EHR Incentive Program

Falcon EHR - Meaningful Use Checklist See Falcon Online Guide > Meaningful Use folder for detailed information on the EHR Incentive Program and links to CMS website for more information.

EPs Must do all of these REQUIRED measures (15 Required for 2012 and 14 required for 2013) Workflow affected

Measure CPOE (Computerized Physician Order Entry) MU #1 30% or Excluded

Writing prescriptions

Falcon Module / Screen eCharting / Patient Manager > Medications

More than 30% of unique patients with at least one prescribed medication in their medication list seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have at least one medication order entered using CPOE.

Falcon Action Use Falcon-SureScripts certified prescription module to send prescriptions electronically to pharmacies. At least one prescribed medication on the medication list in Falcon must have been ordered via e-prescribing.

NOTE: This measure will only apply to patients that have a PRESCRIBED medication on their list AND were seen in the reporting period.

EXCLUSION: If you write fewer than 100 prescriptions during the reporting period. Drug Interaction Warning MU #2 Yes or No

Practice Setup

Implement drug to drug and drug to allergy interaction warnings in the EHR during the entire reporting period. Prepping Chart or Exam

Maintain Problem List MU #3 80% At least 80% of all unique patients seen by the EP or admitted to the eligible hospital have at least one problem entry (or an indication of “none”) recorded as structured data

Practice Manager > Drug Interaction Settings

In Main Menu > Practice Manager > Drug Interaction Settings

eCharting > Problems or Patient Manager > Problem List

Patient problems must be documented in the problem list OR indicate “No known Problems” with the checkbox provided in Falcon. Adding problems to the Assessment and Plan also adds them to the problem list and therefore counts.

Enable these two for the entire reporting period: • Drug-Drug Interactions (Drug-Drug) And • Prior Adverse Reactions (Drug-Allergy)

Note: Problems must be entered as structured data. Free text descriptions of problems and diagnosis in free text fields do not count for this measure. Page 1 of 7

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Measure e-Prescribing (eRx) MU #4 40%

Workflow affected Writing prescriptions

More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

Falcon Module / Screen eCharting / Patient Manager > Medications

EXCLUSION: If you write fewer than 100 prescriptions during the reporting period. Active Medication List MU #5 80%

Prepping Chart or Exam

Prepping Chart or Exam

At least 80% of all unique patients seen by the EP or admitted to the eligible hospital have at least one entry (or an indication of “none” if the patient has no medication allergies) recorded as structured data.

Record Demographics MU #7 50% More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data.

Use Falcon-SureScripts certified prescription module to send prescriptions electronically to pharmacies. Medications > New Prescription. Click “Send to Pharmacy” or “Send to Provider” (who will then approve and send to pharmacy) when prescribing medications.

Note: Using “Print Prescription” or “Call-in Prescription” counts against this measure.

At least 80% of all unique patients seen by the EP or admitted to the eligible hospital have at least one entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data. Medication Allergy List MU #6 80%

Falcon Action

eCharting > Medications or Patient Manager > Medications

Prescription and at home/existing medications must be documented in the medication list in the Patient Manager > Medications.

eCharting > Allergies or Patient Manager > Allergies

Medication allergies must be documented in Falcon under Patient Manager > Allergies or in eCharting > Allergies. Checking the box for “No Known Drug Allergies” also counts for this measure.

Note: Meds must be structured data and chosen from medication drop down list OR check “No Known Medications”.

The type of the Allergy when entered in Falcon must = “Med” or “Drug Class”.

Note: Allergies entered in Falcon as Type = “Other” do not count toward this measure. Patient Registration or Check-in

Patient Manager > Demographics

In Patient Manager > Demographics record all of the following demographics for patients: a. Preferred language b. Gender c. Race d. Ethnicity e. Date of Birth

Note: “No Answer” DOES count as a valid entry for these fields.

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Measure Record Vitals MU #8 50%

Workflow affected Pre-exam or Exam

Falcon Module / Screen eCharting Encounter Note

For more than 50% of all unique patients age 2 and over seen by the EP or admitted to eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23), height, weight and blood pressure are recorded as structured data

Record Smoking Status MU #9 50%

Pre-exam or Exam

eCharting Encounter Note

More than 50% of all unique patients 13 years old or older seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have smoking status recorded as structured data Quality Reporting > Clinical Quality Measures scorecard

a. Height b. Weight c. Blood Pressure d. Calculate and display body mass index (BMI) (Falcon auto calculates BMI when Height is entered) e. For patients 2 -20 yrs. - use ICD9 code V85.5 (Body Mass Index Pediatric) in the patient Problem List Record smoking status in encounter note for patients 13 and older (must be clicked during reporting period even if already filled in for patient).

You can see your CQM measures in Falcon under Quality Reporting > Clinical Quality Measures. Attest to Yes if you intend to report these measures during the attestation. Falcon has provided the calculation and compilation of these measures for you in the CQM scorecard.

Note: Reporting 0 (zero) in the numerator is acceptable for core measures; reporting 0 in both the numerator and the denominator is acceptable for the additional measures.

Implement one clinical decision support rule relevant to your specialty or high clinical priority along with the ability to track compliance to that rule.

In the encounter record and chart changes in the following vital signs:

This field is usually found in Past Medical History, Social History section.

Report CQM measures – 3 Core and 3 Additional MU #10 Yes or No (See Clinical Quality Measures information in Falcon Help)

Clinical Decision Support MU #11 Yes or No

Falcon Action

Anytime

Main Menu > Clinical Decision Support

Enter at least one CDS (Clinical Decision Support) rule in Main Menu > Clinical Decision Support. Print a screen shot of the program you set up showing the creation date. To see the creation date, click on the program.

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Measure Electronic Copy of Health Information MU #12 50% or Excluded

Workflow affected Upon Request

More than 50% of all patients of the EP or the inpatient or emergency departments of the eligible hospital or CAH (POS 21 or 23) who request an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), are provided it within 3 business days.

Falcon Module / Screen Patient Manager > Clinical Summary Or Patient Portal

Clinical summaries provided to patients for more than 50% of all office visits within 3 business days.

Send a Clinical Summary report to a patient upon request. Patient Manager > Clinical Summary. Click Send to Patient. Can be printed or emailed to patient if requested by patient. OR Instruct the patient to access the Falcon Patient Portal: https://falcon.davita.com/ehr/portal All clinical information for the patient is available on the portal including: My Medication, My Allergies, My Lab Results, My Diagnosis, Education Materials

Note: Instructions for accessing patient portal can be found in Falcon Online Help under Job Aids folder: “Job Aid - Patient Portal for Patients”.

EXCLUSION: No requests from patients or their agents for an electronic copy of the patient health information during the reporting period. Clinical Summaries MU #13 50%

Falcon Action

Checkout or after office visit

Check-out or Patient Manager > Clinical Summary

Print or email a Clinical Summary for at least 50% of patients at the end of each office visit. Two ways to do this: Check-out: Click box to print Clinical Summary AND click “Print Documents” button. OR Patient Manager > Clinical Summary, Send to Patient button, Print as PDF

Exchange of Clinical Information (Not Required

Anytime

for attestation reporting period in 2013)

Patient Manager > Clinical Summary

MU #14 Yes or No

Print a screen shot of the patient’s Clinical Summary screen showing date and recipient of the test.

Perform at least one test of the EHR technology’s capability to electronically exchange key clinical information with providers of care or patient authorized entities.

Security Risk Analysis MU #15 Yes or No Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a) (1) and implement security updates as necessary and correct identified security definciencies as part of its risk management processes.

Send a Clinical Summary for any patient (the patient can be ficticious) to another provider using the “Send to Provider” option under Patient Manager > Clinical Summary. Ask the other provider to upload the Clinical Summary.

Note: This is a Y/N attestion and only needs to be done to assure this functionality is present in your EHR. The test does not have to be successful in order to meet the measure. Anytime

Anytime – perform and attest to security checked

Evaluate Falcon security based on requirements specified in measure. See the “Small Practice Security Guide” under Meaningful Use Folder in Falcon Online Guide and “Meaningful Use – Risk Assessment.” Print out the “Falcon Security Risk Assessment” document, review, sign and date and keep for your records. Page 4 of 7

Public Health Measures – Must do at least 1 or exclude both Measure

Immunization registries MS #1 Yes or No

Workflow affected Exam

Falcon Module / Screen eCharting > Immunizations

Performed at least one test of EHR’s technology’s capacity to submit electronic data to immunization registries and follow-up submission if the test is successful

Action Check with your state health department or the local county health department to see if they have an immunization registry with the capability to receive data submitted electronically. If they do, contact Falcon Support to assist you in performing a test and submission of data. In order to have data to submit you must use the Immunization template in eCharting when administering Immunizations; fill out all required fields. If they do not have a registry, you would choose exclusion #2.

EXCLUSION 1 : If you do not perform immunizations during the reporting period. EXCLUSION 2: If your area (state/ county) does not have an immunization registry that has the capacity to receive electronic data, then you can claim the exclusion for this measure. syndromic surveillance MS #2 Yes or No Performed at least one test of EHR’s technology’s capacity to submit electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful.

Administrative and Exam

Practice Manager > Public Health Survelliance Rules eCharting > Assessment and Plan Patient Manager > Problem List

Check with your state health department or the local county health department to see if they have an immunization registry with the capability to receive data submitted electronically. If they do, contact Falcon Support to assist you in performing a test and submission of data. Assign required ICD’s in Practice Manager>Public Health Surveillance Rules and record problems for patients using ICD codes in Problem List and record an on-set date. If they do not have a registry then you would choose Exclusion #2.

EXCLUSION 1 : If you do not collect any reportable syndromic information on your patients during the reporting period. EXCLUSION 2: If there is no public health agency that has the capability to receive the information electronically.

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Optional Measures – Must choose 4 of these Measure drug formulary checks MS #3 Yes or No

Workflow affected

Falcon Module / Screen

No Action Required

Physician - Will see in New Prescriptions

Drug formulary checks are always turned on in Falcon. You can attest Yes to this measure.

Prepping Chart

Lab Interfaced with Falcon Or

If you have an interfaced lab or DVA Labs then the clinical lab test results are flowing into Falcon and being stored as structured data in Patient Manager > Results Inquiry.

Patient Manager > Results Inquiry

If you do not have a lab interface then you can manually enter lab results into Patient Manager > Results Inquiry.

Quick Lists > Patient Lists

Create one report in Quick List with any criteria about problems (diagnosis).

Quick Lists > Patient Reminders > New Reminder

Generate a reminder list with this criteria :

Sys Admin > Patient Portal

Provide patients with access to the Patient Portal (Give patients the patient portal URL and ask them to register: https://falcon. davita.com/ehr/portal )

Enable drug formulary checks in the EHR and has access to at least one internal or external formulary for the entire EHR reporting period. EXCLUSION: If you write fewer than 100 prescriptions during the reporting period.

clinical Lab test results MS #4 40% More than 40% of all clinical lab test results ordered during the reporting period whose results are either a positive.negative or numerical format are incorporated in the EHR as structured data

patient lists MS #5 Yes or No

Anytime

Generate at least one report listing patients of the EP with a specific condition patient reminders MS #6 20% of patients >=65 yrs old or =< 5yrs old

Anytime

More than 20% of all patients 65 yrs and older or 5 years old and younger were sent appropriate reminders during the reporting period

Action

Print the report, and date it to keep for your records.

Age >= 65 or age = 65 or Visit Shortcuts > Educational Materials (Load educational materials for your practice into Falcon under Practice Manager > Documents)

Exam

eCharting > Medications

Action Include Educational Resources in encounter note in the Plan section. Click on Visit Shortcuts and then Educational Materials. Check off material you want to give patient. They are recorded in the encounter and will show up in the Checkout process to be printed.

There are two checkboxes in your encounter (usually in meds section).  atient has been P transitioned into my care

Perform medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the provider.

This checkbox is the denominator and if checked, will count this patient as one that was transitioned into your care and should have their meds reconciled. Medication reconciliation has been performed This checkbox is the numerator and if checked, will count this patient as having reconciled the meds.

transition of care summary MS#10 50% The provider who transitions or refers their patient to another setting of care or provider provides a clinical summary of care record for more than 50% of transitions to care and referrals. EXCLUSION: A Provider who does not transfer a patient to another setting or refer a patient to another provider during the reporting period.

Registration/ Check-in Exam Check-out

eCharting > Assessment and Plan Patient Manager > Clinical Summary > Send to Provider

There are three checkboxes in your encounter (usually in Plan section). Patient is being referred to another provider  atient is being P transitioned into the care of another provider If either of these two boxes are checked, then checking the box below indicates you met the measure.  atient’s clinical summary P will be provided to new or referring provider

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