Meaningful Use Project Plan

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  1. Required Criteria
    1. CPOE
      1. Provider procedure manual priorities
        1. Create tutorial for e-prescribing module, using screenshots as needed
        2. Focus on ensuring the "none" box gets checked for no medication to maintain an adequate numerator
      2. Create reports in OpenEMR
        1. Numerator: Consider subscribing to NewCrop reporting solution to calculate numerator for attestation if OpenEMR unable to count the patients with e-prescriptions
        2. Denominator: Total patients seen in period with "none" checked under medications added to numerator.
      3. Complete core measure procedure documentation
    2. Interaction checks
    3. Problem Lists
      1. Provider procedure manual priorities
        1. Focus on ensuring the "none" box gets checked for no problems to maintain an adequate numerator
      2. Create reports in OpenEMR
        1. Numerator: Total patients with problems added to patients with "None" checked in problem list
        2. Denominator: Total patients seen in period.
      3. Complete core measure procedure documentation
    4. E-prescribing
      1. Provider procedure manual priorities
        1. Create tutorial for e-prescribing module, using screenshots as needed
        2. Focus on ensuring the "none" box gets checked for no medication to maintain an adequate numerator
      2. Create reports in OpenEMR
        1. Numerator: Consider subscribing to NewCrop reporting solution to calculate numerator for attestation if OpenEMR unable to count the number of e-prescriptions
        2. Denominator: Add numerator to total non-controlled prescriptions written on paper. Suggest using carbon prescription blanks and hand counting the copies. Alternately, create a folder for hand written prescriptions in the documents and count the scans.
      3. Complete core measure procedure documentation
    5. Medication list
      1. Provider procedure manual priorities
        1. Create tutorial for e-prescribing module, using screenshots as needed
        2. Focus on ensuring the "none" box gets checked for no medication to maintain an adequate numerator
      2. Create reports in OpenEMR
        1. Numerator: Consider subscribing to NewCrop reporting solution to calculate numerator for attestation if OpenEMR unable to count the patients with e-prescriptions
        2. Denominator: Total patients seen in period with "none" checked under medications added to numerator.
      3. Complete core measure procedure documentation
    6. Allergy List
      1. Provider procedure manual priorities
        1. Focus on ensuring the "none" box gets checked for no allergies to maintain an adequate numerator
      2. Create reports in OpenEMR
        1. Numerator: Total patients with allergies added to patients with "None" checked in problem list
        2. Denominator: Total patients seen in period.
      3. Complete core measure procedure documentation
    7. Demographics
      1. Front office procedure manual priorities
        1. Focus on ensuring the following demographics are captured on each patient (even existing ones) to maintain an adequate numerator.
          1. Preferred language (not from CompuSystems)
          2. Gender
          3. Race (not from CompuSystems)
          4. Ethnicity (not from CompuSystems)
          5. Date of birth
        2. Create a "declined" option for each field in the dropdown for items not from CompuSystems
      2. Create reports in OpenEMR
        1. Numerator: Total patients with all five demographics collected, including those with "declined" field.
        2. Denominator: Total patients seen in period.
      3. Complete core measure procedure documentation
    8. Vital signs
      1. Medical assistant procedure manual priorities
        1. Focus on making sure the following are collected
          1. Height
          2. Weight
          3. Blood pressure
        2. Activate or design a growth chart function including plots for ages 2-20.
      2. Create reports in OpenEMR
        1. Numerator: Add total encounters with all three vital signs entered
        2. Denominator: Total visits in period.
      3. Complete core measure procedure documentation
    9. Smoking status
      1. Provider procedure manual priorities
        1. Provide screenshot of smoking status field
        2. Focus on ensuring the field is populated to maintain an adequate numerator
      2. Create reports in OpenEMR
        1. Numerator: Subtract from the denominator all unique patients 13 and over with blank or "unassigned" in the smoking field
        2. Denominator: Total patients 13 and over seen in period.
      3. Complete core measure procedure documentation
    10. CQM
      1. Determine need for separate CQM server
      2. Set up CQM server (if used)
        1. Budget and acquire hardware
        2. Add to network configuration
        3. Set up mirroring
      3. Choose from the 2013 menu measures
      4. Configure OpenEMR to provide fields for the required values to extract structured data on each measure chosen
      5. Provider procedure manual priorities
        1. Document as structured data smoking cessation information for smokers
        2. Document as structured data follow-up plan for BMI out of normal range
        3. Document as structured data other data points needed for CQM on menu list
      6. Create report template for each measure
      7. Design workflow and schedule for reporting
      8. Draft a schedule for reviewing procedures
        1. Review 2014 measures
        2. Determine electronic submission workflow for future submissions
      9. Complete core measure procedure documentation
    11. Clinical decision support
      1. Choose a clinical decision support rule with high clinical priority and activate it
      2. Provider procedure manual priorities
        1. Create workflow for entering the ICD-9 code for each diagnosis as structured data as well as in a visible field
      3. Conduct load testing on the system to determine if system speed is adequate for workflow
        1. Develop a remedy for the system slowdown if necessary
      4. Complete core measure procedure documentation
    12. Patient electronic copies
      1. Front office procedure manual priorities
        1. Training on safe mounting of patient owned removable media, if allowed
        2. Training on how to transfer the CCR and a web archive of documents into electronic form.
      2. Maintain a log book of all patient requests on paper, or scan in a written request with time and date of request and fulfillment.
        1. Numerator: All patients receiving copies of electronic health records within 3 days
        2. Denominator: Total patients requesting electronic copies
      3. Complete core measure procedure documentation
    13. Patient clinical summaries
      1. Provider procedure manual priorities
        1. Provide printed clinical summaries to all patients.
        2. Focus on ensuring the "Provided Clinical Summary?" box gets checked when clinical summary is provided at time of visit.
      2. Create reports in OpenEMR
        1. Numerator: Total encounters with "Provided Clinical Summary?" box checked
        2. Denominator: Total encounters classified as office visits during reporting period.
      3. Complete core measure procedure documentation
    14. Health information exchange
      1. Design a test of the capability to exchange health information electronically with another provider or patient authorized entity.
        1. Select a test patient (or a real patient) in the system.
        2. Select an entity to receive the transfer.
        3. Create an electronic copy of patient information.
        4. Zip and encrypt the files.
        5. Send over secure email to the recipient.
        6. Capture the log of the transaction.
        7. Document the procedure in detail and present the other party with a copy.
      2. Complete core measure procedure documentation
    15. Protect PHI
      1. Complete security risk analysis
        1. For each deficiency, implement a remedial plan
      2. Document backup plan
      3. Maintain logs of OS and software updates
      4. Create security plan including:
        1. Schedule for review of risk analysis
        2. Schedule for system maintenance
      5. Complete core measure procedure documentation
  2. Optional Criteria (Select at least one from public health and at least five total)
    1. Immunization reporting*
      1. An exclusion must be taken, North Carolina is unable to accept immunization data.
    2. Syndromic surveillance*
      1. An exclusion must be taken, North Carolina is unable to accept syndromic surveillance data.
    3. Drug-formulary checks
      1. NewCrop provides an external formulary (preferred drug list for third-party payors)
      2. Complete measure procedure documentation
    4. Clinical lab results
      1. Further analysis needed
    5. Lists by condition
      1. Provider procedure manual priorities
        1. Create workflow for entering the ICD-9 code for each diagnosis as structured data as well as in a visible field
      2. Conduct load testing on the system to determine if system speed is adequate for workflow
        1. Develop a remedy for the system slowdown if necessary
      3. OpenEMR reporting
        1. Select a condition and associated ICD-9 code and create report
      4. Complete measure procedure documentation
    6. Patient reminders
      1. Further analysis needed
    7. Electronic access
      1. Further analysis needed
    8. Patient education
      1. Further analysis needed
    9. Medication reconciliation
      1. Provider procedure manual priorities
        1. Focus on ensuring the "Transition/Transfer of Care?" box gets checked at encounters involved in transition of care when the patient is RECEIVED.
        2. Perform medication reconciliation at transitions of care
        3. Ensure the "Medication Reconciliation Performed?" box is checked when medication reconciliation related to transitions of care is performed. This box is only available when the "Transition/Transfer of Care?" box is selected.
      2. Create reports in OpenEMR
        1. Numerator: Total encounters with "Medication Reconciliation Performed?" box checked
        2. Denominator: Total encounters with "Transition/Transfer of Care?" box checked
      3. Complete core measure procedure documentation
    10. Transitions of care
      1. Further analysis needed
  3. Menu measure selection process
    1. Both public health measures are exclusions. One may be taken, and four more menu options must be chosen.
      1. Immunization reporting
      2. Drug-formulary checks
      3. Lists by condition
      4. Medication reconciliation
      5. One more must be selected and planned

Suggested staff assignments

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