Preventative Care (Patient Reminders) Stage 2 Core Measure - 12 of 17 Objective: Use clinically relevant information to identify patients who should receive reminders for preventive/followup care and send these patients the reminders, per patient preference. Measure: More than 10 percent of all unique patients who have had 2 or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder, per patient preference when available. Stage 2 changes: Stage 1 menu measure Stage 2 core measure NUMERATOR: Number of patients in denominator sent a reminder for preventative or follow-up care via patient s preference. DENOMINATOR: Number of unique patients who have had two or more office visits with the EP in the 24 months prior to the beginning of the EHR reporting period. > 10% Denominator logic: MU Certified QDM report will create the denominator of unique patients that have had 2-or more visits with an EP in the 24 month period prior to the beginning o the EHR reporting period. Threshold: The resulting percentage must be more than 10 percent in order for an EP to meet this measure. Note: Actions to increase the numerator must occur within the reporting period Exclusion(s): Any EP who has no office visits during the EHR reporting period. Notes In order to meet this objective and measure, the capabilities and standards of CEHRT at 45 CFR 170.314(a)(14) must be utilized. Users are required to leverage the certified Patient List Creation report in QDM to create the denominator for this measure. The provider is permitted, but not required, to limit the measure of this objective to those patients whose records are maintained using certified EHR technology (CEHRT). A patient may also decline to receive reminders. These patients with a reminders preference of Opt Out will be included in both the numerator and the denominator. EPs meet the aspect of per patient preference of this objective if they are accommodating known reasonable requests in accordance with the HIPAA Privacy Rule, as specified at 45 CFR 164.522(b), which is the guidance established for accommodating patient requests. (patient preference is set in LMR Summary 2) Page 1
An EP should use clinically relevant information stored within the CEHRT to identify patients who should receive reminders. To count for the measure, reminders for preventive/follow-up care must be for care that the patient is not already scheduled to receive. Reminders for referrals or to engage in certain activities are also included in this objective and measure. Reminders must be sent using the preferred communication medium only when it is known by the provider. This is limited to the type of communication (phone, mail, secure messaging, etc.) and does not extend to other constraints like time of day. Patients that receive more than one reminder letter from an EP will only count once in both the numerator and denominator. Patients may decline to provide their preferred communication medium in which case the provider may select the communication medium. How to use the LMR to fulfill the Send Reminders to Patients requirement This process will follow the process steps below: Prior to running the 1. Create workflow to document the Individual Patient Reminder Preference. 2. Create a Patient Reminder Template(s) (one time) for the Practice (request help from your Imp/Support analyst) 3. Generate a Patient Query List (stage 2) report in Report Central. 4. Access the report in My Patient List. 5. Document/Generate Reminders. 1. Document Patient Reminder Preference From the LMR, select Patient Chart / Summary 2. The Patient Reminder Preferences section displays at the bottom of the screen with the following options: Patient Gateway (PG), Mail, Phone, and Opt Out. No selection indicates a preference has not been collected for this patient. For a patient with no selection, a letter reminder can be sent, based on the provider s discretion, and will count toward meaningful use. If Patient Gateway is the patient's preference and the Patient Gateway account is removed - the patient's preference will change to "None". If the preference is None, a hardcopy letter reminder can be sent and will count toward meaningful use. Page 2
2. Create Patient Reminder Template From the LMR, select Custom Templates. From the Custom Templates screen, click the Add New dropdown and select Patient Reminder. Select the Category (i.e. letter) and Type (i.e. correspondence). Use system macros, free text and/or custom paragraphs to create the template (the system macro..reminders will pull in patient reminders). 1. Click the <Save> button. 2. Enter Template Name, Note Subject and select Save to: Practice and click the <Save> button. You must save the template to the Practice this will insure the template is available to all users in the Practice who may be generating the reminders from the Reminders Patient List. Page 3
3. Generate a Patient List Query (stage 2) report in Report Central Eligible Professional - Meaningful Use Stage 2 From the LMR, select Reports Report Central. For the Patient List Query (stage 2) report (Provider = My tab; Staff = Meaningful Use tab), click the <Run Now> button. On parameters selection page, select the appropriate reporting period then click <Submit> button. 1. Enter a name for the resulting patient list that will help staff distinguish your list from other lists in the practice. 2. Click the <Save to Reminder List> button. Page 4
4. Access the report in My Patient List From the LMR, select Desktop My Patient List. Click the Reminders tab. 1. Document/Generate Reminders 1. Display only check boxes filter the list (all are selected by default). a. Select/unselect notify preference(s) in Display Only area to filter patients by preference(s). b. Click the <Submit> button; the list is filtered to show only those patients preferring the selected method(s). 2. To display the reminders for an individual patient click Expand Reminder list icon to the left of the patient name. a. To display reminders for all patients, select the Expand All radio button. b. The Collapse All radio button will hide the reminders for all patients in the list. c. Click the patient name link to view the patient chart. 3. To send reminders, select the patient(s) by clicking checkbox to the left of the patient name, click the Add New Using Template dropdown menu and select the template. Page 5
4. The template will display. Click the <Ok-Final> button and Sign the transaction. It is recommended to always use the <Ok-Final> button. The <Ok-Final> button sends the reminder and saves the note as final. The <Ok> button will save the note as Preliminary and does not send the reminder, therefore, will not satisfy Meaningful Use criteria. 5. Click the Date link in the Date Reminded column to view the note generated in the patient chart when the reminder was sent. 6. Click the Display List Information icon to view list information a. Date: Date list was created b. List Name: Name user chose for report when it was created c. Provider: for whose patient reminders are generated d. Pts Reminded: Number of patients that have had reminders sent to them out of the total number of patients in the list Page 6
Changes from Stage 1 to Stage 2 pertaining to this measure The Stage 1 menu set (optional) measure targeted two specific patient populations: (1) 65 years old or older and (2) 5 years old or younger. EPs that chose this menu set measure were required to send an appropriate reminder during the EHR reporting period for more than 20% of these unique patients. The Stage 2 measure has updated this measure to a core set (required) criterion with a few modifications. This Stage 2 core measure applies to all patients with two or more office visits during the past year with an EP, not just the Stage 1 target patient populations. As this change increases the number of eligible patients, the threshold for this criterion was dropped to greater than 10% in Stage 2 as opposed to Stage 1 s 20% threshold Page 7