Q4XWebinar:$$$ - RevolutionEHR · 2014-07-02 · Q4XWebinar:$$$ MU2$Success$Story$ ItCan$Be$Done!$...

Q4X Webinar: MU2 Success Story It Can Be Done!

Sco< Jens, OD, FAAO CEO, RevoluFonEHR

July 1, 2014

Overview

•  Brief Review of MU2 in 2014 •  Discussion with Dr. David James •  About his views on the relaFve “easiness” of MU2’s objecFves

•  About his pracFce’s success with MU2 in Q2 including the HIPAA SRA with WHITEC

•  Q&A

MU2 in 2014

•  Started MU1 in 2011 or 2012 •  One calendar-‐quarter of MU2 required –  If you are going to do MU2 this quarter, today was the starFng point!!

•  UFlize 2014 CerFfied EHR Technology (CEHRT) – RevoluFonEHR v6.2 – RxNT/EHR v7.1 (or an equivalent CEHRT)

No Added Effort

•  These objecFves require li<le effort beyond MU1:

»  CPOE »  e-‐Prescribing »  Demographics

»  Vital Signs »  Smoking Status

»  Protect Health InformaFon

»  Generate PaFent List »  Electronic Progress Notes

Reasonable

•  These objecFves require minor set-‐up and/or workflow changes:

»  CDS »  Clinical Summaries »  PaFent Reminders

»  PaFent EducaFon »  Family Health History

AddiFonal Effort

•  These objecFves require forethought but can be accomplished in due Fme:

»  PaFent VDT from PHR

»  Incorporate Lab Results Electronically » MedicaFon ReconciliaFon

»  Summary of Care Record for Referrals

»  Secure Messaging from PaFents

»  Imaging Results for Orders

»  Clinical Quality Measures »  Security Risk Assessment (SRA)

MU2 ObjecFves (for reference)

•  17 Core objecFves •  6 Menu objecFves

•  Clinical Quality Measures

Core 1: CPOE

•  Create orders for medicaFons, laboratory tesFng, and radiology through RevoluFonEHR

•  MedicaFons (>60% of all) – RxNT or RevoluFonEHR

•  Labs and Radiology (>30% of all) – Use Orders-‐Medical

Core 1: CPOE

•  If originaFng the Rx on paper, click “Originated without CPOE” checkbox

•  Use Orders-‐Medical – Determine commonly ordered LOINC codes

•  Exclusion for <100 orders

Core 1: CPOE •  Order by LOINC code •  Text enter descripFon •  Enter “Ordered by” to reflect the provider

Core 2: e-‐Prescribing

•  On >50% of all medicaFons ordered, must transmit the prescripFon electronically

•  As with CPOE, mark “Originated without CPOE”

•  Use a CerFfied EHR Technology -‐-‐-‐ RxNT/EHR v7.1 is integrated

•  Must have real Fme drug-‐to-‐formulary check

•  Exclusion for <100 prescripFons; pharmacy limitaFon within 10 miles

RevoluFonEHR powered by RxNT/EHR

Core 3: Record Demographics

•  >80% of paFents need Sex, DOB, Preferred Language, Race, and Ethnicity recorded

•  Receive credit for paFents for whom this was previously documented

•  Note: Race selecFon should be for each race reported, as opposed to “mulFracial”

•  SNOMED codes are used behind the scenes to share this data in C-‐CDA documents

Core 4: Record Vital Signs

•  >80% of paFents need vital signs documented – BP for ages 3 and over, Ht/Wt for any paFent


•  You may conFnue to assess the relevance to your scope of care for Blood Pressure, and separately for Height/Weight, and reporFng for any that are relevant

Core 5: Record Smoking Status

•  >80% of paFents need smoking status documented – for ages 13 and older


•  New addiFons include Light Smoker and Heavy Smoker

•  SNOMED codes are used behind the scenes to share this data in C-‐CDA documents

Core 6: Clinical Decision Support •  Have at least 5 CDS rules in place, 4 of which must be related to CQMs

•  RevoluFonEHR v6.2 contains CQMs which may be relevant –  If you deacFvate them, you may void MU

– 2014 CerFfied includes counts of checks for drug-‐drug and drug-‐allergy interacFon checks

•  Insert the CDS screen in your encounters, and note your acFons on any CDS alerts

Core 6: Clinical Decision Support •  Alerts are to be delivered to the provider at a Fme in care that allows for appropriate acFon

•  Alerts are for any Master Dx, not only those that are acFve Today

•  Confirm or Deny points to the provider’s acFon and allow for statement of any Exclusion

Core 7: Incorp. Lab Results

•  Labs ordered should have their results that are numerical, or posiFve/negaFve, incorporated electronically

•  >55% of labs

•  Use Orders-‐Medical to import lab results

•  Make sure to document comments in InterpretaFon and Report slider

Core 8: Generate PaFent List

•  Same requirement as in Stage 1 •  Minimum common idenFfier must be a problem/diagnosis

•  No acFon required, but concept is to idenFfy paFents who are good candidates for recall/acFvaFon

Core 9: PreventaFve Care

•  ExpectaFon is to reacFvate paFents who have been in at least 2 Fmes within 24 months before the start of the reporFng period – When you run a Scorecard, it will look back 24 months from the day before the reporFng period, so the denominator will be staFc

•  Send a Recall Reminder to >10% of the paFents in the denominator


•  Report available by which you can sort for paFents eligible for recall

•  The list allows you to idenFfy paFents in the denominator – it’s a custom PaFent report

Core 10: PaFent Ability to V/D/T

•  >50% of paFents must have online access to protected health informaFon – Give paFents access credenFals to RevoluFonPHR

•  >5% of paFents must View, Download, or Transmit in RevoluFonPHR – PaFent Eye Health InformaFon – ABOUT ME – Clinical Summary – APPOINTMENTS

Core 11: Clinical Summaries

•  Must be delivered within 1 day of informaFon being made available (encounter signed by provider)

•  >50% of office visits (billable services) – Create, print, and deliver in-‐clinic – For paFents with PHR access, credit granted

•  Configure Summary set-‐up in AdministraFon

Clinical Summary ConfiguraFon

Clinical Summary Declined

Core 12: PaFent-‐specific EducaFon

•  Delivering educaFon to >10% of paFents •  Infobu<on is a context-‐aware knowledge retrieval system

•  Press Infobu<on, retrieve a URL, get credit •  Send the paFent the URL via Messaging, or print materials and deliver in-‐clinic

Core 13: MedicaFon ReconciliaFon

•  Same requirement – >50% of new paFents + paFents referred in to the clinic must have medicaFon reconciliaFon performed

•  Simultaneous view of the external medicaFon list and the imported medicaFon list allows for consolidaFon into RevoluFonEHR medicaFon list

•  Direct incorporaFon from C-‐CDA

Core 13: MedicaFon ReconciliaFon

Core 14: Summary of Care

•  >50% of referrals should include provision of a TransiFon of Care document

•  >10% of referrals should include provision of an electronic version of a TransiFon of Care document – BOTH are excluded if <100 referrals done

•  Even if neither are germane, then a test of exchange must be done


•  When referring a paFent to another provider, you are expected to deliver an electronic C-‐CDA file in >10% of cases

•  Create a Referral, then “Send TransiFon of Care” Document

•  Requires use of Direct, so populate Direct addresses for External Providers

RevDirect •  market.revoluFonehr.com •  Register, and acFvaFon will happen within a few days

•  Unlimited Direct addresses for doctors, techs, pracFce locaFons – Cost is 5% of your Monthly Access Fee:

•  $350/mo > RevDirect = $17/mo •  $1000/mo > RevDirect = $50/mo

Sexng Up Direct for Other Providers

•  Used to push messages to external providers •  External providers will need to supply addresses – Direct address logged in External Provider profile – Messaging only available when address logged

Core 15: ImmunizaFon Registry

•  Not eligible, no funcFonality included

•  Do not need a Complete EHR or an EHR module that is cerFfied to do this unless the provider administers immunizaFons

Core 16: Protect Health InformaFon

•  ConFnue diligence with annual HIPAA-‐related Security Risk Assessment

•  Perform acFons within the reporFng period

•  Address new items required for MU2 – Security of data at rest via encrypFon – New cerFficaFon-‐related required features in RevoluFonEHR

Core 17: Secure Electronic Messaging

•  5% of paFents should send the provider a secure message

•  Any provider in the pracFce is eligible for a message (staff not yet in list of potenFal recipients)

•  Encourage paFents to respond to messages that you send

Messaging: PaFents

•  Launched from the PaFent Header bar

•  Message will land in RevoluFonPHR

•  PaFent will need to know how to login •  HIPAA-‐compliant noFficaFon email to paFent

Menu 1: Syndromic Surveillance

•  Not eligible, no funcFonality included

•  Do not need a Complete EHR or an EHR module that is cerFfied to do this unless the provider diagnosis syndromic condiFons that are important to public health

Menu 2: Electronic Progress Notes

•  30% of paFents must have a note created, edited, and signed in the record

•  RevoluFonEHR delivers searchable text fields that meet Menu 2 including: – RFV (PaFent and Provider) – Care Plan Items (General) – Assessment Comments

Menu 3: Imaging Results

•  10% of orders whose result is an image should have that imaged stored within, or accessible through, the EHR

•  Use Orders-‐Medical and the new Care Plan Items for Orders when a paFent case necessitates an imaging test

•  When running the test, load the results and a<ach the image through the I&R

Menu 3: Imaging Results

Menu 4: Family History

•  20% of paFents must have their Family History documented as structured data

•  New Family History screens for Medical and Ocular condiFons as idenFfied by SNOMED – Mother, Father

– Sister, Brother – Daughter, Son

•  Update and review the data

Menu 5: Report Cancer Cases

•  Exclusion – The EP does not diagnose or directly treat cancer

Menu 6: Report Specific Cases

•  Exclusion – The EP does not diagnose or directly treat any disease associated with a specialized registry sponsored by a naFonal specialty society for which the EP is eligible, or the public health agencies in their jurisdicFon •  E.G. “registries in quesFon [include] naFonal medical socieFes covering the EP’s scope of pracFce”

Clinical Quality Measures

•  The CQMs now map to PQRS and you may report CQMs in lieu of PQRS

•  RevoluFonEHR monitors your CQMs behind the scenes

•  This informaFon is more germane than MU1 CQMs had been

•  12 items available and must report on 9

•  Performance sFll does not count in 2014

Scorecard Updates

•  Reports for Stage 1 MU and Stage 2 MU have been updated and enhanced

•  Future webinars will help you understand the data and posiFvely influence it

•  Print copies include logo, version, and all data

Scorecard in RevoluFonEHR

Scorecard Printout

EHR CerFficaFon Number

Q4XWebinar:$$$ - RevolutionEHR · 2014-07-02 · Q4XWebinar:$$$ MU2$Success$Story$ ItCan$Be$Done!$...

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