Q4X Webinar: MU2 Success Story It Can Be Done! Sco< Jens, OD, FAAO CEO, RevoluFonEHR July 1, 2014

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2 Q4X Webinar: MU2 Success Story It Can Be Done! Sco< Jens, OD, FAAO CEO, RevoluFonEHR July 1, 2014

3 Overview Brief Review of MU2 in 2014 Discussion with Dr. David James About his views on the relafve easiness of MU2 s objecfves About his pracfce s success with MU2 in Q2 including the HIPAA SRA with WHITEC Q&A

4 MU2 in 2014 Started MU1 in 2011 or 2012 One calendar- quarter of MU2 required If you are going to do MU2 this quarter, today was the starfng point!! UFlize 2014 CerFfied EHR Technology (CEHRT) RevoluFonEHR v6.2 RxNT/EHR v7.1 (or an equivalent CEHRT)

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6 No Added Effort These objecfves require li<le effort beyond MU1:» CPOE» e- Prescribing» Demographics» Vital Signs» Smoking Status» Protect Health InformaFon» Generate PaFent List» Electronic Progress Notes

7 Reasonable These objecfves require minor set- up and/or workflow changes:» CDS» Clinical Summaries» PaFent Reminders» PaFent EducaFon» Family Health History

8 AddiFonal Effort These objecfves require forethought but can be accomplished in due Fme:» PaFent VDT from PHR» Incorporate Lab Results Electronically» MedicaFon ReconciliaFon» Summary of Care Record for Referrals» Secure Messaging from PaFents» Imaging Results for Orders» Clinical Quality Measures» Security Risk Assessment (SRA)

9 MU2 ObjecFves (for reference) 17 Core objecfves 6 Menu objecfves Clinical Quality Measures

10 Core 1: CPOE Create orders for medicafons, laboratory tesfng, and radiology through RevoluFonEHR MedicaFons (>60% of all) RxNT or RevoluFonEHR Labs and Radiology (>30% of all) Use Orders- Medical

11 Core 1: CPOE If originafng the Rx on paper, click Originated without CPOE checkbox Use Orders- Medical Determine commonly ordered LOINC codes Exclusion for <100 orders

12 Core 1: CPOE Order by LOINC code Text enter descripfon Enter Ordered by to reflect the provider

13 Core 2: e- Prescribing On >50% of all medicafons ordered, must transmit the prescripfon electronically As with CPOE, mark Originated without CPOE Use a CerFfied EHR Technology RxNT/EHR v7.1 is integrated Must have real Fme drug- to- formulary check Exclusion for <100 prescripfons; pharmacy limitafon within 10 miles

14 RevoluFonEHR powered by RxNT/EHR

15 Core 3: Record Demographics >80% of pafents need Sex, DOB, Preferred Language, Race, and Ethnicity recorded Receive credit for pafents for whom this was previously documented Note: Race selecfon should be for each race reported, as opposed to mulfracial SNOMED codes are used behind the scenes to share this data in C- CDA documents

16 Core 4: Record Vital Signs >80% of pafents need vital signs documented BP for ages 3 and over, Ht/Wt for any pafent Receive credit for pafents for whom this was previously documented You may confnue to assess the relevance to your scope of care for Blood Pressure, and separately for Height/Weight, and reporfng for any that are relevant

17 Core 5: Record Smoking Status >80% of pafents need smoking status documented for ages 13 and older Receive credit for pafents for whom this was previously documented New addifons include Light Smoker and Heavy Smoker SNOMED codes are used behind the scenes to share this data in C- CDA documents

18 Core 6: Clinical Decision Support Have at least 5 CDS rules in place, 4 of which must be related to CQMs RevoluFonEHR v6.2 contains CQMs which may be relevant If you deacfvate them, you may void MU 2014 CerFfied includes counts of checks for drug- drug and drug- allergy interacfon checks Insert the CDS screen in your encounters, and note your acfons on any CDS alerts

19 Core 6: Clinical Decision Support Alerts are to be delivered to the provider at a Fme in care that allows for appropriate acfon Alerts are for any Master Dx, not only those that are acfve Today Confirm or Deny points to the provider s acfon and allow for statement of any Exclusion

20 Core 7: Incorp. Lab Results Labs ordered should have their results that are numerical, or posifve/negafve, incorporated electronically >55% of labs Use Orders- Medical to import lab results Make sure to document comments in InterpretaFon and Report slider

21 Core 8: Generate PaFent List Same requirement as in Stage 1 Minimum common idenffier must be a problem/diagnosis No acfon required, but concept is to idenffy pafents who are good candidates for recall/ acfvafon

22 Core 9: PreventaFve Care ExpectaFon is to reacfvate pafents who have been in at least 2 Fmes within 24 months before the start of the reporfng period When you run a Scorecard, it will look back 24 months from the day before the reporfng period, so the denominator will be stafc Send a Recall Reminder to >10% of the pafents in the denominator

23 Core 9: PreventaFve Care Report available by which you can sort for pafents eligible for recall The list allows you to idenffy pafents in the denominator it s a custom PaFent report

24 Core 9: PreventaFve Care

25 Core 9: PreventaFve Care

26 Core 10: PaFent Ability to V/D/T >50% of pafents must have online access to protected health informafon Give pafents access credenfals to RevoluFonPHR >5% of pafents must View, Download, or Transmit in RevoluFonPHR PaFent Eye Health InformaFon ABOUT ME Clinical Summary APPOINTMENTS

27 Core 11: Clinical Summaries Must be delivered within 1 day of informafon being made available (encounter signed by provider) >50% of office visits (billable services) Create, print, and deliver in- clinic For pafents with PHR access, credit granted Configure Summary set- up in AdministraFon

28 Clinical Summary ConfiguraFon

29 Clinical Summary Declined

30 Core 12: PaFent- specific EducaFon Delivering educafon to >10% of pafents Infobu<on is a context- aware knowledge retrieval system Press Infobu<on, retrieve a URL, get credit Send the pafent the URL via Messaging, or print materials and deliver in- clinic

31 Core 13: MedicaFon ReconciliaFon Same requirement >50% of new pafents + pafents referred in to the clinic must have medicafon reconciliafon performed Simultaneous view of the external medicafon list and the imported medicafon list allows for consolidafon into RevoluFonEHR medicafon list Direct incorporafon from C- CDA

32 Core 13: MedicaFon ReconciliaFon

33 Core 14: Summary of Care >50% of referrals should include provision of a TransiFon of Care document >10% of referrals should include provision of an electronic version of a TransiFon of Care document BOTH are excluded if <100 referrals done Even if neither are germane, then a test of exchange must be done

34 Core 14: Summary of Care When referring a pafent to another provider, you are expected to deliver an electronic C- CDA file in >10% of cases Create a Referral, then Send TransiFon of Care Document Requires use of Direct, so populate Direct addresses for External Providers

35 Core 14: Summary of Care

36 RevDirect market.revolufonehr.com Register, and acfvafon will happen within a few days Unlimited Direct addresses for doctors, techs, pracfce locafons Cost is 5% of your Monthly Access Fee: $350/mo > RevDirect = $17/mo $1000/mo > RevDirect = $50/mo

37 Sexng Up Direct for Other Providers Used to push messages to external providers External providers will need to supply addresses Direct address logged in External Provider profile Messaging only available when address logged

38 Core 15: ImmunizaFon Registry Not eligible, no funcfonality included Do not need a Complete EHR or an EHR module that is cerffied to do this unless the provider administers immunizafons

39 Core 16: Protect Health InformaFon ConFnue diligence with annual HIPAA- related Security Risk Assessment Perform acfons within the reporfng period Address new items required for MU2 Security of data at rest via encrypfon New cerfficafon- related required features in RevoluFonEHR

40 Core 17: Secure Electronic Messaging 5% of pafents should send the provider a secure message Any provider in the pracfce is eligible for a message (staff not yet in list of potenfal recipients) Encourage pafents to respond to messages that you send

41 Messaging: PaFents Launched from the PaFent Header bar Message will land in RevoluFonPHR PaFent will need to know how to login HIPAA- compliant nofficafon to pafent

42 Menu 1: Syndromic Surveillance Not eligible, no funcfonality included Do not need a Complete EHR or an EHR module that is cerffied to do this unless the provider diagnosis syndromic condifons that are important to public health

43 Menu 2: Electronic Progress Notes 30% of pafents must have a note created, edited, and signed in the record RevoluFonEHR delivers searchable text fields that meet Menu 2 including: RFV (PaFent and Provider) Care Plan Items (General) Assessment Comments

44 Menu 3: Imaging Results 10% of orders whose result is an image should have that imaged stored within, or accessible through, the EHR Use Orders- Medical and the new Care Plan Items for Orders when a pafent case necessitates an imaging test When running the test, load the results and a<ach the image through the I&R

45 Menu 3: Imaging Results

46 Menu 4: Family History 20% of pafents must have their Family History documented as structured data New Family History screens for Medical and Ocular condifons as idenffied by SNOMED Mother, Father Sister, Brother Daughter, Son Update and review the data

47 Menu 5: Report Cancer Cases Exclusion The EP does not diagnose or directly treat cancer

48 Menu 6: Report Specific Cases Exclusion The EP does not diagnose or directly treat any disease associated with a specialized registry sponsored by a nafonal specialty society for which the EP is eligible, or the public health agencies in their jurisdicfon E.G. registries in quesfon [include] nafonal medical sociefes covering the EP s scope of pracfce

49 Clinical Quality Measures The CQMs now map to PQRS and you may report CQMs in lieu of PQRS RevoluFonEHR monitors your CQMs behind the scenes This informafon is more germane than MU1 CQMs had been 12 items available and must report on 9 Performance sfll does not count in 2014

50 Scorecard Updates Reports for Stage 1 MU and Stage 2 MU have been updated and enhanced Future webinars will help you understand the data and posifvely influence it Print copies include logo, version, and all data

51 Scorecard in RevoluFonEHR

52 Scorecard Printout

53 EHR CerFficaFon Number

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