CHRONIC CARE REPORTS. V 9.0, October eclinicalworks, All rights reserved

CONTENTS ABOUT THIS GUIDE 3 Product Documentation 3 Finding the Documents 3 Webinars 3 eclinicalworks Newsletter 4 Getting Support 4 Conventions 4 CHRONIC CARE REPORTS 6 Configure Chronic Care/Registry Summary Reports 7 Configure Groups for Reporting 7 Creating Conditions Groups for Reporting 8 Configuring Conditions Group Displayed in Summary Reports 11 Creating Medication Groups for Reporting 14 Deleting a Medications Group 16 Configure Medication Groups Displayed In Summary Reports 17 Configuring Labs 18 Configuring Labs for Reporting 19 Configuring Labs Group Displayed In Summary Reports 20 Configuring Vitals for Reporting 21 Configuring Structured Data for Registry Reports 22 Creating Structured Data for Diabetes/CVH Patients under HPI 24 Creating Structured Properties Lists for Diabetes/CVH Patients Under Examination 31 Creating Structured Data for Asthma Patients Under HPI 32 Creating Structured Data for Patients on Anticoagulants Under HPI 38 Configuring Specialty Care Received Items Displayed In Summary Reports 39 Registry Summary Report Details 39 Demographics 40 Visit Info 40 Test and Lab Info 40 Generate Chronic Care Reports/Registry Summary Reports 40 Generating Chronic Care Reports/Registry Summary Reports 40 Generating DPRP Survey Reports 44 Generating HSRP Survey Report 47 Additional Reports 50 Diabetes/CVH Encounter Form 51 Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 1

Contents Configuring and Running the Diabetes/CVH Form 51 Printing the Diabetes Encounter Form 57 Asthma Encounter Form 57 Registry Reports 59 Statistics Reports 66 Running a Statistics Report 66 APPENDIX A: LOINC CODES 69 APPENDIX B: REGISTRY SUMMARY REPORTS 70 APPENDIX C: DETAILED BREAKDOWN OF DIABETES/CVH ENCOUNTER FORM 74 APPENDIX D: NOTICES 79 Trademarks 79 Copyright 79 Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 2

ABOUT THIS GUIDE This document provides information about running the Chronic Care reports available through the eclinicalworks application. Chronic Care Reports are available for practices wishing to report on patients whose conditions require chronic care. These reports can be generated for patients with diabetes, CVH, asthma, and patients taking anticoagulants. Product Documentation The following documentation supports eclinicalworks Electronic Medical Record (EMR), Practice Management (PM), and/or additional software features: System Administration Users Guide Release Notes Front Office Users Guide Patient Portal Users Guide Front Office Setup Guide eclinicalmessenger Users Guide Electronic Medical Records Users Guide eclinicalmobile Users Guide Electronic Medical Records Setup Guide ebo Metadata and Query Studio Users Guide Billing Users Guide ebo Canned Reports Users Guide Billing Setup Guide P2P Users Guide epayment Users Guide Security Attributes and Logs Guide Finding the Documents eclinicalworks Documentation is available from the eclinicalworks Customer Portal: https://my.eclinicalworks.com Webinars For more information, take advantage of the free unlimited online eclinicalworks webinars interactive seminars conducted over the World Wide Web. These courses are presented by product trainers who are experts with eclinicalworks and all of its capabilities. To sign up for an eclinicalworks webinar go to: https://my.eclinicalworks.com Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 3

About This Guide eclinicalworks Newsletter Getting Support To receive important, timely, and informative product notifications, subscribe to the eclinicalworks Newsletter e-mailing list. To subscribe to the newsletter: Click the link available on the Customer Portal: https://my.eclinicalworks.com OR Click the link available on the eclinicalworks website: http://eclinicalworks.com/ OR Click the direct link: eclinicalworks Newsletter Getting Support Send messages directly to eclinicalworks Support through the eclinicalworks Customer Portal: https://my.eclinicalworks.com You may also call or e-mail eclinicalworks Support: Phone: (508) 836-3663 E-mail: support@eclinicalworks.com Conventions This section list typographical conventions and describes the icons used to call out additional information and to indicate item keys, new features, and enhancements to the application. The following typographical conventions are used in this guide: Bold Italic Monospace Identifies options, keywords, and items in a description. Indicates variables, new terms and concepts, foreign words, or emphasis. Identifies examples of specific data values, and messages from the system, or information that you should actually type. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 4

About This Guide Conventions The following icons are used to highlight new features and indicate enhanced features and item keys: Icon Description Indicates this is an item key. Points out helpful tips or additional information. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 5

CHRONIC CARE REPORTS Chronic Care Reports are available for practices wishing to report on patients whose conditions require chronic care. These reports can be generated for patients with diabetes, CVH, asthma, and patients taking anticoagulants. The following elements need to be considered before configuring the reports: 1. CVH Registry Summary Report - The user needs to create an ICD-9 group with the name of CVH and the description of CVH. The CVH ICD-9 group will be used to report the data in the Demographics section of the report (i.e., it will locate all patients with the diagnoses identified in the CVH ICD-9 group and report their demographic information in the Demographics section). The user also has the ability to identify ICD-9 groups when setting up the Conditions for the CVH Registry Summary Report. For more information, refer to Configuring Conditions Group Displayed in Summary Reports on page 11. Note: The conditions identified in the Configure Conditions window are used to report data in the Health Profile section of the CVH Report. 2. Diabetes Registry Summary Report - The system is programmed to search for those patients who have a diagnosis of 250.xx. It then reports the demographic information for those patients in the Demographics section of the report. There is no specific ICD-9 group to set up for the Diabetes Registry Summary Report. The user can, however, set up ICD-9 groups and identify those in the Conditions for the Diabetes Registry Summary Report and that data will be reported in the Health Profile section of the Diabetes report. 3. Asthma Registry Summary Report - The user needs to create an ICD-9 group with the name of Asthma and the description of Asthma. This ICD-9 group will be used to report data in the Demographics section of the report (i.e., it will locate all patients with the diagnosis identified in the Asthma ICD-9 group and report their demographic information in the Demographics section). Unlike CVH and Diabetes, conditions to print out on the Asthma report cannot be identified. 4. Anticoagulant Registry Summary Report - A medication group called Anticoagulant must be created. In this group, identify those medications that are anticoagulants. The system uses this medication group to report data in the Demographics section of the report (i.e., it will locate all patients taking medications identified in the Anticoagulant medication group and report their demographic information in the Demographics section). Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 6

Configure Chronic Care/Registry Summary Reports For information on Chronic Care Reports, refer to the following sections: Configure Chronic Care/Registry Summary Reports on page 7. Registry Summary Report Details on page 39. Generate Chronic Care Reports/Registry Summary Reports on page 40. Additional Reports on page 50. Configure Chronic Care/Registry Summary Reports Registry Summary Reports require configuration of conditions, labs, medication groups, vitals, structured data, and specialty care received items displayed in the reports. For more information on configuring Registry Summary Reports, refer to Configure Groups for Reporting on page 7. Configure Groups for Reporting Various groups, such as conditions, medications, labs, vitals, and structured data for certain Progress Notes categories, must be configured for display in Chronic Care/Registry Summary Reports. For more information on configuring groups and structured data for reporting, refer to the following sections: Creating Conditions Groups for Reporting on page 8. Configuring Conditions Group Displayed in Summary Reports on page 11. Creating Medication Groups for Reporting on page 14. Configure Medication Groups Displayed In Summary Reports on page 17. Configuring Labs on page 18. Configuring Labs for Reporting on page 19. Configuring Labs Group Displayed In Summary Reports on page 20. Configuring Vitals for Reporting on page 21. Configuring Structured Data for Registry Reports on page 22. Configuring Specialty Care Received Items Displayed In Summary Reports on page 39. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 7

Configure Chronic Care/Registry Summary Reports Creating Conditions Groups for Reporting The reports, when run, include those patients in the database whose diagnosis falls under the selected conditions group. For example, the Registry Summary Report for patients with Cardiovascular Health considers all patients whose diagnosis falls under the CVH conditions group. Therefore, it is important to create an ICD group with the name and description as CVH and associate ICD codes to it before running this report. The same applies to the Registry Summary Report for Asthma, for which an ICD group with the name and description as Asthma needs to be created and ICD codes need to be associated with the group. The user must create ICD groups, which will be available for selection as Condition Groups in the Configure Reporting Conditions Group page. To configure conditions groups for display in Chronic Care/Registry Summary Reports, refer to Configuring Conditions Group Displayed in Summary Reports on page 11. To create ICD Groups: 1. On the Billing menu, point to ICD, and then click ICD Groups: The ICD Groups window opens. 2. Click New to create a new ICD group: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 8

Configure Chronic Care/Registry Summary Reports A second ICD Group window opens: a. Enter a group name for the diagnosis in the ICD Group Name field. b. Enter a short description for the ICD Group in the Description field: 3. Click Associate ICDs. The ICD-9 code window opens. To associate the ICD group with multiple ICD codes that begin with the same code, click Associate ICDs by code: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 9

Configure Chronic Care/Registry Summary Reports 4. Click the row that contains the code and click Apply to add to the new group just created. Repeat this process to add more ICD codes to the group. 5. Click OK to exit the window. The newly added codes display in the ICD Groups list: 6. Click OK to save the new group information and return to the first ICD Groups window. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 10

Configure Chronic Care/Registry Summary Reports The newly created group displays in the list and is available for selection: 7. Repeat steps 3-9 to create other groups, as needed. 8. Click OK to save the information and exit. Note: To configure the CVH Report to consider procedure codes as well, it is important to create a Current Procedural Terminology (CPT ) * group with the name and description CVH, and associate CPT codes to that group. The CVH and Asthma ICD groups need to be created by the practice before they run these Registry Summary Reports for patients with CVH and Asthma. The Registry Summary Report for patients with diabetes considers all patients whose diagnosis contains ICD codes that fall under 250.xx. The report considers all patients whose diagnosis contains the ICD code 790.29 as patients under Type Pre-Diabetes. *. CPT only 2010 American Medical Association. All rights reserved. Configuring Conditions Group Displayed in Summary Reports This option allows users to specify condition groups that will display in the Health Profile section of various summary reports. To configure conditions group displayed in Summary Reports: 1. From the Admin band, click the Chronic Care Admin icon: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 11

Configure Chronic Care/Registry Summary Reports The Configure Reports page opens, displaying a list of items that can be configured: Conditions Groups, Medications Groups, Labs Groups, Rx Groups, Vitals, and Reporting Lab Names can all be configured from this window. 2. From the Configure Reports page, click the Configure Conditions Group link. The Configure Reporting Conditions Group window opens: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 12

Configure Chronic Care/Registry Summary Reports 3. Select the report for which the conditions are to be configured, using the drop-down menu at the top of the window. The menu shows a list of those reports that contains the Condition Groups in the Health Profile section. 4. Select the Conditions Group(s) to add from the left pane (hold the Ctrl key on the keyboard to select more than one at a time) and click the > button. To add all groups at once, click the >> button. The selected conditions group displays on the right pane: 5. To remove any unnecessary Conditions Group(s) from the right pane, select them in the right pane (hold the Ctrl key on the keyboard to select more than one at a time) and click Remove. To remove all groups at once, click Remove All. 6. Click Update to add the selected groups to the specified reports. OR Click Insert to replace the groups already on the report with the selected groups in the right pane. A green confirmation text displays on the window to indicate that the records were updated successfully: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 13

Configure Chronic Care/Registry Summary Reports 7. To export a report of the Condition Group Mapping to a Microsoft Excel file, click the Export Conditions Group Mapping to Excel link. 8. To return to the Configure Reports page, click the Chronic Care Admin icon from the Admin band. Creating Medication Groups for Reporting This option allows the users to create new Medications Group(s) or modify existing Medications Group(s) that are used for reporting. These groups will be available for selection in the Configure Reporting Medications Group page. Refer to Configuring Conditions Group Displayed in Summary Reports on page 11 for more information. When Rx Group is set up for Chronic Care, providers may select medications from the Multum or Medi-Span database, depending on database enabled for the practice. To create Medications Groups for reporting: 1. On the Configure Reports page, click the Create Rx Group link. The Configure Reporting Medications window opens: 2. To create a new Medication Group, type the name of the medication(s) to add to this group in the Medication Name field and click Search Medication. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 14

Configure Chronic Care/Registry Summary Reports The medication name is searched in the Rx database (Multum or Medi-Span database, depending on database enabled for the practice) and a list of medications whose names match the text entered (partially or totally) displays in the right pane of the Medication Name section: 3. To remove any unnecessary medications, select them in the right pane (hold the Ctrl key on the keyboard to select more than one at a time) and click Remove. OR To remove all medications listed here and to start over, click Remove All. 4. Check the Create New Group box under the Group Name heading. 5. Enter a name for this group (15 characters maximum) in the Group Name field. Enter a description for the group to display on the report, in the Group Description field: 6. Click Create. The medication selected is added to the new Rx Group. A green confirmation text displays on the window to indicate that the records were updated successfully. 7. To update an existing Medications Group, select the Medication Group to update from the dropdown list in the Group Name section (for example, Anticoagulants). Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 15

Configure Chronic Care/Registry Summary Reports The medications contained in this group are displayed in the right pane of the Group Name section: 8. To remove any unnecessary medications, select them in the right pane (hold the Ctrl key on the keyboard to select more than one at a time) and click Delete Medication. A confirmation window opens: 9. Click OK to confirm the deletion of the selected medication(s). The selected medication(s) are removed from this group. To add new medications to the group or remove any unnecessary medications, refer to Step 3. Click Update to update the changes made to the medications group. A green confirmation text displays on the window to indicate that the records were updated successfully. Deleting a Medications Group The medication group can be deleted at any time from the Configure Reporting Medications window. To delete a medications group: 1. Select the Medication Group to update from the drop-down list in the Group Name section. The medications contained in this group display in the right pane of the Group Name section. 2. Click Delete. A confirmation window opens: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 16

Configure Chronic Care/Registry Summary Reports 3. Click OK to confirm the deletion. A green confirmation text displays on the window to indicate that the records were updated successfully. 4. To export a report of the Rx Group Mapping to an Excel file, click the Export Rx Group Mapping to Excel link. 5. To return to the Configure Reports page, click the Chronic Care Admin icon from the Admin band. Note: The Registry Report Summary for patients with Anticoagulant considers all patients who are taking anticoagulants as medications. It is important to create an Rx Group with the name and description of Anticoagulant before running this report. For help with this section, click the question mark option next to the Create New Group check box. An Internet Explorer window opens with on-screen instructions for both creating new medication groups and updating existing groups. Configure Medication Groups Displayed In Summary Reports This option allows users to specify which Medications Group display in the Medications section of the various summary reports. To configure medications group that display in Summary Reports: 1. On the Configure Reports page, click the Configure Medications Group link. The Configure Reporting Medications Group window opens: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 17

Configure Chronic Care/Registry Summary Reports 2. Select the report for which the Medications Group has to be configured, using the drop-down menu at the top of the window. This menu shows a list of those reports that are made available to display the medications. 3. Select the medications group to add from the left pane (hold the Ctrl key on the keyboard to select more than one at a time) and click the > button. To add all groups at once, click the >> button. The selected medications group displays on the right pane: 4. To remove any unnecessary group, select them in the right pane (hold the Ctrl key on the keyboard to select more than one at a time) and click Remove. OR To remove all groups at once, click Remove All. 5. Click Update to add the selected groups to the specified reports. OR Click Insert to replace the groups already on the report with the selected groups in the right pane. A green confirmation text displays on the window to indicate that the records were updated successfully. 6. To export a report of the Medications Group Mapping to an Excel file, click the Export Medications Group Mapping to Excel link. 7. To return to the Configure Reports page, click the Chronic Care Admin icon from the Admin band. Configuring Labs The two configuration options - Configure Reporting Lab Names and Configure Labs Group are only used for configuring labs on the Diabetes Encounter Form. The four registry summary reports do not use this configuration. The Test Info and Lab Info sections on the four registry reports do report lab information, but these areas rely on the LOINC codes being set up properly for the various tests. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 18

Configure Chronic Care/Registry Summary Reports For more information, refer to LOINC Codes on page 69. Configuring Labs for Reporting The Configure Reporting Labs Names option allows user to configure the names for labs and attributes that are used for reporting. These lab groups will be available for selection in the Configure Reporting Labs Group page (please see Configure Labs Group Displayed In Summary Reports). This configuration option is used for configuring labs on the Diabetes Encounter Form. To configure labs for reporting: 1. On the Configure Reports page, click the Configure Reporting Lab Names link. The Configure Reporting Labs window opens: 2. Select the lab to configure using the lab drop-down menu. This menu contains a standard list of labs that are made available for reporting. 3. Enter a name in the Enter Reporting Name field to change the reporting name for the lab. A confirmation window opens: 4. Click OK to confirm the change. A green confirmation text displays on the window to indicate that the records were updated successfully. 5. To return to the Configure Reports page, click the Chronic Care Admin icon from the Admin band. Note: To configure different labs that display in the Test Info and Lab Info sections of the four Registry Summary Reports, link the labs with the appropriate LOINC codes. For example, to report on an HbA1C lab, first link the lab attributes for HbA1C that are to be considered in the report, with any of the codes from the standard list of LOINC codes for HbA1C. To view a standard list of LOINC codes for different labs, refer to LOINC Codes on page 69. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 19

Configure Chronic Care/Registry Summary Reports Configuring Labs Group Displayed In Summary Reports This option allows users to specify which labs group display in the Diabetes Encounter Form. To configure labs group displayed in Summary Reports: 1. On the Configure Reports page, click the Configure Labs Group link. The Configure Reporting Labs Group window opens: 2. Select the report for which the labs group has to be configured, using the drop-down menu at the top of the window. 3. Select the labs group to add from the left pane (hold the Ctrl key on the keyboard to select more than one at a time) and click the > button. To add all groups at once, click the >> button. The selected conditions group displays on the right pane: 4. To remove any unnecessary group, select them in the right pane (hold the Ctrl key on the keyboard to select more than one at a time) and click Remove. To remove all groups at once, click Remove All. 5. Click Update to add the selected groups to the specified reports. OR Click Insert to replace the groups already on the report with the selected groups in the right pane. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 20

Configure Chronic Care/Registry Summary Reports Green confirmation text displays on the window to indicate that the records were updated successfully. 6. To export a report of the Labs Group Mapping to an Excel file, click the Export Labs Group Mapping to Excel link. 7. To return to the Configure Reports page, click the Chronic Care Admin icon from the Admin band. Configuring Vitals for Reporting This option allows user to configure the vitals that are used for reporting. To configure vitals for reporting: 1. On the Configure Reports page, click the Configure Vitals link. The Configure Reporting Vitals window opens: 2. Enter the vital type that is to be reported on, in the Vitals field. The vital name should be the same as in the database. For more information on associating vital names to vital types, refer to the Electronic Medical Records Setup Users Guide. Note: Although various vitals can be mapped using the Configure Vitals option, the system reports only BP and BMI on the CVH and Diabetes Registry Summary Reports, and reports only BMI on the Asthma and Anticoagulant Registry Summary Reports. 3. Click Search Vital. Vitals carrying the same name that are present in the database will be listed in the right pane: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 21

Configure Chronic Care/Registry Summary Reports 4. Select the reporting vital that has to be configured, using the drop-down menu at the top of the window. This menu contains a standard list of vitals that are made available for reporting. 5. Select the vital type from the list on the right pane. 6. To remove any unnecessary vital, select them in the right pane and click Remove. To remove all vitals from the displayed list at once, click Remove All. 7. Click Link Vital to link the vital type with the reporting vital. A confirmation window opens: 8. Click OK to confirm the association. Green confirmation text displays on the window to indicate that the records were updated successfully. 9. To return to the Configure Reports page, click the Chronic Care Admin icon from the Admin band. Note: A reporting vital can be linked with only one vital type. Linking the reporting vital twice will overwrite any previous association for that reporting vital. Configuring Structured Data for Registry Reports The Registry Summary Reports pulls certain information from the Progress Notes that uses structured data. Structured data elements must be constructed as below to ensure the information is populated correctly and there is no conflict with CDSS alerts. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 22

Configure Chronic Care/Registry Summary Reports To configure structured data for Registry Reports: 1. From the Progress Notes, click HPI. The HPI window opens: 2. Select the HPI parent category on the left pane. 3. Click New at the bottom of the window to create a new subcategory for HPI. The New Item/Category window opens: 4. Enter Registry in the Category Name field. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 23

Configure Chronic Care/Registry Summary Reports 5. Click OK to save the information and exit the window. The new category, Registry, is added to the left pane. 6. Select the category Registry and create three new subcategories under it: Diabetes, Anticoagulation, and Asthma using steps 3-5 above: 7. Complete the steps in Creating Structured Data for Diabetes/CVH Patients under HPI on page 24 Creating Structured Data for Diabetes/CVH Patients under HPI Structured data elements for the category Diabetes/CVH should be created in HPI. To create structured data for Diabetes/CVH category in HPI: 1. From the HPI window, click New at the bottom of the window to create a new subcategory for HPI. The New Item/Category window opens. 2. Create the following structured data elements for the category Diabetes, under HPI: Smoking Antithrombotic Therapy Diabetic Education Pneumovax Decline Diet Counseling Flu Vaccine Decline Retinal Exam Self-Management Goal Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 24

Configure Chronic Care/Registry Summary Reports 3. Create the following properties below the structured data elements: Smoking Properties: Status Date Accessed Cessation Counseling Provided Secondhand Exposure: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 25

Configure Chronic Care/Registry Summary Reports a. Create the following structured text under the property Smoking > Status: Never Current Former: b. Set the property type for Date Accessed and the Cessation Counseling Provided as Date. c. Create the following structured text under the property Secondhand Exposure: Yes No Unknown: d. Return to the HPI window. Diabetic Education a. Create the following properties under Diabetic Education Date Completed Referral: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 26

Configure Chronic Care/Registry Summary Reports b. Set the property type for Date Completed as Date. c. Set the property type for Referral as Boolean. d. Return to the HPI window. Diet Counseling a. Create the following property under Diet Counseling structured data element: Date of Counseling b. Set the property type as Date. c. Return to the HPI window. Retinal Exam a. Create the following properties under Retinal Exam structured data element: Date of Exam Results. b. Set the property type for Date of Exam as Date. c. Set the property type for Results as structured: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 27

Configure Chronic Care/Registry Summary Reports d. Create the following structured text under the property Results: Diabetic Retinopathy absent Diabetic Retinopathy Present: e. Return to the HPI window. Antithrombotic Therapy a. Create the following properties under Antithrombotic Therapy: Date Intolerant. b. Set the property type for Date as Date and the property type for Intolerant as Boolean: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 28

Configure Chronic Care/Registry Summary Reports c. Return to the HPI window. Pneumovax Decline and Flu Vaccine decline a. Create the following property under Pneumovax Decline and Flu Vaccine decline: Date. b. Set the property type for Date as Date: c. Return to the HPI window. Self-Management Goal a. Create the following properties under Self-Management Goal: Date Addressed New SM Goal Set Previous Self-Management Goal Reviewed: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 29

Configure Chronic Care/Registry Summary Reports b. Set the property type for Date Addressed as Date. c. Create the following structured text under the property New SM Goal: Dietary Modifications Exercise Stress Reduction Weight Loss: d. Create the following structured text under the property Self-Management Goal Reviewed: Dietary Modifications Exercise Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 30

Configure Chronic Care/Registry Summary Reports Stress Reduction Weight Loss: The Structured Data for Diabetes/CVH Patients under HPI is configured. Creating Structured Properties Lists for Diabetes/CVH Patients Under Examination Structured properties must be created for Diabetes/CVH patients under Examination. To create structured properties list for diabetes/cvh patients under Examination: 1. From the Progress Notes, click Examination. The Examination window opens. 2. From the Examinations window, click the category General Examination on the left pane. 3. Create the following structured data elements for the category General Examination: Foot Exam, Dental Exam: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 31

Configure Chronic Care/Registry Summary Reports 4. Create the following property under Foot Exam and Dental Exam: Exam Done Date. Set the property type for Date as Date: Creating Structured Data for Asthma Patients Under HPI Structured data elements must be created for the category Asthma under HPI. To create structured data elements for the category Asthma under HPI: 1. Create the following structured data elements for the category Asthma under HPI: Asthma Category, Symptom Free Days, Smoking Assessment, Asthma Action Plan, School/Work Plan, Flu Vaccine declined, Pneumonia Vaccine declined, Peak Flow, Missed School/Work, Visit w/specialist, Allergy Testing, ER/Hospitalizations, Day Care Plan: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 32

Configure Chronic Care/Registry Summary Reports 2. Create the following property under Asthma Category: Severity. 3. Create the following structured text under the property Severity: Exercise induced, Mild intermittent, Mild persistent, Moderate persistent, Severe persistent: e. Return to the HPI window. 4. Create the following property under Symptom Free Days: In last two weeks. a. Set the property type as Numeric: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 33

Configure Chronic Care/Registry Summary Reports b. Return to the HPI window. 5. Create the same properties and property types for Smoking Assessment as under Diabetes > Smoking. a. Refer to Creating Structured Data for Diabetes/CVH Patients under HPI on page 24 for more information: b. Return to the HPI window. 6. Create the following properties: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 34

Configure Chronic Care/Registry Summary Reports Property Asthma Action Plan, School/Work Plan, and Day Care Plan: Date Description 1. Set the property type as Date: Pneumovax Decline and Flu Vaccine decline: Date Peak Flow: Personal best 2. Set the property type as Date: 3. Return to the HPI window. 1. Set the property type for Date Completed as Date. 2. Return to the HPI window. 1. Set the property type as Numeric: 2. Return to the HPI window. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 35

Configure Chronic Care/Registry Summary Reports Property Missed School/Work: Days missed since last visit Description 1. Set the property type as Numeric: Visit w/specialist: Within past year 2. Return to the HPI window. 1. Set the property type as Boolean: 2. Return to the HPI window. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 36

Configure Chronic Care/Registry Summary Reports Property Visit w/specialist: Within past year Description 1. Set the property type as Boolean: ER/Hospitalizations: Since last week 2. Return to the HPI window. 1. Set the property type as Numeric: 2. Return to the HPI window. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 37

Configure Chronic Care/Registry Summary Reports Creating Structured Data for Patients on Anticoagulants Under HPI Structured data elements must be created for the category Anticoagulants under HPI. To create structured data elements for the category Anticoagulants under HPI: 1. Create the following structured data elements for the category Anticoagulation: Target INR, and Complications since starting anticoagulant. 2. Create the following properties under Target INR: Low and High. 3. Set the Low and High properties as type Numeric: 4. Create these three following properties under Complications since starting anticoagulant: Embolic episode, Stroke, Major bleed. 5. Set the type for Embolic Episode, Stroke, and Major bleed as Boolean: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 38

Registry Summary Report Details Configuring Specialty Care Received Items Displayed In Summary Reports The specialty care received items must be configured for them to display in the Summary Reports. To display or hide items in the list of Specialty Care Received items for Diabetes Summary Reports: 1. Go to: C:\eclinicalworks\tomcat5\webapps\mobiledoc\conf 2. Open the file Registry_Diabetes.properties: 3. To display an item in the Summary Report, set the value of that item to Yes. To prevent an item from displaying on the Summary Report, set the value of that item to No. Note: To display or hide items in the list of Specialty Care Received items for CVH Summary Reports, open the file Registry_CVH.properties, located in the same folder. Follow Steps 3 and 4 to set the values for display or to prevent display. Registry Summary Report Details The following sections describe the information displayed in Registry Summary Report Details: Demographics on page 40. Visit Info on page 40. Test and Lab Info on page 40. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 39

Demographics Generate Chronic Care Reports/Registry Summary Reports The Demographics section of the Registry Summary Report displays numbers and percentage for the Gender, Age, and Insurance of patients within predefined clinical diagnosis set (for example, Patients with Asthma). It also displays numbers and percentages for other categories depending on the type of report generated (for example Type of Diabetes is displayed in Registry Summary Report for Patients with Diabetes). Visit Info Numbers and percentages of patients in various diagnostic medical categories are displayed here. This information is pulled from the most recent visit for each patient, and parts of it must be mapped from Admin, such as Medications. Test and Lab Info Numbers and percentages of patients in various lab and diagnostic test categories are displayed here. The Test and Lab Info on the four registry reports rely on the LOINC codes being set up properly for the various tests, and some Test/Lab Info must be configured using structured data, such as INR. For more information, refer to Configuring Structured Data for Registry Reports and LOINC Codes on page 69. Generate Chronic Care Reports/Registry Summary Reports This feature allows the user to generate Chronic Care Reports on the patient database. For more information on generating Chronic Care Reports/Registry Summary Reports, refer to Generating Chronic Care Reports/Registry Summary Reports on page 40. Generating Chronic Care Reports/Registry Summary Reports Chronic Care Reports/ Registry Summary Reports can be generated from the Registry band, under Chronic Care Reports. To generate the Chronic Care reports: 1. From the Registry band, click the Chronic Care Report icon: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 40

Generate Chronic Care Reports/Registry Summary Reports The Chronic Care Reports Reporting Home Page window opens. 2. Filter the results by facility: To filter results by facility group, select one from the Client (Facility Groups) drop-down list. To filter results by facility, select one or more (hold the Ctrl key on the keyboard down to select more than one) from the Site (Facilities) section: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 41

Generate Chronic Care Reports/Registry Summary Reports 3. Click one of the following radio buttons: Patients Seeing PCP at Selected Client(s)/Site(s) - only patients whose PCP and Appointment Providers are the same are displayed for the selected client/site. Patients Seeing Any Provider at Selected Client/Site(s) - all patients are displayed for the selected client/site. Patients Referred to a Provider within the Selected Client/Site(s) - only patients with Referring Providers are displayed for the selected client/site. 4. Filter the results: To filter results by provider, select one from the Provider list. Hold the Ctrl key from the keyboard while selecting the providers to select more than one provider. When the report is generated, the selected providers names are displayed at the top along with a summary of patients seen by those providers. To filter results by Nurse Practitioner or Physician's Assistant, select one from the NP/PA dropdown list. To filter results by insurance carrier, select one or more (hold the Ctrl key on the keyboard down to select more than one) from the Insurer section. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 42

Generate Chronic Care Reports/Registry Summary Reports The Chronic Care Report insurance data is displayed based on the information in the Source of Payment field for the Primary Insurance in the Insurance Information window: MB, C would display Medicare/Govt MC, D would display Medicaid CI, F would display Commercial 5. Select an assessment to run this report on from the Patients With drop-down list. The following options are available: Diabetes - This option is hard-coded in the system. Select the type of diabetes (hold the Ctrl key on the keyboard down to select more than one) from the list to the right of the drop-down list. It also contains the medications specified in the medications group for diabetes. Asthma - This option is specified by the user, and contains all assessments from the ICD Group where the Name and Description are both Asthma. Anticoagulation - This option is specified by the user, and contains all medications under the group Anticoagulants. CVH - This option is specified by the user. It contains all assessments from the ICD Group where the Name and Description are both CVH and all procedures from the CPT * Group where the Name and Description are both CVH. It also contains the medications specified in the medications group for CVH. To view only patients who are enabled with the Registry, check the Registry Enabled Patients box. 6. Click one of the following radio buttons: All Patients - displays all patients matching the other criteria, set by the filters. Only Active Patients - displays only patients not marked as Inactive or Deceased. Patients continuously enrolled for the selected date range - displays only patients with Registry Start Dates before the Start Date specified below, and who have not been marked as Inactive or Deceased before the End Date specified below. Patients visiting PCP for the selected date range - only displays patients with an appointment scheduled during the date range specified. This is only valid for the DPRP Survey Report. IMPORTANT! In all Registry Summary/Chronic Care Reports, patient eligibility criteria have been changed. The patients are included only if they have 250.xx in their assessment in one of the visits in selected time frame. 7. Filter the results: *. CPT only 2010 American Medical Association. All rights reserved. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 43

Generate Chronic Care Reports/Registry Summary Reports To filter by age range, enter a range in the Age Group fields. To search for encounters, enter a date range using the Date Range drop-down calendars. 8. Select Registry Summary Report to run from the Report Name drop-down list. a. Select the method of displaying this report once it is generated from the Report Type dropdown list. b. Click Generate Report. The selected report is generated based on the specified criteria. For examples of Registry Summary Reports, refer to Registry Summary Reports on page 70. Generating DPRP Survey Reports The DPRP (Diabetes Physician Recognition Program) Report can be generated from the Chronic Care Reports window. To generate DPRP Reports: 1. From the Chronic Care Reports window, select DPRP Survey Report from the Report Name dropdown list. When this option is selected, certain filters are selected by default, such as Patients seeing PCP at selected Client(s)/Site(s), condition - Diabetes, Patients visiting PCP for the selected date range, and Report Type - Excel Report (Data Only). Certain other filters are disabled by default. 2. Select appropriate filters for Client, Site, and Provider fields. 3. Select Pediatric (5-17 years) or Adult (18 years or older) in the Age Group field. 4. Select a Start Date and End Date using the More (...) button. 5. Click Generate Report. The report displays in Microsoft Excel: The DPRP (Diabetes Physician Recognition Program) Report captures patients that meet all three eligibility criteria: That are 5 years or older - To select this criteria, age group Pediatric (5-17 years) or Adult (18 years or older) must be selected in the Age Group field as described in step 3. AND, Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 44

Generate Chronic Care Reports/Registry Summary Reports Has a diagnosis of Diabetes (250.xx) in their Assessments list for at least 12 months - When DPRP Survey Report is selected as the Report Name, the condition Diabetes (Type1 & Type2) is selected by default, as explained in step 1. AND, Have a documented face-to-face visit for diabetes with the physician that precedes the most recent visit by at least 12 months - The system checks the last visit date of the patient that took place before the End Date (selected in step 4). It then subtracts 24 months from the last visit date to identify the start date of the abstraction period for the patient. The patient must have a documented provider visit for diabetes within that abstraction period that predates the most recent visit (last visit before the end date) by at least 12 months. The patient must also be Active in the system as of the current date. Note: The abstraction period is unique for each patient, since the last visit date is also unique for each patient. The abstraction period calculation is based on the last visit date. The DPRP Report displays the following information in the report: DPRP Information Chart Number Eligibility Diagnosis Physician Care 12 months Last Visit Last Visit Provider HbA1C Date HbA1C Value Patient s Chart number. Patient s age group. Patient s diagnosis. Description Displays if the patient has been under the care of the physician or physician group for diabetes care for at least 12 months within the abstraction period. Because this criteria is set while running the report, this column always has a value of Yes. Patient s last visit date for diabetes, before the end date of the report. The Last Visit Date column does not consider no-shows, cancels, telephone encounters, and resource visits (All). The Provider column contains the name of the provider who cared for the patient during the last visit. Date of most recent HbA1C test within the abstraction period. Value of the most recent HbA1C test result within the abstraction period. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 45

Generate Chronic Care Reports/Registry Summary Reports DPRP Information BP Date BP Systolic, BP Diastolic Value Insulin Prescribed Retinopathy Retinal Exam Smoking Status Description Date of most recent Blood Pressure test within the abstraction period. Values of most recent Blood Pressure test within the abstraction period. If the patient has been prescribed insulin within the abstraction period. An Rx Group Insulin must be created from EMR menu > Rx Group and Insulin-related medications must be added to this group. If the patient is prescribed any medications within the abstraction period that fall under the Insulin group, then a Yes is displayed in the report for that column. If the patient was diagnosed with retinopathy within the abstraction period. An ICD Group Retinopathy must be created from the Billing menu, and retinopathy related ICD Codes must be added to this group. If the patient has any diagnosis in their Assessments section within the abstraction period that falls under the Retinopathy group, then a Yes is displayed in the report for that column. Patient s most recent retinal exam results within the abstraction period. This is captured from the structured data responses in Results under Retinal Exam in HPI within the abstraction period. For more information, refer to Creating Structured Data for Diabetes/CVH Patients under HPI on page 24. Patient s current smoking status. This is captured from the structured data responses in Smoking, under HPI, within the abstraction period. For more information, refer to Creating Structured Data for Diabetes/CVH Patients under HPI on page 24. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 46

Generate Chronic Care Reports/Registry Summary Reports Cessation Treatment Lipids Cholesterol, Trig, HDL Date, LDL Date LDL DPRP Information Nephropathy Amputation Foot Exam Date Description Date of the most recent smoking cessation counseling. This is captured from the structured data responses in Smoking, under HPI, within the abstraction period. For more information, refer to Creating Structured Data for Diabetes/CVH Patients under HPI on page 24. Dates of most recent Total Cholesterol, Serum Triglyceride, HDL, and LDL tests within the abstraction period. Value of the most recent LDL test result within the abstraction period. By default the result date of most recent 24-hr urine test is captured, if any, within the abstraction period. If the result date is not found for this test, then the result date of the most recent Microalbumin/Creatinine Ratio test is captured, if its in the abstraction period. Captures the most recent value from structured data response to indicate if patient has received an amputation. Create structured data for HPI > Registry (category)> Diabetes/CVH (sub-category) > Foot Exam (symptom) > Amputation (structured data type - Boolean). Captures the date of the most recent foot exam from the structured data response in Examination > Foot Exam - Exam Done Date. For more information, refer to Creating Structured Properties Lists for Diabetes/CVH Patients Under Examination on page 31. Generating HSRP Survey Report The HSRP (Heart/Stroke Recognition Program) Report can be generated from the Chronic Care Reports window. To generate HSRP Reports: 1. From the Chronic Care Reports window, select HSRP Survey Report from the Report Name dropdown list. When this option is selected, certain filters are selected by default, such as Patients seeing PCP at selected Client(s)/Site(s), condition - CVH, Patients visiting PCP for the selected date range, Age Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 47

Generate Chronic Care Reports/Registry Summary Reports Group - 18 years or older, and Report Type - Excel Report (Data Only). Certain other filters are disabled by default. 2. Select appropriate filters for Client, Site, and Provider fields. 3. Select a Start Date and End Date using the More (...) button. 4. Click Generate Report. The report displays in Microsoft Excel: The HSRP Report captures patients that meet all three eligibility criteria: Patients that are 18 years or older - This is selected by default when HSRP Survey Report is selected as the Report Name in step 1. AND, Has a diagnosis of IVD (Ischemic Vascular Disease) in their Assessments list for at least 12 months - When HSRP Survey Report is selected as the Report Name, the condition CVH is selected by default, as explained in step 1. Prior to running the report, create an ICD group from the Billing menu, called CVH, and add IVD related ICD codes to that group. Patients with diagnosis in their Assessments that fall under the CVH group, are captured in the report. AND, Have a documented face-to-face visit for IVD care with the physician that precedes the most recent visit by at least 12 months - The system checks the last visit date of the patient that took place before the End Date (selected in step 3). It then subtracts 12 months from the last visit date to identify the start date of the abstraction period for the patient. The patient must have a documented provider visit for IVD in that abstraction period that predates the most recent visit (last visit before the end date) by at least 12 months. The patient must also be Active in the system as of the current date. The report displays the following data elements: Data Element Chart Number Age Group Patient s Chart Number. Description A Yes is displayed since the report is run on patients that are 18 years of age or older. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 48

Generate Chronic Care Reports/Registry Summary Reports Data Element Diagnosis Seen by PCP Last Visit Date Last Visit Provider DOB Year Gender BP Date BP Systolic, BP Diastolic Chol, Trig, HDL, LDL Dates LDL Value Intolerant Patient s diagnosis. Displays if the patient has been under the care of the physician or physician group for IVD care for at least 12 months in the abstraction period. Because this criteria is set while running the report, this column always has a value of Yes. Displays patient s last visit date for IVD, before the end date of the abstraction period. The Last Visit Date column does not consider no shows, cancels, telephone encounters, and resource visits (All). Displays the name of the provider who cared for the patient during the last visit. Patient s year of birth. Patient s gender. Description Date of most recent Blood Pressure test within the abstraction period. Values of most recent Blood Pressure test within the abstraction period. Dates of most recent Total Cholesterol, Serum Triglyceride, HDL, and LDL tests within the abstraction period. Value of most recent LDL test result within the abstraction period. If the patient is found intolerant to any antithrombotics within the abstraction period, a Yes is displayed in the Intolerant column. Create an Rx Group from the EMR menu, called Antithrombotics. Add drugs that are antithromotics to this group. If a patient is intolerant to any medication in this group, add a structured data allergy for that medication in patient s Allergy section. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 49

Additional Reports Data Element Antothrombotic Last Date Smoke SMK Date Description Date of most recent documentation during the abstraction period of an Antothrombotic is prescribed to the patient in their Progress Notes. 1. Create an Rx Group from the EMR menu, called Antithrombotics. 2. Add drugs that are antithromotics to this group. The most recent date when a drug (in the Antithrombotic group) is prescribed to the patient within the abstraction period, is captured in the report. Patient s current smoking status. This is captured from the structured data responses in Smoking, under HPI, within the abstraction period. For more information, refer to Creating Structured Data for Diabetes/CVH Patients under HPI on page 24. Date when the smoking cessation counseling was provided. This is captured from the structured data responses in Smoking, under HPI, within the abstraction period. For more information, refer to Creating Structured Data for Diabetes/CVH Patients under HPI on page 24. Additional Reports Some additional reports and forms are available in the system that can be used for patient s whose conditions require chronic care, such as Diabetes/CVH Encounter Form, Asthma Encounter Form, Registry Reports, and Statistics Reports. For more information on these additional reports, refer to the following sections: Diabetes/CVH Encounter Form on page 51. Asthma Encounter Form on page 57. Registry Reports on page 59. Statistics Reports on page 66. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 50

Diabetes/CVH Encounter Form Additional Reports This form is available from the Progress Notes and can be used to see and monitor the comprehensive medical summary of diabetic patients. The form displays the patient's vitals from their last and current visit, their lab results, lab attribute goals, any health management plans that the patient underwent, their medications, allergies and intolerance. It also displays a graph of their weight, blood pressure, cholesterol, and blood glucose history against the predefined goals. Configuring and Running the Diabetes/CVH Form To configure and run Diabetes/CVH Encounter Form: 1. To configure the items available on the form, click the Admin band. The Admin options display. 2. Click Chronic Care Admin. The Chronic Care Admin Configuration options display: 3. To display: Conditions a. Click Configure Conditions group. The Configure Reporting Conditions Group page opens. b. From the report options, select Diabetes Encounter form. c. Select the Conditions Group to display on the form. For more information, refer to Configuring Conditions Group Displayed in Summary Reports on page 11. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 51

Additional Reports Medications a. Click Configure Medications Group from the Configure Reports page. The Configure Reporting Medications Group window opens. b. From the report options, select Diabetes Encounter Form. c. Select the Medications Group to display on the form. For information on configuring medications, refer to Creating Medication Groups for Reporting on page 14. Note: The Rx Groups needs to be created from the Create Rx Group option available in the Configure Reports page, for them to display in the Configure Reporting Medications Group page. Labs a. Click Configure Labs Group from the Configure Reports page. The Configure Reporting Labs Group window opens. By default, the report option is selected as the Diabetes Encounter Form Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 52

Additional Reports b. Select the Lab Groups from the left pane and click the (>) button to move the selected ones to the right pane. To move all lab groups to the right pane, click the (>>) button. Use the Control key to select more than one option. c. After the lab groups have been selected and moved to the right pane, click Insert to insert the lab groups into the form. Click Remove or Remove All buttons to remove the selected lab groups from the right pane. For more information, refer to Configuring Labs Group Displayed In Summary Reports on page 20. Note: The labs containing the attributes that are reported on the form should be linked with the appropriate LOINC Codes. 4. Configure the following Services in addition to the ones configured for Chronic Care Reports: Foot Chk: a. From the Examination window in Progress Notes, select the category General Exam. b. Under this category, add an item named Foot Exam. c. Under this item, add a structured question Exam Done Date, with the data type of Date. The Foot Check value pulls from the structured data responses in Progress Notes and displays in the Services section of the form. SelfMonitrBG: a. From the HPI window in Progress Notes, select category Registry > Diabetes/CVH. b. Under this category, add a property named Self Monitoring Blood Glucose. c. Under this property, add a structured question Date with the data type of Date. d. Add another structured question Patient Monitoring with data type of Boolean. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 53

Additional Reports The Self Monitor BG value displays in the Services section of the form. The Self Monitor BG value pulls from the structured data responses in Progress Notes and displays in the Services section of the form. Smk Ce Counseling: a. From the HPI window in Progress Notes, select category Registry. b. Under this category, add a property named Smoking. c. Under this property, add a structured question Cessation Counseling Provided with data type of Boolean. For information on configuring Health Management Services, refer to Configuring Structured Data for Registry Reports on page 22. 5. Configure the Personalized Weight vital in addition to the ones configured for Chronic Care Reports: Personalized Weight: a. From the Admin band, select Admin and then select Vitals. b. Create a new vital item called Personalized Wt. c. From Chronic Care Admin, Configure Reporting Vitals window, link Personalized Wt to vital type Weight. Personalized Weight displays in the patient information section of the form and is denoted as Personalized Goal in the Weight History graph. For information on configuring Vitals, refer to Configuring Vitals for Reporting on page 21. 6. Once the configuration is complete, enter the medical information of a diabetic patient into their Progress Notes. a. Click on the green arrow next to the Ink button on the bottom of the Progress Notes. b. Click Diabetes/CVH Encounter Form. The Diabetes Encounter form opens: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 54

Additional Reports Vitals Patient Demographics Conditions Labs Medications Services The form captures the patient's medical data and lists them against the items in the form. The allergies, intolerant medications, lab results, vitals on the form are reported from the Progress Notes. Medications that were discontinued for the patients are captured from the Progress Notes. The check boxes are disabled; the system checks the boxes with corresponding information in the patient's Progress Notes. The results that are abnormal and do not meet the goal requirements, are highlighted in red. Some goals are predefined and hard-coded into the system: Goal BP: 130/80 Goal HbA1c: <7 Goal Cholesterol: =200 Goal Triglyceride: =150 Goal HDL: > 40 These goal values are displayed in the graphs sections of the form. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 55

Additional Reports Some goals values are captured from structured data or based on a hard-coded formula: Goal Weight is calculated by a formula - dgoalwt = [(24* ((ht*0.0254)2))/ (0.453)] Height is the latest height entered into the system. The Goal Weight displays in the patient information section of the form and Weight History graph and is also denoted as Ideal Goal in the Weight History Graph. Personalized Goal LDL - From the HPI window, select category Registry. Under this category, add a symptom LDL Goal. Under this symptom, add a structured question Personalized Goal, with the data type of Numeric. The last structured data entry for this question is pulled into the form. Personalized goal displays under the Labs section in Pers Goal column and is also denoted as NCEP Goal in LDL History graph. 7. Scroll down the form to view the allergies and the graphs plotted for the patient's Cholesterol, Blood Glucose, weight, and LDL: D/C Med D/C D/C Reason/Dosage Allergies/Intolerant Meds Weight and BP History HbA1C History Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 56

Additional Reports LDL History The system plots the patient's weight, BP, HbA1c, and LDL. Recommendations, current observations, goals, and additional information related to the history are listed on the righthand side of the graphs. For the LDL history, the system lists the current and goal Cholesterol, Triglyceride, and HDL levels of the patient. Printing the Diabetes Encounter Form Click Print to print the Diabetes Encounter Form. To see the detailed breakdown of Diabetes/CVH Encounter Form, refer to Detailed Breakdown of Diabetes/CVH Encounter Form on page 74. Asthma Encounter Form The Asthma Encounter form can be accessed from the patient's Progress Notes. The form comes with a patient self-assessment section and an Asthma Follow-up/ Acute Visit Encounter section. The patient can fill the self-assessment section and review it. The provider can then review the form and fill the Acute Visit Encounter section based on their observations of the asthma patient. To access the Asthma Encounter Form: 1. Open the Progress Notes for a patient who is here on Asthma follow-up visit. 2. Click the green arrow next to the Ink button on the bottom of the Progress Notes. The Ink button options display. 3. Select Asthma Encounter Form: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 57

Additional Reports The Asthma Encounter form opens: The demographics, current medication, allergies, immunization with dates, and selfmanagement plan date (Asthma Action Plan date from HPI) information is pulled from the patient's records. The provider can enter information that is applicable to the patient; the patient can fill the patient self-assessment questionnaire. 4. Select the boxes that apply. Click Print to fill information manually into a printed form and to document the provider's and the patient's/parent's signature. At the end of the form, the patient and the provider can check the Review check box, once they have filled and reviewed the form. 5. Enter signature in the specified location. Note: The check boxes can be checked electronically by clicking on the boxes or manually by printing the form and checking the boxes. The form comes pre-designed and cannot be configured by the user. The form does not save any data back into the patient records. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 58

Registry Reports Additional Reports Registry reporting feature can be found in the Registry Reports window. These reports are very similar to Chronic Care reports, where patients whose conditions require special care can be reported. The reports generated in this case, displays the results by the patient names. Whereas in Chronic Care, the results are displayed in a summary format. There are various reporting options under this feature, such as Diabetes, Asthma, CVH, Labs, and uses many of the same configurations as Chronic Care Reports. Its availability under Registry Reports facilitates running these reporting options by criteria subsets, such as by diagnosis. Thus, these reports can be run on top of the patient list, which is generated after running a search through different tabs in the Registry window. To run Registry Reports for patients whose conditions require special care: 1. From the left navigation band, click Registry. The Registry icons display. 2. Click the Registry icon. The Registry window opens displaying the Demographics tab by default: a. Select the criteria for running a Demographics report. b. Click Run New. c. Once the demographics results are generated, click the ICD tab. d. Select an ICD Group as a criteria. For example, Diabetes. e. Specify other filter options. 3. Click Run Subset. 4. Once the results are displayed for patients that are diabetic in the selected demographics, click the Reports tab. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 59

Additional Reports The Reporting Home Page opens. 5. Select a date range using the More ( ) button: 6. From the Report Name field, select a Report to run on the Registry-generated Diabetic patients: Report Default Patient List Patient List Patient List w/ Address Description Displays patient list for all patients filtered through the Registry search, and lists their name, DOB, sex, age, phone number, account number, race, ethnicity, language, and characteristics. Also displays the total number of patients in the report. Displays patient list for all patients filtered through the Registry search, and lists their chart number, patient name, phone number, and PCP information. Also displays the total number of patients in the report. Displays the Patient List Report along with patient address for all patients filtered through the Registry search. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 60

Additional Reports Report Description DM Annual ABC+ Report Displays patient's results from their last blood pressure vital check (as configured from Chronic Care Admin-Vitals) for all patients filtered through the Registry search. Displays patients with results from their last lab test for the attributes HbA1c, LDL, Micro Albumin Ratio, Creatinine for all patients filtered through the Registry search. The labs with these attributes needs to be linked to proper LOINC codes. Displays patients with last eye exam and foot check (as identified from structured data created for both under Examination); last smoking status and cessation counseling (as identified from structured data created for both under HPI-configured for Chronic Care Reports) for all patients filtered through the Registry search. Displays patients with their last visit date and their chart number from which the results are identified for all patients filtered through the Registry search. DM Annual ABC+ Exception Report Displays patients whose information is missing from at least one of the columns in the report. If a patient has information in all columns, their name will not display. Only patients who do not have data (or in other words, not treated or tested for the items in the report) are listed in this report as exceptions. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 61

Additional Reports Report CVH Annual ABC+ Report Displays patients with other cardiovascular disease (as identified by the ICD Group CVH-configured from Chronic Care Admin-Conditions) for all patients filtered through the Registry search. Run a query in Registry by selecting appropriate filters from different tabs and the ICD group CVH from ICD tab in Registry. Save the queries for future use. Run the saved report and then run the CVH Annual ABC + Report from the Reports tab. Displays patients getting anti-thrombotic therapy (as identified from structured data created under HPIconfigured for Chronic Care Reports) for all patients filtered through the Registry search. Displays patient's results from their last blood pressure check (as configured from Chronic Care Admin-Vitals) for all patients filtered through the Registry search. Displays patients with results from their last lab test for the attribute LDL for all patients filtered through the Registry search. The labs with the attributes LDL needs to be linked to proper LOINC codes. Displays patients with last smoking status and cessation counseling (as identified from structured data created for both, under HPI-configured for Chronic Care Reports) for all patients filtered through the Registry search. Displays patient s chart number. Missing Annual Asthma Report Description Displays patients with asthma (as identified by the ICD Group Asthma-configured from Chronic Care Admin) that do not have a self-management plan (as identified from structured data created under HPI-configured for Chronic Care Reports) for all patients filtered through the Registry search. Displays patient s chart number from which the results were identified, their phone number and PCP information for all patients filtered through the Registry search. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 62

Additional Reports Report Lab Status Report Displays patients with the selected lab, their order date, result date, result and status of the lab for all patients filtered through the Registry search. When the Lab Status Report is selected as the Report Name, the Select a Lab field is enabled, and the user can select a lab to report. Service Status Report Displays patient's results for the selected structured data, encounter date, and status for all patients filtered through the Registry search. When the Service Status Report is selected as the Report Name, the field next to Select a Lab field is enabled and the user can select a structured data to report (as identified from structured data created for Chronic Care Reports). HbA1c Change Report-SM Goal Displays patients with results from their last lab test for the attribute HbA1c, their order date, results prior to last order, order date for the prior order, and the difference between the two test results for all patients filtered through the Registry search. Displays if the patients have a self-management goal (as identified from structured data created under HPIconfigured for Chronic Care Reports) for all patients filtered through the Registry search. Patient Stats Report Displays patients with results from their last lab test for the attributes HbA1c and LDL for all patients filtered through the Registry search. The labs with these attributes needs to be linked to proper LOINC codes. Displays patients with results from their last blood pressure check (as configured from Chronic Care Admin- Vitals). Displays patient s last visit date. Annual ABC Report Description Displays similar information as in Patient Stats Report. Also displays total patients and total patients at goal for HbA1c, LDL, and BP for all patients filtered through the Registry search. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 63

Additional Reports Report CVH Annual ABC+ Exceptions Report Description Displays patients, whose information is missing from at least one of the columns in the report. If a patient has information in all columns, their names will not display. In other words, if no values are present for the patient in one of the columns, they are captured in the report. This gives the practice a chance to track patients with CVH who are not receiving proper care. Only patients who do not have data (or in other words, not treated or tested for the items in the report) are listed in this report as exceptions. Run a query in Registry by selecting appropriate filters from different tabs and the ICD group CVH from ICD tab in Registry. Save the queries for future use. Run the saved report and then run the CVH Annual ABC + Exceptions Report from the Reports tab. Note: For information on configuring the items that display on the following reports, please refer to Configure Chronic Care/Registry Summary Reports on page 7. The rest of the reports are only available to specific clients. 7. Select the format you want this report to be generated in, from the Report Type drop-down list. The three options available are: PDF Report Excel Report Excel Report (Data Only) 8. Click Generate Report. The selected report on the Diabetic patients (as in this example) or for all patients filtered through a specific Registry search, will be generated. The date range is displayed on top and the patient s chart number displays in a separate column. The following is a sample of CVH Annual ABC+ Report: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 64

Additional Reports Note: A Chart number has been added to all patient-specific CVH reports. A Date Range to all patient-specific Registry reports. Note: Diabetes is used, as an example, to filter Diabetic patients through Registry search in order to run different reports on diabetic patients. Different filters or combination of subset filters in the Registry window can be used to filter a section of the patient population based on a certain criteria. Then these reports could be run on top of the filtered patients to provide results that are more specific. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 65

Statistics Reports Additional Reports The Statistics Report gives a goal summary of Blood Pressure, LDL, HbA1c, and summary of Blood Pressure checks by Quarters and Facilities for diabetic patients. These reports are generated for Diabetic patients only, i.e., patients who have 250.xx as an ICD-9 code in their Assessments. Running a Statistics Report To run a Statistics Report: 1. Click the Registry band from the left navigation pane and click the Statistics Reports icon. The Statistics Reports window opens: 2. Click the More (...) button to select an end date for the quarter in the End Date field. Note: This filter is used to find the quarter where the results will display. This date is also considered as the last date of that quarter. Start date of that quarter will be calculated based on the end date of that quarter. At most, the report displays results for last 6 quarters. 3. Enter a name for the quarter that would be displayed on the report in the Description field. For example, Qrtr42009. 4. To view a report for Registry-enabled patients only, check the Registry Enabled Patients box. 5. Click one of the radio buttons to determine whether this report is run for all patients, only active patients, or only patients active within the selected date range. 6. Click Run Report. The data captured by the selected filters in generated and loaded on the back end. A confirmation message displays in green: Data Loaded Successfully. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 66

Additional Reports Note: The data for all three types of reports are generated and loaded successfully in the back end. 7. Select a Facility Group from the Client/Facility Groups box to generate the report for only those facilities that are part of the selected facility group. To generate report for all Facilities, select All Facilities. Note: To get more information on this field, click the question mark icon. 8. Select the type of report you want to run from the Report Name drop-down list. The following options are available: BP Statistics - View blood pressure statistics. The BP is a vital and can be linked to the respective vital type from the Chronic Care Admin-Configure Reporting Vitals page. LDL Statistics - View low-density lipoprotein test result statistics. The labs with this attribute should be linked to the correct LOINC codes. HbA1c Statistics - View hemoglobin A1c test result statistics. The labs with this attribute should be linked to the correct LOINC codes. Note: By default, BP Statistics displays as the report type. These report types are hardcoded into the system. 9. From the Report Type drop-down list: a. Select the format to use to generate the report. Three options available are: PDF Report Excel Report Excel Report (Data Only) b. Click View Saved Report. The data that was just loaded is presented in the specified format (PDF in this example): Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 67

Additional Reports In this sample report, total number and percentages of diabetic patients by facility who have met the goal for blood pressure, as well as those who have not met this goal, are displayed. The BP Goal is hard-coded in the system as 130/80 The HbA1c Goal is hard-coded in the system as <7 The LDL Goal is hard-coded in the system as <100 The report also displays total number and percentages of patients by facility, which did or did not have their blood pressure checked, out of all diabetic patients for that quarter. These results are displayed in the corresponding Annual Tests columns. Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 68

APPENDIX A: LOINC CODES HbA1c: 17856-6, 17855-8, 41995-2, 4637-5, 4548-4, 4549-2 HDL: 12772-0, 2771-2, 2086-7, 2615-8, 2085-9, 14646-4, 47221-7 LDL: 46985-8, 46984-1, 22748-8, 13457-7, 14155-6, 12773-8, 18262-6, 2089-1, 2090-9, 39469-2, 43392-0, 43393-8, 47213-4, 44711-0, 44915-7, 18261-8 Cholesterol: 35243-5, 35200-5, 2093-3, 21197-9, 2096-6, 14647-2, 47228-2, 9342-7, 2565-0, 9833-5, 26017-4 Triglyceride: 3043-7, 34695-7, 2096-6, 44718-5 Creatinine: 11214-4, 12190-3, 12190-5, 12571-6, 12589-9 INR: 34714-6, 38875-1, 46418-0, 5895-7, 6301-6 Micro Albumin 34535-5 Ratio: 24-Hour Urine 13986-5, 13984-0, 13987-3 Protein: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 69

APPENDIX B: REGISTRY SUMMARY REPORTS Samples of the four types of Registry Summary Reports: Copyright eclinicalworks, October 2011 - Chronic Care Reports, V9.0 70