacement (CMS number 0056 v2) Numerator Any value in clinical element field Func Stat Joint Replacement entered on the same date as that of the office visit. Denominator All patients 18 years and older, who have had a total hip arthroplasty (THA) within 180 days before or 180 days after the reporting period with at least one clinical encounter type of Office Visit and either 180 days before the THA OR between 60 days and 180 days after THA. NOTE: CPT procedure code (Primary THA Procedure) is required in the Problem List. Build and Configuration Clinical element: Func Stat Joint Replacement linked to LOINC code Functional Status Assessment for Knee Replacement (CMS number 0066 v2) Numerator Any value in clinical element field Func Stat Joint Replacement entered on the same date as that of the office visit. Denominator All patients 18 years and older, who have had a total knee arthroplasty (TKA) within 180 days before or 180 days after the reporting period with at least one clinical encounter type of Office Visit and either 180 days before the TKA OR between 60 days and 180 days after TKA. NOTE: CPT procedure code (Primary TKA Procedure) is required in the Problem List. Build and Configuration Clinical element: Func Stat Joint Replacement linked to LOINC code Release 11.0 July 2014

33 Chapter 5 - Building and Configuring the EHR Application Children Who Have Dental Decay or Cavities (CMS number 0075 v2) Numerator A diagnosis of Dental Caries on the Problem List dated before the end of the measurement period, and did not end before the start of the measurement period. For a list of Dental Caries diagnosis codes that count for this measure, see Children Who Have Dental Decay or Cavities (CMS number 0075 v2) on page 45. Denominator All patients 20 years old and younger at the start of the measurement period, who have a clinical encounter during the measurement period. Build and None. Configuration Functional Status Assessment for Complex Chronic Conditions (CMS number 0090 v3) Numerator Any value in the clinical element field Func Stat Heart Failure with the same date as both clinical encounters. Denominator All patients 65 years or older at the start of the measurement period who have two clinical encounters during the measurement period, as well as an active diagnosis of Heart Failure. To see a list of Heart Failure diagnosis codes that count for this measure, see Functional Status Assessment for Complex Chronic Conditions (CMS number 0090 v3) on page 48. Exclusions All patients in the denominator who have on their Problem Lists one of the following diagnoses that is active any time before the end of the measurement period. Severe Dementia OR Cancer Build and Configuration Clinical Element: Func Stat Heart Failure linked to LOINC code Use of Appropriate Medications for Asthma (Pediatric Core) (NQF 0036) (CMS number 0126 v2) Numerator A prescription for at least one preferred generic asthma therapy on the current medication list during the measurement period. July 2014 Release

34 Chapter 5 - Building and Configuring the EHR Application Use of Appropriate Medications for Asthma (Pediatric Core) (NQF 0036) (CMS number 0126 v2) Denominator All patients ages 5-64 who have an active diagnosis of Persistent Asthma on their Problem Lists and who have a clinical encounter during the measurement period. To see a list of Persistent Asthma diagnosis codes that count for this measure, see Use of Appropriate Medications for Asthma (Pediatric Core) (NQF 0036) (CMS number 0126 v2) on page 52. NOTE: On the report, the metric is broken down into the following age ranges: 5-64, 5-11, 12-18, 19-50, and Exclusions Build and Configuration All patients in the denominator who have on their Problem Lists one of the following active diagnoses, that starts before the end of the measurement period and that does not end before the start of the measurement period. Chronic Obstructive Pulmonary Disease Emphysema Cystic Fibrosis Acute Respiratory Failure None. Pneumonia Vaccination Status for Older Adults (NQF 0043) (CMS number 0127 v2) Numerator At least one of the following on the Health Maintenance List before the end of the measurement period: Pneumococcal vaccine (for example, PNEUMOCOCCAL POLY or PNEUMOVAX) with Status = X or E Denominator All patients 65 years and older at the start of the measurement period, who have had a clinical encounter during the measurement period. Build and Configuration Health Maintenance: Any pneumococcal vaccine name (for example, PNEUMOCOCCAL POLY or PNEUMOVAX), linked to code 33 and code type CVX. 28 Release 11.0 July 2014

35 Chapter 5 - Building and Configuring the EHR Application Colorectal Cancer Screening (NQF 0034) (CMS number 0130 v2) Numerator One of the following procedures on the problem list: Colonoscopy in the 10 years prior to the end of the measurement period Flexible Sigmoidoscopy in the 5 years prior to the end of the measurement period To see a list of Colonoscopy and Flexible Sigmoidoscopy procedure codes that count for this measure, see Colorectal Cancer Screening (NQF 0034) (CMS number 0130 v2) on page 52. Denominator All patients years old at the start of the measurement period, who have had a clinical encounter anytime in the two years before the end of the measurement period. Exclusions Patients in the denominator who have had one of the following before the end of the measurement period. An active, inactive, or resolved diagnosis for Malignant Neoplasm of Colon Total Colectomy Build and None. Configuration Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (NQF 0028) (CMS number 0138 v2) Numerator The patient is assessed as a smoker in Vitals, and the clinical element Tobacco Intervention check box is selected (value Y) OR a medication is prescribed for tobacco use cessation in the 24 months prior to the end of the measurement period. Denominator Patients who are 18 years or older who have at least two clinical encounters during the measurement period. Exceptions An assessment for tobacco use was not done for medical reasons, or the patient received a diagnosis of Limited Life Expectancy before the end of the measurement period. Build and Clinical element: Tobacco Intervention check box. Configuration Falls: Screening for Future Fall Risk (NQF 0101) (CMS number 0139 v2) Numerator A risk category assessment for Falls Screening with any value during the measurement period. July 2014 Release

36 Adding List Item Names and List Items Chapter 5 - Building and Configuring the EHR Application Falls: Screening for Future Fall Risk (NQF 0101) (CMS number 0139 v2) Denominator Exceptions Build and Configuration Adding List Item Names and List Items All patients 65 years and older at the start of the measurement period, who have had a clinical encounter during the measurement period. A risk category assessment is not done for medical reasons. For example, the Problem List has an entry for Patient Not Ambulatory before the end of the measurement period, and that problem does not end before the start of the measurement period. Clinical element: Falls Screening linked to LOINC code To add a list item name: 1. In Patient Records, select Maintenance > Templates > List Maintenance. The List Names Select screen appears. Figure 10. List Names Select screen 2. Click the New button. The New List Name screen appears. Figure 11. New List Name screen 3. Enter the new list name in the Name field. 4. Click the OK button. 30 Release 11.0 July 2014

37 Chapter 5 - Building and Configuring the EHR Application Adding List Item Names and List Items 5. Select the added list item name. Figure 12. List Names Select screen 6. Click the Edit button. The List Items View screen appears. Figure 13. List Items View screen July 2014 Release

38 Adding Clinical Element Names Chapter 5 - Building and Configuring the EHR Application 7. Click the New button. The List Item screen appears. Figure 14. List Item screen 8. Enter the list item s name in the Name field. 9. Optional Link the list item to a SNOMED or LOINC code. 10. Click the OK button. 11. Repeat steps 7-10 until you have added all list items. Adding Clinical Element Names To add a clinical element name: 1. In Patient Records, select Maintenance > Templates > Clinical Element Names. The Clinical Element Names Select screen appears. Figure 15. Clinical Element Names Select screen 32 Release 11.0 July 2014

39 Chapter 5 - Building and Configuring the EHR Application Adding clinical element names to templates 2. Click the New button. The Clinical Elements Maintenance screen appears. Figure 16. Clinical Elements Maintenance screen 3. Fill in the fields on this screen. 4. Click the Apply button. 5. Click the OK button. Adding clinical element names to templates To add a clinical element name to an existing template: 1. In Patient Records, select Maintenance > Templates > Flow/Lab/Clinical Templates. The Provider/Practice Selection screen appears. 2. Select the provider or practice whose templates you want to edit, or leave the Provider ID and Practice ID fields blank to add a universal template. July 2014 Release

40 Adding clinical element names to templates Chapter 5 - Building and Configuring the EHR Application 3. Click the OK button. The Flow/Lab/Clinical Templates screen appears. Figure 17. Flow/Lab/Clinical Templates screen 4. Select the Clinical Elements option. 5. Select an existing clinical elements template from the list. 6. Click the Edit button. The Flow/Lab Templates screen appears. Figure 18. Flow/Lab Templates screen 34 Release 11.0 July 2014

41 Chapter 5 - Building and Configuring the EHR Application Adding clinical element names to templates 7. Click the plus button (+) next to the Clinical Elements label (in the Template Category tree). The Select Clinical Element Name screen appears. Figure 19. Select Clinical Element Name screen 8. Enter the clinical element s name in the Search field. 9. Click the Search button. 10. Select the clinical element name in the list. 11. Click the OK button. The clinical element name is added to the Template Items list (on the Flow/Lab Templates screen). 12. Use the arrow buttons (on the right-hand side of the screen) to move the clinical element name to the place you want it to appear in the template. Figure 20. Flow/Lab Templates screen July 2014 Release

42 Adding Health Maintenance Names Chapter 5 - Building and Configuring the EHR Application 13. Click the OK button to save your changes and close the screen. 14. Click the Close button to close the Flow/Lab/Clinical Templates screen. Adding Health Maintenance Names To add a health maintenance name: 1. In Patient Records, select Maintenance > Templates > Health Maintenance Names. The Health Maintenance Procedure Names screen appears. Figure 21. Vital Sign Names Select screen 2. Click the New button. The Health Maintenance Procedure Name <New> screen appears. Figure 22. Health Maintenance Procedure Name <New> screen 3. Enter the name of the health maintenance procedure that you want to add in the HM Name field. 4. Fill in the rest of the fields on this screen. 5. Optional Click the More button to open the Health Maintenance More Info screen. Use this screen to add default information (such as vaccination, dose, route, and lot) about the health maintenance procedure name. Click the OK button to save the information and close the screen. 6. Click the OK button to save the information and close the Health Maintenance Procedure Name <New> screen. 36 Release 11.0 July 2014

43 Chapter 5 - Building and Configuring the EHR Application Adding health maintenance procedure names to health Adding health maintenance procedure names to health maintenance templates To add health maintenance procedure names to health maintenance templates: 1. In Patient Records, select Maintenance > Templates > Health Maintenance Templates. The Provider/Practice Selection screen appears. 2. Select the provider or practice whose templates you want to edit, or leave the Provider ID and Practice ID fields blank to add a universal template (that is, templates that can by used by all providers). 3. Click the OK button. The Health Maintenance Templates screen appears. Figure 23. Health Maintenance Templates screen 4. Select the health maintenance template that you want to edit. 5. Click the Edit button. The Health Maintenance Template <Edit> screen appears. July 2014 Release

44 Adding health maintenance procedure names to health maintenance templates Chapter 5 - Building and Configuring the EHR Figure 24. Health Maintenance Template <Edit> screen 6. Click the New Proc button. The Health Maintenance Procedures screen appears. 7. Select the health maintenance procedure name that you want to add to the template. Figure 25. Health Maintenance Procedures screen 8. Click the OK button. The HM Procedure Rules <New> screen appears. 38 Release 11.0 July 2014

45 Chapter 5 - Building and Configuring the EHR Application Adding health maintenance procedure names to health Figure 26. HM Procedure Rules <New> screen 9. Fill in the fields on this screen. 10. Click the OK button to save the information and close the screen. The selected procedure is added to the Health Maintenance Template <Edit> screen. July 2014 Release

46 Adding laboratory data test names Chapter 5 - Building and Configuring the EHR Application Figure 27. Health Maintenance Template <Edit> screen 11. Click the OK button to close the screen. The Health Maintenance Templates screen appears. 12. Click the Close button to close the screen. Adding laboratory data test names To add a laboratory data test name: 1. Select Maintenance > Templates > Lab Data Test Names. The Lab Test Names screen appears. Figure 28. Lab Test Names screen 2. Click the New button. The Laboratory Test <New> screen appears. 40 Release 11.0 July 2014

47 Chapter 5 - Building and Configuring the EHR Application Adding laboratory data test names to laboratory templates Figure 29. Laboratory Test <New> screen 3. Enter the name of the lab test that you want to add in the Test Name field. 4. Fill in the rest of the fields on this screen. 5. Click the OK button to save your changes and close the screen. Adding laboratory data test names to laboratory templates To add a lab data test name to a laboratory template: 1. In Patient Records, select Maintenance > Templates > Flow/Lab/Clinical Templates. The Provider/Practice Selection screen appears. 2. Select the provider or practice whose templates you want to edit, or leave the Provider ID and Practice ID fields blank to add a universal template. 3. Click the OK button. The Flow/Lab/Clinical Templates screen appears. 4. Use the following table to determine your next step: Select the... Lab Review option button Lab Table option button To add a lab data test name to an existing... lab review template. lab table template. 5. Select the template that you want to edit in the list. 6. Click the Edit button. The Flow/Lab Templates screen appears. 7. Click the plus sign (+) next to the Laboratory Data label (in the Template Category tree). The Lab Test Names screen appears. 8. Search for the lab data test that you want to add to the template, or scroll through the list. 9. Click the OK button. The lab data test name is added to the Template Items list (on the Flow/ Lab Templates screen). 10. Use the arrow buttons (on the right-hand side of the screen) to move the lab data test name to the place you want it to appear in the template. July 2014 Release

48 Adding order names Chapter 5 - Building and Configuring the EHR Application 11. Click the OK button to save your changes and close the screen. Adding order names To add an order name: 1. In Patient Records, select Maintenance > Templates > Order Templates > Order Names. The Order Names Select screen appears. Figure 30. Order Names Select screen 2. Click the New button. The Order Name <New> screen appears. Figure 31. Order Name <New> screen 42 Release 11.0 July 2014

49 Chapter 5 - Building and Configuring the EHR Application Adding order names to order trees 3. Select an order type option (Single Order, Visible Order Set, or Hidden Order Set). 4. Enter the name of the order that you want to add in the Order Name field. 5. Fill in the rest of the fields on this screen. 6. Click the OK button save your changes and close the screen. 7. Click the Close button to close the Order Names Select screen. Adding order names to order trees McKesson recommends adding new order names to your order tree(s) to provide quick access to the tests used most frequently. To add an order name to an order tree: 1. Select Maintenance > Templates > Order Templates > Order Trees. The Provider / Practice Selection screen appears. 2. Select the provider or practice whose templates you want to edit, or leave the Provider ID and Practice ID fields blank to add a universal template (that is, templates that can by used by all providers). 3. Click the OK button. The Order Tree screen appears. Figure 32. Order Tree screen 4. The default order tree appears in the box to the right of the screen. 5. In the Order Name box, highlight the order that you want to add. 6. Click the Insert button. The order appears in the box on the right. 7. To move an order in the order tree, in the box on the right, highlight the order and: - To move the order left or right in the order hierarchy, click the left arrow (<) or right arrow (>) buttons. July 2014 Release

50 Adding order names to order trees Chapter 5 - Building and Configuring the EHR Application - To move the order up or down in the order hierarchy, click the up arrow or down arrow buttons. The first level in the order hierarchy, denoted by the plus sign (+) to the left of the level, should always be Order Tree. All orders in the hierarchy should be subordinate to Order Tree. 8. Click the OK button to save your changes and close the screen. 44 Release 11.0 July 2014

51 Appendix A - Diagnosis and Procedure Codes for Clinical Quality Measures This appendix provides lists of diagnosis or procedure codes that count for the following measures. Topic See page Children Who Have Dental Decay or Cavities (CMS number 0075 v2) 45 Functional Status Assessment for Complex Chronic Conditions (CMS number v3) Use of Appropriate Medications for Asthma (Pediatric Core) (NQF 0036) (CMS number 0126 v2) Colorectal Cancer Screening (NQF 0034) (CMS number 0130 v2) 52 Children Who Have Dental Decay or Cavities (CMS number 0075 v2) Code System Code Description ICD10CM K02.3 Arrested dental caries ICD10CM K02.51 Dental caries on pit and fissure surface limited to enamel ICD10CM K02.52 Dental caries on pit and fissure surface penetrating into dentin ICD10CM K02.53 Dental caries on pit and fissure surface penetrating into pulp ICD10CM K02.61 Dental caries on smooth surface limited to enamel ICD10CM K02.62 Dental caries on smooth surface penetrating into dentin ICD10CM K02.63 Dental caries on smooth surface penetrating into pulp ICD10CM K02.7 Dental root caries ICD10CM K02.9 Dental caries, unspecified ICD9CM Dental caries, unspecified ICD9CM Dental caries limited to enamel ICD9CM Dental caries extending into dentine ICD9CM Dental caries extending into pulp ICD9CM Arrested dental caries ICD9CM Odontoclasia 52 July 2014 Release

52 Children Who Have Dental Decay or Cavities (CMS number 0075 v2) Appendix A - Diagnosis and Procedure Codes for Clinical Code System Code Description ICD9CM Dental caries pit and fissure ICD9CM Dental caries of smooth surface ICD9CM Dental caries of root surface ICD9CM Other dental caries SNOMEDCT Dental caries associated with enamel hypomineralization (disorder) SNOMEDCT Dental caries associated with enamel hypoplasia (disorder) SNOMEDCT Dental caries secondary to developmental defects of tooth structure (disorder) SNOMEDCT Dental caries secondary to acquired defects of tooth structure (disorder) SNOMEDCT Primary dental caries, indeterminate origin (disorder) SNOMEDCT Caries of infancy associated with bottle feeding (disorder) SNOMEDCT Incipient enamel caries (disorder) SNOMEDCT On examination - dental caries (disorder) SNOMEDCT Acute dentine dental caries (disorder) SNOMEDCT Chronic dentine dental caries (disorder) SNOMEDCT Acute enamel dental caries (disorder) SNOMEDCT Chronic enamel dental caries (disorder) SNOMEDCT Odontoclasia (disorder) SNOMEDCT Rampant dental caries (disorder) SNOMEDCT Cementum caries (disorder) SNOMEDCT Caries involving multiple surfaces of tooth (disorder) SNOMEDCT Dental caries extending into dentine (disorder) SNOMEDCT Complex dental caries (disorder) SNOMEDCT Enamel caries (disorder) SNOMEDCT Arrested dental caries (disorder) SNOMEDCT Dental caries (disorder) SNOMEDCT Salivary dysfunction caries secondary to aging (disorder) SNOMEDCT Salivary dysfunction caries secondary to medication (disorder) SNOMEDCT Salivary dysfunction caries secondary to radiation therapy (disorder) 46 Release 11.0 July 2014