User Quick GuideMeaningful Use SettingsMeaningful Use Eligible ProfessionalsEligible Providers (EPs) who are participating in the EHR Incentive Program either under Medicare or Medicaidmust complete at least 2 years under Stage 1 before they can advance to Stage 2. Along with certain clinic-levelproperties and configuration, some individual settings are required for each provider. Based on these settings,each provider can track his/her performance on the ARRA Dashboard for the specific reporting period.The required settings are grouped as follows. This whole process will take less than 30 minutes to fully enable. Encounter Type MU Details Provider-level MU Settings Clinic-level MU SettingsEncounter Type MU DetailsNote: Every encounter type must have at least one value designated under the MU Details frame.1. Select Settings Configuration Clinic Enc Types2. Select each Encounter Type individually3. Define the applicable MU Details as followsCopyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use Settingsa. Office Visit – select for every encounter type that is billed with an E&M Code which designates itis an office visit. Per CMS definition, this can include Tele-med encounters.b. Seen by Eligible Provider – select for every encounter where the patient is physically seen bythe Provider. If an encounter is created for a patient who sees the nurse only and not thephysician, this option would not be selected for that encounter type.Note: This is relevant for all measures of meaningful use where it is defined specifically as“unique patients seen by provider”.c. Exempt from MU Reporting – select for every encounter that is not considered for meaningfuluse in the context of a private practice (e.g.: Hospital encounters, Surgery, etc.)MU SettingsThe MU Settings master has 2 components – (a) Provider and (b) Clinic. To access the profile, select Settings Configuration Workflow MU Settings.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use SettingsProvider TabNote: Every provider must have these values defined based upon their specific participation in MU.1. Clickto select the Provider2. Select each Provider individually3. Define Meaningful Use Details for the providera. Select Stage – define which stage of the Meaningful Use program this provider is currentlyparticipating in.Note: If this value is not defined, the ARRA dashboard will display empty with all squaresgrayed-out, and no data will be recorded for the provider.i. None – this is the default value for all providers until the correct stage is selected.When this value is set, no meaningful use data will be captured, and the reports anddashboards will be blank system-wide for the provider.ii. Stage 1 – the first 2 years of participation must be Stage 1iii. Stage 2 – applicable once a provider has reported at least 2 years under Stage 1b. Reporting Period – indicate the calendar date range of the reporting period for the provider, therequirement of which is based upon the program and participation year for the provider.i. Medicare 1st year attesters – any consecutive 90-day period in calendar yearii. Medicare beyond 1st year – must correspond to calendar year quarter 1, 2, 3, or 4iii. Medicaid attesters (any year) – any consecutive 90-day period in calendar yearc. Applicable Core Set Measures – define the measure number for each core set measure forwhich the provider does not qualify to exclude measure-wide as per CMS requirements. Anymeasure number omitted from this field will display grayed-out on ARRA Dashboards and beexcluded from all MU reporting.d. Applicable Menu Set Measures – define the measure number for each menu set measure forwhich the provider does not qualify to exclude measure-wide as per CMS requirements. Anymeasure number omitted from this field will display grayed-out on ARRA Dashboards and beexcluded from all MU reporting.e. Attestation Date – once the EP has attested, please enter the applicable calendar date.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use Settings4. Define Vitals Details, ePrescription, NQF, Immunization Information, & Syndromic Surveillance for theprovider.Notes: The Vital Details, ePrescription, Immunization Information, and Syndromic Surveillance sectionsapply to the ability of the provider to exclude himself/herself from the measure entirely as perprovision within the CMS requirements. If a measure can be excluded on a case-by-case basis, itshould not be flagged as an exclusion at this level. The NQF section defines which individual Clinical Quality Measures are enabled for the provider.a. Vital Details – select the level of exclusion is applicable to you as an individual provider based onyour scope of care to the patient and the patient’s age.b. Exclude Electronic Prescribing of Controlled Substance (EPCS) Stage 2 Only –i. For Stage 1 providers, this box is disabled as EPCS is not applicable.ii. For Stage 2 providers, this box is enabled and active for all providers by default.Note: If you have chosen to not participate in EPCS, this box should be selected toexclude controlled substance medications.c. NQF – displays the 9 Clinical Quality Measures that are enabled for this provider.d. Immunization Information – this box should be selected for providers who do not administervaccinations.e. Syndromic Surveillance – this box should be selected for providers who do not report syndromicdata to public health departments as per local law.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use SettingsClinic TabNote: These values apply to all providers within the practice in the context of Meaningful Use.1. Dashboard framea. Meaningful Use On – select this check box to enable meaningful use logic system-wideb. Show Dashboard – select this check box to display the system-level ARRA Dashboard iconc. Show Encounter Level Dashboard – select this check box to display the encounter-level ARRADashboard icon, which will automatically invoke when closing the encounter2. Vital Tests framea. Height – display or define Test Code for the applicable vital sign bullet with Numeric result typethat the user documents the patient’s height in inchesb. Weight – display or define Test Code for the applicable vital sign bullet with Numeric result typethat the user documents the patient’s weight in poundc. Blood Pressure – display or define Test Codes for the vital sign bullets with Numeric result typethat the user documents the patient’s blood pressure in two distinct, separate numbersNote: Blood Pressure must be entered as two separate numbers. A single, fractional input is notacceptable per current certification requirements.3. Smoking Tests framea. Display or define Test Codes for the Smoking History bullets that the user documents thepatient’s smoking history status.b. For Stage 1, any element(s) the user defines is acceptablec. For Stage 2, user must document using the system-provided element Smoking Status (MU),which is automatically added to all Smoking History templatesNote: Stage 2 requires that the response be mapped to a valid SNOMED Code. These codes areautomatically associated to this default element.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use Settings4. Define Immunization Information & Syndromic Surveillance settings as applicable for the clinic.Note: These settings are applicable at the clinic-level for any Eligible Provider who administers vaccinesor is required to report syndromic data. Providers who qualify to exclude either measure must define theexclusion under the Provider tab as outlined above.a. Immunization Information – select the appropriate status of the State Immunization Registryand level of activity based on that status for the EP to comply with the measure.b. Syndromic Surveillance – select the appropriate status of the Public Health Agency and level ofactivity based on that status for the EP to comply with the measure5. View the Others pane, which displays indicators of system-wide features that has relevance withmeaningful use compliance at a functional level. These values are displayed FYI and are actually definedelsewhere at the system-level.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use SettingsSetup Required TabThis tab allows you to track the status of system interfaces and/or request these as applicable by directlycontacting the Meaningful Use Engineering Team.a. Define Interface Details options as applicable. The Status will display the current level of activity as perthe implementation of the specific feature.a. Immunization Registry 2.5.1 – select the check box to request that an HL7 interface ofImmunization Data be enabled with your state registry for EP who administer vaccinesb. Generate Immunization Test File (Stage 1 Only) – select the check box to request Engineeringto submit a test file on your behalf to the state registry as applicable.Note: This option applies only for Stage 1 attesters who are not already in production with aState Immunization Registry.c. Lab Result 2.5.1 – select the check box to request that an HL7 interface of Laboratory Results beenabled with your Lab Vendor.d. Secure email (N2N) – select the check box to request the practice be setup with Surescripts for asecured email/messaging domain for processing Summary of Care requests.b. Contact Email: – allows you to enter your direct email address so that Engineering can reply as neededto your requests. Click the send email button after selecting the desired check box(es) above.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use SettingsFrequently Asked Questions Regarding Meaningful Use 2014For all requirements, guidelines, and FAQs, please visit the official CMS resources available online islation/EHRIncentivePrograms/.Common QuestionsQ-01A-01How do I identify which stage I should report?Eligible Providers (EP) must complete at least 2 years under Stage 1 before they can advance to Stage 2.The ability to move on to Stage 2 is not contingent upon payment of the incentive, as long as the EPreports on the measures required for a minimum of 2 years.Q-02A-02What Reporting Period should I select for reporting?EP must choose a reporting period based on the EHR Incentive program (Medicare or Medicaid) andparticipation year; i.e.: Medicare first year attesters can select any consecutive 90 days in calendar year 2014. To avoidthe payment adjustment in 2015, you must begin your reporting period by July 1 and attest byOctober 1, 2014. Medicare beyond first year must select a three-month reporting period fixed to any calendaryear quarter (e.g.: Q1: Jan-Mar, Q2: Apr-Jun, Q3: Jul-Sep, or Q4: Oct-Dec). Medicaid attesters of any participation year can select any consecutive 90 days in calendar year2014.Note: For calendar year 2014, both Stage 1 and Stage 2 requires a three-month or 90-day reportingperiod – regardless of participation year.Q-03A-03Why is my ARRA Dashboard grayed out and how can I enable it?When the ARRA Dashboard is grayed out, it is an indication that the MU Settings have not been configured for the Provider. Once the Stage and Reporting Period are defined for the EP, the dashboard willbe enabled and reflect data in conjunction with the other settings for the provider and the clinic.Q-04A-04Smoking status is not showing counts, even if I answer Smoking test under Social History.As per 2014 compliance, smoking status needs to be recorded along with SNOMED code. During V3B1upgrade, a new test Smoking Status (MU) is automatically added to each active Social History template.Q-05If an EP participated in the Medicaid EHR Incentive Program in 2012 and then skipped 2013, canhe/she report in 2014?Yes. Medicaid providers are not required to participate in consecutive years of the Program. EP whoskip a year of participation will resume the progression where they left off. All providers are required tomeet two years of Stage 1 before proceeding to Stage 2; regardless of not participating in consecutiveyears. (Note: There is an exception for EP who began MU in 2011; as Stage 2 is not available for anyoneuntil 2014; hence a user may have 3 years of Stage 1.)A-05Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use SettingsQ-06A-06If an EP fails to meet meaningful use during a participation year in the Medicare EHR IncentiveProgram, can he/she continue to participate and earn incentives for future years?Yes. Medicare providers who participate in the Medicare EHR Incentive Program and does not meet MUfor one participation year is highly encouraged to continue to attest and earn incentive payments forfuture participation years. If an EP does not successfully attest for a given year, he/she will not receivean incentive payment for that year; however, receiving an incentive payment for a future participationyear is based on the provider’s ability to meet MU during that year and not based on success or failurein a previous year. Progression through the stages of MU will continue to follow the CMS timeline oftwo years for each stage regardless of success or failure in consecutive years.For example, if an EP reports 1st year under Stage 1 successfully then fails the 2nd year under Stage 1;upon reporting the 3rd year, he/she will advance to Stage 2. Participation is not contingent upon successas to receiving the incentive payment for each year. Hence, the EP may be eligible to receive payment inthe 3rd year; however, it will be under Stage 2 although the second year of Stage 1 was not successful.Q-07A-07Q-08A-08If an EP withdraws his/her attestation or an audit is initiated by CMS post-payment or pre-paymentduring 1st year participation, can he/she start over again with year 1?If a provider registers to participate in the EHR Incentive Program for the first year then chooses towithdraw his/her attestation, the EP may have the opportunity to start over and repeat the first year if aCMS post-payment or pre-payment audit has not been initiated. If a provider withdraws during or aftera CMS audit has been conducted, he/she forfeits the ability to re-attest as a Year 1 participant and mustattest as a Year 2 participant in the next year. Once the provider has withdrawn and the audit has beeninitiated, the progression along the EHR Incentive Program time-line has begun and the provider wouldneed to meet MU along this schedule in order to earn the associated incentive payments.After the upgrade, my % of Patient Demographics went down on the ARRA Dashboard.As per 2014 compliance, Language/Race/Ethnicity needs to be recorded as per OSNC standards. If thevalue entered is not from the standard list then it will not be counted in the numerator. Some valuesconverted over as Inactive and must be updated using values in the new master list for 2014. To viewfull lists of federally-defined standards, please visit the following reference sites: Q-09A-09Language: http://www.loc.gov/standards/iso639-2/php/English list.phpEthnicity: id hinvads.cdc.gov/vads/ViewValueSet.action?id 94E75E17-176B-DE11-9B520015173D1785#After the upgrade, when I click the Med Hx button to perform Medication Reconciliation, the checkbox is no longer available to get MU credit.As per 2014 compliance, Medication Reconciliation needs to be performed for every transition of carevisit (and not for new patients’ 1st visits only). Medication reconciliation is not based upon applicableTransition of Care status as follows: Stage 1o Denominator – mark visit on Current Medications Transition of Care frame as (aTransition of Care New Patient, b-Transition of Care with Summary of Care, or c-Transition ofCopyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use Settingso Care without Summary of Care)Numerator – for any applicable drug appearing in the Transition of Care frame, from theReconcile pick list, select AddStage 2o Denominator – mark visit on Current Medications Transition of Care frame as (aTransition of Care new Patient or b-Transition of Care with Summary of Care)o Numerator – for any applicable drug appearing in the Transition of Care frame, from theReconcile pick list, select Add or select No Known Transition of Care Medication check boxQ-10 What are the required measures and how many are required for each Stage?A-10 For 2014 compliance, there are three categories of required measures; e.g.: Core Set, Menu Set, andClinical Quality measures. The number required for an EP to report is based upon which stage. Stage 1o 13 Core Seto 5 out of 9 Menu Seto 9 Clinical Quality Measures (NQF)Note: CQM are not divided as mandatory or optional; all EP who attest must report 9 NQF. Stage 2o 17 Core Seto 3 out of 6 Menu SetNote: EP cannot claim exclusion for the 3 reported menu set measures if there are othermeasures for which he/she can successfully report without exclusion. If NONE of the menumeasures apply to your scope of practice and you thus qualify to exclude all 6 of them, then youcan select 3 and claim exclusion for each one.o 9 Clinical Quality Measures (NQF)Note: CQM are not divided as mandatory or optional; all EP who attest must report 9 NQF.Q-11A-11After the upgrade, the Clinical Summary is not the same as it was previously. Can this be customizedas per the old format?As per 2014 compliance, the Clinical Summary must follow the CMS specifications for a CCD (Continuityof Care Document) and hence cannot be customized. However, prior to printing, downloading, oractivating it to the portal, the EP can suppress specific data from the different sections of the Summary.The following data is required at a minimum: Patient name Provider's name and office contact information. Date and location of the visit Reason for the office visit Current problem list Current medication list Current medication allergy list Procedures performed during the visit Immunizations or medications administered during the visit Vital signs taken during the visit (or other recent vital signs) Laboratory test results List of diagnostic tests pending Clinical instructionsCopyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use Settings Future appointmentsReferrals to other providersFuture scheduled testsDemographic information maintained within certified electronic health record technology(CEHRT) (sex, race, ethnicity, date of birth, preferred language)Smoking statusCare plan field(s), including goals and instructionsRecommended patient decision aids (if applicable to the visit)Q-12A-12What reports are available for Meaningful Use tracking in the upgraded version of PrognoCIS?PrognoCIS V3 contains a report category called Meaningful Use. All MU-related reports have beenmoved from the Tabular category to this new category. Within this category, there are classifications ofindividual reports based on their purpose and data contained within the output.o MU-Eligibility – used for providers to determine their volume of Medicaid-eligible patients todetermine eligibility for the Medicaid EHR Incentive Programo 2014-MU – the report equivalent of the ARRA Dashboard, this report (which is based on stage)reflects all measures for the stage and the EP performance as to success or failure for each CoreSet and Menu Set measureo Patient-Lists – these reports are detailed at the patient-level and condition indicated. Both stage1 and stage 2 has measures that require at least one Patient List be generated per each reportingperiod by each Eligible Professionalo NQF-Measures – QRDA (Quality Reporting Data Analysis) reports provide details of ClinicalQuality Measures. Each individual NQF has patient-level details for that individual measure, andQRDA3-Cumulative for all NQF Measures provides a summary of all 64 individual measuresQ-13A-13Is there a report of all patients who have failed any specific measure for either Stage 1 or Stage 2?Yes. There are tabular reports titled “List of patients with . Not Done” for both Stage 1 & Stage 2 thatincludes patient details that are not reflecting numerator criteria per the individual measure.Q-14After the upgrade, the Vitals measure is not getting credited correctly although we are documentingthem on each encounter.As per 2014 compliance, all 3 vital signs of Height, Weight and Blood Pressure need to be recorded asNumeric Result Type elements. If BP is entered as a single value in fraction format (e.g.: 140/85), it willnot count towards the numerator. All databases include separate elements for BP Systolic and BPDiastolic; however, these may not be activated on all Vitals templates. Please verify that the elementsare on the templates used and that the applicable Test Codes are defined under the Clinic tab of MUSettings.A-14Q-15A-15For Stage 2, my Family History measure is not giving me correct credit.For Stage 2, the Family History measure is included in the numerator only when the documentedproblem has an appropriate SNOMED code associated to the problem and all 1st Degree Relations; i.e.:Mother, Father, Brother, Sister, Son and Daughter.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
User Quick GuideMeaningful Use SettingsQ-16A-16Q-17A-17What is “Patient declined MU Summary” check box on the Encounter Close Screen, and if it is selected,will it give credit in the Clinical Summary numerator?Yes. The measure states that the Clinical Summary should be provided per patient request. Hence, if thepatient declines to receive it, the provider still gets credit for providing it per that patient’s preference(which is to not receive it at all).I am adding Patient Education by clicking the , but it is not giving me credit in my numerator.As per requirement, the EHR must identify what education is to be distributed based on encounter-leveltriggers. There are two options that give numerator credit for Stage 1 or Stage 2:o Settings Configuration Clinic Education – defined by triggero PMH or Assessment ICD, Lab result, or Current Medication Note: Clicking thedirectly on the encounter is the equivalent of manually deciding whateducation to provide, which is not compliant.Copyright 2014, Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222, San Jose, CA 95117 (408) 873-3032
Meaningful Use Settings Clinic Tab Note: These values apply to all providers within the practice in the context of Meaningful Use. 1. Dashboard frame a. Meaningful Use On - select this check box to enable meaningful use logic system-wide b. Show Dashboard - select this check box to display the system-level ARRA Dashboard icon
and 'meaningful' way. Meaningful Use Goal O The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States O To show that the utilization of EHRs are done in a 'meaningful' way. O Certified Electronic Health Record Technology (CEHRT) Benefits of Meaningful Use O Complete .
RPMS sites must be using certified EHR to meet meaningful use. In other words, sites using only RPMS roll-and-scroll will not meet meaningful use. Commercial vendors of EHRs are subject to the same meaningful use requirements, standards, process, and schedule as RPMS EHR. 2.2 Stage 1 Meaningful Use Considerations
the meaningful use incentive program. The working group will also establish criteria to determine Stages 2 and 3 of meaningful use. Criteria for Stage 2 of meaningful use will begin in 2014, and criteria for Stage 3 of meaningful use will b
The three mains components of meaningful use are the use of a certified EHR: - in a meaningful manner, - for electronic exchange of health information to improve the quality of health care, and - to submit clinical quality and other measures. "Meaningful Manner" There are a total of 25 meaningful use objectives which were created to show .
DEFINING MEANINGFUL USE To be a considered a meaningful use EHR user the following requirements must be met: Use of certified EHR technology in a meaningful manner (e.g. e-prescribing) Use of certified EHR technology for electronic exchange of health information to improve the quality of healthcare, such as promoting care coordination
LOGIQ e Quick Card 10 11 LOGIQ e Quick Card The Quick Card is a quick reference and not does not replace the User Manual. Please refer to the Basic User Manual for complete safety and operation information. The Quick Card is a quick reference and not does not replace the User Manual. Please refer to the Basic User Manual for complete safety
Meaningful use in a nutshell ARRA/HITECH incentive program – Use certified EHR technology – Be a “meaningful EHR user” . (Microsoft PowerPoint - The Compliance Officer\222s Role in Meaningful Use.
Each 100 mL contains 900 mg of Sodium Chloride, USP (NaCl). The osmolarity is 308 mOsmol/L (calculated). It contains 154 mEq/L sodium and 154 mEq/L chloride. The MINI-BAG Plus Container is a standard diluent container with an integral drug vial adaptor. It allows for drug admixture after connection to a . single dose . powdered drug vial having a . 20 mm closure. A breakaway seal in the tube .