1. Meaningful Use Best Practices and Troubleshooting
Denise Goble, EMR Consulting Team Lead, GE Healthcare
Katie Drennan, EMR Implementation Consultant, GE Healthcare
May 1, 2015

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3. Today’s Agenda Tips for meeting some of the Core and Menu Measures
Tips for meeting some of the Clinical Quality Measures
How to navigate the Meaningful Use User Guide

4. Functional Core Measures

5. Meaningful Use 2015 User Guide
Download from
GE Healthcare IT Service Portal under Documentation in
Centricity Practice Solution or
Centricity EMR
Meaningful Use

6. Functional Core – 01 CPOE Medication Orders, Radiology Orders, Laboratory Orders
Providers must be set up as Eligible Professionals in User Management.
CMS requires that entry only be made by authorized providers - clinical staff that are licensed healthcare professionals or credentialed medical assistants and indicated as such in User Management.

7. Functional Core – 04 (Stage 1) 02 (Stage 2) ePrescribing (eRX)
Stage 2 requires medication be compared against drug formulary.
This requires that prescriptions
not be refilled until drug formulary
information has been pulled.
Opening the document will start the process, but users should wait until the information is visible to complete the refill or new prescription.

8. Functional Core – 07 (Stage 1) 03 (Stage 2) Record Demographics *
Do NOT use “Undetermined” as
a classification for Race or Ethnicity.
Look at Race and Ethnicity subcategories to be sure they are not mapped to “Undetermined” or “Unspecified.”
*Modifications proposed by CMS for in April 2015 proposed rule

9. Functional Core – 08 (Stage 1) 04 (Stage 2) Record Vital Signs *
If BP supine or BP standing are utilized, these observation terms will need to be mapped using the Data Mapping tool.
If custom OBS terms are being used for these readings, those observation terms will also need to be mapped in the Data Mapping tool.
*Modifications proposed by CMS for in April 2015 proposed rule

10. Functional Core – 13 (Stage 1) 08 (Stage 2) Clinical (Visit) Summaries (CVS) *
Using the Handout titled Patient Instructions or Clinical Visit Summary does NOT meet this measure. Users must create the newly formatted CVS.
Save To Chart & Close option should only be selected if the CVS is going to be sent to the patient via Secure Messaging
Print should be used if giving to the patient at the time of the visit
Save To File should be used to store to portable media
*Modifications proposed by CMS for in April 2015 proposed rule

11. Functional Core – 05 (Stage 1) 07 (Stage 2) Patient Electronic Access
Give access to the portal either prior to the start of the reporting period or no later than 4 business days after the 1st office visit in the reporting period.
Count patient access using data from the MU activity log, which is populated by the portal when a patient is registered for access or using the OBS term “PATPORTALPIN” when signed, the MU activity log records that portal access was provided.

12. Functional Menu – 02 (Stage 1) Functional Core - 07 (Stage 2) Clinical Lab Test Results *
Only use Lab Report document type or add the custom document type to the Structured Lab Results(MU) view.
If using lab reports for Pathology reports, change that document type to something other than Lab Report.
If using Lab Report for scanned documents, a value for at least one test on that document will need to be indicated on the flow sheet.
Results expression: Numbers or Positive, negative, pos, neg, y, n, yes, no, true, false, T, F
Of Note: Currently items changed from “Lab Reports” are still showing in CQR.
*Modifications proposed by CMS for in April 2015 proposed rule

13. Functional Menu – 04 (Stage 1) Functional Core - 12 (Stage 2) Patient Reminders (Menu) Preventive Care (Core) *
If sending letters, use Send Reminder option from Inquiries screen. DO NOT print letters from Report screen or from the patient’s chart.
If using Televox or other type of call service for phone calls, run Inquiry in EMR and save. Also save call list from Televox as proof calls were completed in the event of an audit.
Send reminder
Printed Letter
*Modifications proposed by CMS for in April 2015 proposed rule

14. Functional Menu – 06 (Stage 1) Functional Core - 13 (Stage 2) Patient-specific Education Resources
Handouts printed from the InfoButton and the MU Checklist will meet this measure. Other printed handouts, including custom handouts, may be counted when suggested by the EMR if configured appropriately, but require a custom report.
Will we discuss this: If you customize the system to prompt a user to provide patient education based on elements of the patient's chart, GE recommends you create a custom report to capture this workflow for attestation. Note also that you must use the certified capabilities (with a focus on EHR identified educational materials) and, if you wish to rely on the system's meaningful use reporting, must use one of the specified workflows.

15. Functional Menu – 07 (Stage 1) Functional Core - 14 (Stage 2) Medication Reconciliation (1/2)
Encounter should be marked as a Transition of Care.

16. Functional Menu – 07 (Stage 1) Functional Core - 14 (Stage 2) Medication Reconciliation (2/2)
Verify MEDS REVIEW observation term is mapped in Data Mapping with a value of “Done”
All new patients in the EMR will be indicated as a Transition of Care In
Clicking the “Mark Reviewed” button on the Reconciliation form will mark MEDS REVIEW observation term with a value of “Done”.

17. Functional Menu – 08 (Stage 1) Functional Core - 15 (Stage 2) Transition of Care Summary/Summary of Care (1/2) *
Referral order/test order must be to an external provider.
*Modifications proposed by CMS for in April 2015 proposed rule

18. Functional Menu – 08 (Stage 1) Functional Core - 15 (Stage 2) Transition of Care Summary/Summary of Care (2/2) *
Referral order/test order must be to an external provider.
Order must have status of Admin Hold
Generate the TOC “Save & Create” document.
*Modifications proposed by CMS for in April 2015 proposed rule

19. Functional Menu - 03 (Stage 2) Imaging Results *
Only Document Types added to the Imaging Results (MU) view will be considered by the application and then counts its presence in the document as either a link to the image on an external site or as an attachment.
Do NOT use Imaging Results (MU) view for anything other than this type of report that has a link to the actual image in a system such as PACS.
*Modifications proposed by CMS for in April 2015 proposed rule

20. Use the MU Visit Checklist Form in Office Visit
Using this form allows users to ensure that many of the core measures have been addressed at each visit.
Orders section will display ALL orders that the patient has outstanding , regardless of date they were entered.
Orders done during the visit that are in a complete status will not show.

21. Clinical Quality Measures

22. Clinical Quality Measures (CQM) Physician Quality Reporting Service (PQRS)
Selected CQM/PQRS must cover at least three of the National Quality Strategy domains
Patient and Family Engagement
Patient Safety
Care Coordination
Population and Public Health
Efficient Use of Healthcare Resources
Clinical Processes/Effectiveness

23. Reading the Measure Data Requirement Version 1
There are various codes used in capturing data in CQR for CQMs and PQRS:
SNOMED Codes
LOINC Codes
CPT Codes
OBS – Observation Terms

24. Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record
An Order for the SNOMED Code is required.
The Use of CAMS will do this for you as well. Requires the OBS “MEDS REVIEW ” = “Done” and an Order for the SNOMED Code will be sent to Orders.

25. Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record
An Order for the SNOMED Code is required.
The Use of CAMS will do this for you as well. Requires the OBS “MEDS REVIEW ” = “Done” and an Order for the SNOMED Code will be sent to Orders.

26. Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record
An Order for the SNOMED Code is required.
The Use of CAMS will do this for you as well. Requires the OBS “MEDS REVIEW ” = “Done” and an Order for the SNOMED Code will be sent to Orders.

27. Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record
An Order for the SNOMED Code is required.
The Use of CAMS will do this for you as well. Requires the OBS “MEDS REVIEW ” = “Done” and an Order for the SNOMED Code will be sent to Orders.

28. Patient Safety CMS 139/NQF 0101 Falls: Screening for Future Fall Risk
Order placed by mapping OBS to LOINC Code
Risk Category Assessment
Geriatric Assessment – CCC
Falls Tab
uses “FALL SCR” OBS

29. Clinical Processes/Effectiveness CMS123 / NQF 0056 / PQRS 163 Diabetes: Foot Exam
Must report on Pulse, Sensory, and Visual Exam of the Foot with Orders (SNOMED)
SCT Pedal Pulse
SCT Sensory
SCT Visual Foot exam
Using CAMS

30. CMS147 / NQF 0041 / PQRS 110 GPRO PREV-7 Preventive Care and Screening: Influenza Immunization
Requires documentation of influenza in an office visit during the current flu season (Oct-March). Look at Initial Population Data elements for Qualified Encounters in the MU Guide.

31. Related Session: 3:15-3:45PM on Friday in Southern Hemisphere I, Session# 4560: CMS Proposed Changes for Meaningful Use in Mark Segal, Vice President, Government and Industry Affairs, GE Healthcare IT Objectives - Learn about key provisions in the CMS Meaningful Use proposed rule for Understand connections between the proposed rule and the Stage 3 proposed rule - Understand key implications for 2015 meaningful use planning

32. Thank you for attending today.