RUSH and MIPS Quality Measures Documentation Guide (2017)

Transcription

1 RUSH and MIPS Quality Measures Documentation Guide (2017) Table of Contents CMS 154- Appropriate Treatment for Children with Upper Respiratory Infection (URI) (Age 3 months to 18 years)... 2 CMS 147-Preventive Care and Screening: Influenza Immunization (6 months and older)... 3 CMS 117-Childhood Immunization Status (2 years and under)... 4 CMS 155-Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (Ages 3-17)... 4 CMS 2- Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan (Ages 12 and older)... 5 CMS 69-Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up (18 and older)... 6 CMS 138-Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (18 and older)... 7 CMS 68- Documentation of Current Medications in the Medical Record (Ages 18 and older)... 8 CMS 165-Controlling High Blood Pressure (Age 18-85)... 9 CMS 122-Diabetes: Hemoglobin A1C Poor Control (Inverse measure) (Age 18-75) CMS 124-Cervical Cancer Screening (Age 21-64) CMS 125-Breast Cancer Screening (age 50-74) CMS 130- Colorectal Screening (Age 50-75) CMS 127-Pneumonia Vaccination Status for Older Adults (65 and older) CMS 146 Appropriate Testing of Children with Pharyngitis CMS 153 Chlamydia Screening for Women CMS 164 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet Using the Visit Checklist Reviewing Health Maintenance Topics Documenting Refusal for Influenza Immunization Documenting External Results Page 1

2 Scanning Results to an order using Media Manager Reviewing your Dashboard CMS 154- Appropriate Treatment for Children with Upper Respiratory Infection (URI) (Age 3 months to 18 years) Percentage of children 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) and were not dispensed an antibiotic prescription on or three days after the episode Children without a prescription for antibiotic medication for pharyngitis on or three days after the outpatient or ED visit for upper respiratory infection Children 3 months to 18 years of age who had an outpatient or emergency department (ED) visit with a diagnosis of upper respiratory infection (URI) during the measurement period 2017 Exclusions: Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established or who had an encounter with a competing diagnosis within three days after the initial diagnosis of URI Who needs to document this? All Providers treating children 3 to 18. This is an order based measure. DX codes that put the patient into the measure: (if these diagnoses are used- do not order antibiotic) J00 Acute nasopharyngitis [common cold] J06.0 Acute laryngopharyngitis J06.9 Acute upper respiratory infection, unspecified 460 Acute nasopharyngitis [common cold] Acute laryngopharyngitis Acute upper respiratory infections of other multiple sites Acute upper respiratory infections of unspecified site Page 2

3 CMS 147-Preventive Care and Screening: Influenza Immunization (6 months and older) Percentage of patients 6 months of age and older seen for a visit between October 1 and March 31 who received an influenza immunization or for those who have reported receiving an influenza immunization Exclusions: Patients in the denominator who either received an influenza immunization or have documentation of previous receipt of an influenza immunization. January March 2017 is the flu season. October December 2017 is the flu season. All patients 6 months and older seen for at least 2 visits or at least one preventative visit during the measurement period (Flu Season). Documentation of medical reason(s) for not receiving influenza immunization (e.g., patient allergy, other medical reasons) Documentation of patient reason(s) for not receiving influenza immunization (e.g., patient declined, other patient reasons) Documentation of system reason(s) for not receiving influenza immunization (e.g., vaccine not available, other system reasons) Patient has an active allergy to eggs Patient has an allergy to or intolerance of the influenza vaccine The documentation of reasons for not receiving influenza immunization and the allergy or intolerance are within 153 days before to 89 days after the start of the measurement period. Who needs to document this? Clinical Staff and providers can document this. Document in the Immunization Activity as a historical or current immunization. Providers can document a patient s refusal in their note by using dotphrase.meaningfuluse and selecting the influenza immunization was not given. Also, refusal of the influenza immunization can be documented in the Visit Checklist. If given in the hospital this will flow to the Ambulatory documentation. Page 3

4 CMS 117-Childhood Immunization Status (2 years and under) Percentage of children 2 years of age who had four diphtheria, tetanus, and acellular pertussis (DTaP); three polio (IPV); one measles, mumps, and rubella (MMR); three H influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines before. Their 2nd birthday. Children who have evidence showing they received the recommended vaccines, had a documented history of the illness, had a seropositive test result, or had an allergic reaction to the vaccine before their 2nd birthday. Patients who turn two years of age during the measurement period and have a visit during the measurement period 2017 Exclusions: Who needs to document Pediatricians and Family Practice staff and providers this? This is all documented in the Immunization Activity as a historical or current immunization. If given in the hospital this will flow to the Ambulatory documentation. Flu shots count for this measure. Check ICARE to update immunizations. Need 2 flu shots. CMS 155-Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (Ages 3-17) Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported: 1. Percentage of patients with height, weight, and body mass index (BMI) percentile documentation 2. Percentage of patients with counseling for nutrition 3. Percentage of patients with counseling for physical activity 1: Patients who had a height, weight, and BMI percentile recorded during the measurement period 2: Patients who had counseling for nutrition during the measurement year. Page 4

5 3: Patients who had counseling for physical activity during the measurement year. Patients 3-17 years of age with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period 2017 Exclusions: Patients with a diagnosis of pregnancy during the measurement period Who must document this? Any provider who has an office visit with a child. Must be documented in the note using the.meaningfuluse and choosing the weight assessment verbiage. Printing the AVS provides additional information for the patient including resources. This can be satisfied using the Visit Checklist. Adjust your templates to include the.meaningfuluse smartphrase. Your note must be signed for the Visit Checklist to recognize that the measure was documented against. CMS 2- Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan (Ages 12 and older) Page 5 Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen Patients screened for clinical depression on the date of the encounter using an age appropriate standardized tool and if positive, a follow-up plan is documented on the date of the positive screen. The follow-up plan must include one of the following: 1. Additional evaluation for depression 2. Suicide Risk Assessment 3. Referral to a practitioner who is qualified to diagnosis and treat depression. 4. Pharmacological Interventions 5. Other interventions or follow-up for the diagnosis or treatment of depression. All patients 12 years of age and older before the beginning of the measurement period with at least one eligible encounter during the measurement period 2017 Exclusions: Patients with an active diagnosis of depression or bipolar disorder Patient Reason(s) OR Patient refuses to participate Medical Reason(s)

6 OR Patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status Situations where the patient's functional capacity or motivation to improve may impact the accuracy of results of standardized depression assessment tools. For example: certain court appointed cases or cases of delirium Who must document this? Clinical staff or provider PHQ 2/9 is documented in the Rooming Tab. Refusal or medically unable to answer can be documented in the Visit Checklist. The follow up can be documented in the Visit Checklist. You can pull the most recent PHQ2/9 screening into your note by using the smartphrase.phq29. During the visit, you can find the last documented PHQ 2/9 by clicking on Last Filed in the upper right of the PHQ 2/9. If outside of the visit, you can see the last PHQ2/9 in Chart Review<Encounter<(find your office visit). At the bottom of the encounter you will see the PHQ 2/9 flowsheet hyperlink in blue. CMS 69-Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up (18 and older) Percentage of patients aged 18 years and older with a BMI documented during the encounter or during the previous 6 months AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the previous six months of the encounter. Normal parameters: Age 18 or older: BMI >= 18.5 and < 25 Patients with a documented BMI during the encounter or during the previous six months, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the previous six months of the encounter. 1. All patients who are 18 or older on the date of at least one eligible encounter during the measurement period 2017 Exclusions: Patients who are pregnant Page 6

7 Patients who are receiving palliative care Patients who have refused measurement of height and/or weight or refuse follow up. Patients who have a medical or other reason documented explaining why BMI measurement wasn't taken (ie: urgent medical situation) Organizational Goal: 100% Who needs to document this? PCP or OB/GYN Must be documented in the note using the smartphrase.meaningfuluse and choose the BMI verbiage. You can also document the BMI follow-up in the Visit Checklist. Printing the AVS gives additional resources for weight management to the patient. If patient refuses to be weighed, refusal can be documented in the Visit Checklist. Adjust your templates to include the smartphrase.meaningfuluse. Your note must be signed for the Visit Checklist to recognize that the measure was documented against. CMS 138-Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (18 and older) Percentage of patients 18 years of age and older who were screened for tobacco (including smokeless) use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user Patients who were screened for tobacco use at least once within 24 months and who received tobacco cessation counseling intervention if identified as a tobacco user All patients 18 years of age and older who meet one of the following criteria with the EP during the measurement period: Have had at least two office visit, psychiatric, behavioral health, occupational therapy, or ophthalmological encounters Have had at least one preventative care, face-to-face interaction, or annual wellness encounter 2017 Exclusions: Page 7

8 Who needs to document this? Patients with documentation of a medical reason or limited life expectancy for not being screened for tobacco use or for not receiving tobacco cessation counseling if identified as a tobacco user who does not qualify for the numerator population All providers This information is filled out in the Rooming Tab under the Vital Signs section. Counseling questions in the Tobacco Use section must be filled out on patients that are identified as smokers. Document smokeless tobacco use. Do not select unknown. CMS 68- Documentation of Current Medications in the Medical Record (Ages 18 and older) Percentage of visits for patients 18 and older for which the eligible professional attests to documenting, updating, or reviewing the patient's current medications using all immediate resources available on the date of the encounter. This list must include all known prescriptions, over-thecounters, herbals and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosages, frequency, and route of administration. Eligible professional attests to documenting, updating, or reviewing the patient's current medications using all immediate resources available on the date of the encounter. This list must include all known prescriptions, over-the-counters, herbals and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosages, frequency, and route of administration. All visits occurring during the 12 month reporting period for patients 18 years and older before the start of the measurement period 2017 Exclusions: Patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status Who needs to document this? Page 8 All Providers, care tech or nurse You must hit the Mark as Reviewed button in the Medication and Orders section on the day of EACH visit.

9 CMS 165-Controlling High Blood Pressure (Age 18-85) Percentage of patients years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90 mmhg) during the most recent qualifying visit during the measurement period Exclusions: Patients whose blood pressure during the patient's most recent visit is adequately controlled (systolic blood pressure < 140 mmhg and diastolic blood pressure < 90 mmhg). Patients years of age who had an active diagnosis of essential hypertension within the first six months of the measurement period. Patients with an active diagnosis of end-stage renal disease (ESRD) or stage 5 chronic kidney disease during the measurement period Patients who had a dialysis, renal transplant, ESRD monthly outpatient services, or vascular access for dialysis procedure before or during the measurement period. Patients with an active diagnosis of pregnancy during the measurement period. Who needs to document this? All providers Rooming Tab in the Vital Signs section This looks at the most recent blood pressure taken for all patients that have hypertension listed on their problem list or as a visit diagnosis. If the patient s pressure is close to being less than 140/90, re-take the BP because the patient may just have white coat syndrome. The last BP taken during the visit will be the BP used to satisfy the measure. Do not use patient s home BP Log Take BP on all patients Page 9

10 CMS 122-Diabetes: Hemoglobin A1C Poor Control (Inverse measure) (Age 18-75) Percentage of patients years of age with diabetes who had hemoglobin A1C> 9.0% or no hemoglobin A1C test during the calendar year. Patients whose most recent HbA1c level (performed during the measurement period) is > 9.0% or who did not have an HbA1c test performed during the calendar year. Patients years of age with a diagnosis of diabetes with a visit during the calendar year Exclusions: Who must document this? PCP This is a result based measure. If resulted externally, please follow the Documentation of External Results workflow and remember to scan result into the media tab using the scanning workflow. This is an inverse measure. You want the % on your dashboard to be lower than 16. The goal is to have <16% with an A1C > 9%. The patients In Numerator are those patients who haven t had an A1C done in the calendar year or the A1C they had in the calendar year is >9%. CMS 124-Cervical Cancer Screening (Age 21-64) Page 10 Percentage of women years of age who were screened for cervical cancer using either of the following ways: years old- Cervical Cytology performed every 3 years years old- Cervical Cytology and HPV testing every 5 years. Percentage of women years of age who were screened for cervical cancer using either of the following criteria: * Women age who had cervical cytology performed every 3 years * Women age who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years Women years old with a visit during the measurement period 2017 Exclusions: Women who had a hysterectomy with no residual cervix

11 Who must document this? Provider, nurse, medical assistant, MA Health Maintenance and Visit Checklist (if results are from an external source then use the workflow for documentation of External Results). The pap must be completed. It cannot just be ordered. If completed Externally, follow the Documenting External Results workflow. Document history of Hysterectomy in the Surgical History and this will exclude the patient from the measure. You can also document the exclusion in the Visit Checklist. Hysterectomy is the ONLY exclusion reason. Patient refusal does not count! If you are a specialty provider and patient does not have a PAP completed, please do the following: Educate the patient on the importance of getting Pap Identify if the patient has an OB/ GYN or a PCP who can perform PAP Identify the patient s PCP and send an inbasket message (if on Epic) or call the PCP to remind them the patient needs a PAP CMS 125-Breast Cancer Screening (age 50-74) Percentage of women years of age who had a mammogram to screen for breast cancer Women with one or more mammograms during the measurement period or the year prior to the measurement period Women years of age on date of encounter 2017 Exclusions: Women who had a bilateral mastectomy or for whom there is evidence of two unilateral mastectomies. Who must document this? Page 11 Provider or office staff Documents external results in Rooming Tab or create a new Abstract encounter. If results are external use the workflow for documenting External Results). Document the history of a bilateral mastectomy or 2 unilateral mastectomies in the Surgical History. Even though the measure is looking at patients 50-74, Riverside is using yrs old. Patients will show on the HM at 40 yrs old but will show on the Visit Checklist at age 50 yrs old. The Mammogram needs to be completed. It cannot just be ordered. If completed Externally, follow the Documenting External Results workflow. The external result must be scanned into EPIC.

12 CMS 130- Colorectal Screening (Age 50-75) Percentage of patients years of age who had appropriate screening for colorectal cancer Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria: Fecal occult blood test (FOBT) during the measurement period (1 year) Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period (5 years) Colonoscopy during the measurement period or the nine years prior to the measurement period (10 years) Patients years of age with a visit during the measurement period 2017 Exclusions: Patients with a diagnosis or past history of total colectomy or colorectal cancer. Document history of colectomy in the Surgical History. Who must document this? PCP Documents external results in the Rooming Tab or create a new Abstract encounter. If results are external use the workflow for documenting External Results. Document the history of a total colectomy in the Surgical History. As we continue to use Epic and the patient use Riverside for their care, topics will populate automatically. The FOBT/ sigmoidoscopy/colonoscopy needs to actually be completed. It cannot just be ordered. If completed Externally, follow the Documenting External Results workflow. CMS 127-Pneumonia Vaccination Status for Older Adults (65 and older) Page 12 Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine Patients who have ever received a pneumococcal vaccine Patients 65 years of age and older with a visit during the measurement period 2017 Exclusions: Document vaccine in the Immunization Activity as a historical or current immunization. If given in the hospital this will flow to the Ambulatory documentation

13 This counts if patient has one of the two pneumococcal vaccines. CMS 146 Appropriate Testing of Children with Pharyngitis Percentage of children 3-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic, and received a group A streptococcus (strep) test for the episode. A higher score indicates appropriate treatment of children with pharyngitis (e.g., the proportion for whom antibiotics were prescribed with an accompanying step test). Children with a group A streptococcus test in the seven-day period from three days prior through three days after the diagnosis of pharyngitis Children 3-18 years of age who had an outpatient or emergency department (ED) visit with a diagnosis of pharyngitis during the measurement period and an antibiotic ordered on or three days after the visit 2017 Exclusions: Patients who are taking antibiotics for pharyngitis within 30 days before the encounter with a diagnosis of pharyngitis or are a Hospice patient during measurement period Clean up the Problem List. Remove old problems. Include proper diagnosis in Problem list. Order Group Strep A test. Order antibiotics. Use proper diagnoses: The following are included in the measure: Streptococcal pharyngitis (J02.0), Acute pharyngitis due to other specified organisms (J02.8), Acute pharyngitis, unspecified (J02.9), Acute streptococcal tonsillitis, unspecified (J03.0), Acute recurrent streptococcal tonsillitis(j03.01), Acute tonsillitis due to other specified organisms (J03.8), Acute recurrent tonsillitis due to other specified organisms (J03.81), Acute tonsillitis, unspecified (J03.90), Acute recurrent tonsillitis, unspecified (J03.91) CMS 153 Chlamydia Screening for Women Page 13 Percentage of women years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period Women with at least one chlamydia test during the measurement period Women years of age who are sexually active and who had a visit in the measurement period 2017 Exclusions: Women who are only eligible for the initial population due to a pregnancy test and who had an X-ray or an order for a specified medication within 7 days of the pregnancy test

14 Who must document this? Provider Order must be entered Test needs to be resulted CMS 164 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period Patients who had an active medication of aspirin or another antiplatelet during the measurement year. Oral antiplatelet therapy consists of: aspirin, clopidogrel, combination of aspirin and extended release dipyridamole, prasugrel, ticagrelor or ticlopidine. Patients aged 18 years of age and older with a visit during the measurement period who had an AMI, CABG, or PCI during the 12 months prior to the measurement year or who had a diagnosis of IVD overlapping the measurement year 2017 Exclusions: Denominator exclusion- Hospice services for patient received any time during the measurement period or Patients who had documentation of use of anticoagulant medications( Apixaban, Argatroban, Bivalirudin, Dabigatran, Dalteparin, Desirudin, Edoxaban, Enoxaparin, Fondaparinux, Heparin, Lepirudin, Rivaroxaban, Tinzaparin, or Warfarin) overlapping the measurement year Anticoagulant medications consist of: Who must document this? Provider Clean up Problem List. Ensure patient is on antiplatelet medication. Need to be on antiplatelet (not anticoagulant- unless anticoagulant overlaps during the measurement year) Using the Visit Checklist 1. Before you close the visit, click on the Visit Checklist tab found in the Sidebar. On this tab you can check if you have properly documented the required measures needed for Rush Health and MIPS. Objectives that are not met under the Visit Checklist will appear with a yellow yield sign next to them. Page 14

15 2. Click Check Quality Measures to see if you are missing any required documentation. 3. A checklist will generate for you review of the measures. If you are missing items, clicking Add button next to the appropriate choice will apply the information or document this in the section of the chart in which it lives. Click the Apply Selected box (number 1) to update the documentation. See Last Refreshed (number 2). Page 15

16 5.) To view what Quality measures are satisfied click on Currently Satisfied (number 3) Reviewing Health Maintenance Topics Health Maintenance was designed to be used as a preventative health tool to communicate with patients. Health maintenance reminders are sent to patients through MyChart. Health Maintenance displays for providers and clinical staff to serve as a visual reminder of the different preventative screenings that patients may need. Think of the Health Maintenance section as a View only or a To do tab. To review the Health Maintenance Topics for a patient, use the following steps. 1. When the Health Maintenance Tab is highlighted yellow the patient is due or is outstanding preventative health measures. From the Patient s Chart, click on the Health Maintenance tab in the Header. 2. In the table, review pending or overdue Health Maintenance procedures for your patient. In the first column, view the status of each pending or overdue Health Maintenance procedure. Use the legend that appears under the table to determine whether the procedure is overdue, due, or due soon. In the Due Date column, view the date each Health Maintenance procedure is due. In the Date Completed column, view the date each Health Maintenance procedure was addressed. If there is an override, the override type is listed in parentheses. Page 16

17 3. The patient s Health Maintenance plans are listed below the topics section. 4. Providers can react to alerts by using the Visit checklist in the sidebar. For further information about documenting on each individual measure, please see specific measure in guide above. 5. Provider can also Exclude the patient from specific alerts for example, a patient who had a mastectomy, but still has an alert for a mammogram the alerts by using the Toolbar and adding any additional comments needed. Page 17

18 Documenting Refusal for Influenza Immunization Use the Postpone button to document that a patient refused, was unable to get due to insurance, doesn t have time, is ill, or if there is a drug shortage. Please postpone the immunization until the next flu season if the patient refuses. Documenting External Results To document external mammography, colonoscopies, PAP smears, and Hemoglobin A1c not completed at Riverside Healthcare. This can be documented by clinical staff. Once this information is entered in external results will satisfy Health Maintenance. Remember, you must have the actual result to document in QM external results. You can enter external results during a visit or when a patient is not in the office. To enter External Results during an office visit: 1. Go to the Rooming tab and find the section label QM Ext Results. 2. Open this section and click on the icon document on the individual result. To enter external results on more than one section click the icon next to the Health Maintenance section. DO NOT Click order. 3. Document see scanned result in the comment field and the date of the test (not the scanned date) in the date field. Enter the time of 2359 in the time field. What you write in the comments section will populate in the proper tab. Pap smears and Hemoglobin A1c will result on the labs tab. Mammograms are found under imaging and colonoscopies will be found under the procedure tab. 4. Finally, go to the Health Maintenance section by clicking Health Maintenance section in the header. Page 18

19 5. Update the dates and the Health Maintenance topics by clicking the Update HM button. 6. Please scan the results to the order by using Media Manager. Documenting results outside of an office visit These steps are to be followed if result was faxed to the office. 1. From the Epic button, go to Patient care and select Encounter. 2. Search for the patient. 3. Then select New encounter. 4. Enter in a New encounter type of Abstract. Do NOT select Manual Abstraction. Provider can be defaulted to their PCP. Click on PCP. Click accept. 5. From the abstract encounter navigator, you will follow steps 1-5 of Documenting Results through an Office Visit 6. Click Sign Visit to complete the Abstract encounter. Page 19

20 Scanning Results to an order using Media Manager You can complete scanning workflows from within Epic using Media Manager. Use Media Manager to view and acquire scans at the order level. You will scan to the HM order 1. Go to Epic Button > Patient Care > Media Manager. 2. Look up the patient whose scan you're adding. 3. Select the drop-down menu and select Choose an Order. a. Order Level This scan is a result that will be attached to an individual order. i. The order must have been entered in Epic to be able to scan to it. 4. The Order Selection window appears. Find and select the order you want to scan to. You can adjust the date range as necessary. It is best to choose the Search option of all. Verify you are selecting an order that has an Authorizing Provider of Historical Provider. See the screen shot of the health maintenance orders below. The orders have prefix of HM. Page 20

21 5. Click Scan on the activity toolbar. The Scan window opens. 6. Chose the Scan button. 7. After the document is scanned, you will see it appear on the right side of the scan activity. Verify the scanned image is viewable. 8. Select the icon to the right of the Scan button you previously selected. 9. In the Document Description field, enter a specific description of the document you scanned in. 10. Click OK. 11. Click Upload Images to save the scans to the patient record. 12. Close out of the scan activity. Page 21

22 Reviewing your Dashboard To improve upon your own results and Riverside s results, please review your dashboard. The dashboard gives you the ability to drill down to see patients that have fallen out of the measure. Review the steps below to review your results. Reports are run weekly on Mondays. 1. Click your dashboard tab. The RMC OP Clinical Metric Trends: Physician dashboard houses all the Quality Measures. 2. If it is not set as the default, Click the square and find the RMC OP Clinical Metric Trends: Physician 3. The Quality Measures Dashboard is color coded using red, yellow, and green. Hoovering over each percentage will show the goal and thresholds. Page 22

23 3. To drill down to the specific measure, click the carrot (red square) and then choose the Blue highlighted measure (arrow). 4. If you have not review the report within 60 days a pop up will appear. Choose Reactivate and run. It will take approx. 5mins for the report to run. 5. Search for provider s name on using the binoculars. After the reports appear, you can click on the Not in Numerator patients to look at patient s charts who are not meeting the measure. Look at the In Numerator patients for the A1C measure because this is an inverse measure. Page 23