Attestation Sample. This document shows you what to expect when you attest for 2014 using the 2011 Edition of Chiro QuickCharts.

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1 Attestation Sample dbc DB Consultants, Inc. This document shows you what to expect when you attest for 2014 using the 2011 Edition of Chiro QuickCharts. The data contained herein is fictitious. Do NOT enter the numbers or values shown. DB Consultants highly recommends that you review your Clinical and Quality Measures reports periodically to be sure that you are within the acceptable limits. Please do NOT wait until the day of attestation to find out that you do not meet the meaningful use thresholds. If this happens, there is absolutely nothing that DB Consultants or Chiro QuickCharts can do to adjust your data. If you have not done so already, before doing the Attestation, you must: First create a log-on and profile (Must have NPI and TAX ID to create log-in). You can do this at: Next, you must sign up for the PECOS program and EHR Incentive Program during this process. Finally, take screen shots of your reports and document the version of Chiro QuickCharts which generated the reports. For versions before , these reports are available from the Meaningful Use menu, then print both the Clinical Measures and Quality Measures reports. Also, go to the About menu and print this screen which documents the version of Chiro QuickCharts. If you are using version or later, contact DB Consultants at for instructions. Attestation Steps: Log-in at: You will be given a choice between using the 2011 Edition; a combination of the 2011/2014 Edition; or the 2014 Edition alone. Be sure to select the 2011 Edition. You may make this selection because of delays in availability of a 2014 CEHRT technology product. Date Range: First time attesters may use any consecutive 90 day period within If this is not your first time attesting, you must use any calendar quarter within Product Code: Use this product code: P7BPJEAV Attestation Sections: The following pages contain screenshots of the questions you will be going through. The sections are: Clinical Measures Menu Measures Quality Measures Additional Quality Measures.

2 The data on the screen shots are for demonstration purposes only. Follow the examples, but USE THE NUMERATOR AND DENOMINATOR VALUES FROM YOUR OWN REPORTS DO NOT ENTER THE VALUES SHOWN ON THIS DOCUMENT THEY ARE SAMPLE VALUES ONLY! Clinical Measures Section: Enter the data from your Clinical Measures report from CQC. After each question you will have to press the Save & Continue button on bottom. Remember that the data shown below is fictitious and you must enter your own statistics.

3 Gathered from Problem List

4 Gathered from Active Medication

5 Gathered from Medication Allergies

6 Gathered from Demographics

7 Question 8 is continued on the next page

8 Gathered from Vitals, BMI, Growth Charts

9 Gathered from Smoking Status

10

11 Gathered from Electronic Copy of PHI

12 Gathered from Clinical Summaries

13

14 Menu Measures Section: Select the first 5 from the list then proceed to answer the questions. Remember that the data shown below is fictitious and you must enter your own statistics.

15

16

17

18 Quality Measures Section:. Enter the data from your Quality Measures report from CQC. In the Performance Rate box you can only have 1 digit after the decimal. Remember that the data shown below is fictitious and you must enter your own statistics. Gathered from NQF 0013

19 Gathered from NQF 0028a for Tobacco Use Assessment, NQF 0028b for Tobacco Cessation Intervention

20 Gathered from NQF 0421 (age 18-64) for Population Criteria 1 and NQF 0421 (age 65+) for Population Criteria 2.

21 Additional Quality Measures. The first screen you will see will have a lengthy list of choices. You want to select NQF 0027, 0018, and 0052 (the NQF # is on the left, the checkbox is on the right). For 0027 you will use the same values as 0028 a & b from the Quality Measures report in CQC. For 0018 use the same value as The 0052 value is on the report. Remember that the data shown below is fictitious and you must enter your own statistics. Gathered from NQF 0028a for the top box and NQF 0028b for the bottom box.

22 Gathered from NQF 0013 Gathered from NQF 0052

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