MedTeam and Meaningful Use Measures

MedTeam and Meaningful Use Measures MedTeam, an ONC-ATCB certified EHR software, can be utilized to aid your practice in meeting the Meaningful Use Stage 1 requirements as set forth by the government. Information regarding Meaningful Use and what it means to your practice can be found at http://www.cms.gov/ehrincentiveprograms/30_meaningful_use.asp#topof. For more information regarding the CMS EHR Incentive Program, access http://www.cms.gov/ehrincentiveprograms/30_meaningful_use.asp#topof. There are numerous pages of information found within this link to aide you in learning how the EHR Incentive Program can benefit your practice. The following information will advise your practice of how to utilize MedTeam to assist in meeting the Meaningful Use Stage 1 requirements. Click on the measure title below to learn more from CMS about the specific measure and the attestation requirements your providers must meet, as Eligible Professionals, to achieve each particular measure. Utilizing this guide along with the measure specifications found in the links below, your practice will be on its way to achieving meaningful use as set forth by the government. Once you have achieved setting up MedTeam to adhere to these specifications, access User Utility > Reports > Meaningful Use Reports > Meaningful Use 170.302(n) to generate the MedTeam Meaningful Use report to see where your Eligible Professionals stand regarding compliance of each of the calculated measures. *** Please note: Not all measures are reported on the MedTeam Meaningful Use report. Some measures are reported based solely on attestation and do not require a percentage to be calculated. Those measures that MedTeam calculates for each Eligible Professional will be noted as such. *** 1

Eligible Professional Core Measures Objective: 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. (calculated by MedTeam) MedTeam utilizes two methods of computerized provider order entry for medication orders. 1. RelayHealth e-prescribing can be utilized through the Meds tab to enter medications into the patient s medical record. When the e-prescribe button is activated, the user launches a secure connection to the RelayHealth website where the user enters in the patient prescriptions. RelayHealth then returns the prescription information back to the MedTeam software to be loaded automatically into the patient s medication list on the Meds tab. 2. Users may prescribe medications through the Prescribe button on the Meds tab to enter medications directly into the patient s medical record. 2

Implement drug-drug and drug-allergy interaction checks. The EP has enabled this functionality for the entire EHR reporting period. MedTeam utilizes RelayHealth e-prescribing for all drug-drug and drug-allergy interaction checks. Providers should utilize RelayHealth e-prescribing to meet the drugdrug and drug-allergy Core Measure. 3

Maintain an up-to-date problem list of current and active diagnoses. More than 80% 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. (calculated by MedTeam) The Prob tab within the MedTeam EMR is utilized to maintain an up-to-date problem list for the patient. If a patient has no existing problems, then No Prob Known must be clicked on the Prob tab for the Eligible Professional to receive credit for the patient. If No Prob Known is not selected and there are no existing problems in the problem list, the patient will not qualify in the numerator for this measure. 4

Generate and transmit permissible prescriptions electronically (erx). More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. (calculated by MedTeam) MedTeam interfaces with RelayHealth s e-prescribing module for e-prescribing capabilities. MedTeam will calculate this measure s percentage based on the e- prescriptions returned by RelayHealth to your database. Prescriptions written directly out of MedTeam using the Prescribe button do not count as e-prescriptions. NOTE: If your practice utilizes another vendor for e-prescribing, MedTeam will be unable to calculate this measure. 5

Maintain active medication list. More than 80% 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. (calculated by MedTeam) MedTeam will calculate the number of patients with an active medication list based on entries made to the Meds tab in MedTeam EMR. If a patient is not taking any medications, the button No Meds must be selected to receive credit in the numerator for the patient. 6

Maintain active medication allergy list. More than 80% 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. (calculated by MedTeam) Patient allergies are recorded on the Meds tab within the MedTeam EMR. To receive credit in the numerator for this measure, the EP must record an allergy or NKDA within the allergy section of the EMR. Allergies 7

Record all of the following demographics: Preferred language, gender, race, ethnicity, and date of birth. More than 50% of all unique patients seen by the EP have demographics recorded as structured data. (calculated by MedTeam) MedTeam will calculate this measure s percentage based on all patients specified for the reporting period. Each patient must have the preferred language, gender, race, ethnicity, and date of birth recorded on the General tab in patient demographics to qualify in the numerator. 8

Record and chart changes in the following vital signs: Height, weight, blood pressure, calculate and display body mass index (BMI), plot and display growth charts for children 2-20 years, including BMI. For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data. (calculated by MedTeam) Height and weight are recorded within the Vitals section of the MedTeam EMR. When height and weight are recorded, MedTeam automatically calculates and displays the patient s BMI. As well, if the patient falls between 2 and 20 years of age, MedTeam will automatically chart the patient s height and weight on the appropriate growth chart. 9

Record smoking status for patients 13 years old or older. For more than 50% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data. (calculated by MedTeam) Smoking status is recorded within the templates of MedTeam EMR. To gain credit for documenting the patient s smoking status, the EP must document the status with the use of EMR List 911 within the templating structure of the EMR. For example, the EP could add List 911 to an existing Social History that records the use of tobacco for the patient. The list includes the recodes required to be reported and displayed by the government and cannot be modified. The user may report other items related to the patient s smoking status within other line items of the tobacco use widget/template. 10

Report ambulatory clinical quality measures to CMS or, in the case of Medicaid EPs, the States. Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS. Clinical Quality Measures (CQM) are tracked within MedTeam via numerous methods, depending on the context of the CQM. Each CQM required as core or alternate, as well as CQMs that can be chosen by the practice specifically are documented within another white paper specific to each of the CQMs. Reporting of the CQMs chosen by a practice can be found within User Utility > Reports > CQM/PQRI Reports. 11

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. Clinical decision support rules are customized by each practice. These rules are structured around diagnoses, medications, lab results, allergies, patient age, and patient gender. MedTeam calls the rules Provider Alerts. To create a Provider Alert, access User Utility > Import/Export > Reminders/Alerts. Click New to access the Patient Alert screen, then enter the name of the alert being created. As well, determine the number of days between being reminded, and include a provider message regarding the alert that will be displayed when activated within the patient s chart. For example, a rule called Colon Health is created. The minimum days between reminders is 360, and the Message Provider Alert states that the patient is due for a colonoscopy due to the patient s age. 12

Once the Provider Alert is established, you will need to create the types of patients that need to be triggered for this rule. Click on the Edit Rule button. Select any appropriate diagnosis codes, medications, lab results, allergies, age range, and gender that should be associated with the rule. Click OK to save the selections. To utilize this feature within the patient s record, click on the Alert button in the Tool Bar at the top of the screen. This will launch any active alerts for the open patient. By double-clicking on the alert, the user may manage the alert for the patient. 13

Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies) upon request. More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days. (calculated by MedTeam) MedTeam generates an electronic copy of the patient s health information that can be burned to CD, put on an external USB drive, or emailed to the patient. From the Clinic tab in the patient record, click on the MR Request button to document the request from the patient or other requesting entity. 14

Click New to document the request for information. Enter in pertinent information pertaining to the medical records request. Once the request is fulfilled, mark the request complete. 15

To electronically create the record to be sent, click the Export USB or Export Disk button as displayed above in the screen shot of the Clinic tab. To email the record securely to the patient, select the Export Disk button. As with the Export USB feature, highlight the records that you wish to send to the patient. Then, click on the Email button, or just click Start to create a zip file that can be copied to a CD. Note that an email address must exist in the patient record to be able to send email to the patient. Once the email is generated, a password will be created and noted by a pop up alert. This password will need to be given to the patient or entity receiving the email. This can be done over the phone, or if the patient is in the office, the password will also generate on their receipt. If a password is forgotten, the password is noted in the security log of the patient demographics on the Log tab. Note: Each practice must contact the Helpdesk prior to emailing patient records. There are several system level items that must be set up prior to this feature working in your practice database. 16

Provide clinical summaries for patients for each office visit. Clinical summaries provided to patients for more than 50% of all office visits within 3 business days. (calculated by MedTeam) MedTeam generates a clinical summary, or CCD record, for each patient visit. This record can be printed or sent to the patient electronically. To generate a clinical summary, have the patient open in EMR, then click on the File menu and click Generate CCD Document. If you choose to email or give this to the patient electronically, then follow the above steps on how to do this. Otherwise, you may print the document for the patient. Here is a portion of a CCD record: Note: The display and printing of CCD documents generated with MedTeam require the use of IE8 or IE9 as the user s default web browser. Other versions of IE and other browsers may not accurately display the document and are not supported by MedTeam. 17

Capability to exchange key clinical information (for example: problem list, medication list, 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 information. MedTeam utilizes the same features as noted above in the previous two measures to generate secure electronic files that can be emailed or put on removable media to be sent to other healthcare entities. Please refer to the above for information on how to complete this test required for attestation. 18

Protect electronic health information 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 164.308(a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process. There are no MedTeam related instructions for this measure. If you need assistance with your security risk analysis, please contact the Helpdesk. 19

Eligible Professional Menu Set Measures Objective: 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. MedTeam utilizes RelayHealth e-prescribing for all drug formulary checks. Providers should utilize RelayHealth e-prescribing to meet the drug formulary checks measure. 20

Incorporate clinical lab test results into EHR as structured data. More than 40% 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. (calculated by MedTeam) MedTeam imports lab test results as structured data from the following laboratories: Quest, LabCorp, CPL, Ameripath, and ProPath. These results are stored within the database and will be reported on accordingly. If your practice currently does not do imports but utilizes any of the labs listed, please contact your lab representative to initiate the process of being able to accept the HL-7 files from the lab. Please also inform your lab representative that they will need to transmit LOINC codes within the HL-7 file. If you have further questions, after contacting your lab representative, please contact the Helpdesk. 21

Generate patient lists 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. EPs may generate lists based on multiple items recorded as structured data within MedTeam. To generate the lists, access User Utility > Import/Export > Export Patient Lists. Here, the user will find multiple reports that can be used to generate patient related lists. From EMR Exports > EMR DX/Drug/Lab Export, the EP may generate lists based on any combination of diagnoses, medications, labs, and the patient s age. 22

Send patient reminders per patient preference for preventive/follow-up care. More than 20% of all patients 65 years or older or 5 years or younger were sent an appropriate reminder during the EHR reporting period. (calculated by MedTeam) MedTeam generates patient related reminders based on rules set up by the practice. To create these rules, access User Utility > Import/Export > Reminders/Alerts > Reminder Templates. Create a Reminder Template by clicking the New Button. Identify the rule by giving it a name. Designate the maximum days from the patient s last visit that you would want a reminder generated as well as the minimum number of days between the reminders being triggered. Create a patient message to be sent in an email to the patient, then click Update. 23

Click Edit Rule to designate what patient population you would like this reminder to trigger. Complete the diagnosis, medications, lab results, allergies, age, and gender that you would like to trigger with your rule and click OK. To generate the Reminder Status Report, access User Utility > Import/Export > Reminders/Alerts > Reminder Status Report. The list will display any reminders that are pending at any given time to be worked. The patient demographics can be accessed through this work list, as well, reminders can be set done or reverted back to pending, if needed. If a practice desires to use bulk email to send reminders, the practice must acquire a bulk email vendor, then contact the Helpdesk for assistance in setting up the email feature. 24

Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP. At least 10% of all unique patients seen by the EP are provided timely (available to the patient within 4 business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP s discretion to withhold certain information. (calculated by MedTeam) MedTeam generates an electronic copy of the patient s health information that can be burned to CD, put on an external USB drive, or emailed to the patient. From the Clinic tab in the patient record, click on the MR Request button to document the request from the patient or other requesting entity. 25

Click New to document the request for information. Enter in pertinent information pertaining to the medical records request. Once the request is fulfilled, mark the request complete. 26

To electronically create the record to be sent, click the Export USB or Export Disk button as displayed above in the screen shot of the Clinic tab. To email the record securely to the patient, select the Export Disk button. As with the Export USB feature, highlight the records that you wish to send to the patient. Then, click on the Email button, or just click Start to create a zip file that can be copied to a CD. Note that an email must exist in the patient record to be able to send email to the patient. Once the email is generated, a password will be created and noted by a pop up alert. This password will need to be given to the patient or entity receiving the email. This can be done over the phone, or if the patient is in the office, the password will also generate on their receipt. If a password is forgotten, the password is noted in the security log of the patient demographics on the Log tab. Note: Each practice must contact the Helpdesk prior to emailing patient records. There are several system level items that must be set up prior to this feature working in your practice database. 27

Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. More than 10% of all unique patients seen by the EP are provided patient-specific education resources. (calculated by MedTeam) Patient specific educational resources are identified within the document templates set up with MedTeam. From User Utility > Options > Templates > open an existing educational document template description by highlighting and clicking edit. Designate the document as educational by checking the Education Resource Document check box. Then, set up any Education Selection Rules by clicking the Education Selection Rules button. 28

Designate any related and appropriate diagnoses, medications, lab results, and patient age to be used to trigger the documents displaying during the documentation of a patient encounter within the MedTeam EMR. To trigger any patient related document(s), navigate to the Docs tab in the patient record then click on the New Edu button. If there are any educational documents triggered for that patient, the list will be displayed so the document can be accessed and printed for the patient. 29

The EP who receives a patient from another setting of care of provider of care or believes an encounter is relevant should perform medication reconciliation. The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP. (calculated by MedTeam) MedTeam utilizes the line items in their templates to notate the status of the patient s transfer of care into their facility as well as if a medication reconciliation was performed. Within the template editor, assign a Field Name of XferIn to the associated line regarding the transfer of care into the practice. For the medication reconciliation, assign a field name of MedRecon. To gain credit for this measure, select these line items within the widget when documenting a patient encounter. 30

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% of transitions of care and referrals. (calculated by MedTeam) MedTeam utilizes the line items in their templates to notate the status of the patient s transfer of care out of their facility as well as if a summary of care record was sent. Within the template editor, assign a Field Name of XferOut to the associated line regarding the transfer of care out of the practice. To document the summary of care record being sent, assign the Field Name SumSent to the widget line item. To gain credit for this measure, select these line items within the widget when documenting a patient encounter. 31

Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice. 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 information has the capacity to receive the information electronically). If your practice submits immunizations to the State registry, currently, the existing export structure is all the State of Texas will accept for ImmTrac. The State is currently undergoing changes to be able to accept the HL-7 format required by the government for certified EHR software. MedTeam is capable of generating the required HL-7 but practices must contact the Helpdesk to get the required system components installed before attempting the test for attestation. 32

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 information has the capacity to receive the information electronically). MedTeam creates syndromic surveillance data as patients are processed through the MedTeam Queue and End of Day submission. A file is generated that can then be sent to a public health agency. MedTeam requires system level set up to be able to create this file. Please contact the Helpdesk for assistance with the set up your system requires. 33

MedTeam Certification Information This Complete EHR is 2011/2012 compliant and has been certified by an ONC-ATCB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. Trellix Engineering Corporation Certification Date: March 31, 2011 Version: 11.12 Certification ID: 03312011-1019-8 Clinical Quality Measures Certified: NQF0013, NQF0024, NQF0028, NQF0038, NQF0041, NQF0067, NQF0070, NQF0083, NQF0421 Additional Software Used: McKesson/RelayHealth 34