iPatientCare, Inc. One Woodbridge Center, Suite 812 Woodbridge, New Jersey 07095 Phone: 732.607.2400 Fax: 732.676.7667 E-mail:
[email protected] Website: www.iPatientCare.com
How to achieve Meaningful Use Incentive using iPatientCare Document Version: 1.0.0.5 Document updated on: October 5, 2012
Version History Version 1.0.0.0 1.0.0.1
Updated August 17, 2011 January 11, 2012
1.0.0.2
April 03, 2012
1.0.0.3
September 12, 2012
1.0.0.4
September 24, 2012
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October 5, 2012
Document Version 1.0.0.5
Comments Original Document Updated Document for following points: List of CQM-Additional % of Patients with up-to-date problem list of current and active diagnoses Capability to exchange key clinical information Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities Updated Document for following points: NQF 0047/PQRI 53 Asthma Pharmacologic Therapy NQF 0001/PQRI 64 Asthma Assessment NQF 0036 Use of Appropriate Medications for Asthma Updated Document for following points: 15 - % of transitions in care where Medical Reconciliation was performed Updated Document for the following points: NQF 0012 - % of Patients with Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) NQF 0014 - % of D (Rh) negative, unsensitized patients, Prenatal Care: given Anti-D Immune Globulin NQF 0033 - % of Women with Chlamydia Screening Updated document for the following points: NQF 0052 - % of patients with primary diagnosis of low back pain who did not have imaging study within 28 days of diagnosis NQF 0068 - % of patients with Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
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The material presented in this document is intended for use of iPatientCare clients only and may not be reproduced in any form, by any method, for any purpose without the expressed permission of iPatientCare, Inc.
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Table of Contents 1. About Document .......................................................................................................................... 6 2. Meaningful Use Reports............................................................................................................... 6 3. Core Set Reports ......................................................................................................................... 8 3.1 07 - % of Patients for whom Medication orders entered by physicians through CPOE ......... 8 3.2 Implement drug-drug and drug-allergy checks ...................................................................10 3.3 08 - % of permissible prescriptions transmitted electronically ...........................................13 3.4 04 - % of patients whose demographics is recorded as structured data .............................15 3.5 01 - % of Patients with up-to-date problem list of current and active diagnoses................17 3.6 02 - % of Patients with Active Medication List ....................................................................19 3.7 03 - % of Patients with active medication allergy list .........................................................21 3.8 09 - % of patients whose vitals are recorded as structured data ........................................23 3.9 10 - % of patients 13 years or older whose smoking status is recorded .............................25 3.10
Implement one clinical decision support rule ..................................................................27
3.11
Report ambulatory quality measures to CMS or the States..............................................29
3.12 12 - % of patients provided with an electronic copy of their health information, upon request ...............................................................................................................................30 3.13
13 - % of encounters for which clinical summaries were provided .................................33
3.14
Capability to exchange key clinical information ..............................................................35
3.15 Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities ....................37 4. Menu Set Reports (Choose any 5 out of this list) ........................................................................38 4.1 Implement drug-formulary checks......................................................................................38 4.2 11 - % of clinical lab results incorporated into EHR as structured data ..............................40 4.3 Generate at least one report listing patients of the EP with a specific condition .................43 4.4 14 - % of Patients sent reminders for preventive/follow up care .......................................46 4.5 06 - % of all patients with timely electronic access to their health information .................49 4.6 05 - % of patients who have been provided patient specific educational resources ...........51 4.7 15 - % of transitions in care where Medical Reconciliation was performed ........................53 4.8 16 - % of transitions in care for which summary care record is shared ..............................56 4.9 Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice ...........................60 4.10 Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice ......................................61 5. CQM – Core .................................................................................................................................62 5.1 NQF 0013 - Hypertension: Blood Pressure Measurement ....................................................62 5.2 NQF 0028 - Tobacco use assessment and cessation intervention........................................65 5.3 PQRI 128 - Adult Weight Screening and Follow-up .............................................................69 6. CQM - Additional (Choose any 3 from this list) ...........................................................................72 6.1 PQRI 1 - Hemoglobin A1c Poor Control ...............................................................................72 6.2 PQRI 111 - Pneumonia Vaccination for Patients 65 years and older ...................................75
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6.3 PQRI 112 - Screening Mammography .................................................................................77 6.4 PQRI 113 - Colorectal Cancer Screening .............................................................................79 6.5 PQRI 2 - Low Density Lipoprotein (LDL) Management and Control .....................................81 6.6 PQRI 3 - Blood Pressure Management ................................................................................84 6.7 NQF 0047/PQRI 53 Asthma Pharmacologic Therapy...........................................................87 6.8 NQF 0001/PQRI 64 Asthma Assessment.............................................................................90 6.9 NQF 0036 Use of Appropriate Medications for Asthma ........................................................93 6.10 NQF 0012 - % of Patients with Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) .......................................................................................................................100 6.11 NQF 0014 - % of D (Rh) negative, unsensitized patients, Prenatal Care: given Anti-D Immune Globulin ..............................................................................................................106 6.12
NQF 0033 - % of Women with Chlamydia Screening .....................................................115
6.13 NQF 0052 - % of patients with primary diagnosis of low back pain who did not have imaging study within 28 days of diagnosis .......................................................................125 6.14 NQF 0068 - % of patients with Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic ....................................................................................................129 7. Acknowledgments ....................................................................................................................136 8. Disclaimer ................................................................................................................................136
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1. About Document The following document gives a complete description on How to achieve Meaningful Use Incentive using iPatientCare. 2. Meaningful Use Reports List of Meaningful Use Reports are mentioned below: SR. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 1. 2. 3. 1.
Report Name Core Set Reports 07 - % of Patients for whom Medication orders entered by physicians through CPOE Implement drug-drug and drug-allergy checks 08 - % of permissible prescriptions transmitted electronically 04 - % of patients whose demographics is recorded as structured data 01 - % of Patients with up-to-date problem list of current and active diagnoses 02 - % of Patients with Active Medication List 03 - % of Patients with active medication allergy list 09 - % of patients whose vitals are recorded as structured data 10 - % of patients 13 years or older whose smoking status is recorded Implement one clinical decision support rule Report ambulatory quality measures to CMS or the States 12 - % of patients provided with an electronic copy of their health information, upon request 13 - % of encounters for which clinical summaries were provided Capability to exchange key clinical information Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities Menu Set Reports (Choose any 5 out of this list) Implement drug-formulary checks 11 - % of clinical lab results incorporated into EHR as structured data Generate at least one report listing patients of the EP with a specific condition 14 - % of Patients sent reminders for preventive/follow up care 06 - % of all patients with timely electronic access to their health information 05 - % of patients who have been provided patient specific educational resources 15 - % of transitions in care where Medical Reconciliation was performed 16 - % of transitions in care for which summary care record is shared Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice CQM - Core NQF 0013 - Hypertension: Blood Pressure Measurement NQF 0028 - Tobacco use assessment and cessation intervention PQRI 128 - Adult Weight Screening and Follow-up CQM - Alternate Core (Submit only if any of 3 CQM - Core report's Denominator is 0) NQF 0024 - Weight Assessment and Counseling for Children and Adolescents NQF 0038 - Childhood Immunization Status PQRI 110 - Influenza Immunization for Patients 50 Years Old or Older CQM - Additional (Choose any 3 from this list) PQRI 1 - Hemoglobin A1c Poor Control
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2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38.
PQRI 111 - Pneumonia Vaccination for Patients 65 years and older PQRI 112 - Screening Mammography PQRI 113 - Colorectal Cancer Screening PQRI 2 - Low Density Lipoprotein (LDL) Management and Control PQRI 3 - Blood Pressure Management Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective Continuation Phase Treatment Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care Asthma Pharmacologic Therapy Asthma Assessment Appropriate Testing for Children with Pharyngitis Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and Tobacco Use Cessation Strategies Diabetes: Eye Exam Diabetes: Urine Screening Diabetes: Foot Exam Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation Ischemic Vascular Disease (IVD): Blood Pressure Management Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Prenatal Care: Anti-D Immune Globulin Chlamydia Screening for Women Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement Controlling High Blood Pressure Cervical Cancer Screening Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) Use of Appropriate Medications for Asthma Low Back Pain: Use of Imaging Studies Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control Diabetes: Hemoglobin A1c Control (> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “RX” Section Note: More than 30 percent of medication has to be prescribed by any Physician into the practice.
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3.2 Implement drug-drug and drug-allergy checks Objective: Implement drug-drug and drug-allergy checks. Measure: The EP has enabled this functionality for entire EHR reporting period. Exclusion: None
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Action to be taken The drug-drug and drug-allergy interaction is available while prescribing the medication. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “RX” Section Drug-drug interaction:
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Drug-Allergy Interaction:
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3.3 08 - % of permissible prescriptions transmitted electronically Objective: Generate and transmit permissible prescriptions electronically (Note: only non-controlled substances are permissible) Measure: More than 40 percent of all permissible prescriptions written by EP are transmitted electronically using certified EHR technology Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period qualifies for an exclusion from this objective/measure Denominator: Number of prescriptions given by specific provider within the reporting period Numerator: Number of prescription transmitted electronically
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Action to be taken You can transmit Rx by selecting the Rx and entering the pharmacy details and clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “RX” Section>> Click on “Transmit” button
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3.4 04 - % of patients whose demographics is recorded as structured data Objective: To Record demographics • Preferred language • Gender • Race • Ethnicity • Date of Birth Measure: More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data Exclusion: None Denominator: Number of encountered patients within the reporting period Numerator: Number of patients for whom Preferred Language, Gender, Race, Ethnicity and Date of Birth is recorded
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Action to be taken You need to record the “Name”, “Preferred Language”, “Gender”, “Race”, “Ethnicity” and “Date of Birth” on the Demographics Screen. Or Check the “Patient declined to provide information or prohibited by state law” check box. Path: Click on “Open Chart” icon>> Click on “New” button
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3.5 01 - % of Patients with up-to-date problem list of current and active diagnoses Objective: Maintain an up-to-date problem list of current and active diagnoses Measure: More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data Exclusion: None Denominator: Number of Encountered patients within the reporting period Numerator: Number of patients for whom Problem/diagnosis is recorded
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Actions to be taken You can add new Active Diagnosis by clicking on “New” button. If there is no diagnosis code to record then check the “No known problem” check box Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Problem DX” Section
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3.6 02 - % of Patients with Active Medication List Objective: Maintain active medication list Measure: More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data Exclusion: None Denominator: Number of encountered patients within the reporting period Numerator: Number of patients for whom Current Medication is recorded
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Actions to be taken You can add new Current Medication by clicking on “New” button. If there is no medication to record then check the “No Active Medication” check box Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Current Medication” Section Note: The “No Active Medication” check box will enable only if there is no active medication available in the list.
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3.7 03 - % of Patients with active medication allergy list Objective: Maintain active medication allergy list Measure: More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data Exclusion: None Denominator: Number of encountered patients within the reporting period Numerator: Number of patients for whom Allergy is recorded
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Actions to be taken You can add new Allergy by clicking on “New” button. If there is no allergy to record then check the “NKDA” check box. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Allergies” Section Note: The “NKDA” check box will enable only if there is no active allergy available in the list.
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3.8 09 - % of patients whose vitals are recorded as structured data Objective: Record and chart changes in vital signs: • Height • Weight • Blood pressure • Calculate and display BMI • Plot and display growth charts for children 2-20 years, including BMI Measure: For more than 50 percent of all unique patients of age 2 years and over seen by the EP, height, weight and blood pressure are recorded as structured data Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice during the EHR reporting period qualifies for an exclusion from this objective/measure Denominator: Number of encountered patients (of age 2 years or older) within the reporting period Numerator: Number of patients for whom Vitals (Height, Weight, Blood Pressure and BMI) is recorded
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Actions to be taken You can record “Height”, “Weight”, “Blood pressure”, “Calculate and display BMI” and Plot and display growth charts for children 2-20 years, including BMI. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Vitals” Section>> Click on “New” button Note: The BMI will be auto calculated once you enter Height and Weight.
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3.9 10 - % of patients 13 years or older whose smoking status is recorded Objective: Record smoking status for patients of 13 years old and above Measure: More than 50 percent of all unique patients 13 years old or older seen by the EP have “smoking status” recorded Exclusion: Any EP who sees no patients 13 years or older during the EHR reporting period qualifies for an exclusion from this objective/measure Denominator: Number of encountered patients (of age 13 years or older) within the reporting period Numerator: Number of patients for whom Smoking status is recorded
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Actions to be taken You can record Smoking Status for the patient by selecting the Smoking Status and clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “PFSH” Section>> Select “Social HX”>> Click on “Tobacco History” icon
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3.10 Implement one clinical decision support rule Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority with the ability to track compliance to that rule Measure: Implement one clinical decision support rule Exclusion: None Action to be taken You can add new Clinical Data Element by clicking on “New” button. Path: iPatientCare Administrator>> Click on “Masters” Menu>> Select “Clinical Data Elements” Menu option
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You can add new Disease to by clicking on “New” button. Path: iPatientCare Administrator>> Click on “Masters” Menu>> Select “Disease Management” Menu option>> Select “Adult” option
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3.11 Report ambulatory quality measures to CMS or the States Objective: Report ambulatory quality measures to CMS or the States Measure: For 2011, provide aggregate numerator and denominator through attestation For 2012, electronically submit the measures Exclusion: None Action to be taken You need to submit numerator and denominator while doing attestation
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3.12 12 - % of patients provided with an electronic copy of their health information, upon request Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies), upon request (electronic copy must be in an electronic form patient portal, PHR, CD, USB, etc.) Measure: More than 50 percent of all patients of the EP who request an electronic copy of their health information are provided it within 3 business days Exclusion: Any EP that has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period qualifies for an exclusion from this objective/measure Denominator: Number of requests made by patients for electronic copy of their health information within the reporting period Numerator: Number of electronic copies provided within the 3 business days of request
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Action to be taken You need to create a request first. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Click on “Clinical Information Request” icon On Clinical Information Request screen, you can create a request for electronic copy of specific patient’s health information.
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You can select specific Clinical information Request, select the path by clicking on “Browse” button and click on “Ok” button to provide electronic copy of health information. The .xml (electronic copy) file will be generated at browsed file path. Path: Click on “Tools” Menu>> Select “Export Clinical Summary” Menu option Note: • Health information should be provided within 3 business days of request
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3.13 13 - % of encounters for which clinical summaries were provided Objective: Provide clinical summaries of patients for each office visit. Measure: Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days. An office visit is defined as any billable visit that includes: 1) Concurrent care or transfer of care visits, 2) Consultant visits and 3) Prolonged Physician Service without Direct (Face-To-Face) Patient Contact (tele-health). A consultant visit occurs when a provider is asked to render an expert opinion/service for a specific condition or problem by a referring provider. Exclusion: Any EP who has no office visits during the EHR reporting period qualifies for an exclusion from this objective/measure. Denominator: Number of encounters created within the reporting period Numerator: Number of encounters for which clinical summary is provided
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Action to be taken You can print Visit Summaries from Patients visit note. Check the “I have given the following instruction to the patient” check box. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Visit Summary” section Note: • Clinical summary should be provided within 3 business days of the office visit. • The Visit Summary opens the letter which is selected in “Patient Letter” drop down letter on Tools>> Preferences>> User Preference>> Patient Letter Tab
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3.14 Capability to exchange key clinical information Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies, diagnostic test results), among providers of care and patient authorized entities electronically. Measure: Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information the use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. Exclusion: None Additional Information: The test of electronic exchange of key clinical information must involve the transfer of information to another provider of care with distinct certified EHR technology or other system capable of receiving the information. Simulated transfers of information are not acceptable to satisfy this objective. The transmission of actual patient information is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. When the clinical information is available in a structured format it should be transferred in a structured format. However, if the information is unavailable in a structured format, the transmission of unstructured data is permissible. EPs can use their clinical judgment to identify what clinical information is considered key clinical information for purposes of exchanging clinical information about a patient at a particular time with other providers of care. A minimum set of information is identified in the HIT Standards and Criteria rule at 45 CFR 170.304(i), and is generally outlined in this objective as: problem list, medication list, medication allergies, and diagnostic test results. An EP’s determination of key clinical information could include some or all of this information, as well as information not included here. An EP should test their ability to send the minimum information set in the HIT Standards and Criteria rule at 45 CFR 170.304(i). If the EP continues to exchange information beyond the initial test, then the provider may decide what information should be exchanged on a case-by-case basis. EPs must test their ability to electronically exchange key clinical information at least once prior to the end of the EHR reporting period. Testing may also occur prior to the beginning of the EHR reporting period. Every payment year requires its own, unique test. If multiple EPs are using the same certified EHR technology in a shared physical setting, testing would only have to occur once for a given certified EHR technology. An unsuccessful test of electronic exchange of key clinical information will be considered valid for meeting the measure of this objective.
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Action to be taken You can provide Patients with electronic copy of their health information by selecting the path by clicking on “Browse” button. Path: Click on “Tools” Menu>> Select “Export Clinical Summary” Menu option
You can import Patient CCD Data file by clicking on “Browse” button. Path: Click on “Tools” Menu>> Select “Import CCD Data” Menu option
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3.15 Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities. Measure: Conduct or review a security risk analysis per 45 CFR 164.308 (a) (1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process. The testing can occur prior to the beginning of the EHR reporting period. A security update could be updated for software for certified EHR technology to be implemented as soon as available, to changes in workflow processes, or storage methods or any other necessary corrective action that needs to take place in order to eliminate the security deficiency or deficiencies identified in the risk analysis. Exclusion: None Additional Information: iPatientCare does not perform any calculations for this measure. Providers must conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a)(1). Providers must then implement security updates and correct security deficiencies as necessary. This measure is reported through self-attestation. You may refer Privacy and Security Risk Assessment v1.0.0.0.doc for the sample.
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4. Menu Set Reports (Choose any 5 out of this list) 4.1 Implement drug-formulary checks Objective: Implement drug-formulary checks. Measure: The EP has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period. Exclusion: None
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Action to be taken iPatientCare gives Drug Formulary Check while adding new Medication for a Patient. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Current Medication” Section>> Click on “New” button>> Click on “Generic” Search icon
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4.2 11 - % of clinical lab results incorporated into EHR as structured data Objective: Incorporate clinical lab-test results into EHR as structured data. Measure: More than 40 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data. Exclusion: An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period qualifies for an exclusion from this objective/measure. Denominator: Number of Lab orders within the reporting period Numerator: Number of Lab results available either in a positive/negative or numerical format
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Action to be taken You can order Lab Test which will be counted in denominators. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Labs” Section Select the lab order by checking the check box and click on “Print” or “Transmit” button to order a Lab.
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You can record Clinical Lab results by entering the values and by clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Lab Reports” Section>> Click on “New” button
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4.3 Generate at least one report listing patients of the EP with a specific condition Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach. Measure: Generate at least one report listing patients of the EP with a specific condition. Exclusion: None
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Action to be taken You can generate the list by entering the Search criteria details and by clicking on “Generate List” button. Path: Click on “Report” Menu>> Click on “Report Template” Menu option
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Patient Reminder Screen opens. You can view the list of Patients.
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4.4 14 - % of Patients sent reminders for preventive/follow up care Objective: Send reminders to patients per patient preference for preventive/ follow up care Measure: More than 20 percent of all unique patients of 65 years or above or 5 years old or below were sent an appropriate reminder during the EHR reporting period Exclusion: An EP who has no patients of 65 years old or above or 5 years old or below with records maintained using certified EHR technology qualifies for an exclusion from this objective/measure Denominator: Number of encountered patient (of age 65 years or older and 5 years and younger) within the reporting period Numerator: Number of patients for whom Patient Confidential Communication Preference is set and reminders is sent
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Action to be taken You need to select the communication preference from “Patient Confidential Communication Preference” drop down list. Path: Click on “Open Chart” icon>> Select Patient>> Click on “Modify” button
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Generate a list of patients to whom reminder to be sent. Select the patient Name and Click on “Save” button. Path: Correspondence >> Appointment Reminder
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4.5 06 - % of all patients with timely electronic access to their health information Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP Measure: More than 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information Exclusion: Any EP that neither orders nor creates any of the information listed at 45 CFR 170.304(g) (e.g., lab test results, problem list, medication list, medication allergy list, immunizations, and procedures) during the EHR reporting period qualifies for an exclusion from this objective/measure Denominator: Number of encountered patients within the reporting period Numerator: Number of patients having access of Patient Portal
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Action to be taken You can provide patients with timely electronic access by clicking on “Patient Login” button. Path: Click on “Open Chart” icon>> Click on “New” button
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4.6 05 - % of patients who have been provided patient specific educational resources Objective: Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate Measure: More than 10 percent of all unique patients seen by the EP are provided patient specific education resources Exclusion: None Denominator: Number of encountered patients within the reporting period Numerator: Number of patient to whom Patient Education is provided
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Action to be taken You can record the patient education by checking the checkbox from the list of documents or you can also record that the patient education is given by checking “I have given education resources to the patient” check box displayed at the bottom panel of the screen. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Patient Education” Section
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4.7 15 - % of transitions in care where Medical Reconciliation was performed Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. Measure: The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP. “Relevant encounter” is an encounter during which the EP performs medication reconciliation due to new medication or long gaps in time between patient encounters or for other reasons determined appropriate by the EP. Essentially an encounter is relevant if the EP, judges it to be so. “Transition of care” is the movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory, specialty care practice, long-term care, home health, rehabilitation facility) to another. When conducting medication reconciliation during a transfer of care, the EP that receives the patient into their care that should conduct the medication reconciliation. Exclusion: An EP who was not the recipient of any transitions of care during the EHR reporting period qualifies for an exclusion from this objective/measure.
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Action to be taken for Denominator Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Click on “New” button You need to check “Transition in Care” checkbox while creating a new visit note for a patient. If this checkbox is checked then it will be populated in Denominator of “15 - % of transitions in care where Medical Reconciliation was performed” report. Note: • Transition in Care checkbox can also be checked while scheduling new appointment for a patient and also while creating new visit note from Practice Dashboard Screen. • Transition in Care checkbox will be automatically checked while creating new appointment if the selected patient has referring provider. You can uncheck the checkbox in case you do not want to record transition in care.
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Action to be taken for Numerator You can check the “I have reviewed all Medications” check box. If this checkbox is checked then it will be populated in Numerator of “15 - % of transitions in care where Medical Reconciliation was performed” report. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Current Medication” Section
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4.8 16 - % of transitions in care for which summary care record is shared Objective: The EP who transitions their patient to another setting of care or refers their patient to another provider of care should provide summary care record for each transition of care and referral. Measure: The EP who transitions or refers their patient to another setting of care or provider of care should provide summary of care record for more than 50 percent of transitions of care and referrals “Transition of care” is the movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory, specialty care practice, long-term care, home health, rehabilitation facility) to another. Exclusion: An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period qualifies for an exclusion from this objective/measure.
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Action to be taken for Denominator Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Refer To” Section To generate denominator, you need to record that the Patient is referred out. You can record it by checking the box in “Refer To” section.
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Action to be taken for Numerator You can check “Summary of Care record provided” check box to view the preview of Referral Letter generated for the patient. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Refer To” Section>> Click on “Preview” button
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OR You can provide Patients with electronic copy of their health information by selecting the path by clicking on “Browse” button. Once the File Path is specified, Click on “Ok” button to export the summary Path: Click on “Tools” Menu>> Select “Export Clinical Summary” Menu option
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4.9 Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice Measure: Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information have the capacity to receive the information electronically) The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. Exclusion 1: An EP who does not perform immunizations during the EHR reporting period would be excluded from this requirement Exclusion 2: If there is no immunization registry that has the capacity to receive the information electronically, an EP would be excluded from this requirement
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4.10 Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice Measure: Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information have the capacity to receive the information electronically) The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective Exclusion 1: If an EP does not collect any reportable syndromic information on their patients during the EHR reporting period, then the EP is excluded from this requirement Exclusion 2: If there is no public health agency that has the capability to receive the information electronically, then the EP is excluded from this requirement
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5. CQM – Core 5.1 NQF 0013 - Hypertension: Blood Pressure Measurement Objective: Hypertension: Blood Pressure Measurement Measure: Percentage of patient visits for patients aged 18 years and older with a diagnosis of hypertension that has been seen for at least 2 office visits, with blood pressure (BP) recorded. Denominator: Number of encountered patients aged 18 years and older, with a diagnosis of Hypertension within the reporting period and has been seen for at least 2 office visits Numerator: Number of patients for whom blood pressure is recorded
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Action to be taken You can record Hypertension as active problem by selecting the problem from the pre-defined list and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Problem DX” Section>> Click on “New” button
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You can add Blood Pressure from the Visit note of the patient and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Vitals” Section>> Click on “New” button
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5.2 NQF 0028 - Tobacco use assessment and cessation intervention Objective: Preventive Care and Screening Measure Pair: a. Tobacco Use Assessment, b. Tobacco Cessation Intervention. Measure: Percentage of patients aged 18 years and older who have been seen for at least 2 office visits who were queried about tobacco use one or more times within 24 months b. Percentage of patients aged 18 years and older identified as tobacco users within the past 24 months and have been seen for at least 2 office visits, who received cessation intervention. Denominator 1: Number of encountered patients (of age 18 years or older) within the reporting period and has been seen for at least 2 office visits Numerator 1: Number of patients for whom tobacco use is recorded Denominator 2: Number of patients who uses the tobacco Numerator 2: Number of patients to whom tobacco cessation is provided
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Action to be taken You can record Smoking Status for the patient by selecting the Smoking Status and clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “PFSH” Section>> Select “Social HX”>> Click on “Tobacco History” icon
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You can check “I have provided tobacco cessation counseling” check box and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Patient Education” Section
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OR You can Prescribe RX to the patient by clicking on Search icon of Medication and selecting the RX from the predefined Medication list. Path: Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “RX” Section>> Click on “New” button
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5.3 PQRI 128 - Adult Weight Screening and Follow-up Objective: Adult Weight Screening and Follow-up Measure: Percentage of patients aged 18 years 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
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Action to be taken You can record Height and Weight of the patient and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Vitals” Section>> Click on “New” button
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You can record Follow Up details for the patient and click on “Ok” button to save the record for future requirement. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Follow Up” Section
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6. CQM - Additional (Choose any 3 from this list) 6.1 PQRI 1 - Hemoglobin A1c Poor Control Objective: Diabetes: Hemoglobin A1c Poor Control Measure: Percentage of patients 18 - 75 years of age with diabetes (type 1 or type 2) who had hemoglobin A1c > 9.0%. This measure is to be reported a minimum of once per reporting period for patients with diabetes mellitus seen during the reporting period. The performance period for this measure is 12 months. Denominator: Number of encountered patients (of age between 18 to 75 years), who are diabetic Numerator: Number of patients for whom Hemoglobin A1c is performed in last 12 months and the result is less than 9
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Action to be taken You can record Diabetes as active problem by selecting the problem from the pre-defined list and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Problem DX” Section>> Click on “New” button
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You can record the Lab Result by selecting New Lab radio button and clicking on Search icon to search the lab and click on “Ok” button to save the record. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Lab Repots” Section>> Click on “New” button
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6.2 PQRI 111 - Pneumonia Vaccination for Patients 65 years and older Objective: Pneumonia Vaccination Status for Older Adults Measure: Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine. Performance for this measure is not limited to the reporting period. Denominator: Number of patients of 65 years or older Numerator: Number of patients to whom pneumococcal vaccine is given
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Action to be taken You can record Vaccination Details for the patient by entering all the required details and save the record by clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Immunization” Section>> Select “Immunization”>> Click on “Status”
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6.3 PQRI 112 - Screening Mammography Objective: Preventive Care and Screening: Screening Mammography Measure: Percentage of women aged 40 through 69 years who had a mammogram to screen for breast cancer within 24 months Denominator: Number of women aged 40 through 69 years Numerator: Number of women who had a mammogram to screen for breast cancer within last 24 months
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Action to be taken You can record “Mammogram” result for female patient and save the record by clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Click on “Diagnostic Test Report” Section>> Click on “New” button
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6.4 PQRI 113 - Colorectal Cancer Screening Objective: Preventive Care and Screening: Colorectal Cancer Screening Measure: Percentage of patients aged 50 through 75 years who received the appropriate colorectal cancer screening. Performance for this measure is not limited to the reporting period Denominator: Number of patients aged 50 through 75 years Numerator: Number of patients who received the appropriate colorectal cancer screening
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Action to be taken You can record Colorectal Cancer test result for the patient and save the record by clicking on “Ok” button. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Click on “Diagnostic Test Report” Section>> Click on “New” button
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6.5 PQRI 2 - Low Density Lipoprotein (LDL) Management and Control Objective: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus Measure: Percentage of patients aged 18 through 75 years with diabetes mellitus who had most recent LDL-C level in control (less than 100 mg/dl). This measure is to be reported a minimum of once per reporting period for patients with diabetes mellitus seen during the reporting period. The performance period for this measure is 12 months.
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Action to be taken You can record Diabetes as active problem by selecting the problem from the pre-defined list and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Problem DX” Section>> Click on “New” button
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You can record the Lab Result by selecting New Lab radio button and clicking on Search icon to search the lab and click on “Ok” button to save the record. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Lab Repots” Section>> Click on “New” button
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6.6 PQRI 3 - Blood Pressure Management Objective: Diabetes: Blood Pressure Management Measure: Percentage of patients within 18 - 75 years of age with diabetes (type 1 or type 2) who had blood pressure Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Problem DX” Section>> Click on “New” button
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You can record Blood Pressure from the Visit note of the patient and click on “Ok” button to save the changes. Path: Click on “Open Chart” icon>> Select the Patient>> Click on “Open Chart” button>> Open Visit Note>> Click on “Vitals” Section>> Click on “New” button
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6.7 NQF 0047/PQRI 53 Asthma Pharmacologic Therapy Objective: Asthma Pharmacologic Therapy Measure: Percentage of patients aged 5 through 40 years with a diagnosis of mild, moderate, or severe persistent asthma who were prescribed either the preferred long‐term control medication (inhaled corticosteroid) or an acceptable alternative treatment. Exclusion: Medication not done due to Patient reasons like Medication Allergy or Medication Adverse Event or Medication Intolerance Denominator: No. of Patients of age between 5 to 40 years, diagnosis of mild, moderate, or severe persistent asthma Numerator: No. of Patients Prescribed either the preferred long-term control medication or an acceptable alternative treatment
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Action to be taken for Denominator You need to add Asthma problem by clicking on “New” button. Now click on “Modify” button. Edit Problem Screen gets opened. You can mark Severity of Asthma as “Persistent” from Severity drop down list. Click on “Ok” button to save the details. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Problem/Dx” Section>> Select Asthma Problem Dx>> Click on “Modify” button
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Action to be taken for Numerator You can prescribe medication to the patient for Asthma from Rx section. Click on “New” button. Select Medication Screen gets opened. Select the medication and click on “Ok” button. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Rx” Section
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6.8 NQF 0001/PQRI 64 Asthma Assessment Objective: Asthma Assessment Measure: Percentage of patients aged 5 through 40 years with a diagnosis of asthma and who have been seen for at least 2 office visits, which were evaluated during at least one office visit within 12 months for the frequency (numeric) of daytime and nocturnal asthma symptoms. Exclusion: None Denominator: No. of Patients of age between 5 to 40 years, with a diagnosis of asthma and who have been seen for at least 2 office visits Numerator: No. of Patients evaluated during at least one office visit within 12 months for the frequency (numeric) of daytime and nocturnal asthma symptoms
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Action to be taken for Denominator You can view Encounter Date of the selected Visit Note under Update Visit Note tab. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Problem/Dx” Section
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Action to be taken for Numerator You need to record number of daytime and nocturnal asthma symptoms from CC/HPI Section. You need to select Asthma Chronic option then select Asthma Timing. Now you can record no. of day time and night time symptoms for Asthma by selecting appropriate number from Number Pad window and clicking on “Ok” icon. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “CC/HPI” Section
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6.9 NQF 0036 Use of Appropriate Medications for Asthma Objective: Use of Appropriate Medications for Asthma Measure: The percentage of patient’s 5‐50 years of age during the measurement year that were identified as having persistent asthma and were appropriately prescribed medication during the measurement year. Report three age stratifications (5‐11 years, 12‐50 years, and total). Exclusion: Patients having Active Diagnosis of COPD, Cystic Fibrosis, Emphysema or Acute Respiratory Failure Denominator 1: The percentage of patients between 5-11 years of age during the measurement year who were identified as having persistent asthma Numerator 1: No. of Patients aged 5 to 11 prescribed appropriate asthma medication Denominator 2: The percentage of patients between 12-50 years of age during the measurement year who were identified as having persistent asthma Numerator 2: No. of Patients aged 12 to 50 prescribed appropriate asthma medication Denominator 3: The percentage of patients between 5-50 years of age during the measurement year who were identified as having persistent asthma Numerator 3: No. of Patients aged 5 to 50 prescribed appropriate asthma medication
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Action to be taken for Denominator1 You can record Problem Asthma as Persistent for Patient between 5-11 years of age. You need to add Asthma problem by clicking on “New” button. Now click on “Modify” button. Edit Problem Screen gets opened. You can mark Severity of Asthma as “Persistent” from Severity drop down list. Click on “Ok” button to save the details. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Problem/Dx” Section>> Select Asthma Problem Dx>> Click on “Modify” button
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Action to be taken for Numerator1 You can prescribe medication to the patient between 5-11 years of age for Asthma from Rx section. Click on “New” button. Select Medication Screen gets opened. Select the medication and click on “Ok” button. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Rx” Section
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Action to be taken for Denominator2 You can record Problem Asthma as Persistent for Patient between 12-50 years of age. You need to add Asthma problem by clicking on “New” button. Now click on “Modify” button. Edit Problem Screen gets opened. You can mark Severity of Asthma as “Persistent” from Severity drop down list. Click on “Ok” button to save the details. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Problem/Dx” Section>> Select Asthma Problem Dx>> Click on “Modify” button
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Action to be taken for Numerator2 You can prescribe medication to the patient between 12-50 years of age for Asthma from Rx section. Click on “New” button. Select Medication Screen gets opened. Select the medication and click on “Ok” button. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Rx” Section
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Action to be taken for Denominator3 You can record Problem Asthma as Persistent for Patient between 5-50 years of age. You need to add Asthma problem by clicking on “New” button. Now click on “Modify” button. Edit Problem Screen gets opened. You can mark Severity of Asthma as “Persistent” from Severity drop down list. Click on “Ok” button to save the details. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Problem/Dx” Section>> Select Asthma Problem Dx>> Click on “Modify” button
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Action to be taken for Numerator3 You can prescribe medication to the patient between 5-50 years of age for Asthma from Rx section. Click on “New” button. Select Medication Screen gets opened. Select the medication and click on “Ok” button. Path: iPatientCare EHR Click on “Open Chart” icon>> Select Patient>> Click on “Open Chart” button>> Select “Rx” Section
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6.10 NQF 0012 - % of Patients with Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) Objective: Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) Measure: Percentage of patients, regardless of age, who gave birth during a 12‐month period who were screened for HIV infection during the first or second prenatal visit Exclusion: Exclusion for Problem and Clinical Alert Denominator 1: Patients, regardless of age, who gave birth during a 12-month period Numerator 1: Patients who were screened for HIV infection during the first or second prenatal care visit
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Action to be taken for Denominator 1 Step 1: Create Prenatal Visit Note Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button Select Prenatal Visit Note under List tab. Click on “New” button to create new Prenatal Visit Note. Note: Make sure to select Case No. while creating new Prenatal Visit Note.
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Step 2: Record EDD Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Open Prenatal Visit Note Select EDD Section. Enter LMP date. Once the LMP date is entered, system will automatically calculate EDD date.
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Step 3: Record Diagnosis Code for New Encounter Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Create New Prenatal Visit Note Select Problem DX Section. Click on “New” button. Select ICD related to delivery live births. Click on “Ok” button.
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Step 4: Perform Office Procedure Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Create New Prenatal Visit Note Select Office Procedure Section. Select Procedure related to delivery live births. Click on “Pending” link. Once the Office Procedure is performed, then status will get changed from Pending to Performed. Note: Date Difference between Procedure delivery of live births and Estimated Conception Date should be > Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Lab Order Section. Select Lab related to HIV Screening. Click on “Pending” link to record the lab result. Once the lab result is recorded the status will get changed from pending to done. Note: Lab Order and Result date should be Select Female Patient>> Click on “Open Chart” button Select Prenatal Visit Note under List tab. Click on “New” button to create new Prenatal Visit Note. Note: Select Case No. while creating new Prenatal Visit Note.
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Step 2: Record Diagnosis for New Encounter Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button Create New Prenatal Visit Note. Select Problem DX Section. Click on “New” button. Select ICD related to delivery live births.
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Step 3: Perform Office Procedure Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Office Procedure Section. Select Procedure related to delivery live births. Click on “Pending” link. Once the Office Procedure is performed, then status will get changed from Pending to Performed.
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Step 4: Record Diagnosis for Previous Encounter Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Problem/Dx Section. Click on “New” button. Select ICD related to D(Rh) negative.
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Step 5: Record Diagnosis for Previous Encounter Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Problem/Dx Section. Click on “New” button. Select ICD related to Primigravida.
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Step 6: Record Lab Result for Previous Encounter Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Lab Reports Section. Click on “New” button. Select New Lab for Rh Screening. Enter the result. Note: Result should be negative.
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Action to be taken for Numerator 1 Step 1: Record EDD Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select EDD Section. Enter LMP date. Once the LMP date is entered, system will automatically calculate EDD date.
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Step 2: Record Medication Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Rx Section. Click on “New” button. Click on “Search” icon to record medication related to anti‐D immune globulin. Note: Patient characteristic: Estimated date of conception should be >= 26 weeks and > Select Female Patient>> Click on “Open Chart” button Select Visit Note under List tab. Click on “New” button to create new Visit Note.
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Step 2: Perform Office Procedure Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Office Procedure Section. Select Procedures indicative of sexually active women. Click on “Pending” link. Once the Office Procedure is performed, then status will get changed from Pending to Performed.
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OR Step 3: Record Diagnosis Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Problem Dx Section. Click on “New” button. Select ICD related to sexually active woman.
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OR Step 3: Record Lab Result Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Lab Reports Section. Click on “New” button. Order Lab for Pregnancy Test. Record Lab Result.
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OR Step 3: Record PFSH Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select PFSH Section. Record IUD Device Applied under Sexual History column
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OR Step 3: Record Device Allergy Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Allergy Section. Click on “New” button. Record Allergy as IUD Device
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OR Step 3: Record Patient Education Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Patient Education Section. Educate patient on Contraceptive Use by selecting the related document.
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OR Step 3: Record Lab Result Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Lab Reports Section. Record Lab Result indicative of sexually active woman
Note: Record Denominator2 and Denominator3 for the age group as mentioned in the definition by following the same steps as described for Denominator1.
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Action to be taken for Numerator 1: Step 1: Record Lab Result Path: Click on “Open Chart” icon>> Select Female Patient>> Click on “Open Chart” button>> Prenatal Visit Note Select Lab Reports Section. Record Lab Result for Chlamydia Screening
Note: Record Numerator2 and Numerator3 for the age group as mentioned in the definition by following the same step as described for Numerator1.
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6.13 NQF 0052 - % of patients with primary diagnosis of low back pain who did not have imaging study within 28 days of diagnosis Objective: Low Back Pain: Use of Imaging Studies Measure: Percentage of patients with a primary diagnosis of low back pain who did not have an imaging study (plain x-ray, MRI, CT scan) within 28 days of diagnosis. Exclusion: None Denominator 1: Patients between age of 18 to 49 with the diagnosis of low back pain Numerator 1: Did not have imaging study done within 28 days of diagnosis
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Action to be taken for Denominator 1: Step 1: Create Encounter Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button Select Visit Note under List tab. Click on “New” button to create new Visit Note.
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Step 2: Record Problem/Dx Details Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button>> Open Visit Note Select Problem/Dx section. Click on “New” button. Select ICD related to Low Back Pain.
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Action to be taken for Numerator 1: Step 1: Order and Record Diagnostic Test in a new Visit Note Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button>> Create New Visit Note First of all you need to order Diagnostic Test for Back Pain. Once Diagnostic Test is ordered, select Diagnostic Test Report Section. Click on “New” button. Now you need to record Diagnostic Test result by entering the results in the appropriate fields. Click on “Ok” button. Note: • If Diagnostic Test is performed within 28 days of Onset date of Low back pain then the numerator will not be populated. • The Diagnosis has to be attached with specific visit note and Diagnostic Test.
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6.14 NQF 0068 - % of patients with Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Objective: Ischemic Vascular Disease (IVD): Use of Aspirin or another Antithrombotic Measure: Percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1November 1 of the year prior to the measurement year, or who had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior to the measurement year and who had documentation of use of aspirin or another antithrombotic during the measurement year. Exclusion: None Denominator 1: 18 years and older discharged alive for AMI, CABG or PTCA from Jan 1- Nov 1 of the year prior to the measurement year, or IVD diagnosed during the measurement year and prior to measurement year Numerator 1: Patients who had documentation of use of aspirin or another antithrombotic during the measurement year
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Action to be taken for Denominator 1 Step 1: Create Encounter Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button Select Visit Note option under List Tab. Click on “New” button to create a Visit Note.
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Step 2: Record Office Procedure Details Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button>> Visit Note Select Office Procedures/Injections section. Select CPT code related to Ischemic Vascular Disease. Note: You need to make sure that Performed Date should be between 14 to 24 months before Measurement End Date.
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OR Step 2: Record Office Procedure Details Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button>> Visit Note Select Office Procedures/Injections section. Select CPT code related to Ischemic Vascular Disease. Note: You need to make sure that Performed Date should be between 14 to 24 months before Measurement End Date.
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OR Step 2: Record Problem/Dx Details Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button>> Visit Note Select Problem/Dx section. Click on “New” button. Select ICD code related to Ischemic Vascular Disease. Note: You need to make sure that Onset Date should be between 14 to 24 months before Measurement End Date.
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OR Step 2: Record Problem/Dx Path: Click on “Open Chart” icon>> Select a Patient>> Click on “Open Chart” button>> Visit Note Select Problem/Dx section. Click on “New” button. Select ICD code related to Ischemic Vascular Disease. Note: You need to make sure that Onset Date should be > Select a Patient>> Click on “Open Chart” button>> Visit Note Select “Rx” section. Click on “New” button. Select Medication related to Ischemic Vascular Disease.
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7. Acknowledgments Prepared by the Technical Writer Team at iPatientCare, Inc 8. Disclaimer Information in this document is subject to change without notice. Contact your iPatientCare Representative for the latest information. iPatientCare, Inc. One Woodbridge Center, Suite 812 Woodbridge, New Jersey 07095 Phone: 732.607.2400 Fax: 732.676.7667 E-mail:
[email protected] Website: www.iPatientCare.com
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