q4xwebinar:$$$ - revolutionehr · 2014-07-02 · q4xwebinar:$$$ mu2$success$story$ itcan$be$done!$...
TRANSCRIPT
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Q4X Webinar: MU2 Success Story It Can Be Done!
Sco< Jens, OD, FAAO CEO, RevoluFonEHR
July 1, 2014
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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
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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)
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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
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Reasonable
• These objecFves require minor set-‐up and/or workflow changes:
» CDS » Clinical Summaries » PaFent Reminders
» PaFent EducaFon » Family Health History
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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)
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MU2 ObjecFves (for reference)
• 17 Core objecFves • 6 Menu objecFves
• Clinical Quality Measures
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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
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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
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Core 1: CPOE • Order by LOINC code • Text enter descripFon • Enter “Ordered by” to reflect the provider
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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
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RevoluFonEHR powered by RxNT/EHR
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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
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Core 4: Record Vital Signs
• >80% of paFents need vital signs documented – BP for ages 3 and over, Ht/Wt for any paFent
• Receive credit for paFents for whom this was previously documented
• 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
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Core 5: Record Smoking Status
• >80% of paFents need smoking status documented – for ages 13 and older
• Receive credit for paFents for whom this was previously documented
• New addiFons include Light Smoker and Heavy Smoker
• SNOMED codes are used behind the scenes to share this data in C-‐CDA documents
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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
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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
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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
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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
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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
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Core 9: PreventaFve Care
• 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
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Core 9: PreventaFve Care
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Core 9: PreventaFve Care
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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
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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
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Clinical Summary ConfiguraFon
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Clinical Summary Declined
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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
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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
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Core 13: MedicaFon ReconciliaFon
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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
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Core 14: Summary of Care
• 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
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Core 14: Summary of Care
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Menu 3: Imaging Results
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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
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Menu 5: Report Cancer Cases
• Exclusion – The EP does not diagnose or directly treat cancer
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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”
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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
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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
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Scorecard in RevoluFonEHR
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Scorecard Printout
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EHR CerFficaFon Number
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