Meaningful Use - Stage 1 And Practice Maximus The following explains how Practice Maximus certified EHR module allows user to achieve meaningful use objectives for Stage 1. Eligible Professionals (EP) must complete: 15 core objectives 5 objectives out of 10 from a menu set 6 Clinical Quality Measures (3 core or alternate and 3 alternate) (Note exclusions for some objective are permitted based on EP clinical practice) Page 1 of 51
Core Objectives EPs are required to meet all core objectives. However, some core objectives may not be applicable to the EPs clinical practice. EPs will satisfy these objectives by attesting to their exclusion. Page 2 of 51
1. CPOE (Computer physician order entry) for medication orders Medication orders are placed using the E-Prescribe option within the patient s EHR record listing. After choosing E-Prescribe, you will be directed to Practice Maximus direct interface with certified E-Prescribing internet portal DrFirst. Medication orders are entered via the DrFirst prescribing portal. Page 3 of 51
2. Drug-drug and Drug-allergy interaction checks Drug and allergy checks are performed via the DrFirst E-prescribing portal. Allergies can be recorded on the DrFirst site. Page 4 of 51
2. Drug-drug and Drug-allergy interaction checks (continued) Allergies recorded on DrFirst are shown within the patient s EHR record in Practice Maximus. Page 5 of 51
3. Maintain an up-to-date problem list of current and active diagnoses Diagnoses are entered on the Assessment/Plan tab of the patient s EHR record. Page 6 of 51
3. Maintain an up-to-date problem list of current and active diagnoses (continued) In addition, non ophthalmic diagnosis can also be recorded on the DrFirst site. Page 7 of 51
4. Generate and transmit permissible prescriptions electronically (erx) Electronic prescriptions are placed using the E-Prescribe option within the patient s EHR records listing. After choosing E-Prescribe, you will be directed to Practice Maximus direct interface with certified E-Prescribing internet portal DrFirst. Prescriptions are entered via the DrFirst prescribing portal and electronically sent to the patient s pharmacy. Page 8 of 51
5. Record demographics Demographics are recorded on the demographics tab on the patient record. Page 9 of 51
6. Maintain active medication list Active medications can be maintained via the DrFirst E-prescribing portal. Medications are automatically transferred to the patient s EHR record in Practice Maximus. Page 10 of 51
6. Maintain active medication list (continued) A patient s active medication list can be viewed from the E-Prescribing tab in on the History tab of the patient s EHR record. Page 11 of 51
7. Maintain active medication allergy list Active medication allergies can maintained via the DrFirst E-prescribing portal. Allergies are automatically transferred to the patient s EHR record in Practice Maximus. Page 12 of 51
7. Maintain active medication allergy list (continued) A patient s allergies can be viewed from the E-Prescribing tab in on the History tab of the Patient s EHR record. Page 13 of 51
8. Record and chart vital signs Vital signs are recorded on the Health Info tab of the patient s EHR record. Page 14 of 51
9. Record smoking status for patients 13 years old or older Smoking status is recorded on the Health Info tab of the patient s EHR record. Page 15 of 51
10. Implement one clinical decision support rule Clinical rules can setup for implementation thru the Setup Menu EHR tab under Clinical Rules. Page 16 of 51
10. Implement one clinical decision support rule (continued) If the patient meets the criteria setup for the clinical decision rule, the message entered for the rule will be displayed prior to saving or exiting the patient s EHR record. Page 17 of 51
11. Report clinical quality measures to CMS/states Practice Maximus accumulates statistics for Clinical Quality Measures: NQF 0013, NQF 0024, NQF 0028, NQF 0038, NQF 0041, NQF 0086, NQF 0088, NQF 0089 and NQF 0421. To calculate the Clinical Quality Measures, choose EHR from the Reports Menu. After entering the reporting date range and the doctor you are reporting for, hit print. Page 18 of 51
11. Report clinical quality measures to CMS/states (continued) A save file dialogue box will display. The saved Clinical Quality Measure Statistics file in XML format (Extensible Markup Language) can be submitted to the proper agency. Page 19 of 51
12. Provide patients with an electronic copy of their health information upon request You can provide an electronic copy of patients health information using DropBox. DropBox is a free web based file hosting service operated by DropBox, Inc. From the EHR menu choose the Summary option. Highlight the EHR and choose the Upload Summary to DropBox option Page 20 of 51
12. Provide patients with an electronic copy of their health information upon request (continued) The save file dialogue box will be displayed with the encrypted file name, hit save. A notification message will display indicating an email was sent to the patient with a link to view an electronic copy of their health information. Page 21 of 51
13. Provide clinical summaries for patients for each office visit To provide a clinical summary for a patient, from the EHR menu choose the Summary option. Highlight the EHR and choose the Create Clinical Summary option Page 22 of 51
13. Provide clinical summaries for patients for each office visit (continued) The save file dialogue box will be displayed with the encrypted file name, hit save. The displayed print dialogue box allows the option of printing the summary to screen or printer. Page 23 of 51
14. Capability to exchange key clinical information Practice Maximus has several options for the exchange of clinical information. All options are contained within the EHR menu Immunization tab allows for import and export in HL7 (Health Level Seven) format. Page 24 of 51
14. Capability to exchange key clinical information (continued) Summary tab allows for read and display of CCD (Continuity of Care Document) and CCR (Continuity of Care Record) files. In addition, the XML (Extensible Markup Language) file created in the Clinical Summary can also be used for exchange. Page 25 of 51
15. Protect electronic health information Electronic health information is protected by encryption, when exchanging health information. Extensive password protected users, time out limitations and user access restrictions add to the protection levels provided by Practice Maximus. For additional information on setting user restrictions, contact a Practice Maximus support specialist. Page 26 of 51
Menu Set Of Objectives EPs must meet a minimum of 5 objectives Page 27 of 51
1. Implement drug-formulary checks Drug formulary checks are performed via the DrFirst E-prescribing portal. A formulary code is displayed next to the drug name. For a list of formulary codes, see the What Do These Codes Mean? Page 28 of 51
2. Incorporate clinical lab test results as structured data To record clinical lab test results, choose the Laboratory tab from the EHR menu. Lab test results can be recorded as structured data Page 29 of 51
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3. Generate list of patients by specific conditions To generate patient lists choose EHR from the Reports Menu. Enter specific information for the list, hit print. Page 31 of 51
4. Send reminders to patients per patient preference for preventive/follow up care To generate patient reminders choose EHR from the Reports Menu. Enter specific information for the reminders, hit print. Page 32 of 51
5. Provide patients with timely electronic access to their health information See instructions for core objectives: #12 -- Provide patients with an electronic copy of their health information upon request And #13 -- Provide clinical summaries for patients for each office visit Page 33 of 51
6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate Use the Education tab on the Patient Screen to provide patient specific education. Page 34 of 51
6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate (continued) The patient s medications, diagnosis and lab results are displayed. A list available education documents are also displayed. Select the document(s) you wish to print for this patient. Page 35 of 51
6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate (continued) After printing, you may save a copy of the patient education document in the Patient s MYDOCS folder. Page 36 of 51
7. Medication reconciliation Medication reconciliation can be done using the PBM Hx (pharmacy benefits manage history) Page 37 of 51
8. Summary of care record for each transition of care/referrals See instructions for core objective: #13 -- Provide clinical summaries for patients for each office visit Page 38 of 51
9. Capability to submit electronic data to immunization registries/systems To record immunizations information, choose the Immunizations tab from the EHR menu. Immunization tab allows for import and export in HL7 (Health Level Seven) format. Page 39 of 51
10. Capability to provide electronic syndromic surveillance data to public health agencies Immunization tab allows for import and export in HL7 (Health Level Seven) format. Page 40 of 51
Clinical Quality Measures EPs must report a minimum of 3 clinical quality measures from a core set or the alternate core set measures. In addition, EPs must report 3 additional measures from the list of 38 additional set clinical quality measures based on the provider s specialty. Page 41 of 51
Practice Maximus provides for the following Core Set Quality Measures: 1. Hypertension: Blood Pressure Measurement Blood pressure information is recorded on the Health Info tab of the patient s EHR record. Page 42 of 51
2. Preventive Care and Screening Measure Pair: a. Tobacco Use Assessment b. Tobacco Cessation Intervention Tobacco use and intervention are recorded on the Health Info tab of the patient s EHR record. Page 43 of 51
3. Adult Weight Screening and Follow-Up Weight screening and follow-up are recorded on the Health Info tab of the patient s EHR record. Page 44 of 51
Practice Maximus provides for the following Alternate Core Set Quality Measures 1. Weight Assessment and Counseling for Children and Adolescents Weight screening and follow-up are recorded on the Health Info tab of the patient s EHR record. Page 45 of 51
2. Preventive Care and Screening: Influenza Immunization for Patients 50 Years Old or Older To record immunizations information, choose the Immunizations tab from the EHR menu. Immunization information for the patient can be recorded in detail Page 46 of 51
3. Childhood Immunization Status To record immunizations information, choose the Immunizations tab from the EHR menu. Immunization information for the patient can be recorded in detail Page 47 of 51
Practice Maximus provides for the following Additional Set Quality Measures 1. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation Statistics are based on diagnosis from EHR records Assessment Plan tab And information entered in Fundus Exam ONH C/D Ratio and Appearance Page 48 of 51
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2. Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Statistics are based on diagnosis from EHR records Assessment Plan tab And information entered in Fundus Exam Media and Macula Page 50 of 51
3. Diabetic Retinopathy: Communication with Physician Managing Ongoing Diabetes Care Statistics are based on diagnosis from EHR records Assessment Plan tab And communication information on the Health Info tab Page 51 of 51