Medication Reconciliation – to satisfy the Medication Reconciliation objective, you’ll need to review the patient’s medication list on the timeline summary screen within the EMR. To do this, open the patient’s chart within the EMR and be sure the timeline summary chart tab is open. In the lower left hand corner of the screen, click the icon that appears as a clip board with two checkmarks on it. This will launch the patient reconciliation window. Review the patient’s allergies, medications and problems and toggle the action column as needed if there are any changes that need to be made. Once you are satisfied with the actions to be taken, ensure that the “mark as reviewed” box is checked and click save.
These steps must be performed for more than 50% of patients seen during the attestation period who are new to the provider or are established patients who are transitioning into the providers care from another care setting. The only exclusion for this objective is if a provider does not have any new patients or patients transfer into their care during the attestation period.
Patient Education – to satisfy the patient education objective, load the patient’s chart in the EMR and navigate to the patient education tab. In the search box at the top, type in at least 3 letters of the education document you wish to dispense to the patient and all matching results will return in the search window. Select the document you wish to dispense by clicking on its name. This will load it into the screen. Make sure the box next to it is checked. Then either press print to generate the document and hand it to the patient yourself or press the save button. Pressing save will send the document to the print view tab of the quick pay screen where the checkout staff can print the document for the patient and/or send it to the patient’s My Medical Locker account. This objective must be performed for more than 10% of patients seen during the attestation period by the provider. The only exclusion for this objective is if the provider has no office visits during the attestation period.
Protect PHI – To satisfy the Protect PHI objection, the provider must conduct a Security Risk Assessment as defined by CMS which results in a security risk analysis document which includes any security deficiencies found during the assessment and any actions taken to correct those deficiencies. There are no steps that can be taken within OfficeEMRTM to achieve this objective. Although you are not required to use it, iSALUS has partnered with HIPAA One, an industry leader in HIPAA compliance whose solution offers a step-by-step guide to the requirements to perform an adequate security risk assessment and maintain compliance. Click the link in the implementation section of the Protect PHI in the provider dashboard to learn more about this offer. If you have completed your security risk assessment and would like the provider dashboard to reflect that it has been completed and show the Protect PHI as green, simply click the box “A security risk assessment has been completed for my office” and hit the close button. An assessment must be conducted for each attestation period. There is no exclusion available to you for this objective.
To satisfy the decision support objective, there are two separate requirements which are divided into two tabs on the provider dashboard.
1. To satisfy Tab No. 1 of the Decision Support Objective, the provider must have 5 clinical support criteria in effect during the reporting period. This objective is met within OfficeEMR so long as the provider and all EMR users in the database have the Decision Support Section of the summary chart tab enabled. As OfficeEMR has automatically created five Decision Support Criteria related to high priority health conditions in each client database where one or more providers is attempting to achieve Meaningful Use.
To see any Decision Support criteria related to a patient go to the patient's chart in the EMR. Open the summary chart tab and view any information displayed in the decision support section. There is no exclusion for this tab of the Decision Support Objective.
2. To satisfy Tab No. 2 of the Decision Support Objective, a provider must have drug-to-drug and drug-to-allergy alerts enabled for the prescription pad and medication history screens within OfficeEMR during the attestation period. These interactions are controlled by company settings which can be found by launching the OfficeEMR search window and searching for display interaction alerts in the company settings subcategory. By default, each client database has these alerts enabled.
A provider may file an exclusion for this part of the objective if they write few than 100 prescriptions during the attestation period.
To satisfy the CPOE or Computerized Provider Order Entry Objective, there are three separate requirements which are divided into three tabs on the provider dashboard. To satisfy Tab No. 1 of the CPOE Objective, the provider must use OfficeEMR to print or electronically save more than 60% of all medication orders during the attestation period. To achieve this tab of the objective for a patient, go to the EMR portal and load the patient's chart. Then navigate to the prescriptions chart tab and either print or send a new prescription or refill an existing medication to satisfy the objective. Please note that any medications entered into a patient's chart as "patient reported" will not count towards the calculation of this objective. A provide may file an exclusion for Tab No. 1 of the CPOE objective if they write fewer than 100 prescriptions during the attestation period.
To satisfy Tab No. 2 of the CPOE objective, the provider must place more than 30% of their radiology orders during the attestation period using OfficeEMR. To achieve this tab of the objective a patient, go to the EMR portal and load the patient's chart. Then navigate to the order entry chart tab. Select the appropriate radiology test or tests from those available. Enter the pertinent details for each and save the patient's chart. A provider may file an exclusion for Tab No. 2 of the CPOE objective if they order fewer than 100 radiology tests during the attestation period.
To Satisfy Tab No. 3 of the CPOE objective, the provider must place more than 30% of their laboratory orders during the attestation period using OfficeEMR. To achieve this tab of the objective for a patient, go to the EMR portal and load the patient's chart. Then navigate to the order entry chart tab. Select the appropriate lab test or tests from those available. Enter the patient details for each and save. A provider may file an exclusion for Tab No. 3 of the CPOE objective if they order fewer than 100 lab tests during the attestation period.
To satisfy the e-prescribe objective there are two separate requirements which are shown on one tab on the provider dashboard. The first requirement is that all prescriptions sent or printed by the provider must be queried for a drug formulary. This requirement is controlled by an administrative company setting called RxHub which is enabled by default for all of our client databases where one or more providers are attempting to achieve meaningful use. There's no action required to meet this component other than ensuring that the setting is enabled and stays enabled throughout the attestation period. The second requirement is that more than 50% of the permissible medication orders prescribed by the provider during the attestation period must be sent electronically to a pharmacy. Permissible, in this case, is described as any prescription that can legally be e-prescribed nationwide. Because the adoption of EPCS has not been fully implemented by some states Schedule 2, 3 or 4 medications are not taken into consideration for the calculation of this objective. A provider may file an exclusion for the ePrescribe objective if they write fewer than 100 permissible prescriptions during the attestation period. They may also file an exclusion if there is no pharmacy within their organization and there are no pharmacies that accept e-Rx within 10 miles of the practice's location when the attestation period starts.
To satisfy the health exchange objective there are two separate requirements which are shown on one tab of the provider dashboard. The first requirement is for a provider to create a summary of care record for every patient seen during the reporting period that has transitioned or referred to another setting or provider of care. OfficeEMR automatically creates a summary of care record for each patient visit in the OfficeEMR so there are no additional steps required to complete this aspect of the requirement.
The second requirement is that the summary of care be electronically transmitted to the receiving doctor or a care facility using direct messaging for more than 10% of all referrals or transitions. To achieve this requirement for a patient, you will need to follow the steps to complete direct messaging setup located in the iSALUS University. Once you are fully set up with a direct email address, go to the office communications screen for a patient. Initiate a new communication and designate it at a direct email. Fill out the summary of care record for the correct patient and the receiving direct email address which can be configured in the provider’s setup window. Then send the message with the provider's summary of care attached. A provider may file for an ;exclusion for this objective, if they transition a patient to another setting of care or refer a patient to another provider less than 100 times during the attestation period.
To satisfy the Electronic Access objective, there are two separate requirements which are divided into two tabs on the provider dashboard. To complete Tab 1, a provider and their staff must give more than 50% of patients seen during the attestation period, timely access to their health information. This is done through the patient's My Medical Locker account. To achieve this measure, simply provide the patient with a My Medical Locker setup letter within 4 business days of their visit if they do not already have an account. If the patient already has a My Medical Locker account and has connected it to your practice, they will satisfy this tab for the objective. Instructions for connecting a patient's MML account to your practice are included on the My Medical Locker setup letter.
To complete Tab No. 2 for 2016 a provider must have at least one patient view, download or transmit to a 3rd party their health information during the attestation period. In 2017, the attestation for this tab changes from at least one patient to more than 5% of their patients seen during the attestation period. To achieve this measure, you'll need a patient who has an MML account connected to your practice to log into their MML account, go to the My Chart section and press "get chart" to retrieve their ambulatory summary. A provider may file for an exclusion to this measure if they conduct 50% or more of his or her patient encounters in a county that does not have 50% or more of its housing units with four megabytes per second broadband availability according to the latest information available from the FCC on the 1st day of the EHR reporting period.
To satisfy the secure messaging objective for 2016 the provider must send at least 1 message to a patient seen during the attestation period using the EMR secure electronic messaging component. In 2017 the objective changes from at least 1 patient to at least 5% of the patients seen by the provider during the attestation period. To achieve this within OfficeEMR simply initiate a message to a patient's MML account or if they send a message or appropriate request to the practice, replying to the patient-initiated message will count towards the objective as well. The provider may file for an exclusion from this measure if they conduct 50% or more of his or her patient encounters in a county that does not have 50% or more of its housing units with 4 megabytes per second broadband availability according to the latest information available from the FCDC on the 1st day of the EHR reporting period.
PUBLIC HEALTH REPORTING
The Public Health Reporting Objective is a combination of the old immunization registry and syndromic surveillance objectives with some additional changes added as well. To achieve this objective the provider must meet the requirement for two of the three tabs listed for this item on the provider dashboard. All three tabs require active engagement which CMS has broken into options which apply to all three tabs. The first is to complete registration to submit data within 60 days of the start of the attestation period. The second option is when the provider is in the process of testing and validating the electronic submission of data and the third is when the provider is actively submitting production data. For tracking purposes on a provider dashboard, if a provider is in active engagement to meet this requirement they can check the box saying "this measure has been met." And if two of the three tabs have this box checked for a reporting period the objective will show in green on the dashboard.
Tab No. 1: To satisfy this requirement a provider must be in active engagement to send electronic immunization data to a public health agency. A provider may file for an exclusion for this requirement if they do administer administrations; operate in a jurisdiction where there is no immunization registry capable of receiving electronic data per CMS standards; or their registry is unable to enroll additional providers.
Tab No. 2: To satisfy this requirement a provider must be in active engagement to submit electronic syndromic surveillance data to a public health agency. A provider may file for an exclusion from this requirement if they do no collect syndromic surveillance data; operate in a jurisdiction where there is no agency capable of receiving electronic syndromic surveillance data per CMS standards or their agency is unable to enroll additional providers.
Tab No. 3: To satisfy this requirement a provider must be in active engagement to submit electronic health data to a specialized health registry. A provider may file for an exclusion for this requirement if they do not diagnose or treat any disease or condition of which data is collected by a specialized registry in their jurisdiction. Additionally, they may file for an exclusion if the specialized registry for which they collect data exists, but that registry is unable to receive electronic data per CMS standards
With iSALUS’ OfficeEMRTM you’ll never have to use paper again with. Access documents from anywhere, send and receive electronic faxes, upload images and even finish charting from your iPhone to get out of the office earlier.
In just a moment, I'll show you how to obtain a completely paperless office. But first, a brief introduction. Have you ever wished your office was completely paperless? Well, you're not alone. And while many providers and billing staff wish they had paperless offices, the truth is that most EHR and billing systems lack the features necessary to allow a practice to become completely green. So despite having an EHR, most are still maintaining lots of files cabinets and paper in boxes.
They're lacking features like intuitive fax integration, mobile document access, batch scanning, intelligent document routing and online folder systems. And at iSALUS, this really got our gears turning. Our idea was to completely rid medical practices and billing offices of paper. And according to our customers, we're succeeding. By the way, not a single piece of paper was used during the filming of the following demonstration.
Since iSALUS is web-based, you can access documents from anywhere, including an iPhone. Let's start by scanning a primary insurance card. Let me show you how simple it is to scan a batch of documents. You really don't have to be a computer scientist. After a couple of mouse clicks we're done. Now we can easily disperse the batch that we just scanned. We'll name the document batch, attach it to the appropriate patient, place it in the appropriate file folder and route it to the right clinician for review. iSALUS also lets you import documents from your computer. And once it's imported it's very easy to route to staff and providers for review.
iSALUS lets you receive and send electronic faxes. When a fax comes in, you simply save it to documents and then process it. We will attach it to a patient chart, save it in a file folder, then select the provider or staff to route it to. With our secure task list, providers can easily and effectively review documents and then mark them as reviewed. Let’s review and mark as reviewed now. Here's another document, looks like a lab review. Again, we're reviewing and then we're going to mark as reviewed and this time we're going to put a comment on the document. And it's that simple. And all documents that have been associated with a patient's chart will be displayed on a patient's timeline for easy retrieval.
The iSALUS feature-rich iPhone app means that practices don't have to buy new equipment to take patient photos. And once you take a patient's photo you can save it as their head shot and that head shot displays any time you open their chart. Let's use the power of the iPhone to take a picture of a patient's foot and then send it to another staff member for review. And if a provider has a busy day at the office, instead of carrying home 20 patient charts, just do your document reviews on your iPhone while sitting at home on your couch with your family. And add our comments and we're done.
It's that simple. All good things come to an end. Thanks for joining us.
ELECTRONIC ORDERS AND LABS
Easy access to patient data is critical. Everything is literally a couple of clicks away with OfficeEMRTM. Labs with red flags for abnormal values can be reviewed and routed with automated workflow processes that increase efficiency.
In a few moments, we'll demonstrate our iSALUS' Electronic Orders and Labs functionality gets providers out of the practice and home on time for dinner. But first, a quick introduction. This is Timmy. He's the fastest runner in his second grade class and he loves to show off his expert running capabilities. And this is Dr. Tom, Timmy's dad. He loves practicing medicine, but he's rarely at home before nightfall to spend any time with Timmy and check out his running skills. Inefficient processes like ordering labs or worse yet, complicated electronic health records programs can keep providers handcuffed to their practices, costing them valuable time with their families. I'll now show you how iSALUS' easy to learn electronic orders and labs features give you time with the people you love by accelerating office efficiencies.
One of the most important aspects of an electronic health record is providing busy doctors fast access to critical patient data. In iSALUS, everything is literally a click away and it's insanely easy to learn. Here's a lab from Quest. We automatically flag abnormal values in red and bold the text so you can quickly see what matters. And ordering labs couldn't be easier. Let's go ahead and order a lab now.
You can select the right diagnosis codes and then route to the right lab facility or even an internal processor. And after we order a metabolic panel we can review the results in a screen that displays important clinical markers on a single graph allowing providers to better understand how medications intersect with patient health. New electronic lab results will be received in an inbox style queue that allows providers to flow results on the fly. And clinical decision support alerts can be set up to automatically remind you to order labs for specific patients. You can also print patient education based on lab results or a lab order. And sharing lab results with fellow staff members or even tasking a front desk receptionist to schedule a follow up couldn't be easier.
And you might be wondering if you can fax lab results to others. Well, I'm glad you asked. Let's do that. Ordering labs is not the only thing the iSALUS Order's Engine will do. You can set up automated workflow rules that task staff members to schedule follow ups, refer patients to specialists or print patient education materials upon checkout. Providers can also have multiple customized orders templates to meet the unique practice workflow needs.
Last but not least, you can set up custom routing rules based upon the order type. Let's take a look.