MediSYS EHR About Meaningful Use

MediSYS EHR About Meaningful Use
Contact Us ASAP if you plan to participate Register CMS: Select one of two Programs: Medicare / Medicaid If Medicaid, also register at: Medicaid easier first year/ greater incentive Eligible Professional: Medicaid (20% Peds) 30% - Patient Volume CRNP Medicare EP First Year: Medicaid: Adopt/Implement/Upgrade Medicare: 90 days ‘Meaningful Use’ Attestation Second Year: Medicaid ‘Meaningful Use’ (not consecutive) Medicare entire year ‘Meaningful Use’ 9/20/2018

Incentives Double Dipping
Must Start MU Attestation in 2012 to get full incentive for Medicare cannot receive a Medicare EHR incentive payment and an eRx incentive program in the same program year, or vice versa. can receive an incentive payment under the eRx incentive and Medicaid EHR program in the same program year. can receive PQRS with eRX or EHR program incentive To complicate matters a bit: Originally rule: participating in the Medicare EHR incentive program still must report the eRx measure to avoid the penalty Recent changes to rule: Submit one of four new exemption codes via web portal by 11/1/11 9/20/2018

MediSYS EHR Client Meaningful Use Link
Helpful Links MediSYS EHR Measure Videos Reports: Available by date range Report Tracker CQM Report Tracker Medicare Attestation Practice Link: 9/20/2018 MU Reports may need adjustments per Provider based on system use, interoperability, etc. Over half-a-million and counting paid to Alabama providers using MediSYS

Core & Menu Measures Reporting/ Attest
Reporting Period First Year - continuous 90 Day Subsequent Years – entire 12 months Reporting may vary by Provider Provider using MediSYS EHR for all Patient Encounters – MediSYS EHR reports will perform calculations Assistance Provided by MediSYS CMS Measures Published with FAQ by Measure: Medicare Attestation Worksheet: CMS FAQ “How EPs select Menu Objectives…” 9/20/2018

Core Measure 1 of 15 CPOE for Medication Orders
9/20/2018 Measure Quick Steps Report / Attest At least one prescription tied to an encounter for more than 30% of unique patients seen. Patient Encounter RX tied to Encounter Complete Encounter for Automatic Calculation Report: Percentages (CPOE) Numerator/Denominator Resulting % >30% Exclusion: EP writes fewer than 100 RX Clicking “e-Prescribe”, “Phone-in Prescription” or “Print Prescription” button satisfies this measure.

Core Measure 1 – CPOE for Medication Orders
9/20/2018

Core Measure 2 of 15 Drug Interaction Checks
9/20/2018 Measure Quick Steps Report / Attest Enable drug-drug and drug-allergy interaction checks for each EP. Settings/Drug Severity Alerts: Set up by provider: drug/drug, drug/allergy, drug/disease Patient Encounter or Patient Chart Interactions displayed at time of eRX Report: Not Applicable Attest: YES / NO Exclusion: No Exclusion

Core Measure 2 – Drug Interaction Checks (1 of 2)
9/20/2018

Core Measure 2 – Drug Interaction Checks (2 of 2)
9/20/2018

Core Measure 2 – Drug Interaction Checks
9/20/2018

Core Measure 3 of 15 Maintain Problem List
‘Up-to-Date’’ means list populated with most recent diag. known by EP. Core Measure 3 of 15 Maintain Problem List 9/20/2018 Measure Quick Steps Report / Attest Maintain up-to-date problem list of current & active diagnosis for more than 80% of unique patients seen. Patient Encounter Assessment Tab Add Diagnosis Selected Diagnosis:  Problem (to add to patient’s current Problem List) Report: Percentages (Up-to-Date Problem List) Numerator/Denominator Resulting % >80% Exclusion: No Exclusion

Core Measure 3 – Maintain Up-to-date Problem List
9/20/2018

Core Measure 3 – Maintain problem List
9/20/2018

Core Measure 4 of 15 Generate & Transmit Permissible Prescriptions Electronically (eRX)
9/20/2018 Measure Quick Steps Report / Attest While in an encounter, generate and transmit permissible prescriptions electronically for more than 40% of unique patients seen. Prescriptions Tab or Planning Tab ePrescribe button to electronically transmit eRX Report: Percentages (Generate and Transmit eRX) Numerator/Denominator Resulting >40% Tip: REPORT Applicable G-Codes for the appropriate # of events tied to an Encounter. Differs from Core Measure 1 because this only counts encounters where prescriptions are sent electronically to the pharmacy.

Core Measure 4 – Generate & Transmit eRX
Core Measure 4 of 15 Generate & Transmit Permissible Prescriptions Electronically (eRX) 9/20/2018 Differs from Core Measure 1 because this only counts encounters where prescriptions are sent electronically to the pharmacy.

Core Measure 4 – Generate & Transmit eRX
9/20/2018

Core Measure 5 of 15 Maintain Active Medication List
9/20/2018 Measure Quick Steps Report / Attest Maintain Active Medication List for more than 80% of unique patients seen. Patient Encounter Constitutionals Tab Medication List Perform one of the following: ePrescribe, enter Meds, update Meds or indicate No Meds. Check: Medications Reviewed Complete Encounter Report: Percentages (Active Medication List) Numerator/Denominator Resulting % >80% Exclusion: No Exclusion

Core Measure 5 – Active Medication List
9/20/2018

Core Measure 5 – Maintain Active Medication List
9/20/2018

Core Measure 6 of 15 Active Medication Allergy List
9/20/2018 Measure Quick Steps Report / Attest Maintain Active Medication Allergy list for more than 80% of unique patients seen. Patient Encounter Constitutional Tab Add allergy / reaction or  No known Allergy  Allergies Reviewed Complete Encounter Report: Percentages (Active Medication Allergy List) Numerator/Denominator Resulting % >80% Exclusion: No Exclusion Snomed Database for Allergic Reactions

Core Measure 6 – Medication Allergy List
9/20/2018

Core Measure 6 – Maintain Active Medication Allergy List
9/20/2018

Core Measure 7 of 15 Record Demographics
9/20/2018 Measure Quick Steps Report / Attest For more than 50% of unique patient seen, record all of the following demographics: Preferred language Gender Race Ethnicity DOB MediSYS PM Patient Account if not, using MediSYS PM, enter demographics in EHR Patient Medical Record (all elements) Report: Percentages (Record Demographics) Numerator/Denominator Resulting % >50% Exclusion: No Exclusion

Core Measure 7 – Record Demographics (MediSYS PM M2)

Core Measure 7 – Record Demographics (1 of 2)
9/20/2018

Core Measure 7 – Record Demographics (2 of 2)
9/20/2018

Core Measure 7 – Record Demographics
9/20/2018

Core Measure 8 of 15 Record Vital Signs
MediSYS EHR will calculate BMI when height & weight are entered. Core Measure 8 of 15 Record Vital Signs 9/20/2018 Measure Quick Steps Report / Attest For more than 50% of unique patients seen 2 yrs or older, Record & chart changes in following vital signs: Height Weight BP BMI plot & display growth charts children 2-20, including BMI Patient Encounter Constitutional Tab Record Vitals Complete Encounter Report: Percentages (Vitals, BMI, Growth Charts) Numerator/Denominator Resulting % >50% Exclusion: EP who see no patients 2 yrs or older, or who believes all 3 vital signs have no relevance to scope of their practice Patients age 2-20 display Growth Charts in Patient Chart Tab

Core Measure 8 – Record Vital Signs
9/20/2018

Core Measure 9 of 15 Record Smoking Status
9/20/2018 Measure Quick Steps Report / Attest Record smoking status for more than 50% of unique patients seen 13 years or older. Patient Encounter PFSH Wellness Initiatives: Smoking Status (select from dropdown which includes unknown) Select Counseling Complete Encounter Report: Percentages (Record Smoking Status) Numerator/Denominator Resulting % >50% Exclusion: EP who sees no patients 13 years or older.

Core Measure 9 – Record Smoking Status
9/20/2018

Core Measure 10 of 15 Clinical Quality Measures (CQMs)
Clinical Quality Measures for Medicare EHR also apply to Medicaid EHR incentive program that are also in CHIPRA initial Core Measure Set. Core Measure 10 of 15 Clinical Quality Measures (CQMs) 9/20/2018 Measure Quick Steps Report / Attest Report 6 Ambulatory Clinical Quality Measures to CMS in the manner specified by CMS EP performs & document according to applicable Clinical Quality measures Complete Encounter No CMS requirement of a minimum numerator /denominator or exclusion fields. The value may be zero. YES/NO & Numerator/Denominator Exclusion: No Exclusion Measure Steward: NQF – National Quality Forum

Core Measure 10 of 15 Report 6 Clinical Quality Measures
A plan is to be developed to integrate the EHR incentive program with PQRI by 1/1/12. Core Measure 10 of 15 Report 6 Clinical Quality Measures 9/20/2018 3 required CQM core measures (substituting alternate core measures where necessary) 3 additional measures (select from 38 clinical quality measures). Per CMS: It is acceptable to have a '0' denominator provided the EP does not have an applicable population. CMS is currently working with EHR vendors on reporting. Please Review the Details on Clinical Quality Measures that apply to your provider at :

MU #10 – Clinical Quality Measures Need 3 CORE Sets
Hypertension – Blood Pressure Measurement NQF 0013 Preventive Care and Screening Pair NQF 0028 a) Tobacco Use Assessment b) Tobacco Cessation Intervention Adult Weight Screening & Follow up NQF 0421(PQRS 128) Alternate CORE Sets Weight Assessment & Counseling for Children & Adolescents NQF 0024 Preventive Care & Screening – Influenza Immunization for Patients 50 or older NQF 0041 (PQRS 110) Childhood Immunization Status NQF 0038 9/20/2018

Core Measure 10 – Clinical Quality Measures
9/20/2018

Core Measure 11 of 15 Clinical Decision Support Rule
9/20/2018 Measure Quick Steps Report / Attest Implement one clinical decision support rule. Setup one Clinical Decision Support rule in: Settings / CDS Select: Preventive, Disease, Meds, Allergy, Labs Associated reminders displayed on Orders Tab Report: Not Applicable YES / NO Exclusion: No Exclusion Drug/Drug & Drug/Allergy alerts CANNOT be use for this measure.

Core Measure 11 – Clinical Decision Support Rule
9/20/2018

Core Measure 12 of 15 Electronic Copy of Health Information
CCD – Continuity of Care Document Core Measure 12 of 15 Electronic Copy of Health Information 9/20/2018 Measure Quick Steps Report / Attest More than 50% of all patients who request an electronic copy of their health information provided it within 3 business days. (including diagnostic test results, problem list, med list, med allergies) Patient Portal Patient Selects Option to: Download Full CCD OR Patient Chart Create a CCD Click on: Patient Requested Report: Percentages (Patient Request) Numerator/Denominator Resulting % >50% Exclusion: EP who has no requests from patient of their agents for an electronic copy of PHI during reporting period. Best Practice : If provider does not have Patient Portal, for all Patients WHO REQUEST electronic copy, Create CCD & Click Patient Requested

Core Measure 12 – Electronic Copy of Health Information (1 of 2)
9/20/2018

Core Measure 12 – Electronic Copy of Health Information (2 of 2)
Best Practice : If provider does not have Patient Portal, for all Patients WHO REQUEST electronic copy: Create CCD & Click Patient Requested

Core Measure 12 – Electronic Copy of Health Information
9/20/2018

Core Measure 13 of 15 Clinical Summaries
Office visits include separate, billable encounters that result from E&M code-see details. Core Measure 13 of 15 Clinical Summaries 9/20/2018 Measure Quick Steps Report / Attest For more than 50% of all office visits, clinical summaries provided to patients within 3 business days. Click: Create Clinical Summary: Encounter or Chart And / OR Patient Portal Patient Selects Option to: Download Single Visit CCD Report: Percentages (Clinical Summary Report) Numerator/Denominator Resulting % >50% Exclusion: Any EP who has no office visits during the EHR reporting period. Best Practice : At end of ALL Office Visit Encounters Click: Create Clinical Summary Rev

Core Measure 13 – Clinical Summaries
Best Practice : At end of Encounter - Click: Create Clinical Summary for all Office Visits.

Core Measure 13 – Clinical Summaries
9/20/2018

Core Measure 14 of 15 Electronic Exchange Key Clinical Information
9/20/2018 Measure Quick Steps Report / Attest Performed at least one test of EHR’s capacity to electronically exchange key clinical information (i.e. problem list, med list, med allergies, test results) among providers of care & patient authorized entities electronically. Patient Encounter Complete Encounter Create a CCD Exchange with appropriate entity Report: Not Applicable YES / NO Exclusion: No Exclusion CCD - Continuity of Care Document– Includes problem list, med list, med allergies, test results)

Core Measure 14 – Electronic Exchange of Clinical Information (1 of 2)
9/20/2018

Core Measure 14 – Electronic Exchange of Clinical Information (2 of 2)
9/20/2018

Core Measure 14 – Electronic Exchange Key Clinical Information
9/20/2018

Core Measure 15 of 15 Protect Electronic Health Information
9/20/2018 Measure Quick Steps Report / Attest EP must attest to conducting a review of security risk analysis in accordance with the requirements under 45 CFR (a)(1) & implement security deficiencies as part of its risk management process. Conduct the security risk analysis MediSYS EHR Settings: establish practice-defined security settings for: “inactivity timeout”, password security settings, etc. Report: Not Applicable YES / NO Exclusion: No Exclusion

Core Measure 15 – Protect Electronic Health Information
9/20/2018

Pick 5 “Menu” Set Objectives
9/20/2018 Capability to submit electronic data to immunization registries/systems.* Capability to provide electronic syndromic surveillance data to public agencies* Implement Drug-formulary checks Incorporate clinical lab test results as structured data Generate lists of patients by specific condition Send reminders to patients per patient preference for preventive/follow up care Provide patients timely electronic access to their health info. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate Medication reconciliation Summary of care record for each transition of care/referral *At least 1 public health objective must be selected CMS FAQ – “How should EPs select menu objectives…”

Menu Set Measure Selections – Public Health Objective
9/20/2018

Menu Set Measure Selections -
9/20/2018

Menu Set Measure 1 of 10 Immunization Registries Data Submission*
*At least 1 public health objective (menu 1 or 2) must be selected. If applicable, may have “exclusion” on either menu 1 or 2, but not both. If applicable, may attest to both menu 1 or 2. Menu Set Measure 1 of 10 Immunization Registries Data Submission* 9/20/2018 Menu Measure Quick Steps Report / Attest 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. Test Patient Medical Record Chart Tab: Immunization History Click: Export Immunization Save file Upload file to ADPH Print “Successful” YES / NO Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically. OR activate ADPH (formerly Immprint)– Immunization orders electronically submitted via Orders Tab and Updating ADPH through Chart / Import

Menu Set 1 – Immunization Registries Data Submission
9/20/2018

Menu Set 1 – Immunization Registries Data Submission ADPH
Active ADPH Interface – Use Real Patient Data 9/20/2018 Automatically Submit to ADPH: Order Test and/or Add Immunization

Menu Set Measure – Public Health List 1 (Immunization Registries)
9/20/2018

Menu Set Measure 2 of 10 Syndromic Surveillance Data Submission*
*At least 1 public health objective must be selected Menu Set Measure 2 of 10 Syndromic Surveillance Data Submission* 9/20/2018 Menu Measure Quick Steps Report / Attest 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. Another Test Patient Medical Record Chart Tab: Immunization History Click: Export Immunization Save file Upload file to ADPH Print screen of “Successful” YES / NO Exclusion: An EP who does not collect syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically.

Menu Set 2 – Syndromic Surveillance Data Submission
9/20/2018

ADPH On-Line Submission
Used For Menu Measures 1 and 2 ADPH On-Line Submission Go To: Click: Security Portal New User (register & check: ADPH MU) Upload Save file of Test Patient Print “Successful” message for file 9/20/2018

Menu Set Measure – Public Health List 2 (Syndromic Surveillance)
9/20/2018

Menu Set Measure 3 of 10 Implement Drug Formulary Checks
9/20/2018 Menu Measure Quick Steps Report / Attest The EP has enabled drug formulary checks and has access to at least one internal or external formulary for the entire EHR reporting period. Electronically prescribe via MediSYS EHR Report: Not Applicable YES / NO Exclusion: EP who writes fewer than 100 RX during reporting period. MediSYS EHR Uploads Latest Formularies

Menu Set 3 – Drug Formulary Checks
9/20/2018

Menu Set 3 – Implement Drug Formulary Checks
9/20/2018

Menu Set Measure 4 of 10 Incorporate Lab Test Results in EHR
9/20/2018 Menu Measure Quick Steps Report / Attest Incorporate lab test results as structured data in EHR for more than 40% of all clinical labs ordered. Patient Encounter Order Tab Order Lab Lab Results Entered (interface or data-entry) Report: Percentages (Incorporate Lab Results) Numerator/Denominator Resulting % >40% Exclusion: EP who orders no lab tests whose results are either in a positive /negative or numeric format during the reporting period

Menu Set 4 – Clinical Lab Test Results (1 of 2)
9/20/2018

Menu Set 4 – Clinical Lab Test Results (2 of 2)
9/20/2018

Menu Set 4 – Incorporate Lab Test Results in EHR
9/20/2018

Menu Set Measure 5 of 10 Generate Lists of Patients by Specific Condition
9/20/2018 Menu Measure “Quick Steps Report / Attest Generate at least one report listing patients of the EP with a specific condition. Report : Patient List (Diagnosis / Problem) Select Report Format Print Report: Patient List (Diagnosis/Problem) YES / NO Exclusion: No exclusion Printing this report from EHR satisfies this measure.

Menu Set 5 – Patient Lists Specific Condition
9/20/2018

Menu Set 5 – Generate Lists of Patients by Specific Condition
9/20/2018

Menu Set Measure 6 of 10 Send Patient Reminders for Follow-up
MediSYS EHR includes Patient Record field to indicate Communication Preference (i.e. Patient Portal, phone, etc.) Menu Set Measure 6 of 10 Send Patient Reminders for Follow-up 9/20/2018 Menu Measure Quick Steps Report / Attest More than 20% of all patients 5 yrs or younger and 65 years or older were sent an appropriate reminder during the EHR reporting period per patient preference for preventive/follow-up care. Patient Record Select: Patient Preferred Communication Method EHR Report Patient Reminder List Report Format Print Reports: Patient Reminder List: Allergies, Demographics, Lab Results, Medications, Problems Percentage (Patient Reminder) Numerator/Denominator Resulting % >20% Exclusion: EP who has no patients 65 yrs old or older or 5 years old or younger with records maintained using certified EHR technology.

Menu Set 6 – Patient Reminders for Preventive/Follow-up Care (1 of 2)
9/20/2018

Menu Set 6 – Patient Reminders for Preventive/Follow-up Care (2 of 2)
9/20/2018

Menu Set 6 – Send Patient Reminders for Follow-up
9/20/2018

Menu Set Measure 7 of 10 Patient Electronic Access to Health Information
9/20/2018 Menu Measure Quick Steps Report / Attest More than 10% of all unique patients seen by the EP are provided timely (within 4 bus. days) electronic access to their health information (including lab results, problem list, med list, & allergies). Patient Portal Report: Percentages (Timely Access) Numerator/Denominator Resulting % >10% Exclusion: EP that neither orders nor creates lab tests or information that would be contained in problem list, med list, med allergy list, or other info. during report period.

Menu Set 7 – Patient Electronic Access to Health Information
9/20/2018

Menu Set Measure 8 of 10 Patient-Specific Education Resources
9/20/2018 Menu Measure Quick Steps Report / Attest More than 10% of all unique patients seen by EP are provided patient-specific education resources. Patient Encounter Planning Tab Patient Education Select: Print Report: Percentages (Patient-Specific Education) Numerator/Denominator Resulting % >10% Exclusion: No exclusion Printing Patient Education sends calculation to report Practice generated Patient Education or optional Krames Patient Education

Menu Set 8 – Patient-specific Education Resources
9/20/2018

Menu Set 8 – Patient-Specific Education Resources
9/20/2018

Menu Set Measure 9 of 10 Medication Reconciliation
9/20/2018 Menu Measure “2” Quick Steps Report / Attest Perform medication reconciliations for more than 50% of transition of care patients. Check Patient  Check: “Referred by”, enter refer name Patient Encounter Constitutionals  Meds Reviewed Report: Percentages (Medication Reconciliation) Numerator/Denominator Resulting % >50% Exclusion: EP who was not the recipient of any transitions of care during the EHR reporting period.

Menu Set Measure 9 – Medication Reconciliation (1 of 3)
9/20/2018

Menu Set 9 – Medication Reconciliation (2 of 3)
9/20/2018

Menu Set 9– Medication Reconciliation (3 of 3)
9/20/2018

Menu Set 9 – Medication Reconciliation
9/20/2018

Menu Set Measure 10 of 10 Transition of Care Summary
9/20/2018 Menu Measure “2”Quick Steps Report / Attest Provide a Summary of Care record for more than 50% of the transitions of care and referrals. Patient Encounter Planning Tab Referral, Select Refer provider  Summary of Care Provided Check Assessment Complete Encounter Post Visit: Create a CCD Report: Percentages (Patient Summary Record) Numerator/Denominator Resulting % >50% Exclusion: An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.

Menu Set 10 – Transition of Care Summary (1 of 2)
9/20/2018

Menu Set 10 – Transition of Care Summary (2 of 2)
9/20/2018

Menu Set 10 – Transition of Care Summary
9/20/2018

Core Measure 10 – Clinical Quality Measures (CQM)
Report on 6 CQMs 6 CQMS = 3 Core Measures + 3 Alternate Measures Core Measures can be made up of Core or Alternate Measures 9/20/2018

Core Measure 10 – Clinical Quality Measures Core Measures
9/20/2018 Core Measure 10 – Clinical Quality Measures Core Measures

Core Measure 10 – Core Clinical Quality Measures
9/20/2018

Core Measure 10 – Clinical Quality Measures Alternate Measures
9/20/2018 Core Measure 10 – Clinical Quality Measures Alternate Measures

Core Measure 10 – Alternate Core Clinical Quality Measures
9/20/2018

Core Measure 10 – Alternate Clinical Quality Measures
9/20/2018

Core Measure 10 – Clinical Quality Measures Additional Measures
9/20/2018 Core Measure 10 – Clinical Quality Measures Additional Measures

Core Measure 10 – Additional Clinical Quality Measures
9/20/2018

Report Tracker 9/20/2018

Measure Reporting may vary by Provider
IMPORTANT - individual Provider usage of electronic records for encounters (i.e. all encounters entered into MediSYS EHR, partial use of MediSYS EHR for patient encounters, etc.) will determine if the denominator for some of the measures, as defined by CMS, will need to be compiled from another reporting source outside of MediSYS EHR. This applies to the measures on the follow slides that have the word “Denominator” in red: Core Measures: 3, 5, 6, 7, 8, 9,13 and Menu Measures: 4, 5, 6 Please contact us for specifics or if you have any questions. 9/20/2018

Thank you! Disclaimer: This seminar is intended to provide a general overview. It is not intended to serve as legal or consulting advice. For the latest details, please refer to CMS and other carrier links and publications for more information. The MedConnect/MediSYS Electronic Health Record software (Software) was certified as a 2011/2012 compliant Complete EHR by Drummond Group, Inc., an ONC-ATCB, in accordance with the applicable certification criteria adopted by the Secretary of the U.S. Department of Health and Human Services (HHS). The 2011/2012 criteria support the Stage 1 meaningful use measures required to qualify eligible providers and hospitals for funding under the Health Information Technology for Economic and Clinical Health (HITECH) Act. To achieve ‘meaningful use’ providers must take specific action for each measure, therefore MedConnect/MediSYS is not responsible nor does MedConnect/MediSYS guarantee (i) the ability of users of the Software to demonstrate meaningful use as such term may be defined pursuant to the HITECH Act or its implementing regulations or (ii) the receipt of any form of incentive payments, including Medicare and/or Medicaid incentive payments under the HITECH Act. 9/20/2018

MediSYS EHR About Meaningful Use

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