Stage 1: Meaningful Use Manual Promoting Meaningful Use in Your Practice March
Stage 1: Meaningful Use Manual Promoting Meaningful Use in Your Practice March 15, 2011 Dear BayCare Connect Participating Physicians and Practices, We hope you find this manual helpful for your practices in achieving Meaningful Use. Thanks to Chris Eakes, Manager, EMR Technical Liaison, and Alex Rennick, Systems Analyst, for assisting me in preparing this manual. We appreciate the information and feedback provided to us by the eClinicalWorks team. If you have questions or need assistance, please contact us. Sincerely, Patrick Cimino, MD, MPH Medical Director BayCare Health System O - (727) 467.4032 | M - (727) 253.6825 | F - (727) 467.4626 Patrick.Cimino@baycare.org BayCare.org/EMRConnect BayCare Health System is a leading community-based health system in the Tampa Bay area. Composed of a network of 10 not-for-profit hospitals, outpatient facilities and services such as imaging, lab, behavioral health and home health care, BayCare provides expert medical care throughout a patient’s lifetime. With more than 214 locations throughout the Tampa Bay area, BayCare connects patients to a complete range of preventive, diagnostic and treatment services for any health care need. The extraordinary health care professionals across the BayCare network seek to advance the health of their patients and their communities by setting the standard for compassionate care that respects the dignity of every individual. BayCare Connect is BayCare’s initiative to promote EMR implementation in affiliated physician practices. :: 3 What Is Meaningful Use? Meaningful Use is the term coined by the Centers for Medicare and Medicaid Services EHR Incentive Program to promote the use of EHR by Eligible Professionals (EP) to: • Improve the quality of care, efficiencies and safety in treating patients • Reduce health disparities • Engage patients and families • Improve care coordination • Improve population and public health • Guarantee adequate privacy and security protection of PHI BayCare’s Commitment to EHR BayCare has made a huge commitment to inpatient EHR through the BEACON project. BayCare Connect is BayCare’s commitment to promoting EHR in physician practices, facilitating implementation, communication and interoperability, quality initiatives and therefore Meaningful Use. This Meaningful Use manual is provided by BayCare Connect to give guidance on meeting Meaningful Use with the eClinicalWorks (eCW) EHR by: • Identifying the feature(s) which cover each measure • Identifying the settings that need to be in place • Identifying where data needs to be recorded • Meeting multiple measures within one workflow • Evaluating reporting on the local (practice) level as well as across the BayCare eCW community This manual is intended to provide Eligible Professionals using the eClinicalWorks EMR, promoted by BayCare, minimal information on achieving Meaningful Use. It is by no means all-inclusive and assumes some proficiency with the eCW EMR. In general, the manual includes only one straightforward means to achieve Meaningful Use, while there may be others appropriate for your practice. eClinicalWorks has detailed information on Meaningful Use on their support portal at http://support.eclinicalworks.com. You will need your User Name and Password to access this. Particularly helpful is the Meaningful Use Training Scenarios Guide. On the support portal go to the main toolbar to Documents > Meaningful Use (on the lower toolbar) > Step 2. Further Meaningful Use tracking and reporting tools are available through eCW’s Meaningful Use, Adoption, Quality (MAQ) Dashboards in Version 9. Introduction 4 :: Score Card What Are the Measures? • Fifteen Core Measures (C) • Five Menu Measures out of a menu of 10 (M) • Within one Core Measure: Six Clinical Quality Measures - Three Core CQMs (CQM-C) or Alternate Core CQMs (CQM-A) - Three Additional Set CQMs (CQM) TOTAL: 25 Measures How do I start? The registration process is open as of January 3, 2011, for the Medicare Incentive. The Medicare and Medicaid Registration Manuals are available online* To register, an Eligible Professional will need • National Provider Identifier (NPI) • National Plan and Provider Enumeration System (NPPES) User ID and Password • Payee Tax Identification Number (if you are reassigning your benefits) • Payee National Provider Identifier If you need an NPI, go to the following CMS link: https://nppes.cms.hhs.gov/NPPES/Welcome.do Highlights of the 2011 incentives include the following: • The Eligible Professional is required to attest on any 90 days for 2011. • Reporting for 2011 is by attestation. The Attestation process will be available in April 2011. In 2012 reporting directly to CMS will be required. The Index of the 2011 Meaningful Use Measures is a separate document attached to this manual. The Index Measures are catalogued with letters and numbers for BayCare Connect is providing these materials to assist our physicians with the attainment of Meaningful Use. While every effort has been made to assure the accuracy of the materials within, please recognize that none of the information contained herein constitutes legal or clinical advice and that the final responsibility for achievement of this aim remains the responsibility of the participating provider(s). The Meaningful Use process is in evolution so changes will need to be made to this Manual. * https://www.cms.gov/EHRIncentivePrograms/20_RegistrationandAttestation.asp :: 5 reference purposes. They are specific to this manual and intended to make it easier to keep track of the measures. Refer to this while reviewing the manual. Related Measures are covered together, so it is helpful to refer to the Index. Meaningful Use requires that a lot of information in the electronic record be reportable. It is important that reportable information be entered in structured or discrete data, like a pick list. This usually means it is “flagged” for reporting by being placed in a certain format or field, e.g. a cell in a table. Generally free text is not discrete or structured so is not reportable. It may be used but should be limited to areas where reporting is not crucial. When data is referred to as discrete or structured, it means that it is reportable. eClinicalWorks has developed the MAQ Dashboard to track compliance with the key Meaningful Use Measures that require structured data and have to meet a threshold. The following section describes workflows where multiple measures can be met. These workflows are color coded in the Manual, the Index and the checklist to facilitate reference between the documents. The Index is straight from CMS describing the Measures. The checklist is to help the practices select the measures where there are choices. Following are workflow topics where multiple measures are met in a single workflow. Demographics Vitals Medication-related Measures Smoking Status and Cessation By fully addressing these topics, one can achieve 15 Meaningful Use Measures, and at least two CQM Additional Set Measures. The remainder of the manual will give information on the other Measures. Ready? Let’s begin our Meaningful Use journey. 6 :: Demographics Demographics Measures Met: C.1. Race and ethnicity are government requirements as listed on the left. Information must be recorded as structured data More than 50% of all unique patients seen by the EP have demographics recorded as structured data • Date of birth • Gender • Race • Ethnicity • Preferred language Race: American Indian or Alaska Native Asian Black or African American White ….. Unreported/Refused to Report Ethnicity: Hispanic or Latino Not Hispanic or Latino Refused to Report Preferred Language: Creole English Spanish Other :: 7 C.1. Record Demographics Threshold: 50% The Patient Information (demographic) is recorded in the Info screen of patient chart and can be accessed from a variety of areas in the chart. The Gender and Date of Birth are on the first page and are set by default as mandatory. Further demographic information can be accessed by clicking the Additional Info button in the lower left of the Patient Information, which brings up a second screen with more fields. The Additional Info screen has fields to record Race, Ethnicity and Language. A practice should deal with capturing this information through front office workflow. Race, Ethnicity and Language fields may be made Mandatory Fields when the Additional Info screen is accessed. From the main Toolbar go to Patients > Configure Demographics Mandatory Fields and check the appropriate boxes for these fields. The MAQ reports will track this measure. Numerator: Unique patients with language, gender, race, ethnicity and date of birth ALL recorded as structured data Denominator: Total unique patients seen during the reporting period Demographics (continued) 8 :: Vitals Vitals Measures potentially met: C.2. CQM.C.1. CQM.C.2. CQM.A.1. CQM.C.1. Percentage of patient visits for patients age 18 and older with a diagnosis of hypertension who have been seen for at least two office visits, with blood pressure (BP) recorded CQM.C.2. Percentage of patients age 18 and older with a calculated BMI in the past six months or during the current visit documented in the medical record AND if the most recent BMI is outside parameters, a follow-up plan is documented CQM.A.1. Percentage of patients age 2-17 who had an outpatient visit with a Primary Care Physician (PCP) or OB/GYN who had evidence of BMI percentile documentation, counseling for nutrition and counseling uploads/Sante/ mu-guide 1 .pdf
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