Understanding Your Meaningful Use Report

Transcription

1 Understanding Your Meaningful Use Report Distributed by Kowa Optimed

2 EMRlogic activehr Understanding Your Meaningful Use Report, version 2.1 Publication Date: May 8, 2012 OD Professional and activehr OD Professional and activehr are identical products with the exception that activehr is ONC Certified for Meaningful Use through the Drummond Group while OD Professional is not EMRlogic Systems Incorporated. All rights reserved.

3 Table of Contents Introduction What is Meaningful Use? Core Set and Menu Set Measures How is Meaningful Use Calculated? Percentage score Example Note on Using Test Patients Running the Meaningful Use Report Accessing the Report To access the Meaningful Use Attestation report: Loading the Report To load the Meaningful Use report: Changing Report Settings To change report settings: Core Measures Core 1 - Computerized Provider Order Entry (CPOE) Core 2 - Drug Interaction Checks To set e-prescribing drug interaction alerts: Core 3 - Maintain Problem List To maintain an active problem list: Core 4 - e-prescribing (erx) Printing the RX Report To access the Rx report: To print the Rx report: Core 5 - Active Medication List To add a medication in Billing and Coding: Core 6 - Medication Allergy List To add a drug allergy in Billing and Coding: To add a drug allergy in Rcopia: Core 7 - Record Demographics To record patient demographics: Core 8 - Record Vital Signs To record a patient s vital signs : Core 9 - Record Smoking Status To record a patient s smoking status: Understanding Your Meaningful Use Report, v. 2.1 i

4 Core 10 - Clinical Quality Measures (CQMs) Core 11 - Clinical Decision Support Rule Core 12 - Electronic Copy of Health Information To generate and print the CCD report: Core 13 - Clinical Summaries Core 14 - Electronic Exchange of Clinical Information Performing the Electronic Exchange Test To perform the test: Core 15 - Protect Electronic Health Information Menu Set Measures Menu Set 1 - Drug Formulary Checks To view medication : Menu Set 2 - Clinical Lab Test Results To import an.hl7 lab results file: To enter lab results manually: Menu Set 3 - Patient Lists To generate a list of patients: Menu Set 4 - Patient Reminders To set communication preferences: To print a reminder list: Menu Set 5 - Patient Electronic Access Menu Set 6 - Patient-specific Education Resources To access the educational resources area of activehr: Menu Set 7 - Medication Reconciliation To perform medication reconciliation: Menu Set 8 - Transition of Care Summary To provide a summary of care record: Menu Set 9 - Immunization Registries Data Submission Menu Set 10 - Syndromic Surveillance Data Submission Quality Measures During the Attestation Period Generating Quality Measures Data Accessing the Clinical Quality Page To access the Clinical Quality measures page: Entering Provider Information To enter provider : Adding Measures Understanding Your Meaningful Use Report, v. 2.1 ii

5 To add measures to the report: Generating the Report To generate the report: Printing the Data To print the data: NQF Hypertension: Blood Pressure Measurement NQF Weight Assessment & Counseling for Children and Adolescents NQF Tobacco Use Assessment and Cessation Intervention NQF Influenza Immunization for Patients 50 Years Old or Older NQF Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation NQF Diabetic Retinopathy - Macular Edema NQF Diabetic Retinopathy - Communication with the Physician NQF Adult Weight Screening and Follow-up NQF Childhood Immunization Status Attestation FAQ Do I get penalized for taking an Exclusion? Is there a limit of Exclusions I can take? If I am excluded from a Menu Set measure, can it count as one of the five? Why does the growth chart not display data on some patients? Understanding Your Meaningful Use Report, v. 2.1 iii

6 What is Meaningful Use? Introduction This guide provides on: How to run the Meaningful Use report How to interpret your results A listing of all the core, alternative and quality measures How the report determines the data results for each measure Fast track guidance for meeting each measure. Step-by-step instructions for entering data to meet the core and menu set measures. Note: The data for some measures is obtained directly from the report, while others require you to take certain steps outside the software (such as providing printed brochures to patients). For each measure you ll find on how to use the report data for attestation. What is Meaningful Use? From the CMS.gov website: The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use: 1. The use of a certified EHR in a meaningful manner, such as e-prescribing. 2. The use of certified EHR technology for electronic exchange of health to improve quality of health care. 3. The use of certified EHR technology to submit clinical quality and other measures. Attesting successfully to Meaningful Use demonstrates that you are using certified EHR technology and your usage has been measured in respect to both quality and quantity. Meaningful Use is thus an indicator that a certain level of quality in care has been given to patients. Core Set and Menu Set Measures There are two sets of Meaningful Use criteria - a core set and a menu set: The core set is a group of 15 measures that all must be met, unless the doctor is exempt from a particular measure. The menu set is a group of 10 measures of which a doctor has to meet or be exempt from 5 measures of his or her choice. Exemption is granted if a measure does not apply to the practitioner. Read more at How is Meaningful Use Calculated? Some of the measures pertaining to Meaningful Use are measured by percentage score, while others require a Yes/No answer. Understanding Your Meaningful Use Report, v

7 Note on Using Test Patients Percentage score For these measures, your practice s performance is calculated as a percentage. Percentages are measured using this formula: Numerator/Denominator x 100 The denominator is the set of criteria for the measure The numerator is the data set used for the measure Example Let's use the first core Meaningful Use measure as an example (from EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf): The objective of the first core measure is to "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. The measure itself is this: "More than 30 percent of all unique patients [repeat patients will be counted only once] with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE. For this measure, The denominator is Number of unique patients with at least one medication in their medication list seen by the EP during the EHR reporting period. The numerator is The number of patients in the denominator that have at least one medication order entered using CPOE. Say that 200 patients in a particular time frame meet the criteria for the denominator, so 200 unique patients have been seen and have at least 1 medication on their medication list. Of those, 150 have had their medication orders entered using e-prescribing through the DrFirst Rcopia integration in activehr, which qualifies as a computerized provider order entry. 150/200 x 100 = 75% In this example, the measure would be met. Many measures have exclusions as well. For this measure, any provider who does not write more than 100 prescriptions within the attestation period can be excluded. Note on Using Test Patients If you are creating test patients or practice patients in your live database, you must ensure that they are excluded from the Meaningful Use report counter. The system will automatically exclude patient records with the following surnames: N/A, OD, Practice, Test 1, Testcase and TestDB. You also have the option of adding particular last names to this list, or specifying a list of particular chart numbers to be excluded. See Changing Report Settings on page 7. Understanding Your Meaningful Use Report, v

8 Note on Using Test Patients Running the Meaningful Use Report Run the Meaningful Use report to help you assess your readiness for attestation and to obtain data for many of the attestation questions. Analyze the to determine: The measures you have met The measures from which you can be excluded The measures you are close to meeting What actions you can take so as to meet a particular measure When you are ready to attest, you use the report data for many of the measures directly as input on the attestation. Note: Each provider at your location must collect patient data and attest individually. Accessing the Report Only users defined as Eligible Providers (EPs) or those with administrative rights can run the report. A provider will have direct access only to their report. An administrator will be able to select a provider from a drop-down list. To access the Meaningful Use Attestation report: 1. From the top menu bar, choose Tools > Administrative Reports > Meaningful Use. The Security Access dialog box appears. 2. Enter your user name and password and click Access. You must have provider or administrative status. Understanding Your Meaningful Use Report, v

9 Note on Using Test Patients The report appears in the Web Browser view, not yet generated. Loading the Report Load the report any time during the attestation period to assess your progress in meeting the requirements, and again at the end of the period to determine your results for those measures calculated by activehr. To load the Meaningful Use report: 1. In the Start Date and End Date fields, set the appropriate time period for the attestation. For example, for the initial attestation period, you would set a period of 90 days. Click anywhere in the date fields to open a calendar and select a date. 2. If you logged in as an administrator, select the appropriate provider from the Provider dropdown list. Understanding Your Meaningful Use Report, v

10 Note on Using Test Patients 3. Click Load Report. The message Please wait, the system is loading appears and then the generated report appears. Each of the 15 core meaningful use measures is listed in the Attestation Core section, followed by the 10 menu set measures. Each measure includes the following: The objective, measure and any exclusions from U.S. government documentation The numerator and denominator calculated by the system, where applicable. The result attained, shown to the far right A link to detailed on the measure provided on the cms.gov. website. Understanding Your Meaningful Use Report, v

11 Note on Using Test Patients Notice that the headings are color-coded. The colors indicate the following: Color: Green Red Gray Meaning: The system has all the required and the measure passed May mean any of the following: Incorrect or missing More action required The measure did not pass Indicates one of the following: The report does not provide data for the measure. The measure is not applicable to optometry and the exclusion applies. 4. For each core measure: Verify the result attained on the far right. For percentages, compare them to the required percentage stated in the measure description on the left. Verify if any exclusions apply. Exclusions appear underneath the raw data. See Core Measures on page 10 for details on specific measures. 5. For the ten menu set measures, select the five that apply best to your practice. See Menu Set Measures on page 39 for on specific measures. 6. If needed, verify the patient count at the bottom of the report. Some or all of this may be helpful in assessing your data. 7. If you find that one or more of the results does not match your expectations, please contact the First Response Support Team. The team will be able to verify your results and troubleshoot any configuration issues that might be having an effect. Understanding Your Meaningful Use Report, v

12 Note on Using Test Patients Changing Report Settings Several optional settings are available for customizing how the report creates the set of valid patients. It is highly recommended that you contact the First Response Support Team for assistance with the modification of any of these settings. Administrative rights are required to view and change report settings. These settings apply to your entire practice, not individual providers. You can specify: The surnames to exclude from the report (for test patients) The patient task statuses (such as Active, Completed or Waiting) to include in the report. Tasks (such as Exam, Exam 2, Chart Review, Appointment, and so on) to exclude from the report. These can be either activehr default tasks or tasks that you have defined for your practice. For example, if you created a task for patients coming into the office to pick up contact lenses, you could exclude those visits. Several other options are available for Support troubleshooting. To change report settings: 1. Click Settings at the top right of the report. The Meaningful Use Attestation Settings page appears. Understanding Your Meaningful Use Report, v

13 Note on Using Test Patients 2. In the Provider Options section, keep the default setting - Use CMSName. All other options are for Support troubleshooting purposes. 3. In the Excluded Patient Options section, specify the surnames of any test patient records that you want the system to exclude from the report by doing one of the following: Select Use Surname list to start with a set of pre-defined test patient surnames. You can delete any of the names by clicking Delete to the right of the name, or add to the list by typing in a new name in the text box and clicking Add. Select Use Chartnumber list to specify patient records to exclude by entering the chart numbers, as shown in the example below. Only valid existing chart numbers will be added to the list. 4. In the Included Task Status Options section, specify the task statuses for which patient records will be included in the report. Select: Default - Active or Completed to include patient records with these statuses. Use following to specify a different set of statuses to include. Select a status and click Add. Repeat as needed. You can modify the list any time by deleting a selected status as shown below. Understanding Your Meaningful Use Report, v

14 Note on Using Test Patients 5. In the Included Base Module Options section, keep the default setting - Default - Appointment or Task. The Use following option is for Support troubleshooting purposes. 6. In the Excluded Task Options section, specify any tasks, either default or defined by your practice, to exclude from the report. Select: No Exclusion (the default) to include all tasks. Use following to specify exclusions. Select a task from the drop-down list and click Add. Repeat as needed. You can delete selected statuses any time by clicking Delete. 7. Click the X in the upper right corner of the window to exit. Note: The settings are saved as they are set. To reset any section to its default, select the first (top) option listed. Understanding Your Meaningful Use Report, v

15 Core 1 - Computerized Provider Order Entry (CPOE) Core Measures In this section, each of the core measures is listed along with the steps you need to take in activehr in order to achieve this measure. You need to attest to each core measure. For each measure, a table provides the following : The objective, measure and exclusion descriptions from the CMS.gov website. The location in activehr where you enter data for the measure. The method the report uses to derive the denominator and numerator values (where applicable) Fast track tips for achieving the measure How you use the report data when attesting A link to the CMS.gov full text on the measure. Additional details on achieving the measure are also given after each table. Core 1 - Computerized Provider Order Entry (CPOE) Computerized Provider Order Entry (CPOE) involves the provider s use of computer assistance to directly enter medication orders from a computer or mobile device. The order must also be captured in a digital, structured and computable format to improve safety and organization. Measure #1 Objective Measure Exclusion activehr location Computerized Provider Order Entry (CPOE) 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. More than 30% of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE. Any EP who writes fewer than 100 prescriptions during the EHR reporting period would be excluded from this requirement. Exclusion from this requirement does not prevent an EP from achieving meaningful use. EHR module e Prescribing Understanding Your Meaningful Use Report, v

16 Core 1 - Computerized Provider Order Entry (CPOE) Denominator Numerator Fast Track Attestation Usage Link for more The number of unique patients seen by the provider within the Attestation period who have at least one medication in their medication list in the Medication List on the Billing & Coding screen. This is derived from the unique Chart Numbers on the Patient Address View and the Medication List on the Billing & Coding screen. The number of patient records with a medication in the Medications list in the Billing & Coding segment as a result of having been transferred to this list after being entered into DrFirst Rcopia using the e Prescribing tab on the ribbon. Use Rcopia for prescribing medications to patients throughout the attestation period. Enter report data directly into Attestation. 1_CPOE_for_Medication_Orders.pdf For instructions on prescribing medications in Rcopia, please see the e-prescribing RX End User Learning Manual, available in the Client Login area of the EMRlogic website. Medications entered in Rcopia are transferred to the Medications list in the Billing and Coding screen automatically when you click the Return to EMR button in Rcopia. Navigate to the Billing and Coding exam, and scroll down to view the Medication list populated from Rcopia. Understanding Your Meaningful Use Report, v

17 Core 2 - Drug Interaction Checks Note: For you to pass this Meaningful Use measure, you must prescribe via an e-prescribing service; using the Add New function in Billing and Coding does not qualify. To learn more about how activehr and DrFirst Rcopia work together, please refer to the DrFirst and e-prescribing learning video, available in the Client Login area of the EMRlogic website: Core 2 - Drug Interaction Checks In Rcopia, drug-drug and drug-allergy interaction alerts are generated when the system detects a conflict between the medication being prescribed and known allergies or medications that have already been previously prescribed. Measure #2 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Drug Interaction Checks Implement drug drug and drug allergy interaction checks. The EP has enabled this functionality for the entire EHR reporting period. No exclusion. EHR module e Prescribing N/A this measure is not attested to by percentage but rather by yes/no. Drug drug and drug allergy interaction checks and alerts are automatic in Rcopia. Eligible Providers (EPs) who have used Rcopia for the length of the reporting period can attest YES to having enabled drug drug and drug allergy interaction checks. Report provides only it assumes usage of Rcopia. 2DrugInteractionChecks.pdf Understanding Your Meaningful Use Report, v

18 Core 2 - Drug Interaction Checks Optionally, you can set the behavior of the drug and allergy alerts using the following procedure. To set e-prescribing drug interaction alerts: 1. In the EHR module, navigate to the e-prescribing module by clicking on the e-prescribing tab. 2. Navigate to the Options section of the e-prescribing area. 3. Select Preferences - practice. 4. Select an option in each of the drop-down lists shown: Set these options to: All interactions and All warnings to cause notification alerts to automatically appear for all drug-drug and drug-allergy interactions. Understanding Your Meaningful Use Report, v

19 Core 3 - Maintain Problem List Contraindicated Only or Severe and contraindicated only and Ingredient and specific group allergies only for the alerts to only appear in these cases. 5. Click the Make these Changes button at the bottom of the Practice-Wide Preferences page to activate your selections. Core 3 - Maintain Problem List A problem list is a record of the patient s health issues. You created and maintain the problem list in the Billing & Coding exam, by searching the ICD9 codes database from within activehr. Measure #3 Objective Measure Exclusion activehr location Denominator Numerator Maintain Problem List Maintain an up to date problem list of current and active diagnoses. More than 80 percent 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. No exclusion. EHR module Billing and Coding The number of unique patients seen by the EP within the Attestation period. The number of patient records with an entry on the Problem List in Billing & Coding. This entry is either a problem or a special entry saying there is no problem. The system also checks for patient records with a generated CCD and adds any that were not already included Fast Track Maintain the Problem List in Billing and Coding. Attestation Usage Link for more Enter report data directly into Attestation. 3MaintainProblemList.pdf If a patient does not have a problem, you can add a Normal State entry into the Problem List using code V65. It is recommended to do this to maximize your percentage for the measure. Understanding Your Meaningful Use Report, v

20 Core 3 - Maintain Problem List To maintain an active problem list: 1. Navigate to the Billing & Coding exam and enter a problem such as migraine into the Search ICD9 Codes box.type in a keyword, part of a word, or an ICD9 code to bring up the results found in the database. 2. Scroll down the list to find the most accurate problem description. 3. Select the code / problem you want to add. Your selection appears on the Today tab. To view a complete list of all problems selected, click on the Complete List tab. The following screen example shows the V65 - Normal State code for patients with no problems. 4. Once you have added a problem, you can modify it by double clicking in any column. For example, to indicate that this is no longer a problem for the patient, double-click the word active in the Status column. Understanding Your Meaningful Use Report, v

21 Core 4 - e-prescribing (erx) A drop down menu appears, allowing you to choose resolved. Core 4 - e-prescribing (erx) You can generate and transmit new prescriptions via the e-prescribing module. Measure #4 Objective Measure Exclusion activehr location Fast Track Denominator Numerator Attestation Usage Link for more e Prescribing (erx) Generate and transmit permissible prescriptions electronically (erx). More than 40 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. Any EP who writes fewer than 100 prescriptions during the EHR reporting period. EHR module e Prescribing Prescribe medications in Rcopia. Print the RX report in Rcopia to determine the number of prescriptions that were transmitted electronically. Determine your total number of prescriptions and calculate the percentage that were done electronically. N/A Report provides only. Use data from Rcopia as described in Fast Track, above. 4PermissiblePrescriptions.pdf For instructions on prescribing medications in Rcopia, please see the e-prescribing RX End User Learning Manual, available in the Client Login area of the EMRlogic website. Understanding Your Meaningful Use Report, v

22 Core 4 - e-prescribing (erx) Printing the RX Report The Rx report prints a list of prescriptions by patient for a specified date range and provides you with the total number of prescriptions. With this you can determine if: You qualify for the exclusion (if you filled fewer than 100 prescriptions filled in the period) More than 40% of your prescriptions were done electronically. This report has a maximum date range of 90 days. When attesting for a 1 year period, it is recommended for you to run this report several times, specifying four 90-day ranges, and one range of 5 days. Each time you run it, jot down the total number of prescriptions for and add them up to get the total for the year. To access the Rx report: Do one of the following: Select View > e-prescribe Prescription Report from the activehr top menu bar. The following screen appears. Click Access e-prescribe Prescription Report. or: Open any patient record in activehr and click e-prescribing on the EHR module ribbon. The currently selected patient s e-prescribe record is displayed. Understanding Your Meaningful Use Report, v

23 Core 4 - e-prescribing (erx) Click Rx Report. The Prescription Report options appear. To print the Rx report: 1. Select your name from the Provider drop-down list. 2. Set the Patient to All Patients. 3. Set the Status to All. A Completed section appears that allows you to set the date range. 4. Select Range, and set the appropriate range. For example, for the initial attesting period, set a 90 day range. 5. If needed, change the Maximum prescriptions to Click Display Report. The report displays at the bottom of the screen. Scroll down until you see the total. Understanding Your Meaningful Use Report, v

24 Core 5 - Active Medication List 7. To print the report with the total showing, right-click anywhere in the report and choose Print. Note: The Print Report option prints the report without the total. Note: To learn more about e-prescribing, please refer to the e-prescribing RX End User Learning Manual and the DrFirst and e-prescribing learning video, both available in the Client Login area of the EMRlogic website. Core 5 - Active Medication List In activehr, you maintain an active medication list in the Billing and Coding screen. For the purposes of this measure, you can add medications to the list in two ways: By prescribing medications in Rcopia. The medications automatically appear in the Billing and Coding list after you return to the screen from Rcopia. By adding medications directly to the list in Billing and Coding. Measure #5 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Active Medication List Maintain active medication list. More than 80 percent 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. No exclusion. EHR module e Prescribing The number of unique patients seen by the provider during the attestation period. The sum of the number of patients who have an entry on the Medication list in the Billing & Coding screen and any additional patients who have a generated CCD. Prescribe medications in Rcopia whenever possible. Otherwise, enter them in the Medications list. Ensure that you are generating a CCD for each patient visit. Enter report data directly into your attestation. 5ActiveMedicationList.pdf Understanding Your Meaningful Use Report, v

25 Core 6 - Medication Allergy List For instructions on prescribing medications in Rcopia, please see the e-prescribing RX End User Learning Manual, available in the Client Login area of the EMRlogic website. Medications entered in Rcopia are transferred to the Medications list in the Billing and Coding screen automatically when you click the Return to EMR button in Rcopia. Recording No Known Medications for Patients To increase your percentage of patients with an entry in the list, for patients with no medications you are aware of, you can add an entry in the list and type No known medications in the Medication column. However, if you are regularly generating CCD reports for every patient, this is not necessary, because No Known Medications is printed in the Medications section of the CDD automatically if the Medications list is empty, as shown in this screen example: For this reason, to determine the total for the numerator for this measure, the report adds patient records with a generated CCD to those with an active medication list (if they are not already included). To add a medication in Billing and Coding: 1. Scroll down until you see the Medications grid. 2. Click Add New. A blank entry is created in the list. 3. Double-click in each column and add concerning the medication. Core 6 - Medication Allergy List In activehr, you maintain a medication allergy list in the Billing and Coding screen. For the purposes of this measure, you can add allergies to the list in two ways: By entering allergies in Rcopia. The allergies automatically appear in the Billing and Coding list when you return to the screen from Rcopia. Understanding Your Meaningful Use Report, v

26 Core 6 - Medication Allergy List By adding allergies directly to the Allergy list in Billing and Coding. Measure #6 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Medication Allergy List Maintain active medication allergy list. More than 80 percent 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. More than 80 percent 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. EHR module Billing and Coding The number of unique patients seen by the provider within the Attestation period. The sum of the number of patients who have a medication allergy listed in the Allergy List on the Billing & Coding screen and any additional patients with a generated CCD. Maintain each patient s allergy list and generate a CCD after each exam. Enter report data directly into your attestation. 6MedicationAllergyList.pdf For instructions on adding allergies in Rcopia, please see the e-prescribing RX End User Learning Manual, available in the Client Login area of the EMRlogic website. Allergies entered in Rcopia are transferred to the Allergies list in the Billing and Coding screen automatically when you click the Return to EMR button in Rcopia. Recording No Known Drug Allergies (NKDA) for Patients To increase your percentage of patients with an entry in the list, for patients with no medications you are aware of, you can add an entry in the list and type No known drug allergies in the Medication column. However, if you are regularly generating CCD reports for every patient, this is not necessary, because NKDA is printed in the Medications section of the CDD automatically if the Allergies list is empty, as shown in this screen example: Understanding Your Meaningful Use Report, v

27 Core 6 - Medication Allergy List For this reason, to determine the total for the numerator for this measure, the report adds patient records with a generated CCD to those with an active allergy list (if they are not already included). To add a drug allergy in Billing and Coding: 1. Scroll down until you see the Allergies grid. 2. Click Add New. A blank entry is created in the list. 3. Double-click in each column and add concerning the medication. To add a drug allergy in Rcopia: 1. Navigate to the e-prescribing module from the Billing & Coding exam by clicking on the e-prescribing link. 2. In the Current Allergies/Adverse Reactions area, click on the Add/View Allergies link. 3. Select a common allergy from the Common Allergies drop-down menu, and click on the Add Common Allergy button. Understanding Your Meaningful Use Report, v

28 Core 6 - Medication Allergy List 4. On the next screen that appears, select a Reaction and Onset Date from the corresponding drop-down menus, and click Add. The selected allergy and reaction will then be displayed on the Active/Current Allergies area in a list format. Understanding Your Meaningful Use Report, v

29 Core 7 - Record Demographics Core 7 - Record Demographics Record patient demographics in the Patient Address View. Measure #7 Objective Measure Exclusion activehr location Denominator Numerator Record Demographics Record all of the following demographics: (A) Preferred language (B) Gender (C) Race (D) Ethnicity (E) Date of birth More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data. No exclusion. Patient Address View The number of unique patients seen by the provider within the Attestation period. The number of patient records with a unique chart number that have in all of the following fields: Birth Date Gender Preferred Spoken Language Race Ethnicity Fast Track Review all patients and update their demographics. Attestation Usage Link for more Enter report data directly into your attestation. 7RecordDemographics.pdf Ensure for all patients you have seen that the demographic in the Patient Address View is correct. To record patient demographics: 1. Open the patient s record in the Patient Address View. 2. Enter the required as shown in the following screen example: Understanding Your Meaningful Use Report, v

30 Core 8 - Record Vital Signs Core 8 - Record Vital Signs Record a patient s vital signs in the Pre-test exam. Measure #8 Objective Measure Exclusion activehr location Record Vital Signs Record and chart changes in the following vital signs: (A) Height (B) Weight (C) Blood pressure (D) Calculate and display body mass index (BMI) (E) Plot and display growth charts for children 2 20 years, including BMI For more than 50 percent of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data. 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. EHR module Pre test Exam Understanding Your Meaningful Use Report, v

31 Core 8 - Record Vital Signs Denominator Numerator Fast Track Attestation Usage Link for more The number of unique patients seen by the provider within the Attestation period who are above the age of 2. The number of patients who have data recorded in one or more of the following fields in the Pre Test exam: Blood Pressure: diastolic & systolic Height Weight BMI For each patient seen over the age of 2, ensure that at least one entry has been made for Blood Pressure, Height or Weight. Enter report data directly into your attestation. 8RecordVitalSigns.pdf To record a patient s vital signs : 1. In the EHR module ribbon, click Pre-test to display the Pre-test exam. 2. Click Vital Signs. Understanding Your Meaningful Use Report, v

32 Core 8 - Record Vital Signs The Vital Signs page appears. 3. Enter the patient s height, weight, and blood pressure. Entering both height and weight data auto-calculates the BMI (Body Mass Index), which will display in the Pre-Test Exam window at the right. 4. The system tracks the growth of patients between the ages of 2-20 years old and creates growth charts based on the height and weight data that you enter in the Vital Signs page. To view these charts, in the Tasks tab in the Action Manager click the Exams icon, scroll to the end of the Exam task list and click the Reports icon. Next, click the Growth Charts icon. Understanding Your Meaningful Use Report, v

33 Core 9 - Record Smoking Status The charts display, as shown in the following example: Each red dot on the chart represents a visit by the patient where the weight and height were recorded. Core 9 - Record Smoking Status Record a patient s smoking status in the History exam. Measure #9 Objective Measure Exclusion activehr location Denominator Record Smoking Status Record smoking status for patients 13 years old or older. More than 50 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data. Any EP who sees no patients 13 years or older. EHR module History Exam The number of unique patients seen by the provider within the Attestation period who are above the age of 13. Understanding Your Meaningful Use Report, v

34 Core 9 - Record Smoking Status Numerator Fast Track Attestation Usage Link for more The number of patients whose tobacco usage status is recorded in the History Exam under Social History tobacco use. One of the first 6 options (usage status) must be selected. Ensure that for each patient seen is entered as to their smoking status. Enter report data directly into your attestation. 9RecordSmokingStatus.pdf To record a patient s smoking status: 1. In the EHR module ribbon, click History to display the History exam. 2. Click Social History. 3. Enter the patient s tobacco usage in the Tobacco use section by selecting one of the first 6 options. Understanding Your Meaningful Use Report, v

35 Core 10 - Clinical Quality Measures (CQMs) Core 10 - Clinical Quality Measures (CQMs) You can calculate the following clinical quality measures: core, alt-core and specialty. These calculated measures are compliant with all 6 of the core (3 core and 3 alternative-core) clinical quality measures, and can be electronically submitted in an XML document format. Measure #10 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Clinical Quality Measures (CQMs) Report ambulatory clinical quality measures to CMS. Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS. No exclusion. EHR module Billing and Coding N/A this measure is not attested to by percentage but rather by yes/no For this measure you will be asked if you intend to submit clinical quality measure (CQM) data. Be prepared to submit CQM data and answer Yes. Report provides only. Understanding Your Meaningful Use Report, v

36 Core 11 - Clinical Decision Support Rule Link for more 10ClinicalQualityMeasures CQMs.pdf Core 11 - Clinical Decision Support Rule The EHRs are able to generate and implement Clinical Decision Support (CDS) rules based on patient health. These rules are triggered according to health that you have entered into the e-prescribing module, and will generate care suggestions in real time that are relevant to the health entered. In addition to these rules, drug-drug and drug-allergy contraindication checking will be provided, based on data included in the problem list, medication list, demographics and laboratory test results. The care suggestions generated will remind the doctor of steps or protocols that can help ensure consistency and accuracy in the care being provided to each patient. Measure #11 Objective Measure Exclusion activehr location Fast Track Denominator Numerator Attestation Usage Link for more Clinical Decision Support Rule Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule. Implement one clinical decision support rule. No exclusion. EHR module and activehr analytics All providers using activehr automatically qualify for this measure, as the application features EHRs that are built on Clinical Decision Support. N/A this measure is not attested to by percentage but rather by yes/no Enter report data directly into your attestation. 11ClinicalDecisionSupportRule.pdf Understanding Your Meaningful Use Report, v

37 Core 12 - Electronic Copy of Health Information Core 12 - Electronic Copy of Health Information One of the key tenets of Health Care Reform is interoperability. Certified EHRs must be capable of creating and receiving two primary documents: the Continuity of Care Document (CCD) and the Continuity of Care Record (CCR). In simple terms, the CCD may be shared between the doctor and the patient and the CCR is shared between providers (doctors) only. Measure #12 Objective Measure Exclusion activehr location Fast Track Denominator Numerator Attestation Usage Link for more Electronic Copy of Health Information Provide patients with an electronic copy of their health (including diagnostic test results, problem list, medication lists, medication allergies) upon request. More than 50 percent of all patients who request an electronic copy of their health are provided it within 3 business days. Any EP that has no requests from patients or their agents for an electronic copy of patient health during the EHR reporting period. CCD report Meet patients requests for this by printing the CCD and giving it to them. Keep a record of CCD requests, provided copies and the date provided. N/A Report provides only. Calculate the percentage from your own collected data. 12ElectronicCopyofHealthInformation.pdf To generate and print the CCD report: 1. In the EHR module ribbon, select Output Documents. 2. Click Create Continuity of Care Document. The report is generated as a PDF document that displays in the workspace. Understanding Your Meaningful Use Report, v

38 Core 13 - Clinical Summaries 3. To print the CCD report, click the printer icon in the upper left corner of the PDF window. Note: Do not use right-click-print or File > Print as these methods will print the web page of the report, not the report itself. 4. If needed, you can view and print previously generated CCDs from the Document Management module. Double-click Documents under the patient in the Browse tab to open the module. Locate and click on the appropriate CCD in the Generated CCD (Readable) section in the left pane, then click the Print button at the top of the page Core 13 - Clinical Summaries You can provide patients with a clinical summary of their visit to your office by printing out and handing them the CCD report. The CCD report includes at a minimum: Problem list Allergies, adverse reactions and alerts Medication list Diagnostic test results Measure #13 Objective Measure Exclusion Clinical Summaries Provide clinical summaries for patients for each office visit. Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days. Any EP who has no office visits during the EHR reporting period. Understanding Your Meaningful Use Report, v

39 Core 14 - Electronic Exchange of Clinical Information activehr location Denominator Numerator Fast Track Attestation Usage Link for more CCD report The number of unique patients seen by the provider within the Attestation period. The number of patients whose CCD was generated within 3 days of the latest exam. After printing the CCD, be sure to provide it to the patient within 3 days. The report shows you the percentage of patients whose CCD was generated within the specified time range. It is your responsibility to print the CCD and deliver it to the patient. We recommend keeping a record of the patients to whom you provided a CCD. Report provides only it shows the maximum number of patients to whom you could have delivered the CCD. Use your own records as described in Fast Track, above. 13ClinicalSummaries.pdf For on generating the CCD report, see To generate and print the CCD report: on page 32 Core 14 - Electronic Exchange of Clinical Information For this measure, you perform a test that shows that your system is set up to exchange electronically, using a test patient s CCD. The CCD includes such as diagnostic test results, problem list, medication list, and medication allergy list. Measure #14 Objective Measure Exclusion activehr location Electronic Exchange of Clinical Information Capability to exchange key clinical (for example, problem list, medication list, medication allergies, and diagnostic test results), among providers of care and patient authorized entities electronically. Performed at least one test of certified EHR technology s capacity to electronically exchange key clinical. No exclusion. CCD Report Understanding Your Meaningful Use Report, v

40 Core 14 - Electronic Exchange of Clinical Information Denominator Numerator Fast Track Attestation Usage Link for more N/A this measure is not attested to by percentage but rather by Yes/No Perform the test provided by EMRlogic to prove your capacity to exchange key clinical using activehr. If the test is successful, you can attest Yes. Report provides only it defaults to Yes, assuming that you have performed and passed the test during the attestation period. 14ElectronicExchangeofClinicalInformation.pdf Performing the Electronic Exchange Test The following instructions apply to all Eligible Providers intending to attest for a Meaningful Use period. Each provider at an office must complete the test once during each attestation period. Note: If you have multiple locations, the provider only needs to perform the test at one location. To perform the test: 1. Log into activehr using your normal login credentials. 2. Generate a CCD for a test patient by doing the following: Add some fake data for the patient in Billing and Coding. For example, add an entry in the Problem List and Allergies list. Click on the Output Documents tab and then click Create Continuity of Care Document. See To generate and print the CCD report: on page 32 and Note on Using Test Patients on page 2 for more on these topics. 3. From the top menu bar in activehr, click on Security and select Exchange. The Security Access window appears. 4. Enter your Administrative level security credentials and click Access. Understanding Your Meaningful Use Report, v

41 Core 14 - Electronic Exchange of Clinical Information The Security Exchange window appears. 5. In the Chart field, enter the chart number of the test patient you are using. 6. In the Password field, enter a password of your choice. You will later send this password to EMRlogic in an (see steps 9-10). Note: You can leave all other fields blank, and ignore the instruction to Please browse for the file to exchange. 7. Click the Test button. The following message appears. 8. Click OK. Log data is displayed below the Security Exchange window for the last CCD generated for the chart number you specified in step 5. A sample of this data is shown below: 9. Compose a new including the following : To: Send to ccdtest@emrlogic.com Subject: Testing Exchange of Key Clinical Information - Your Name, O.D. Body of Practice name: Practice location Understanding Your Meaningful Use Report, v

42 Core 15 - Protect Electronic Health Information Your Name (Eligible Provider) The password you used in step 6. Copy and paste the log data generated on your system after clicking Test in step Send the . Once verified, a return will include a test status indicating whether or not the test passed. If successful, the test is complete and nothing remains to be done. Core 15 - Protect Electronic Health Information The HIPAA (Health Insurance Portability and Accountability Act of 1996) Security Rule establishes national standards to protect individuals electronic personal health that is created, received, used, or maintained by a covered entity. The Security Rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health Measure #15 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Protect Electronic Health Information Protect electronic health created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities. 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. No exclusion. N/A N/A Conduct or review a security risk analysis in accordance with the requirements under HIPAA Security Rule 45 CFR (a)(1) and implement security updates as necessary; correct identified security deficiencies prior to or during the EHR reporting period. Report provides only. Understanding Your Meaningful Use Report, v

43 Core 15 - Protect Electronic Health Information Links for more 15ProtectElectronicHealthInformation.pdf securityrule/index.html 45cfr pdf Understanding Your Meaningful Use Report, v

44 Menu Set 1 - Drug Formulary Checks Menu Set Measures In this section, please find each menu set measure listed and what you need to do in activehr 2011 in order to achieve this measure. You need to attest to 5 of the menu set measures. For each measure, a table provides the following : The objective, measure and exclusion descriptions from the CMS.gov website. The location in activehr where you enter data for the measure. The method the report uses to derive the denominator and numerator values (where applicable) Fast track tips for achieving the measure How you use the report data when attesting A link to the CMS.gov full text on the measure. Additional details on achieving the measure are also given after each table. Menu Set 1 - Drug Formulary Checks Rcopia automatically displays whether the drugs you are prescribing are in the patient s specified formulary. A drug that is in the formulary is indicated by the letter F in green font beside the drug name. A drug that is not in the formulary is indicated by NF in red font. Note: To ensure that formulary is displayed, the following demographic for the patient in activehr must match exactly with the demographics that the patient s insurance company has on record: First Name Last Name Date of birth Home phone number Zip code Gender Measure #1 Objective Measure Exclusion Drug Formulary Checks Implement drug formulary checks. The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period. Any EP who writes fewer than 100 prescriptions during the EHR reporting period. Understanding Your Meaningful Use Report, v

45 Menu Set 2 - Clinical Lab Test Results activehr location Denominator Numerator Fast Track Attestation Usage Link for more EHR module e Prescribing N/A this measure is not attested to by percentage but rather by yes/no. Use Rcopia during the entire attestation period and check formulary as you are prescribing medications. Report provides only it defaults to Yes, assuming that you are using Rcopia. 1DrugFormularyChecks.pdf To view medication : 1. Navigate to the e-prescribing module. 2. Click on Manage Meds located in the top grey links bar. 3. Type the medication name into the search box in the Patient Medication Report area, and click on Find. Information pertaining to this medication name will then display below the search box. You also see the same when prescribing a medication, as shown in the following screen example. Menu Set 2 - Clinical Lab Test Results You can add clinical lab test results into activehr in two ways. You can: Import an.hl7 file containing the results Add the results manually in the Results grid in the Billing and Coding screen. Once you have added the results, you can view them by generating the patient s CCD. They appear in the Results table at the bottom of the CCD. Understanding Your Meaningful Use Report, v

46 Menu Set 2 - Clinical Lab Test Results Note: If you are using EMRcloud, you can only use the manual method to enter lab results. Measure #2 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Clinical Lab Test Results Incorporate clinical lab test results into EHR as structured data. More than 40 percent 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. An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period. EHR module Output documents Receive HL7 Lab Results. N/A The total number of lab results entered and imported into activehr. Import or enter lab results into activehr. Determine the total number of lab results you have received, whether added to activehr and use this as your denominator. Using the numerator supplied by the report, you can calculate your percentage for the measure. Report provides on the number of lab results entered into activehr. Use this to determine the percentage of lab results that you have added to the system. 2ClinicalLabTestResults.pdf To import an.hl7 lab results file: 1. Place the.hl7 file in the following directory: D:\Odprofessional\OptoData\Databases\ODpro\HL7Input The file name should have the following format: <chart-number>.hl7 2. Load the patient s record into the Patient Address View. Important: Ensure that you have selected the correct patient. Understanding Your Meaningful Use Report, v

47 Menu Set 2 - Clinical Lab Test Results 3. Navigate to the EHR module and click Output Documents on the ribbon. 4. Click the Receive HL7 Lab Results link. The following message appears. To enter lab results manually: 1. Load the patient s record into the Patient Address View. 2. In the EHR module, access Billing and Coding. 3. Scroll down to the Result grid and click Add New. A new result record is created. 4. Double click in each field and enter the results. Understanding Your Meaningful Use Report, v

48 Menu Set 3 - Patient Lists Menu Set 3 - Patient Lists You can electronically select, sort, retrieve, and generate lists of patients according to the following criteria: problem list, medication list, demographics and laboratory test results. This feature allows you to create and display patient lists based on specified and found in the problem lists, medication lists, demographics and laboratory test results of patients meeting the search criteria specified. Measure #3 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Patient Lists Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. Generate at least one report listing patients of the EP with a specific condition. No exclusion. Tools > Administrative Reports > Patient Lists N/A this measure is not attested to by percentage but rather by Yes/No Your usage of the Patient Lists screen is not tracked by activehr. To meet this measure, generate at least one report listing your patients with a specific condition in the reporting period. You can then attest in the affirmative. Report provides only. 3PatientLists.pdf To generate a list of patients: 1. From the top menu bar, choose Tools > Administrative Reports > Patient Lists. Understanding Your Meaningful Use Report, v

49 Menu Set 4 - Patient Reminders The Patient Lists report options appear. 2. For Type, select Clinical if it s not already selected. 3. Enter a name for the report in the Name field. For example, Patients with diabetes. This name will appear at the top of the report. 4. Set the demographics for the patients you want to include in the report: Set the age range if needed by changing the default ages in the From and To fields. Set the gender if needed by clicking in the Gender field and selecting Male or Female. Leaving the field blank defaults to both genders. In the Display Inactive field, set whether to include only active records or also inactive records. 5. Enter one parameter to search on. For example, in the Problem field, enter a diagnosis code such as or a diagnosis description such as diabetic retinopathy. Note: The system currently only searches on one parameter. 6. Press Enter after typing in the parameter. 7. Click Search. The patient list generates and appears in the report space to the right. 8. Click Printer friendly version to print the report. Menu Set 4 - Patient Reminders This measure requires you to send reminders to patients for preventive or follow up care. In activehr, you can print patient reminder lists containing two or more patients for follow-up care. You can filter reminder lists to display only those patient records that contain specific problems, medications, allergies, demographics and laboratory test results. Measure #4 Objective Patient Reminders Send reminders to patients per patient preference for preventive/follow up care. Understanding Your Meaningful Use Report, v

50 Menu Set 4 - Patient Reminders Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more More than 20 percent of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period. An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology. Tools > Administrative Reports > Patient List, and Patient Address View for setting the patient s communication preferences The total number of unique patients seen within the Attestation period who are 5 years old or younger and who are 65 years old or older. N/A The denominator value is provided to inform you of the total number of patients that can receive reminders pertaining to this measure. This should give you an idea of the effort required to pass the measure. Also, if you keep track of the reminders you provide to patients, you can calculate your percentage using that value as the numerator. Reminders must be in accordance with the patient's communication preference. Report provides only as activehr does not track the reminders that are sent out to patients. 4PatientReminders.pdf To set communication preferences: 1. Go to the Patient Address View window. 2. In the Communication Preferences tab, set the patient s first, second and third contact preference using the three drop-down menus. Understanding Your Meaningful Use Report, v

51 Menu Set 4 - Patient Reminders To print a reminder list: 1. Go to Tools > Administrative Reports > Patient List. 2. Select Reminders from the Type drop-down list. 3. Type a name for the report in the Name field and press Enter. For example, Reminders List. This name will appear at the top of the report. 4. Optionally, set the patient age range and/or specify a gender. 5. Set whether you want inactive patients included. 6. Optionally, filter the report results by adding any problems, results, medications, or allergies. Type the filter in the column on the right and press Enter. 7. Click Search. The patient list generates and appears in the report space to the right. Note that the patients communication preferences are displayed. 8. Optionally, print the list by clicking Printer friendly version. When the report appears, rightclick anywhere in the report and choose Print. 9. Contact the patients according to the method indicated in the Communication Preferences column. Understanding Your Meaningful Use Report, v

52 Menu Set 5 - Patient Electronic Access Menu Set 5 - Patient Electronic Access You can provide patients with electronic access to their health in activehr. Note: This only applies if a patient requests the access. To implement this, please submit a request to the First Response Support Team. Measure #5 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Patient Electronic Access Provide patients with timely electronic access to their health (including lab results, problem list, medication lists, and allergies) within 4 business days of the being available to the EP. At least 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health subject to the EP s discretion to withhold certain. Any EP that neither orders nor creates lab tests or that would be contained in the problem list, medication list, medication allergy list (or other as listed at 45 CFR (g)) during the EHR reporting period. Online Access tab in Patient Address View. The number of unique patients seen by the EP within the Attestation period. The number of patients whose CCD was generated within 4 days of their latest exam. Print out access code and give it to the patient. Report provides only it shows the percentage of patients whose CCD was prepared within the stipulated time frame, and was available had the patient requested it. 5PatientElectronicAccess.pdf Menu Set 6 - Patient-specific Education Resources You can provide educational resources to the patient using the WebLinks area of activehr. The educational resources must be patient-specific and address data found in the patient s problem list, medication list and laboratory test results. Understanding Your Meaningful Use Report, v

53 Menu Set 6 - Patient-specific Education Resources This feature ensures that patients are receiving the educational resources they need so they can learn and understand more about their diagnosis. Measure #6 Objective Measure Exclusion activehr location Denominator Numerator Fast Track Attestation Usage Link for more Patient specific Education Resources Use certified EHR technology to identify patient specific education resources and provide those resources to the patient if appropriate. More than 10 percent of all unique patients seen by the EP are provided patient specific education resources. No exclusion. EHR module Exam Configurations page N/A Provide patients with educational resources related to their diagnosis using the procedure below and keep a record of your distribution. Report provides only. 6Patient specificeducationresources.pdf To access the educational resources area of activehr: 1. Navigate to the Exams Task in the Tasks tab of the Workspace Manager. 2. Use the scroll arrow to scroll down to the WebLinks icon. 3. Click the icon. Understanding Your Meaningful Use Report, v

54 Menu Set 7 - Medication Reconciliation The following web links are displayed. 4. Click one of the following icons to display the corresponding web page. ColorVision Counseling AOA Meds Optiport MedLine Plus For example, if a patient requires more on the disease glaucoma, you can click on the MedLine Plus icon. This displays the MedLine website on the right, where you can print out for the patient. Menu Set 7 - Medication Reconciliation In Rcopia, you can review a patient s medication history with the patient. This is beneficial when the patient has been transitioned into your care. Measure #7 Objective Measure Exclusion activehr location Denominator Numerator Medication Reconciliation 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. The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP. An EP who was not the recipient of any transitions of care during the EHR reporting period. EHR module e Prescribing N/A in activehr Understanding Your Meaningful Use Report, v

55 Menu Set 8 - Transition of Care Summary Fast Track Attestation Usage Link for more For patients who have been transitioned into your care, review their medication history with them in Rcopia. Report provides only. 7MedicationReconciliation.pdf To perform medication reconciliation: 1. Ensure that the patient s insurance has been properly recorded in the Patient Address View. 2. Navigate to the e-prescribing module. The patient s formulary should automatically appear, based on the insurance that you specified in step Click on Medication History. 4. Review Medications in the Med list with the patient (if there are meds in the Med History list). 5. Click on Medication History is Complete. Menu Set 8 - Transition of Care Summary You can record transitions of care in Rcopia and print the summary of care document to provide for the referral Measure #8 Objective Measure Exclusion activehr location Denominator Numerator Transition of Care Summary The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral. 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 percent of transitions of care and referrals. An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period. EHR module e Prescribing N/A from activehr Understanding Your Meaningful Use Report, v

56 Menu Set 9 - Immunization Registries Data Submis- Fast Track Link for more Record the patient transition and referral date in Rcopia and then provide the summary of care to either the patient or the next care setting 8TransitionofCareSummary.pdf In Rcopia, you will need to work in three tabs to execute this objective: Demographics, Care, and Care Summary. To provide a summary of care record: 1. Indicate that the patient is transitioning: In the Demographics section, click on Select next to the Ancillary Services field. A pop up window appears. Select the area into which you are transitioning the patient. Select Other if none of the listed areas applies. Click Submit. 2. Enter the date that you referred the patient: In the Care tab, find Ancillary Service Visit. Under date ordered, enter the date that you referred the patient. Note: You must follow up with the patient to find out if they did follow through on the visit. If yes, enter the date in Date Performed. 3. Enter the referral date in the Care Summary: In the Care Summary tab, find the Clinical Summary Tracking box located just below the Alert section. Enter the date you referred the patient in the first (of three) date fields. This date should match the ordered date you entered in the Care tab. 4. Provide the summary of care record by doing one of the following: Give a printed copy of the Care Summary to the patient Fax the copy to the next care setting. Menu Set 9 - Immunization Registries Data Submission This measure is not applicable to optometry. Optometrists can enter an exclusion when attesting Measure #9 Objective Immunization Registries Data Submission Capability to submit electronic data to immunization registries or immunization systems and actual submission according to applicable law and practice. Understanding Your Meaningful Use Report, v

57 Menu Set 10 - Syndromic Surveillance Data Submis- Measure Exclusion activehr location Denominator Numerator 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 has the capacity to receive the electronically). An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the electronically. N/A N/A this measure is not attested to by percentage but rather by yes/no. Fast Track Not applicable to optometry, automatic exclusion. Attestation Usage Link for more Report provides only. 9ImmunizationRegistriesDataSubmission.pdf Menu Set 10 - Syndromic Surveillance Data Submission This measure is not applicable to optometry. Optometrists can enter an exclusion when attesting. Measure #10 Objective Measure Syndromic Surveillance Data Submission Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice. 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 has the capacity to receive the electronically). Understanding Your Meaningful Use Report, v

58 During the Attestation Period Exclusion activehr location Denominator Numerator An EP who does not collect any reportable syndromic on their patients during the EHR reporting period or does not submit such to any public health agency that has the capacity to receive the electronically. N/A N/A this measure is not attested to by percentage but rather by yes/no. Fast Track Not applicable to optometry, automatic exclusion. Attestation Usage Link for more Report provides only. 10SyndromicSurveillanceDataSubmission.pdf Quality Measures This section provides on: How to build up quality measures data for attestation How to generate quality measures data During the Attestation Period It is recommended that you carefully maintain the Problem List in Billing and Coding throughout the attestation period, in particular for cases of: Glaucoma - for NQF See NQF Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation on page 58 Diabetic retinopathy - for NQF See NQF Diabetic Retinopathy - Macular Edema on page 59. Note that for a patient s data to be included in the quality measures results, they must have had 2 or more visits during the attestation period. Generating Quality Measures Data Before you attest, and after the attestation period has completed, generate and print the quality measures data using the Quality Measures page. Understanding Your Meaningful Use Report, v

59 Generating Quality Measures Data The following table shows you the steps to obtain your quality measures data, with links to further details.: Step: See: 1. Access the Quality Measures page Accessing the Clinical Quality Page on page Enter provider Entering Provider Information on page Add measures from left panel Adding Measures on page Generate the data Generating the Report on page Print your results Printing the Data on page 56 Accessing the Clinical Quality Page Access this page from the Exams task list. To access the Clinical Quality measures page: 1. Load any patient record into the Patient Address View, and assign the patient an Exam task. 2. Click the Tasks tab in the Task list. 3. In the Exams task list, scroll down until you see the Quality Measures icon. 4. Click the icon to display the Quality Measures page. Note: If a Message from webpage dialog box appears when opening the page, click Ok to close the box. Understanding Your Meaningful Use Report, v

60 Generating Quality Measures Data Entering Provider Information To generate the data correctly, identify to the system the provider type and required date range. To enter provider : 1. In the EHR tree on the left side of the screen, enable the Quality Measures check box and then enable the Provider / Encounter Information check box. The following page appears. 2. Select a Provider type. 3. Enter the start and end date for the attestation period (or the period for which you want to view the quality measures data). Click anywhere in the data fields to display a calendar. Click the Month to select the month, and the year to select a year. 4. Leave the Encounter location /Type options unchanged. All options should be disabled. 5. Click the Quality Measures button to return to the Quality Measures page. Adding Measures The default settings display some but not all of the available quality measures on the right side screen. The available measures are listed in the left pane. If you want to include data for some of the additional measure, add them to the right pane. Understanding Your Meaningful Use Report, v

61 Generating Quality Measures Data Note: All measures are generated whether or not they are displayed in the right pane. To add measures to the report: 1. If needed, expand the left pane to the right to view the full text of the measures. 2. Enable the check box for a measure you want to add. The measure is added to the right pane and a data entry tool opens for the measure. 3. Close the data entry tool. Note: Do not select the PQRI Electronic Reporting Generating the Report Generate the report to view data derived from your database. To generate the report: Click the Recalculate Quality Measures link. The data on the page is refreshed. Printing the Data When you are happy with your results, print the data to have it available for attestation. To print the data: Right-click anywhere on the page and select Print from the menu. Understanding Your Meaningful Use Report, v