Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals CPSI is dedicated t making yur transitin t Meaningful Use as seamless as pssible. Therefre, we have cme up with a radmap t assist yu in implementing each bjective fr Meaningful Use. Each facility will need t purchase the fllwing applicatins in rder t meet Meaningful Use: Interface Management System (IMS) Hspital Infrmatin Management (HIM) Electrnic File Management (EFM) Labratry Pharmacy Pharmacy Clinical Mnitring Pint f Care (POC) and\r Electrnic Frms (E-Frms) Cre Measures ChartLink Cmputerized Physician Order Entry (CPOE) Medicatin Management Micrmedex/Care Ntes Medical Practice EMR (MP-EMR) (if desire t apply fr Eligible Prviders) Clinical Vcabulary In additin t the abve, each facility will als need t d the fllwing: Cnvert t Linux Server Cnvert t User Based Lgins (UBLs) Cnvert Immunizatins t standardized CVX cdes Cntact Kay Jhnsn at CPSI fr a Cmplete System Analysis and Final Preparatin. Once a system analysis and final preparatin ccur, individual situatins will be pened fr each bjective. A representative will review all setup that is required and suggested. Revisin Date: 08/02/2013 1
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Belw are suggestins n hw t implement each bjective. Cre Objectives: CPOE - Mre than 30% f unique patients with at least ne medicatin in their medicatin list have at least ne medicatin rder entered via CPOE. This bjective will be supprted by the CPOE team via the CPOE Applicatin. Telephne and verbal rders cunt fr this bjective. Check test physician in Special Functins Physician Security fr all test physicians. This way test physician statistics will nt pull t the statistic reprt. Ensure rder pathways fr ER/IP are set up fr ER/IP t be included in statistics. Drug-Allergy, Drug-Drug Interactin checks - Implement Drug-Drug, Drug-Allergy interactin checks - Attestatin fr entire reprting perid. This bjective will be supprted by the Pharmacy team. Implement Clinical Mnitring Checks via Pharmacy/Nursing/CPOE and ensure apprpriate levels are set up. Recrd Demgraphics - Mre than 50% f all unique patients have demgraphics recrded as structured data. This bjective will be supprted by the Registratin team. CPSI suggests the fllwing demgraphics are required, r a census edit set up t ensure the fllwing infrmatin is captured: Race Ethnicity DOB Preferred Language Gender Date and preliminary cause f death (within hspital) - this will shw a tab f paper when expired within hspital discharge cde is used. Revisin Date: 08/02/2013 2
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Maintain up-t-date prblem list f current and active diagnses - Mre than 80% f all unique patients have at least ne entry r an indicatin that n prblems are knwn fr the patient recrded as structured data. This bjective will be supprted by the CPOE team. CPSI will cntact yur facility and assist in using this applicatin. Clinical Vcabulary must be purchased in rder fr this t be turned n. This is dne thrugh an rder situatin. View Prblem List Camtasia. Prblem List Type and Prblem List Surce will need t be set up in New Table Maintenance. Security Switch 117 will allw access t the Prblem List fr thse that are nt physicians. Shw Prblem List has t als be checked n page tw f the ChartLink Cntrl Table. Maintain active medicatin list - Mre than 80% f all unique patients seen have at least ne entry (r an indicatin that the patient is nt currently prescribed any medicatin) recrded as structured data. This bjective will be supprted by the CPOE team. This is a byprduct f Medicatin Order Entry including Pharmacy, CPOE r POC. If site des nt have Medicatin Management installed, n active meds will need t be addressed via the CPOE Prfile. Maintain active medicatin allergy list - Mre than 80% f all unique patients have at least ne entry (r an indicatin that the patient has n knwn medicatin allergies) recrded as structured data. This bjective will be supprted by the Pharmacy team. Ensure current prcesses are in place fr capturing patient medicatin allergies. Revisin Date: 08/02/2013 3
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Recrd and chart changes in Vital Signs - Mre than 50% f all unique patients age 2 and ver - height, weight and bld pressure are recrded as structured data. Plt and display grwth charts fr children 2-20 years, including BMI. This bjective will be supprted by the POC team. Set up BMI via virtual chart. Set up grwth charts via virtual chart. Recrd smking status fr patients 13 and Older - Mre than 50% f all unique patients 13 years r lder have smking status recrded. This bjective will be supprted by the Registratin team. Smking status can be captured via POC/Census/E-Frms. CPSI suggests a census edit be set up t ensure smking status is captured in Census. Nte: If using E-Frms, ensure yur drp-dwn ptins reflect chices in Census. Implement ne Clinical Decisin Supprt Rule - Implement ne clinical decisin supprt rule relevant t specialty r high clinical pririty alng with ability t track cmpliance t that rule (real time) Attestatin. This bjective will be supprted by the CPOE team. CPSI will cntact custmer t assist with set-up. This is a by-prduct f Clinical Decisin supprt, Pharmacy and ChartLink. Demgraphics Duplicate Therapy Checks Disease Interactin Checks Patient Specific Dsing Age/General Precautins Revisin Date: 08/02/2013 4
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Specific Patient Diagnsis/Cnditins Test Results (Reference Range Checking) Patient Med List Reprt Quality Measures t CMS r State - Reprt quality measures t CMS r State Attestatin. This bjective will be supprted by the Cre Measures team. The initial phase f Meaningful Use des nt require electrnic submissin f data. Hwever, if yu wish t electrnically submit this data, an interface is required. Site will need t cmplete an Interface Request Frm and cntact yur Accunt Manager t initiate the develpment fr facility. This reprt will be fund via the fllwing path: Hspital Base Menu > Other Applicatins and Functins > Indicatr Measurement/Cre Measures > Quality Measures > Add Reprt > NQF Table 10 Reprt. The fllwing will need t be set up via CPSI: SnMed/ICD-9 Crsswalk Quality Measures Reprting Table set up in New Table Maintenance with IPPAT and EDPAT. Prvide patients with electrnic cpy f their health infrmatin, upn request - Mre than 50% f all patients wh request an electrnic cpy f their health infrmatin are prvided it within three business days. This bjective will be supprted by the HIM team. Sme type f prtable electrnic media will be needed t meet this bjective, i.e. USB drive, etc. Set up the fllwing in Release f Infrmatin System via Medical Recrds: Requestr Type will need t be set up fr Patient. Purpse cde will need t reflect Electrnic Health Recrd. MU Due Date t reflect the number f business days after request is made that this is due. Revisin Date: 08/02/2013 5
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Must set up abve in ROI cntrl recrd as Purpse. Access Print EMR ptin t select dcuments t prvide t patient. Answer Yes when prmpted whether t update Release f Infrmatin. Fill ut Received, Cmpleted and MU Due Date inf. Prvide patients with a cpy f the Discharge Instructins at the time f discharge, upn request - Mre than 50% f patients wh are discharged are prvided an electrnic cpy f Discharge Instructins, at time f discharge, if requested. This bjective will be supprted by the POC team. Set up the fllwing in Release f Infrmatin System via Medical Recrds: Requestr Type will need t be set up fr Patient (can be same cde as abve). Purpse cde will need t be set up t reflect Discharge Instructin. Must set up abve in ROI cntrl recrd as Purpse cde fr electrnic cpy f Discharge Instructins. Chse Print EMR, chse Discharge Instructins, prtable media, update Release f Infrmatin. Make sure patient request and purpse cde (frm abve) are chsen and then Received, MU Due Date inf (discharge date), and Cmpleted Date are filled in. Capability t exchange key clinical infrmatin - Capability t exchange key clinical infrmatin amng prviders f care and patient authrized entities electrnically - Attestatin (perfrmed at least ne test). This bjective will be supprted by the HIM team: This can be accmplished in ne f the fllwing ways and has t use the standards indicated fr this exchange - using an encrypted CCD. This is an attestatin that yu have tried t send this infrmatin. Belnging t State HIE/RIO with a repsitry will fulfill this bjective - Interface Required (Cntact Sales). Print EMR/Submit t HIE will be used fr this scenari. Exchanging CCD data between tw legal entities via Secure Email. Revisin Date: 08/02/2013 6
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Prtect Electrnic Health Recrd - Cnduct r review a security risk analysis and implement security updates as necessary and crrect identified security deficiencies as part f its risk management prcess Attestatin. This bjective will be supprted thrugh installatin and utilizatin f the fllwing functinalities: Linux UBL Encryptin Audit Lg Reprt Path t Audit Lg Reprt: Hspital Base Menu > Other Applicatins and Functins > Wrd Prcessing > Ad Hc Reprt > Reprt Dashbard > Add Reprt > Audit Lg r thrugh Sever Menu > Special Functins > Audit Lg. Break the Glass Optin t Break the Glass fr Physicians: Server Menu > Special Functins > System Security > Physician Security > Emergency Access t PHI. Optin t Break the Glass fr Emplyee: Server Menu > Emplyee Security > Emergency Access t PHI (if yu want nursing t be able t break the glass, set this t Y). Menu Objectives: Implement Drug Frmulary checks - The facility has enabled this functinality and has access t at least ne internal r external drug frmulary fr the entire reprting perid - Attestatin. This bjective will be supprted by the Pharmacy team. Cntact CPSI t purchase Micrmedex/Care Ntes. This will be accmplished by the use f Micrmedex. Recrd Advanced Directive fr patients 65 and lder fr inpatients - Mre than 50% f all unique patients 65 years and lder have an indicatin f advanced directive status recrded. Revisin Date: 08/02/2013 7
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals This bjective will be supprted by the Registratin team. CPSI suggests Advanced Directives is a required field r a census edit set up t ensure this infrmatin is captured in Census. Incrprate clinical lab results int EHR as structured data - Mre than 40% f all clinical lab tests rdered whse results are either ps/neg r numerical are incrprated int the certified EHR as structured data. This bjective will be supprted by the Labratry team. This is met by the current functin f the CPSI Labratry Infrmatin System. Generate list f patients by specific cnditins - Generate at least ne reprt listing patients with a specific cnditin t use fr quality imprvement, reductin f disparities, research r utreach - Attestatin. This bjective will be supprted by the Ancillary team. CPSI will cntact yur facility t review. This new reprt will nw be fund in: Path t Patient List based n Medicatins, Labs, Prblems: Hspital Base Menu > Other Applicatins and Functins > Wrd Prcessing > Ad Hc Reprt > Reprt Dashbard > Add Reprt > Patient List based n Medicatins, Labs, Prblems. Use certified EHR technlgy t identify patient-specific educatin resurces and prvide if apprpriate - Mre than 10% f all unique patients are prvided patient-specific educatin resurces. This bjective will be supprted by the POC team. Patient Educatin Dcuments, Patient Drug Infrmatin, Patient Lab Infrmatin Dcuments will be used t meet this bjective. LOINC cdes will be used t tie patient educatin labratry dcuments t previus patient. Revisin Date: 08/02/2013 8
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals Perfrm Medicatin Recnciliatin at relevant encunters and each transitin f care - Perfrm medicatin recnciliatin n mre than 50% f transitins f care. This bjective will be supprted by the POC team. Cntact CPSI t purchase Medicatin Management. View Medicatin Recnciliatin Camtasia. Prvide Summary f Care recrd fr each transitin f care and referral - Facility that transitins r refers patients t anther setting r prvider f care prvides a summary f care recrd fr mre than 50% f transitins f care and referrals. This bjective will be supprted by the POC team. Set up the fllwing in Release f Infrmatin System via Medical Recrds: Requestr Type will need t be set up fr Patient (can be same cde as abve). Purpse cde will need t be set up fr Patient Summary. MU Due Date t reflect the discharge date. The abve will need t be added t ROI cntrl recrd Purpse Cde fr Patient Summary Sent fr Transferred Patient. Frm Medical Recrds-Access Print EMR ptin t select dcuments t prvide t patient. Answer Yes when prmpted whether t update Release f Infrmatin. Fill ut Received, Cmpleted and MU Due Date (Discharge Date). Frm Pint f care-access Patient Summary-CCD frm the virtual chart (listed under named tab it was created under). Release f Infrmatin will be autmatically updated. Additinal Infrmatin: This bjective will nw be called Transitin f Care Summary n the Stage 1 Meaningful Use Statistics Reprt. Revisin Date: 08/02/2013 9
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals There is nw a user defined cntrl table t include Discharge Cdes fr this bjective-transferred ut f the facility. If user des nt define, the system will utilize the default Discharge Cdes (02, 03, 05, 43, 51, 62-66, 70) t ppulate the statistics reprt. The new table path is Special Functins-System Security-Page 2-Meaningful Use-Statistic Cntrl. If the user defined ptin is used, nly thse with the Discharge Cdes defined will be cunted tward this statistic. Capability t submit electrnic data t immunizatin registries - Perfrmed at least ne test f certified EHR s capability t submit electrnic data t immunizatin registries and fllw up submissin if the test is successful (unless nne f the immunizatin registries t which the facility submits the infrmatin have the capability t receive the infrmatin electrnically). Item Cnfiguratin and immunizatin table set-up fr this bjective will be supprted by the POC team. The submissin f immunizatin recrds will be set up and supprted by an interface. T electrnically submit, an interface is required. Please cmplete an Interface Request Frm and cntact yur Accunt Manager t initiate the develpment fr yur facility. Capability t prvide electrnic submissin f reprtable lab results t public health agencies - Perfrmed at least ne test f certified EHR s capability t submit electrnic reprtable labs and fllw up submissin if the test is successful (unless nne f the public health agencies t which the facility submits the infrmatin have the capability t receive the infrmatin electrnically). Item Cnfiguratin fr this bjective will be supprted by the Ancillary/Labratry team. The submissin f results will be set up and supprted by an interface. T electrnically submit, an interface is required. Please cmplete an Interface Request Frm and cntact yur Accunt Manager t initiate the develpment fr yur facility. Capability t prvide electrnic syndrmic surveillance data t public health agencies - Perfrmed at least ne test f certified EHR s capability t submit electrnic syndrmic surveillance and fllw up submissin if the test is successful (unless Revisin Date: 08/02/2013 10
Meaningful Use Radmap Stage 1-2011 Editin Eligible Hspitals nne f the public health agencies t which the facility submits the infrmatin have the capability t receive the infrmatin electrnically). Electrnic submissin fr this bjective will be set up and supprted by an interface. T electrnically submit, an interface is required. Please cmplete an Interface Request Frm and cntact yur Accunt Manager t initiate the develpment fr yur facility. Statistics Reprting The statistics reprting will be supprted by the Data Prcessing team. CPSI has a Meaningful Use Stage 1 Statistics reprt available via Special Functins. This reprt cntains all infrmatin n percentage-based Objectives. Reprt Cntrls Determine which patients in which statistics will be captured. Per CMS: Sites must reprt n ne f the fllwing: IP and All ER Patients OR IP and Observatin Service Patients Befre attesting hspitals will have t indicate which methd they are chsing. Statistic Cntrls- Determines which Discharge Cdes are used fr the Transfer f Care/Prvide Summary f Care fr each Transitin f Care bjective. Revisin Date: 08/02/2013 11