Meaningful Use Best Practices and TroubleshootingDenise Goble, EMR Consulting Team Lead, GE HealthcareKatie Drennan, EMR Implementation Consultant, GE HealthcareMay 1, 2015

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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

Functional Core Measures

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Meaningful Use 2015 User Guide

Download from• GE Healthcare IT Service Portal

under Documentation in • Centricity Practice Solution

or • Centricity EMR

Meaningful Use

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Functional Core – 01 CPOEMedication 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.

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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 formularyinformation 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.

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Functional Core – 07 (Stage 1) 03 (Stage 2)Record Demographics *

Do NOT use “Undetermined” asa 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 2015-2017 in April 2015 proposed rule

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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 2015-2017 in April 2015 proposed rule

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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 2015-2017

in April 2015 proposed rule

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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.

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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

*Modifications proposed by CMS for 2015-2017 in April 2015 proposed rule

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Functional Menu – 04 (Stage 1) Functional Core - 12 (Stage 2) Patient Reminders (Menu) Preventive Care (Core) *

Send reminder

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.

Printed Letter

*Modifications proposed by CMS for 2015-2017 in April 2015 proposed rule

Functional Menu – 06 (Stage 1) Functional Core - 13 (Stage 2) Patient-specific Education Resources

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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.

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Functional Menu – 07 (Stage 1) Functional Core - 14 (Stage 2)Medication Reconciliation (1/2)

Encounter should be marked as a Transition of Care.

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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”.

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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 2015-2017 in April 2015 proposed rule

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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 HoldGenerate the TOC “Save & Create” document.

*Modifications proposed by CMS for 2015-2017 in April 2015 proposed rule

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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 2015-2017 in April 2015 proposed rule

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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.

Clinical Quality Measures

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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

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Reading the Measure Data Requirement Version 1

There are various codes used in

capturing data in CQR for CQMs and PQRS:

SNOMED CodesLOINC CodesCPT Codes

OBS – Observation Terms

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Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record

An Order for the SNOMED Code 428191000124101 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

428191000124101 will be sent to

Orders.

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Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record

An Order for the SNOMED Code 428191000124101 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

428191000124101 will be sent to

Orders.

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Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record

An Order for the SNOMED Code 428191000124101 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

428191000124101 will be sent to

Orders.

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Patient Safety CMS68 / NQF 0419 / PQRS 130 Documentation of Current Medications in the Medical Record

The Use of CAMS will do this for you

as well. Requires the OBS “MEDS REVIEW ” = “Done” and an

Order for the SNOMED Code

428191000124101 will be sent to

Orders.

An Order for the SNOMED Code 428191000124101 is required.

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Patient Safety CMS 139/NQF 0101 Falls: Screening for Future Fall Risk

Geriatric Assessment – CCC

Falls Tabuses “FALL SCR” OBS

Order placed by mapping OBS to LOINC CodeRisk Category Assessment

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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-91161007 Pedal PulseSCT-134388005 SensorySCT-401191002 Visual Foot exam

Using CAMS

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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.

Related Session: 3:15-3:45PM on Friday in Southern Hemisphere I, Session# 4560: CMS Proposed Changes for Meaningful Use in 2015-2017Mark Segal, Vice President, Government and Industry Affairs, GE Healthcare IT

Objectives - Learn about key provisions in the CMS Meaningful Use proposed rule for 2015-2017 - Understand connections between the 2015-2017 proposed rule and the Stage 3 proposed rule - Understand key implications for 2015 meaningful use planning

Thank you for attending today.