Table of Contents AOA MORE Enrollment 2 AOA MORE Practice Director Version.2-3 Practice Director Update Instructions. 3-4 AOA Management Setup....5-6 AOA Submission Trial and Production Submission Run 7-12 Trial Submission Run... 7-9 Production Submission Report.. 9-12 MIPS Quality Measures... 13-17 Guidelines for entering Quality Data 15-17 1
Complete enrollment with AOA MORE if you have not already done so by going to the AOA MORE website www.aoa.org/more When the website launches select the ENROLL button located on the right side of the screen Follow the prompts to complete registration If you have questions on whether or not you have registered or on how to register you can click the HELP DESK button and a member of the AOA MORE team will follow up with you Practice Director Versions 5.1.63 and after contain access to AOA MORE. To verify your version from Practice Director: Select Help Select About Practice Director The About dialog will open Verify that Build # is equal or greater than 5.1.63 2 2
If the build # is equal or greater than 5.1.63 you can complete the AOA Management setup with in Practice Director If the build # is less than 5.1.63 you can run the CDU to update Practice Director to the most recent version Instructions for Running CDU You will install the update on your server by launching the CDU. Please note we have made improvements to the reliability and stability of the CDU to reduce errors when running in the office. In order to run the update you must be logged in as an administrator. Locate the CDU icon on your server. Once you have located the CDU icon follow the steps below: The passcode for this update is: More Update Directions for all Operating Systems: Windows 8/Windows 7/Windows Vista/Windows Server 2012/Windows Server 2008 R2/Windows Server 2008: 1. Locate the Client-Driven Updater icon on your desktop. 2. Right-click on the icon. 3. Select Run As Administrator. You will need to run the Client-Driven Updater as an administrator. 4. Click 'Update' and enter the passkey supplied above. 5. Wait for confirmation software was updated successfully Windows XP/Windows Server 2003: 1. Locate the Client-Driven Updater icon on your desktop. 2. Double click on the icon to launch the Client-Driven Updater. 3. Click 'Update' and enter the passkey supplied above. 4. Wait for confirmation software was updated successfully Running the Client-Driven Updater will shut down the PD server and install the latest Practice Director software. Once the update is completed, your PD service will be restarted automatically. Please allow at least 5 minutes for it to complete its start up cycle. After Practice Director has started, you can log into PD at the workstations and use the new version. 3
Mac: 1. Locate the Client-Driven Updater icon on your desktop. 2. Click on the icon to launch the Client-Driven Updater. 3. Provide your administrator password to install the software 4. Click 'Update' and enter the passkey supplied above. 5. Wait for confirmation software was updated successfully 6. Use 'Start PD Server' app located in '/Applications/Williams Group' Running the Client-Driven Updater will shut down the PD server and install the latest Practice Director software. Once the update is completed, you will need to restart the PD server (Start PD Server.app). Please allow at least 5 minutes for it to complete its start up cycle. After Practice Director has started, you can log into PD at the workstations and use the new version. If you have any issues with running the Client-Driven Updater, please call our Support Line at 402-454-7173 please give the support representative the error code you received in order to schedule a manual update. If you have any questions regarding the update, please contact the Practice Director Support Team at 402-454-7173 or support@practicedirector.com 4 4
AOA Management Setup Once you are on version 5.1.63 or greater you can setup Practice Director to communicate with AOA MORE Registry. The information below is also covered in Training Video 28.1 AOA Registry Menu Items, located at training.practicedirector.com. You can contact Practice Director Support if you are unsure of your Username and Password. Log into Practice Director Select EHR Options Select AOA Registry Select AOA Management The AOA Management dialog will open (All fields are required for submission) 1. Practice Director will keep the first four dates updated for you. At this time AOA MORE is only accepting 2016 data. 5
2. Click on the lookup to select any AOA provider to be the Legal Authenticator. The authenticator assumes legal responsibility of the generated QRDA Category I files being submitted to the AOA Registry. Select the date that the selected provider took responsibility. 3. Click on the lookup to select any AOA provider to be the Custodian. The custodian represents the organization that is in charge of maintaining the generated QRDA Category I files being submitted to the AOA Registry 4. Submission Date & Time - For the Day you can select between Wednesday or Thursday for submission. AOA requires the AOA Registry End Date to be prior to the weekly submission deadline. AOA releases the weekly provider white list on Wednesday at noon and the AOA weekly submission deadline is Friday at 5:00pm. The default selection is Wednesday. You may specify any time for submission after 6:00pm on Wednesday or Thursday. 5. Select Enable 6. Select Save Once saved your information will transfer to AOA MORE Registry per your setup specified in AOA Management. 6 6
AOA Submission Trial and Production Submission Run Practice Director has given the user two options for verifying information that has been or will be transmitted to the AOA. AOA Trial Submission Run will allow you to view and or save the results of the data that would be sent in the Submission Run. This will allow you to verify that all anticipated patients are going to be transmitted to AOA. If any problems are detected you can resolve them before the Production run occurs. Trial Submission Run Select EHR Options Select AOA Registry Select AOA Trial Submission Run 1. Provider select the desired provider from the drop down 2. The date fields are pre-populated with the dates setup in AOA Management, you can override any date by clicking on the calendar 3. Destination Leave empty (this is for the Practice Director support team to troubleshoot file problems if needed). 4. Select OK to save You will see the AOA Trial Submission Run dialog showing the progress. You can wait or select Run in Background so that you can continue to work 7
Once the run is complete the results will display on the screen or in the tray (if you selected Run in Background) 8 8
1. The Provider, ecqm Reporting Period, and AOA Registry Reporting Period will display 2. Each NQF will display with the numerator and denominator counts that will be sent to AOA MORE in the Production Run To see the patients that make up the counts you can go to EHR Options>AOA Registry>AOA ecqm Verification Report 3. If there are any patients that will not push up their names and the issue will be listed, if no problems you will see No problematic patient QRDA I data was detected 4. You will see a list of patients that have been seen by the provider since the last submission. 5. You can select Save to Save the report locally and then you can print from the saved location if desired Production Submission Run Report The Production Submission Run Report is used to view what was sent to the AOA during the weekly run. The Report will show you if there are any patients that were not transmitted and will list the reason why. You can use this report to fix the data before the next scheduled upload. To run the Production Submission Run Report Select EHR Options Select AOA Registry Select AOA Production Submission Run Reports 9
The AOA Production Submission Run Report dialog will open In the upper left hand side of the screen you will see a list of Provider Names and the Submitted Date. The user is able to sort by the Provider and or the Submitted Date by clicking on the header. * Note Run Information is only retained for 90 days To view details about a specific Provider and Submitted Date, select the desired information. Once selected data about the run will display on the right side of the screen 10 10
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1. The Provider, ecqm Reporting Period, and AOA Registry Reporting Period will display 2. A list of each NQF will display along with the submitted Numerator and Denominator counts To see the patients that make up the counts you can go to EHR Options>AOA Registry>AOA ecqm Verification Report 3. This area lists any patients that had errors and could not be submitted. Before the next AOA submission you will want to resolve the errors 4. Select Save to save the report locally. Once saved locally, the information can be printed 12 12
MIPS Quality Measure (NQF/CQM/eCQM/PQRS) In 2017 Doctors of Optometry must report on 6 Quality Measures. With Practice Director and AOA MORE you can submit your Quality measures through the AOA MORE Registry. You must include one outcomes measure (if you cannot report an outcomes measure, you must report one high priority measure). You must report on 50% of your patients across all payers. Practice Director and AOA MORE are structured to report on the following measures: Measure Name Diabetes: Eye Exam Measure Description Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period emeasure ID NQF CMS131v5 55 PQRS 2022F or 2024F or 2026F or 3072F Additional Info Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months CMS142v5 89 5010F + G8397 or G8398 Bonus Points High Priority Primary Open- Angle Glaucoma (POAG): Optic Nerve Evaluation Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits w/in 12 months CMS143v5 86 2027F Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months CMS167v5 88 None 13
Measure Name Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) Measure Description Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period emeasure ID NQF CMS122v5 59 PQRS 3064F or 3046F 8P or 3044F or 3045F Additional Info Bonus Points, Outcome & High Priority Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user CMS138v5 28 4004F or 1036F Controlling High Blood Pressure Percentage of patients 18-85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90mmHg) during the measurement period CMS165v5 18 G8752 or G8753 Bonus Points Outcome & High Priority Closing the Referral Loop: Receipt of Specialist Report Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred CMS50v5 N/A None Bonus Points High Priority Documentation of Current Medications in the Medical Record Percentage of visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration. CMS68v6 419 G8427 or G8430 or G8428 Bonus Points High Priority 14 14
Guidelines for entering Quality data within Practice Director for Compliance Users will continue to document these measures as they always have in the Practice Director EHR. Insurance Billers will NOT select the PQRS codes for claims submission on the Invoice Screen (this is different). We recommend completing as many measures as you can, CMS will take your top 6 scoring measures. The guidelines below will not show all coding possibilities. To see the full listing of code sets, please see the Measures Help tab within EHR Options>AOA Registry>AOA ecqm Help Each of these measures are also reviewed in our training videos located at: training.practicedirector.com NQF 0018 Hypertension: BP Measurement (only if BP controlled the numerator will be populated) Video 28.6 Patient age 19 85 during measure period Has an completed office visits recorded (Medical 99xxx) during measurement period in Coding/Final Hypertension diagnosis recorded in Coding/Final <= 6 months start after start of measurement period in Coding/Final Or Diagnosis of Essential Hypertension ends before the start of the measurement period Record controlled range of Systolic <140 and Diastolic < 90 BP in Vitals section of the EHR NQF 0028 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Video 28.7 Patient age 18 years and older At least 2 office visits recorded (Medical 99xxx or 92xxx) in Coding/Final Smoking status selected in Respiratory section of ROS o o If a non-smoker, this is all that is needed If a current smoker, will need a Cessation Counseling code recorded (99406 or 99407) NQF 0050 Closing of Referral Loop: receipt of specialist report Video 28.5 Any patient who has been referred out, regardless of age Medical or 92002, 92004, 92012, and 92014 coding Referral saved to exam Complete the referral loop by importing the referral report back into the EHR. 15
NQF 0419 Documentation of Current Medication in the Medical Record Video 28.11 Patients 18 years and older At least 1 office visit recorded (92xxx) in Coding/Final Add all current medications to the ERx portal Check the Documented all current medications box in Current Medication section of EHR NQF 0086 POAG: Optic Nerve Evaluation Video 28.8 Patients 18 and older At least 2 office visits recorded (99xxx or 92xxx) in reporting period in Coding/Final POAG dx code recorded in Coding/Final Optic Nerve Head Evaluation recorded (2027F) in Coding/Final Cup to Disc Ratio results recorded in Disc Assessment section Appearance recorded in Disc Assessment section NQF 0088 Diabetic Retinopathy Examination Video 28.9 Patient 18 years and older At least 2 office visits recorded (99xxx or 92xxx) within reporting period in Coding/Final Diabetic Retinopathy dx recorded in Coding/Final Macular or Fundus Exam recorded (2021F) in Coding/Final PD EHR Macular Edema and Retinopathy Severity (Severity cannot be normal) fields populated in the Posterior Segment section. NQF 0089 Diabetic Retinopathy Communication Video 28.10 Patients 18 years and older NQF 0088 is met Create Referral letter and save to EHR, including Posterior Segment section in report Finding communicated to physician recorded (5010F) in Coding/Final NQF 0055 Diabetes Eye Exam Video 28.2 Patients 18-75 Patient has a diabetes diagnosis in Coding/Final Has had a retinal or dilated eye exam during the reporting period, or a negative retinal exam with no evidence of retinopathy 12 months prior 92xxx codes do not count 16 16
PD Fundoscopy section of exam completed (dilated method, etc) 2022F, 2024F, 2026F or 3072F entered in Coding/Final NQF 0059 Diabetes: Hemoglobin A1C Poor Control Video 28.3 Patients 18-75 years old Patient has diabetes diagnosis in Coding/Final Has had hemoglobin A1C >9% during the reporting period Results from hemoglobin test entered as Lab Result in Practice Director. Using the following LOINC codes 4549-2, 17856-6, 4548-4, 17855-8 Lab Results show that A1C is still not controlled and is still >9% You want this measure to have small percentage Important Information about CQM Numerator Counts As of October 1, 2016, the ICD10 list was updated for diagnosing patients. However, the value sets used to determine/calculate the Clinical Decision Support interventions and the Clinical Quality Measures have NOT been updated to include the newly released ICD10 codes. Because of this, both your system interventions may trigger and your CQM counts may have lower numerators. We have contacted the governing bodies asking for the new value sets. We have not yet received responses. Once the new value sets are released and implemented, the system will accurately include all entered data/patients in these counts/interventions. Please continue to enter your exam data as needed. Understanding that if you entered a new POAG or Diabetes ICD10, those will get counted correctly as soon as we receive the updated value sets. 17