meaningful use dashboard calculation guide · stage 2 meaningful use dashboard calculation guide...

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MeaningfulUseDashboardCalculationGuideLearnhowtousePracticeFusion’sMeaningfulUseDashboardtohelpyouachieveMeaningfulUse.Formoreinformation,visittheMeaningfulUseCenter.

General Functionality

HowdoIaccesstheDashboard?

§ GotoReportsandclickon“MeaningfulUsedashboard.”

HowdoIsetuptheDashboard?

§ WhenfirstnavigatingtotheMeaningfulUsedashboard,you’llselectyourattestationdetails.

§ Selectthecorrectproviderandwhatattestationyearofthedashboardyou’dliketoview.

§ Byclickingthegearicon,youcanselectwhetheryou“plantoattest”orifyou“don’tplantoattest.”

§ YoucanselecttheyearyoufirstattestedsuccessfullyforMeaningfulUse,andwhetheryou’reparticipatingintheMedicareorMedicaidEHRIncentiveProgram.ThisselectionwillinformwhatStageoftheprogramyouarein.In2015,Stage1providerswillbeina“ModifiedStage2.”In2016,allproviderswillbeinStage2.

§ Selectyourreportingperiod.In2015,allproviderswillcompletea90dayreportingperiod.In2016,providerswillcompletea90dayreportingperiodorafullyearreportingperiod.Ifyouhaveselecteda90dayreportingperiodpreviously,youcanclick“Loadapreviousreportingperiod”toviewthedatafromthosereportingperiods.

§ Click“update”whenyouhavecompletedyourselectionsintheMeaningfulUseDashboardsettings.

HowdoestheDashboardupdate?

§ TheMeaningfulUseDashboardvaluesupdatedailyafter9PMET/6PMPTforactionstakenduringthepreviousday.

§ OnlyvisitswithdatesofserviceduringyourreportingperiodareincludedintheDashboardcalculations.

§ Patientsaredefinedas“seenduringtheEHRreportingperiod”whentheyhaveanencounterthatiscategorizedasanOfficeVisit,HomeVisit,NursingHomeVisit,orTelemedicineVisitduringthereportingperiodselectedonyourDashboard.Encountertypesareselectedinthechartnote.

§ Onlysignednoteswiththeappropriateencountertypesselectedwillcountformeasuresbasedonuniquepatientsorvisits,sosignyournotespromptlytoseeaccurateprogressforeachmeasure.

§ Foreachmeasurebasedonasignednotewithanappropriateencountertypeselected,onlytheproviderwhosignsthenotewillgetdenominatorcredit.

§ CriteriacompletedoutsideoftheEHR(e.g.SecurityRiskAnalysisfromProtectPatientHealthInformation)arenotcalculatedbythedashboard.Tonotethisonyourdashboard,checktheComplete

Stage2MeaningfulUseDashboardcalculationguide

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boxundertheCurrentcolumntologthatthemeasuresarecomplete.Youmustalsomaintainsupportingdocumentationoftheseactionsforyourrecords.

§ Ifyoubelieveaspecificmeasuredoesnotapplytoyourscopeofpractice,youmaybeeligibleforanexclusion.Tonoteanexclusiononyourdashboard,switchthetogglefromNonetoClaimedundertheReportcolumnandselectthereasonforexclusion.Youmustalsomaintainsupportingdocumentationoftheexclusionforyourrecords.

HowdoIstartcompletingcriteria?

§ StartchartingpatientvisitsusingPracticeFusion.

§ MeaningfulUseappliestoallpatientsyousee,regardlessoftheirinsurance.

WhatdoIdoifIhavenotmetallthecriteria?

§ UsetheGapReportbyclickingthenumeratoranddenominatorundertheCurrentcolumntoseewhichpatientsaremissingrequiredinformationforspecificmeasures.Gapreportsareonlyavailableformeasuresthatarepatient-centric,meaninganymeasurewherePracticeFusioncanproducealistofpatientsnotmeetingthemeasure.

§ Ifyoufeelyournumbersaren’taccurateintheDashboard,reviewthisguidetoensurethatyouunderstandhowallofthemeasuresarecalculatedandensurethatyouhavesignedallofyournotesandselectedappropriateencountertypesforvisitsduringthereportingperiod.

OtherTips

§ Makesureyoucompletethecriteriaduringyourreportingperiod,notafter.

§ Ifyoubelieveaspecificmeasuredoesnotapplytoyourscopeofpractice,youmaybeeligibleforanexclusion.LearnmoreaboutqualifyingforexclusionsinourKnowledgeBase.

Measure Calculations and Tips

ToachieveMeaningfulUse,youshouldfirstmakesureyouunderstandhowtomeetallofthemeasuresusingPracticeFusion’sEHR.VisittheKnowledgeBaseorclickonthemeasuretitledirectlyintheDashboardforfullinformationonhowthemeasuresarecalculatedinPracticeFusion.

EachobjectiveandmeasurebelowcontainsinformationontheCMSmeasurespecificationfromwhichPracticeFusionderivedtheMeaningfulUseDashboardcalculations.WealsoincludePracticeFusion’srecommendedworkflowandtipsforensuringthatyouractionsinPracticeFusionwillhelpyouachievecreditintheDashboard.Ifapplicable,theCMS-approvedexclusionislisted.

CMShastransitionedStage1toModifiedStage2forthe2015reportingperiodandbeyond.The13coreand9menurequirementshavebeenadjustedto10objectives.

PracticesthatarereportingforStage1in2015willnowreportonalltheStage2objectiveswithmodifiedspecificationsand/orexclusionsformeasuresthatwerenotinStage1.ThisinterimsetofrequirementsisbeingcalledModifiedStage2,andisclarifiedfurtherbelowintheindividualobjectives.


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OBJECTIVES:

OBJECTIVE1:PROTECTELECTRONICHEALTHINFORMATIONMeasure:ConductorreviewasecurityriskanalysiswithrespecttoabidingbytheHIPAASecurityRule,specificallytheSecurityManagementProcess[45CFR164.308(a)(1)].Youalsoneedtoimplementsecurityupdatesasnecessaryandcorrectidentifiedsecuritydeficienciesaspartofyourriskmanagementprocess.YoumustconductorreviewasecurityriskanalysisandimplementsecurityupdatesasnecessaryatleastoncepriortotheendoftheEHRreportingperiod.

PracticeFusionworkflow:UsetheONCSecurityRiskAnalysistooltoconductanddocumentacomprehensiveassessmenttoidentifyrisksinyourorganization.Besuretosavethesedocumentsandanyotherdocumentsrelatedtoactionscompletedaspartofcompletingthesecurityriskanalysis(e.g.receiptsfornewsecuritysoftware)foryourrecords

Dashboardtip:Aftercompletingtherequirementsforthismeasure,youcanmanuallyindicatethisinyourMeaningfulUseDashboardbycheckingtheboxnexttothismeasure.

OBJECTIVE2:CLINICALDECISIONSUPPORTObjective:Thisobjectiverequiresthatyouimplementclinicaldecisionsupport(CDS)notificationsintheEHRtoimprovehealthoutcomes.Therearetwomeasuresforthisobjective:

§ Measure1:ClinicalDecisionSupport-ImplementfiveclinicaldecisionsupportinterventionsrelatedtofourormoreclinicalqualitymeasuresatarelevantpointinpatientcarefortheentireEHRreportingperiod.

§ Measure2:DrugInteractionChecks-Implementthefunctionalityfordrug-druganddrug-allergyinteractionchecksfortheentireEHRreportingperiod.

Exclusion:Formeasure2:Anyproviderwhowritesfewerthan100medicationordersduringtheEHRreportingperiod.

ModifiedStage2SpecificationforMeasure1:Stage1/ModifiedStage2providerswillberequiredtoimplementoneclinicaldecisionsupportrulefortheentirereportingperiod.

PracticeFusionworkflow:PracticeFusionenablesallCDSrulesbydefault,butyoucanconfigureCDSnotificationsanddruginteractionsundertheSettingssectionoftheEHRorbyclickingtheCDSsettingsandAlertsettingsontheMeaningfulUseDashboard.EnsurethatyouhaveatleastfiveCDSinterventionsenabledandatleastonealertfordrug-druganddrug-allergyinteractionsenabledfortheentirereportingperiod.

Dashboardtip:IfyouoryourpracticeadministratordisablesfourormoreCDSrulesoralldruginteractionalerts,theDashboardwillindicatethatyouhavenotmetthismeasureandyouwillnotbeabletocompletethismeasureuntilthenextreportingperiod.Itisa


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goodpracticetoensurethateveryoneonyourstaff,includingEHRaccountadministrators,understandstheselimitationsanddoesnotdisableoralterCDSadvisoriesordruginteractionalertswithoutunderstandingtheramificationstoyourMeaningfulUsestatus.OBJECTIVE3:COMPUTERIZEDPROVIDERORDERENTRY(CPOE)Thisobjectiveincludesthreemeasures.Thethresholdrequirementsofallthreemeasuresmustbemetinordertoachievethismeasure.CPOEistheentryoftheorderintotheEHRanddoesnotrelatetohowthatorderisfilledorotherwisecarriedout.Thisobjectiverequiresthatyouusecomputerizedphysicianorderentry(CPOE)torecordthefollowingitemsduringyourEHRreportingperiod:

• Measure1:Morethan60%ofmedicationorders• Measure2:Morethan30%oflaborders• Measure3:Morethan30%ofradiology/imagingorders

Exclusion:Anyproviderwhowritesfewerthan100medication,radiology,and/orlaboratoryordersduringtheEHRreportingperiodisexcludedfromthecorrespondingmeasure.ModifiedStage2AlternateMeasuresandExclusions:Stage1/ModifiedStage2providersin2015canmeettheCPOEforMedicationOrdersmeasureinthefollowingtwoways:recordatleastonemedicationorderusingCPOEformorethan30%ofpatientsseenduringthereportingperiod;oruseCPOEtorecordmorethan30%ofmedicationorders.Stage1/ModifiedStage2providerswillnotberequiredtoreportCPOEforLaborImagingOrdersin2015becausethosemeasuresdidnotexistinStage1.MEASURE1:CPOEFORMEDICATIONORDERS

Exclusion:Anyproviderwhowritesfewerthan100prescriptionsduringtheEHRreportingperiod.

Denominator:Thenumberofprescriptionsrecorded,printedore-prescribed(includingrefills)duringtheEHRreportingperiod.

Numerator:ThenumberofprescriptionsinthedenominatorthatarerecordedusingCPOE.

PracticeFusionWorkflow:Toaddamedicationtoapatient’sencounterandsendane-prescription,scrolltothePlansectionoftheencounterandclickRecord.FromtheMedicationstab,searchforandselectamedication.Pleaseclickonthenewlyaddedmedicationtoproceedwithordering.Adddirectionsandastartdatealongwithanynotestothepharmacyinthedetailswindow,thenclickOrder.Reviewyourprescriptionsummaryandselectapharmacytofilltheorderifapplicable.ClickSendeRx,PrintRx,orRecordRx. OBJECIVE3B:CPOEFORLABORDERS

Exclusion:Anyproviderwhowritesfewerthan100labordersduringtheEHRreportingperiod.

Denominator:ThenumberoflabtestsorderedduringtheEHRreportingperiod.

Numerator:ThenumberoflabtestsinthedenominatorrecordedusingCPOE.


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PracticeFusionworkflow:UndertheActionsmenuofapatient’schart,select“Addlaborder”togainaccesstotheorderingworkflow.Fromwithintheorderingscreen,selectthelabyouwanttosendorderstoandthenenterintherequiredinformation.Whenenteringalabtest,youmustadda'TestCode'ifyouareorderingacustomtest.Ifyouareconnectedwithalab,clickSendtosubmittheorderelectronicallytothelab.Ifyouarenotconnectedwithalab,clickPrint.

Dashboardtip:Ifyouhaveyourofficestaffrecordordersonyourbehalf,theymustselectyournameundertheOrderingPhysiciandrop-downinorderforyoutoreceivecreditintheMeaningfulUseDashboard.

OBJECTIVE3C:CPOEFORRADIOLOGYORDERS

Exclusion:Anyproviderwhowritesfewerthan100radiologyordersduringtheEHRreportingperiod.

Denominator:ThenumberofradiologytestsorderedduringtheEHRreportingperiod.

Numerator:ThenumberofordersinthedenominatorthatarerecordedusingCPOE.

PracticeFusionworkflow:UndertheActionsmenuofapatient’schart,selectAddimageordertogainaccesstotheorderingworkflow.Fromwithintheorderingscreen,selecttheimagingcenteryouwanttosendorderstoandthenenterintherequiredinformation.Ifyouarenotconnectedwithanimagingcenter,youhavetheoptiontoselectOther.Whenenteringanimagingtest,youmustadda'TestCode'ifyouareorderingacustomtest.Ifyouareconnectedwithanimagingcenter,clickSendtosubmittheorderelectronicallytotheimagingcenter.Ifyouarenotconnectedwithanimagingcenter,clickPrint.

Dashboardtip:Ifyouhaveyourofficestaffrecordordersonyourbehalf,theymustselectyournameunderthe“OrderingPhysician”menuintheorderingscreeninorderforyoutoreceivecreditintheMeaningfulUseDashboard.

OBJECTIVE4:ELECTRONICPRESCRIBINGMeasure:Toachievethee-prescribingobjective,morethan50%ofallprescriptionsshouldbecheckedfordrugformularyandsentelectronically.E-refillsareconsideredelectronicprescriptionsandcounttowardsmeetingthisrequirement.Dependingonwhetherornotyouareabletosendelectronicprescriptionsforcontrolledsubstances,youwillattesttooneofthefollowingmeasures:

• e-Prescribing:Permissible• e-Prescribing:PermissibleandControlledSubstances

ModifiedStage2Specifications:Stage1/ModifiedStage2providersmustsendmorethan40%ofallpermissibleprescriptionselectronically.


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MEASURE4A:E-PRESCRIBING:PERMISSIBLE

Exclusion:Providerswhowritefewerthan100prescriptionsduringtheEHRreportingperiodorifnopharmaciesaccepte-prescriptionswithin10milesofthepracticelocationatthestartofthereportingperiod.

Denominator:NumberofprescriptionswrittenfordrugsotherthancontrolledsubstancesduringtheEHRreportingperiod.

Numerator:Numberofprescriptionsfromthedenominatorthataregeneratedandtransmittedelectronically.

PracticeFusionWorkflow:Fromthepatient’sSummarysection,clicktheicontotherightofMedicationsandsearchforamedicationbytypingintothesearchbar.Alternately,starta“Newencounter”andclick“Record”byMedicationstosearchforamedication.Afterselectingthemedicationandincludingprescribinginformation,click“OrderRx.”Reviewtheprescriptioninformation,clicknext,andthen“SendeRx.”

MEASURE4B:E-PRESCRIBING(PERMISSIBLEANDCONTROLLEDSUBSTANCES)

Exclusion:Providerswhowritefewerthan100prescriptionsduringtheEHRreportingperiodorifnopharmaciesaccepte-prescriptionswithin10milesofthepracticelocationatthestartofthereportingperiod.

Denominator:Numberofprescriptions,includingcontrolledsubstances,writtenduringtheEHRreportingperiod.

Numerator:Numberofprescriptionsfromthedenominatorthataregeneratedandtransmittedelectronically.

PracticeFusionWorkflow:Fromthepatient’sSummarysection,clicktheicontotherightofMedicationsandsearchforamedicationbytypingintothesearchbar.Alternately,starta“Newencounter”andclick“Record”byMedicationstosearchforamedication.Afterselectingthemedicationandincludingprescribinginformation,click“OrderRx.”Reviewtheprescriptioninformation,clicknext,andthen“SendeRx.”

OBJECTIVE5:HEALTHINFORMATIONEXCHANGE

Measure:Whenyoutransitionorreferyourpatienttoanothersettingofcareorproviderofcare,youmustcreateasummaryofcarerecordandelectronicallytransmitittoareceivingproviderformorethan10%oftransitionsofcareandreferrals.


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Exclusion:Anyproviderwhotransfersapatienttoanothersettingorrefersapatienttoanotherproviderlessthan100timesduringthereportingperiod.

AlternateExclusionforModifiedStage2:Stage1/ModifiedStage2providerscanclaimanexclusiontothisobjectivein2015becausethereisnoequivalentmeasureinStage1.

Denominator:Numberoftransitionsofcareandreferralsmadeduringthereportingperiod.

Numerator:Numberoftransitionsofcareandreferralswhereasummaryofcarerecord,includingaclinicaldocument,wassuccessfullyelectronicallytransmittedusingPracticeFusionduringthereportingperiod.

PracticeFusionworkflow:

FromtheActionsdrop-downmenuinapatient’schart,selectCreateclinicaldocument.Youmaygenerateeitheraclinicalorreferralsummary,butwerecommendareferralsummaryforcompleteness.

Onceyouhavegeneratedyourclinicaldocument,selectAddreferralfromtheActionsdrop-downmenu.

Inordertoreceivecreditforthismeasure,youmustsendreferralelectronicallytoanotherPracticeFusionproviderorprovideroutsidethePracticeFusionnetworkusingDirectmessaging.Youmustattachtheclinicaldocumenttotheelectronicreferral.

Dashboardtip:Referralsdonotneedtobesentwithin24hoursofapatient’schartnotetomeetthismeasure.FaxreferralsandindicatingthereferralwassentintheScreenings/Interventions/Assessmentssectionofthechartnotedonotcounttowardsthismeasure.Attachingachartnotetothereferraldoesnotmeettherequirementsofthismeasure.Aclinicaldocument(clinicalsummaryorreferralsummary)mustbeattachedtothereferralforcredit.

OBJECTIVE6:PATIENTSPECIFICEDUCATION

Measure:Useclinicallyrelevantinformationtoidentifypatient-specificeducationresourcesandprovidethoseresourcestothepatient.

Exclusion:Anyproviderwhohasnoofficevisitsduringthereportingperiodisexcludedfromthismeasure.



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Denominator:NumberofuniquepatientsyouseeduringtheEHRreportingperiod.

Numerator:Numberofpatientsinthedenominatorwhoareprovidedpatient-specificeducationresourcesusingPracticeFusion.

PracticeFusionworkflow:Clickon"MedlinePlus"or"PatientEducationMaterials"inanydiagnosis,lab,ormedicationwindowandprovidetheresourcestothepatient.

OBJECTIVE7:PERFORMMEDICATIONRECONCILIATION

Measure:Whenreceivingapatientfromanothersettingorproviderofcare,performmedicationreconciliation.

Exclusion:AnyproviderwhowasnottherecipientofanytransitionsofcareduringtheEHRreportingperiod.

AlternateExclusionforModifiedStage2:Stage1/ModifiedStage2providerscanclaimanexclusiontothisobjectivein2015iftheydidnotintendtoattesttothemenumeasure.

Denominator:NumberoftransitionsofcareduringtheEHRreportingperiodforwhichyouwerethereceivingpartyofthetransition.

Numerator:Numberoftransitionsofcareinthedenominatorwheremedicationreconciliationwasperformed.

PracticeFusionworkflow:Withintheencounter,mark"TransitionofCare-incoming"underQualityofCaretoindicatethatthiswasanewpatientorapatientthatwastransitionedintoyourcarefromanotherprovideroranothersetting.Confirmthatyourpatient’smedicationlistisuptodateandselecttheMedicationReconciliationcheck-box.

Dashboardtip:Whileinthissectionofthechartnote,selecttheDocumentationofcurrentmedicationscheck-box,whichwillgiveyoucreditforoneoftheMeaningfulUseClinicalQualitymeasures.

OBJECTIVE8:TIMELYELECTRONICACCESSFORPATIENTS

Objective:Providepatientstheabilitytoviewonline,download,andtransmittheirhealthinformationwithin4businessdaysoftheinformationbeingavailabletotheprovider.Thereare2measuresforthisobjective:


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• Measure1:PatientElectronicAccess-Providemorethan50%ofalluniquepatientsseenduringthereportingperiodtimelyaccesstoviewonline,download,andtransmittoathirdpartytheirhealthinformation.

• Measure2:View,Download,Transmit-Atleast1patientseenbytheproviderduringthereportingperiodviews,downloadsortransmitshisorherhealthinformationtoathirdpartyduringthereportingperiod.

Exclusion:Anyproviderwhodoesn’torderorcreateanyoftheinformationlistedforinclusion.ForMeasure2:Conducts50%ormoreofhisorherpatientencountersinacountythatdoesnothave50%ormoreofitshousingunitswith4MbpsbroadbandavailabilityaccordingtothelatestinformationavailablefromtheFCConthefirstdayofthereportingperiod.

AlternateExclusionforModifiedStage2:Formeasure2,Stage1/ModifiedStage2providerscanclaimanexclusiontothismeasurein2015becausethereisnoequivalentmeasureinStage1.

MEASURE1:PATIENTELECTRONICACCESS

Denominator:Numberofuniquepatientsseenduringthereportingperiod.

Numerator:Thenumberofpatientsinthedenominatorwhohaveonlineaccesstotheirhealthinformationwithinfourbusinessdaysofthedateofservice.

PracticeFusionWorkflow:Usetheauto-invitefeaturetoprovidepatientstimelyaccesstotheirPatientPortal.Inordertoeffectivelyusetheauto-invitefeatureforthismeasure,youmustsignyourchartnoteswithin4businessdaysofthechartnote’sdateofservice.YoucanalsomanuallyenrollyourpatientsinthePatientPortalbyclickingtheActionsdrop-downmenuintheupper-rightcornerandselectInvitetopatientportal.Click"Addrecordaccess,"andenterthecontactinformationofthepatientorauthorizedrepresentative.Youcanselectthecontact'srelationshiptothepatientfromthedropdownmenu.Oncecompletingthecontactdetailssection,clickto"Enableaccess"foryourpatient.

Dashboardtip:AnyoneinyourpracticewhohasauthoritytogivepatientsaccesstothePatientPortalcandosoandyouwillstillachievecreditforthismeasure.AnaccountadministratorcanchangethepatientengagementsettingsundertheSettingssectionoftheEHR.Patientsbetweentheagesof18-85willbeautomaticallyinvitedtotheportalifthepatienthasarecordedemail,phonenumber,andsignedchartnote.

MEASURE2:VIEW,DOWNLOAD,TRANSMITDenominator:Numberofuniquepatientsseenduringthereportingperiod.


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Numerator:Thenumberofpatientsinthedenominator(orpatient-authorizedrepresentative)whoview,download,ortransmittoathirdpartytheirhealthinformation.PracticeFusionworkflow:AfteryouinvitepatientstothePatientPortal,encourageyourpatientstocompletetheenrollmentassoonastheygethomefromtheappointmentusingthePINcodethatyougivethemduringthevisitortheirphonenumber.YourpatientsmustlogintothePatientPortalatleastonceduringthereportingperiodinorderforyoutogetcreditforthismeasure

OBJECTIVE9:SECUREELECTRONICMESSAGINGMeasure:Usesecureelectronicmessagingtocommunicatewithpatientsonrelevanthealthinformation.

Exclusion:Anyproviderwhohasnoofficevisitsduringthereportingperiod,oranyproviderwhoconducts50percentormoreofhisorherpatientencountersinacountythatdoesnothave50percentormoreofitshousingunitswith3MbpsbroadbandavailabilityaccordingtothelatestinformationavailablefromtheFCConthefirstdayofthereportingperiod.


PracticeFusionworkflow:AnadministratormustenablesecuremessagingbyclickingtheMessagingSettingslinknexttothemeasureintheMeaningfulUseDashboardorclickingthe Settings intheupperright-handcornerofyourPracticeFusionaccountandselecting PatientCommunications.Withinthe PatientCommunicationSettings, select the PatientMessages tab.Toopt-intopatientmessaging,checkthe"Enablesecuremessaging"box.Enablingordisablingpatientmessagingwillupdatethissettingfortheentirepractice.ThissettingmustbeenabledandstayenabledduringthereportingperiodtoreceivecreditforthisobjectiveontheMeaningfulUsedashboard.Oncemessagingisenabled, everymemberofyourpractice canusethenewfeature.

AfteryouenrollapatientinthePHR,thepatientcancompleteenrollmentusingtheuniquePINthatyougivetothemandthenutilizethePatientFusionmessagingfeaturetosendamessagetoyourpractice.

OBJECTIVE10:PUBLICHEALTHREPORTING

Objective:thisobjectiverequiresyoubeinactiveengagementwithapublichealthagencytosubmitelectronicpublichealthdatafromPracticeFusion.Theobjectivehasthreemeasures:

• Measure1:ImmunizationRegistryReporting-Theproviderisinactiveengagementwithaimmunizationregistrytosubmitimmunizationdata.

• Measure2:SyndromicSurveillanceReporting-Theproviderisinactiveengagementwithapublichealthagencytosubmitsyndromicsurveillancedata.


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• Measure3:SpecializedRegistryReporting-Theproviderisinactiveengagementtosubmitdatatoaspecializedregistry.

Stage1/ModifiedStage2providerswillneedtomeet1ofthe3measures,andStage2providerswillneedtomeet2ofthe3measures.

MEASURE1:IMMUNIZATIONREGISTRYREPORTING

Exclusion:Anyeligibleprovidermeetingoneormoreofthefollowingcriteriamaybeexcludedfromtheimmunizationregistryreportingsub-measureiftheeligibleprovider:

• Doesnotadministeranyimmunizationstoanyofthepopulationsforwhichdataiscollectedbyitsjurisdiction'simmunizationregistryorimmunizationinformationsystemduringtheEHRreportingperiod.

• OperatesinajurisdictionforwhichnoimmunizationregistryorimmunizationinformationsystemiscapableofacceptingthespecificstandardsrequiredtomeettheCEHRTdefinitionatthestartoftheEHRreportingperiod

• OperatesinajurisdictionwherenoimmunizationregistryorimmunizationinformationsystemhasdeclaredreadinesstoreceiveimmunizationdatafromtheEPatthestartoftheEHRreportingperiod.

PracticeFusionworkflow:Visittoyourlocalimmunizationregistry’swebsiteandregisteryourintenttosubmitimmunizationdatawithinthefirst60daysofyourreportingperiod.IfyourregistrydoesnothavethecapabilitytoreceiveHL72.5.1dataelectronically,youcanqualifyforanexclusion.InPracticeFusion,gototheImmunizationregistrysectionofyourpracticeSettingsandsetupyouraccountforelectronictransmission.Learnhowtosetupelectronictransmissiontoyourregistry>>Thisprocesswillvarydependingontheregistry.Refertothedefinitionof"activeengagement"belowtodetermineifyouhavemettherequirementsforthismeasurebasedonthestatusofyourintegration.Yourregistrywillbethecontactforanyconfirmationaboutcompletionofthismeasure,somakesuretosavedocumentationofallcommunicationwithyourregistryforyourrecords.OnceyouareconnectedandyouactivateyourintegrationintheImmunizationregistrysectionofyourpracticeSettings,youcanstartsubmittingimmunizationfilesdirectlytoyourstateregistryonanindividualpatientbasis.Inordertodoso,visittheImmunizationssectionofthepatient’schart,clickon"Actions,"andthenselect“Transmittoimmunizationregistry.”MEASURE2:SYNDROMICSURVEILLANCEREPORTINGExclusion:Anyeligibleprovidermeetingoneormoreofthefollowingcriteriamaybeexcludedfromthesyndromicsurveillancereportingmeasureiftheprovider:

• Isnotinacategoryofprovidersfromwhichambulatorysyndromicsurveillancedataiscollectedbytheirjurisdiction'ssyndromicsurveillancesystem;

• OperatesinajurisdictionforwhichnopublichealthagencyiscapableofreceivingelectronicsyndromicsurveillancedatainthespecificstandardsrequiredbyCEHRTatthestartoftheirEHRreportingperiod;

• OperatesinajurisdictionwherenopublichealthagencyhasdeclaredreadinesstoreceivesyndromicsurveillancedatafromEPsatthestartoftheEHRreportingperiod.


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AlternateExclusionfor2015:Providerscanclaimanalternateexclusionforameasureiftheydidnotintendtoattesttotheequivalentpriormenuobjective.PracticeFusionworkflowFindyourlocalpublichealthdepartmentandemailthemtoseeiftheycanacceptsyndromicsurveillancedatainHL72.5.1format.Iftheyareunabletoacceptthedatainthisformat,youmayqualifyforanexclusion.IfyourpublichealthdepartmentcanacceptsyndromicsurveillancedatainHL72.5.1format,confirmwhattheirlistofreportablediseasesareandwhethertheyacceptambulatorysyndromicsurveillancedata.Ifyoudon'tcollectanyreportablesyndromicsurveillanceinformationaccordingtoyourpublichealthdepartment,youmayqualifyforanexclusion.IfyoudocollectreportablesyndromicsurveillancedataandyourpublichealthdepartmentcanacceptthefileinHL72.5.1format,youmustproceedtosendthemthefileifyoudon’tqualifyforanyotherexclusionstothemeasure.IntheEHR,undertheActionsdrop-downmenuofapatient'schartnote,select"SyndromicSurveillance."Exportthefile,saveittoyourcomputer,andsubmittheexportedfiletoyourlocalpublichealthdepartmentfollowingtheirspecifiedreportingmethod.Continuetofollowadditionalinstructionsforongoingsubmission.Makesuretokeepdocumentationofyourcommunicationwithyourpublichealthdepartment.MEASURE3:SPECIALIZEDREGISTRYREPORTINGExclusion:Anyeligibleprofessional(EP)thatmeetsatleast1ofthefollowingcriteriamaybeexcludedfromthisobjective:

• DoesnotdiagnoseortreatanydiseaseorconditionassociatedwithorcollectrelevantdatathatisrequiredbyaspecializedregistryintheirjurisdictionduringtheEHRreportingperiod.

• OperatesinajurisdictionforwhichnospecializedregistryiscapableofacceptingelectronicregistrytransactionsinthespecificstandardsrequiredtomeettheCEHRTdefinitionatthestartoftheEHRreportingperiod.

• OperatesinajurisdictionwherenospecializedregistryforwhichtheEP,eligiblehospital,orCAHiseligiblehasdeclaredreadinesstoreceiveelectronicregistrytransactionsatthebeginningoftheEHRreportingperiod.

AlternateExclusionfor2015:Providerscanclaimanalternateexclusionforameasureiftheydidnotintendtoattesttotheequivalentpriormenuobjective.

Workflow:PracticeFusiondoesnotsupportthismeasure,asbecomingcertifiedtothismeasurewasnotrequiredaspartof2014editioncertification.ProvidersmayuseelectronicsubmissionmethodsbeyondthefunctionsofCEHRTtomeettherequirementsfortheSpecializedRegistryReportingmeasure.

Dashboardtip:YoumustmanuallyindicatethatyouhavecompletedthisrequirementintheMeaningfulUseDashboard.Besuretomaintaindocumentationoftheexchangeforyourrecords,suchasacopyoftheemailfromthereceivingparty.


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