Has anyone seen the new GE Clinical Summary for EMR 9.8/CPS 12? It's horrible. I don't know how I'm going to sell printing this to my providers. It printed 6 pages of old HPI, PMH and ROS data, on a simple patient. An older patient with more history, printed 28 pages. The first page and a half are ridiculous document ID, encounter ID and table of contents info. Each heading is listed, even if there is no data available. I can't believe a patient will understand this or think this is "meaningful".
According to all the documentation, this is the ONLY way to get credit for MU2 Measure 8. We must use this form. Can anyone confirm that? Have others modified this in some way? How did you sell it to your providers?
Is it a handout template you can edit or is it hidden in the system like the ExitCare handouts are?
It is nothing you can edit from the handouts. It's "hidden" in that sense. You can customize from their form, but that is several extra clicks to remove items.
Its a CCDA document, it opens kind of like an html form except it doesnt have to be in an update. I have looked for it and can't find it. If anyone does locate it or figure out how to edit it I would love to know how. We are on CPS 12 but still use the handout at the moment because of the length issue (I know it doesnt count for MU) we are going to try to attest Q3 though so we need to figure something out ...
If it is a CCDA/HTML document, most likely it is going to live in the JBoss file structure on the Clinical Web Services server. I looked at the patch files they released for the immunization bug in the HTML form and it gets installed via a file copy to the JBoss file structure.
We are testing this as well. You can select the customize button and then uncheck specific elements to exclude them, but only on an individual basis. It will be tedious for providers to do this over and over again - and a very hard sell. Ugh.
You also can't customize a some of the things on there. Like the ROS and HPI (that prints for 5 pages on some pages because it pulls EVERYTHING). I've tried doing a bunch of traces with it not showing anything other than a function being called. It doesn't look like the function lives on the SQL server (CPS v12). We are only sending these to the patient portal for now and clicking "Denied CVS" if they don't have a patient portal.
EMR 9.8 SP1 trimmed down the CCD size. We're probably still going with workflow alternatives, but the Service Pack did reduce the size to more of an 'encounter based' level.
James,
What workflow alternatives are you planning to employ?
This is what we've found when testing the Visit Summary against our custom forms and the CCD forms -
Assessments: display only when a comment is entered; if we click only the radio button only nothing shows under the heading except "No information available."
Family History: only works if we use the CCC form
History of Past Illness: displays only if something is added; "reviewed" check box does not cause hx to display
Plan of Care: as far as we can tell, we must use the CCC form
Results: only BMI displays in our test database
Review of Systems: only "There may be information available, but it has not been provided by the sender" displays whether a ROS was done or not and whether we are using CCC forms or our custom form (which is really the Medicalogic form with some changes).
Social History: only displays risk factors
Instructions: again, as far as we can tell, we have to use the CCC form
I would like to hear from others about their experience with the Visit Summary/TOC/CCD documents and any ideas they might have to make them work properly. We want to give out providers 2 opportunities to meet MU 2 so will have to upgrade soon.
All the ones I have tested had 1 - 2 pages worth of repeated HPI and then some more pages of ROS. Everything else seems to be one or two paragraphs as it was done in the office visit.
My first post. (Yay, me!)
It sounds like someone, at some level, is confused on the documentation requirements. MU Measure 8 refers to transfers of care - referrals, change in doctor, etc. CMS calls this a "Transition of Care Summary". This is in contrast to the "Clinical visit Summary" which is what we give patients at the end of visits, which has fewer requirements but also seems to have ballooned recently, and denoted by "Measure 13".
The regulation also states that the visit summary may be given electronically, though they don't say how to record that in the EMR.
We are supposed to upgrade from 9.5 to 12 in June, hopefully this gets fixed before then, or I am going to have to designate a dummy printer that doesn't work to print these tree-slaughtering requirements. For good measure, healthit.gov also suggests that a pre-visit summary be printed for patients.
David Sacco, MD
We are on CPS 12.0.3 and have found this document overwhelming, not only for the amount of paper it prints but the information it contains. Has anyone found a way to customize this form or use another type of form and still get the MU credit?
Thanks
Laurie
SP5 (August) and/or the 9.9/12.x releases (September) will re-address the CCD's volume of data.
Until then, your alternative is "Patient-Declined".