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MU2 and CQR

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MU, CQR, PQRS, etc.

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cecild

(@cecild)

Posts: 314

Reputable Member

Topic starter

Let's get a discussion going about MU2 and CQR. I would like to share my experiences and compare against others.

Core 2 - I am having great difficulty getting core 2 above 50%. I understand the eligibility response has to be received before the script is signed. I believe my true number should be in the 70 percentile. I see a lot over visits in the failed list that I really question. My providers really seem to have maxed out.

Core 7a - This was looking good until the upgrade to CQR over the weekend. This week alone I have lost over 50% of my numbers. I checked failed and have found patients with no office visit this reporting period as well as patient that are registered portal users.

Core 7b - How are you getting the patients to view, print, or transmit a chart summary. This almost seems unfair. How can we be responsible for what the patient does. All we can do is provide the tools. This is like us being responsible for a patient not going to an appointment for an eye exam.

The above are the ones I experience the most problems with, but definitely not the only ones.

Help me heat up this conversation and let's see if we can help each other find a solution, since GE has failed to.

Thanks

Cecil Dickey

Prime Care Medical Center

Posted : November 18, 2014 10:26 am

shepde3

(@shepde3)

Posts: 16

Eminent Member

I feel your pain. 2 points:

1. Core 7A - You remember that Centricity no longer uses office visits for denominators but rather uses E&M codes, right? Still, a 50% drop is a helluva drop!

2. Core 7B - you are right, it's not fair. Lots of people have made this point. This, however is a CMS requirement, not a GE screwup. There's really nothing GE can do other than lobby CMS for it's customers.

Our organization has actually hired interns to meet & greet patients in the waiting room and 'assist' them in registering for the patient portal plus sending an initial email to their provider. We'll see how that works.

Posted : November 18, 2014 11:03 am

LisaStemska

(@lisastemska)

Posts: 17

Eminent Member

CQR and MU, "seen by" denominator is supposed to look for the CPT code. We do have a couple of practices not using the orders module and we were told we could implement a SNOMED code to every office visit - which we tried without success and then heard from GE rep that they have not yet seen that work for anyone yet.
As for the remainder of our practices, we are using orders module but the reports are not capturing them because the codes were not built with a prefix "CPT-". This was communicated to be fixed in 9.8.5. We are now on 9.8.6 and this issue still is not fixed AND our data mapping is not accessible - EMR crashes.
We are seeing no data for our specialists and PCP's denominator is defaulting to any office visit that was signed by them or co-signed - so even if they are not the responsible provider, didn't see the patient, it is included in the denominator. We use a different document type for our specialists, "office visit specialist" which is not being accepted either, so we need these SNOMED or CPT code issue to be fixed.
Our Vitals and Smoking Status is no longer captured not only in the CQR reports but also on the portal and CCD. GE can't figure out why, something must have happened in our SP6 install - but can't pinpoint what.
COre #17 - communicate electronically with patients - this report is not counting requests for appointments or any secure messages routed to the secure message practice inbox - only counting when routed directly to EMR desktop as "secure message". The patient is communicating to us by email through the portal - why would that not be counted!

I can go on....It has been weeks of wasted time and total frustration in trying to get this system working!

Posted : November 18, 2014 11:19 am

hbias

(@hbias)

Posts: 83

Estimable Member

Core 2 is being worked on in a patch to come out where as long as there isn't an error on the formularies it will count, even if not completed or if there isn't one. I also believe it currently is counting historical and reprints/refax and it will remove those counts as well.

Menu 4 family health history has some issue as well. going to be fixed in a patch. was not counting of the patient has no family history.

Core 12 Preventative care is another one we are having problems with. GE is working on it as well.

anyone using CQM 166 use of imaging studies for low back pain who is not using orders for E&M. we have one clinic who does not do service orders and we are using the snomed code instead but it is not working for us.

overall we are pleased with our numbers, just need to get the fixes done.

Posted : November 20, 2014 6:03 am

sborchardt

(@sborchardt)

Posts: 218

Reputable Member

Cecil, on #7 a we also had a drop in our Portal Access numbers but have seen this before (July/ August). GE wrote us a script to correct this we are hoping to do that again.

Lisa, on #17 we have a similar issue and use the Kryptiq Portal. We are multi-specialty and have a proxy set up for each specialty. With Kryptiq if you send a message from the proxy it will count towards the physician in the Responsible Provider box in registration. If the responsible provider is blank, no one gets the credit.

Steph B.

Posted : November 20, 2014 9:37 am

cecild

(@cecild)

Posts: 314

Reputable Member

Topic starter

Thanks to everyone for the information and I would love to see this continue as we all receive new information.

I had a conference call with GE today to demonstrate the discrepancies that I had found in their calculations. So now we wait and see what comes from it.

Yes, I to have heard of a fix for Core 2 that is forthcoming. I requested today for information and/or details about this.

Lisa, the way we approached 7 in our clinic is by sending all normal results to patients via the portal. But with you being a specialty that might not be a good workflow for you.

Steph B, I would greatly appreciate it if you get an answer or a script, that you would share it.

Thanks again everyone and lets keep it going,

Cecil

Posted : November 20, 2014 10:00 am

cecild

(@cecild)

Posts: 314

Reputable Member

Topic starter

I got a copy of the updated scripts for CQR data today. Has anyone loaded them and did you get better numbers?

Cecil

Posted : November 25, 2014 10:52 am

Rhomi

(@rhomi)

Posts: 12

Active Member

Hey guys! We have multiple clinics, multi specialities and multiple providers as well as staff. We have and continue to struggle with MU2. Our toughest measurement thus far has been Measure 15, Transition of Care. It is my understanding that the responsible provider for the document must generate the TOC. I barely get my doctors to sign the charts. ha
Anyone has any workflows they have been using and suggest?

-Missy

Posted : November 25, 2014 12:43 pm

JenWagaman

(@jenwagaman)

Posts: 74

Trusted Member

Missy,
We are working with Kryptiq on a solution that uses their ACM functionality to automate this process. (ADD-Provider module). The idea is to make this seamless for providers, so if referrals are created & signed it will automatically generate a CCDA and send to the service provider attached to the referral. It first looks to find a direct address, then a secure email, then lastly a fax number or can print. We are currently ironing out the details of how we can put an obs term based condition that would 'kill' the direct address attempt if the patient has opted out of using an HIE altogether. We currently use their ACM functionality for sending CVS's to patients (ADD-patient) and it works great.

Hope this helps.

Posted : November 26, 2014 3:24 am

cecild

(@cecild)

Posts: 314

Reputable Member

Topic starter

Missy,

I have been successful with 15a on the CQR site. As for 15b I have resulted to inquires to calculate my own on this.

For 15a - when our referral coordinators complete the scheduling and notify the patient they choose "Save & Create", if you have them choose print from there then it will click the counter on 15a.

For 15b - I have yet to find the magic flow. But we are sending TOC summaries through the Kryptiq portal to all clinics that have direct addresses. I print a monthly report for now as evidence for measure, mark transitions that meet the requirement, then calculate the percentage. If you have Kryptiq portal there is a SM-TOC form that is similar to the SM-Basic form that aids in send TOC summaries through the portals. We do this upon the Referral order going to the in process status.

I hope this helps,

Cecil

Posted : November 26, 2014 3:59 am

Rhomi

(@rhomi)

Posts: 12

Active Member

Thanks for the great input. I think what we may be doing wrong is we are not PRINTING the TOC document, we are just saving to chart and closing. We use Kryptiq as well, but in an area where we are not getting alot of providers with Secure Electronic Address. The ones that we have sent with the address, Kryptiq interface worked great, however, we are still not meeting our numbers.
Thanks!
Happy Thanksgiving all!
-Missy

Posted : November 26, 2014 4:06 am

cecild

(@cecild)

Posts: 314

Reputable Member

Topic starter

Missy,

You most welcome. I have had to call around to some the clinic we refer to the most. I have found a few that are not in the Kryptiq/Surescripts network but use some other HIE for Direct Messaging. We don't have many available yet as well. But it does look like it is going to be just enough to get us the percentage needed.

And Happy Thanksgiving to you,

Cecil

Posted : November 26, 2014 4:11 am

Rhomi

(@rhomi)

Posts: 12

Active Member

Cecil,
I modified our workflow on Core 15a without success. Maybe I am missing something. We have our EP add the referral order with all the information & sign, then our front office staff and/or nurse calls and makes referral and informs patient, then the Save and Create TOC document is generated. I tested this with just a handful of providers and our percent is still 0%!
The only ones that have counted for us thus far are the ones that Qvera has generated and sent. Any help or input would be greatly appreciated.
Thanks!
-Missy

Posted : December 1, 2014 4:51 am

cecild

(@cecild)

Posts: 314

Reputable Member

Topic starter

Missy,

After "Save and Create" we have to choose "Print". You can email me at [email protected] if you continue to have issues.

Cecil

Posted : December 2, 2014 11:41 am

Rhomi

(@rhomi)

Posts: 12

Active Member

How are you guys documenting secure messaging between providers and patients? What document type is it using in the chart?
-Missy

Posted : December 3, 2014 6:34 am

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