Meaningful Use - Core Measure 3 Record Demographics Configuration Guide

Transcription

1 Enterprise EHR Meaningful Use - Core Measure 3 Record Demographics Configuration Guide Last Updated: October 20, 2013 Copyright 2013 Allscripts Healthcare, LLC.

2 MU Core 3 - Demographics This guide will provide instructions on how to configure the necessary setup and preferences to enable Enterprise EHR to report on MU Core 3 Measure Record Demographics. Final Rule Requirements More than 80% of all unique patients seen by the eligible professional (EP) have demographics recorded as structured data. Core Objective: Menu Objective: Numerator: The numerator includes the number of unique patients counted in the denominator who have all demographics (or a specific exclusion if the patient declined to provide one or more elements, or if recording an element is contrary to state law) rec orded as structured data. Denominator: The number of unique patients seen by the eligible provider during the EHR reporting period. Exclusion: None Objective is shared across eligible providers: Yes: No: Objective must be recorded during the reporting period: Yes: No: Prerequisites Base functionality Availability: Prior to v11.2: Enhanced v11.4.1: Registration interface Availability: Prior to v11.2: Enhanced v11.4.1: Configuration Steps Review Language Editable, Ethnicity Editable, and Race Editable Preferences: Language Editable determines if the Language field is editable from the Patient Profile page. When this information is edited in Allscripts Enterprise EHR the Practice Management System (PMS) is not updated. Ethnicity Editable enables organizations to allow users to edit the Ethnicity value from the Patient Profile page. The Practice Management System is not updated when this field is edited. Copyright 2013 Allscripts Healthcare, LLC. 2

3 Race Editable enables organizations to allow users to edit the Race box for patients from the Patient Profile page. The Practice Management System is not updated if this field is edited. It is best practice to set these fields to N if this value is being captured and sent from the practice management system. Use scroll bar on right to find appropriate section and click on drop down arrow in Value column to set these fields to Y only if they are not captured or sent from the practice management system. 1. Access TWAdmin. 2. Click on Preferences in left hand column, and Choose General in Preference drop down box. 3. The following screen shots highlight the three preferences to review : Copyright 2013 Allscripts Healthcare, LLC. 3

4 Copyright 2013 Allscripts Healthcare, LLC. 4

5 Review Show MU Alerts Preferences: Show MU Alerts displays clinical alerts in the data section of Encounter Summary. The alert types that are displayed on Encounter Summary include: Meaningful Use (MU) requirements, Overdue Ordered Clinical Items (such as orders, immunizations, and prescriptions), Order Reminders, and Charge Code Alerts. Meaningful Use alerts are preceded by. Overdue clinical items and reminder alerts are preceded by. Charge code alerts are preceded by 1. Choose Alerts in Preference drop down box. 2. Find Show MU Alerts and it should read Show MU Alerts in Encounter Summary in the description field. 3. Click on drop down arrow in Value column to set this field to Y. It is best practice to set this field to "Y" and not allow user override. Copyright 2013 Allscripts Healthcare, LLC. 5

6 Review Ethnicity is not documented, Language is not documented, and Race is not documented Preferences (available in ): Ethnicity is not documented determines when and where an alert is displayed on Encounter Summary if the patient s ethnicity demographic is not documented. Language is not documented determines when and where an alert is displayed on Encounter Summary if the patient s language demographic is not documented. Race is not documented determines when and where an alert is displayed on Encounter Summary if the patient s race demographic is not documented. It is best practice to set these fields to "Show in my Alerts" for non-providers and "Show in other alerts" for providers. It is recommended to allow the user to override these preferences, but it is at the discretion of the organization to review if you want to let users modify th ese settings. (As part of the upgrade to , this new preference will pull its value from t he previous "Ethnicity, Language, and Race is not documented" preference.) Copyright 2013 Allscripts Healthcare, LLC. 6

7 1. Choose Alerts in Preference drop down box. 2. The following screen shots highlight the three preferences to review: 3. Click on drop down arrow in Value column to set the field for the preferences. Copyright 2013 Allscripts Healthcare, LLC. 7

8 Review Registration Interface Demographics. 1. Confirm that the desired demographic fields (language, gender, race, ethnicity, and date of birth) are populated in the EHR from the practice management system, if the intention is to route all that information from the Practice Management System to EEHR. 2. If the demographic fields are not part of the registration interface and you want the fields to be sent, plan and schedule the necessary interface c hanges. At a minimum, date of birth and gender must be included in the registration interface. 3. If race, ethnicity, or language is currently captured in your practice management system, consider mapping dictionary entries from your practice management system to EEHR. This can be discussed with your Interface Analyst on your best approach. In , EEHR can receive more than one race value via the interface. If you are sending race via the registration interface and want to be able to send more than one value, you will need to work with your interface analyst to update the registration interface. Map Client Defined Race Values to OMB Standard: Centers for Medicare and Medicaid Services (CMS) requires the use of Office of Management and Budget (OMB) standards for both race and ethnicity entries. Allscripts will deliver the OMB mappings to the delivered race and ethnicities entries (these are the enforced entries). You will need to link any entries that your organization has defined to the corresponding OMB standard i n the respective dictionary. Copyright 2013 Allscripts Healthcare, LLC. 8

9 1. Go to TWAdmin, select Dictionaries, Additional Information, and select Race. 2. Filter entries for client defined active entries by setting the Inactive Filter to False and Enforced Filter to False. 3. Pick Appropriate OMB Standard for each entry. Click Save. Copyright 2013 Allscripts Healthcare, LLC. 9

10 Map Client Defined Ethnicity Values to OMB Standard: Centers for Medicare and Medicaid Services (CMS) requires the use of Office of Management and Budget (OMB) standards for both race and ethnicity entries. Allscripts will deliver the OMB mappings to the delivered race and ethnicities entries (these are the enforced entries). You will need to link any entries that your organization has defined to the corresponding OMB standard in the respective dictionary. 1. Go to TWAdmin, select Dictionaries and select Ethnicity. 2. Filter entries for client defined active entries by setting the Inactive Filter to False and Enforced Filter to False. Copyright 2013 Allscripts Healthcare, LLC. 10

11 3. Pick Appropriate OMB Standard for each entry. Click Save. 1. Map Client Defined Language Values to ISO Standards: CMS requires the use of ISO 639-2, constrained by ISO standards for language values. Allscripts will deliver the ISO mappings to the delivered language entries. For any entries that your organization has defined, you will need to link them to the corresponding ISO standard in the dictionary. 1. Go to TWAdmin, select Dictionaries and select Language. Copyright 2013 Allscripts Healthcare, LLC. 11

12 2. Filter entries for client defined active entries by setting the Inactive Filter to False and Enforced Filter to False. 3. Pick Appropriate ISO Standard for each entry. 4. Click on icon. 5. Search for the appropriate ISO Code by ISO Code or Language. 6. Click OK. Click Save. Copyright 2013 Allscripts Healthcare, LLC. 12

13 2. Review Language Values in Language MU Alert: In , you can indicate which languages you want to appear in the Language MU alert's context menu, to quickly document the language from the alert. The delivered values for the MU alert are: English, Spanish, and French (the top 3 most spoken languages in the Unite d States). If you want to add other languages to the MU Alert, follow the steps below. 1. Go to TWAdmin, select Dictionaries and select Language. 2. Search for language of interest and select the shot in MU Alert Check box. Copyright 2013 Allscripts Healthcare, LLC. 13

14 Review Patient Profile User Security Settings: 3. Patient Profile- Edit controls the ability to edit information in Patient Profile on Patient Banner. Ensure that your staff who should be updating Language, Ethnicity, and Race in the EEHR have the security to do so. This is controlled by the Patient Profile- Edit Security Code 1. Go to TWAdmin then to Security Admin Security Tab 2. Select Security Classification. 3. Choose the appropriate Security Classification for your user group that should have access to edit the Patient Profile. 4. Click on Assign Codes. 5. Pick Patient Profile Edit. 6. Click on the down arrow. 7. Click Ok. Copyright 2013 Allscripts Healthcare, LLC. 14

15 8. Assign security classification to appropriate users if this has not already been done (Can select Assign Users from Security or go to TWAdmin TWUser Admin Select User Go to Security Section). 9. If you believe that all users in your organization should be able to make edits in Patient Profile, you can also unlock the gate and open acce ss to everyone. 10. Change drop down to Security Gates. 11. Click on the description column to list the alphabetically. 12. Pick Patient Profile- Edit. 13. Change the setting to the blank row (first selection in the drop down). 14. Click ok. Copyright 2013 Allscripts Healthcare, LLC. 15

16 Workflow Considerations Ensure that the support staff updates the language, race, and ethnicity fields in the practice management system, from the Patient Profile or MU Alerts window. Your organization will have to establish and review policies and procedures for gathering information on race and ethnicity, as well as train staff on how to capture race and ethnicity information from patients. Note: Updates made in the EHR to language, race, and ethnicity will not be routed back to the practice management system. Copyright 2013 Allscripts Healthcare, LLC. 16

17 If state law prohibits gathering information on ethnicity or race, set Patient Race or Ethnicity values in the Patient Profile dialog to Declined. How EEHR Calculates the MU2 Report Numerator For each unique patient, the system will count once any patient that has the following: A recorded language, including Decline and Unknown Language must be mapped to an ISO standard AND: A recorded gender, including Unknown Gender must be mapped to a standard value AND: A recorded race, including Decline and Unknown Race must be mapped to an OMB standard AND: A recorded ethnicity, including Decline and Unknown Ethnicity must be mapped to an OMB standard AND: A recorded date of birth AND: All of the above values are present during the chosen reporting p eriod Denominator The system will count once each unique patient seen by the provider during the reporting period. Exclusion None. Indicators When the numerator divided by the denominator is greater than 80% When the numerator divided by the denominator is between 70% and 80%. When the numerator divided by the denominator is 70% or below Copyright 2013 Allscripts Healthcare, LLC. 17

18 Report Calculation Flow Diagram Reporting Considerations A response of Unknown to gender, language, race, or ethnicity, is meant to indicate that the patient does not know the appropriate response. The question therefore will be considered as asked and captured, and the response will be counted in the numerator. A response of Decline to language, race, or ethnicity, is meant to indicate that the patient was asked, but declined to provide the information. The question therefore will be considered as asked and captured, and the response will be included in the numerator. A response of Not Reported to language, race, or ethnicity, is meant to indicate that the patient was NOT asked. The question therefore will NOT be counted in the numerator. This is seen as equivalent to a null value. All Race, Ethnicity, and Language dictionaries values need to be mapped to their appropriate OMB or ISO standard to be included in the report (see above for steps to take to complete action). The exceptions are Decline and Unknown, where an OMB standard does not need to be assigned. The data mapping will no longer be used for Stage 2 reporting, that was previously performed as part of the Y implementation for Stage 1 reporting (this change pertains to mapping for race and ethnicity values). Copyright 2013 Allscripts Healthcare, LLC. 18

19 Additional Reference Materials Here is a list of reference documents, and where you can find them in the system. Certified Workflows: ClientConnect > Toolbox > Product Documentation > Allscripts Enterprise EHR > Certified Workflows Appointment Scheduling (A) Document Appointment Preparation (B) Document Appointment Check-In (C) Document Application Design and Behavior Resource (ADBR): ClientConnect > Toolbox > Product Documentation > Allscripts Enterprise EHR > Pick your version > Manual Guides > Application Design and Behavior Resource (ensure you save it to your PC) Demographics Update: ClientConnect > Toolbox > Product Documentation > Allscripts Enterprise EHR > > Enhancement Supplements > Demographic Updates For the CMS specification for recording patient demographics, see: Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPCore_3_RecordingDemogr aphics.pdf Copyright 2013 Allscripts Healthcare, LLC. 19