Neehr Perfect Activity: Meaningful Use Stage 2 – Clinical Quality Measures (for Eligible Professionals) Overview This activity focuses on Meaningful Use Stage 2 and is designed for the intermediate and advanced EHR user. The activity uses online resources from the CMS website, patients from the Neehr Perfect EHR and content found in this activity. This Meaningful Use activity focuses on Clinical Quality Measures, Core Objectives and Menu Objectives for the eligible professional. Prerequisites Completion of Scavenger Hunts Levels I – III Completion of Neehr Perfect Activity: Reporting in the EHR Completion of Neehr Perfect Activity: Meaningful Use Stage 1 for Providers Completion of Neehr Perfect Activity: Meaningful Use Stage 2 CQM for Hospitals (Optional) Student instructions If you have questions about this activity, please contact your instructor for assistance. Document your answers directly on this document as you complete the activity. When you are finished, save this document and upload it to your Learning Management System (LMS). If you have any questions about submitting your work to your LMS, please contact your instructor Screen displays are provided as a guide and some data (e.g. dates and times) may vary. Additional resources Go to the website CMS.gov (Centers for Medicare & Medicaid Services) to read the following documents: Stage 2 Eligible Professional (EP) Meaningful Use Core and Menu Measures Table of Contents located at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf Eligible Professionals Guide to Stage 2 of the EHR Incentive Programs. http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf 2014 Clinical Quality Measure (CQMs) Adult Recommended Core Measures located at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_CQM_AdultRecommend_CoreSetTable.pdf Objectives Explain what each Core Objective and Menu Objective is for Stage 2 of Meaningful use, for both providers and hospitals. Differentiate between core measures, clinical quality measures and national quality strategy domains. Identify the appropriate online resources and documents related to Meaningful Use Stage 2. Identify who qualifies as an eligible provider. Analyze the impact of not meeting core measures on patient care. Develop a policy for auditing charts internally. Glossary Clinical quality measures (CQMs): Tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals (CAHs) within our health care system. These measures use data associated with providers’ ability to deliver high-quality care or relate to long term goals for quality health care. CQMs can deliver effective, safe, efficient, patient-centered, equitable and timely care. Although CQM reporting has been removed as a core objective, EPs are still required to report CQM data in order to demonstrate meaningful use. Eligible Professional (EP): EPs under the Medicare EHR Incentive Program include: Doctors of medicine or osteopathy Doctors of dental surgery or dental medicine Doctors of podiatry Doctors of optometry Chiropractors A hospital-based EP furnishes substantially all of his or her Medicare-covered professional services in a hospital inpatient or emergency room setting. Hospital-based EPs are not eligible for incentive payments. EPs under the Medicaid EHR Incentive Program include: Physicians (primarily doctors of medicine and doctors of osteopathy) Dentists Nurse practitioners Certified nurse midwives Physician assistants practicing in a Federally Qualified Health Center led by a physician assistant or Rural Health Clinic National Quality Strategy (NQS): National Quality Strategy pursues three broad aims. These aims guide and assess local, state, and national efforts to improve health and the quality of health care. NQSs focus more on the patient’s needs. Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe. Healthy People/Healthy Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social and, environmental determinants of health in addition to delivering higher-quality care. Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government. National Quality Strategy (NQS) domains: National Quality Strategy domains, which represent the Department of Health and Human Services’ NQS priorities for health care quality improvement. The activity The EHR Incentive Programs consist of 3 stages of meaningful use. Each stage has its own set of requirements for meaningful use. Stage 2 focuses on advanced clinical procedures, including: Measures focused on more rigorous health information exchange (HIE) Additional requirements for e-prescribing and incorporating lab results Electronic transmission of patient care summaries across multiple settings Increased patient and family engagement For EPs, Stage 2 means: New Criteria – Starting in 2014, providers participating in the EHR Incentive Programs who have met Stage 1 for two or three years will need to meet meaningful use Stage 2 criteria. Improving Patient Care – Stage 2 includes new objectives to improve patient care through better clinical decision support, care coordination, and patient engagement. Saving Money, Time, Lives – With Stage 2, EHRs will: Save our health care system money Save doctors and hospitals time Save lives Review of Core and Menu Objectives Stage 1 established a core and menu structure for objectives that providers had to achieve in order to demonstrate meaningful use. Core objectives are objectives that all providers must meet. There are also a predetermined number of menu objectives that providers must select from a list and meet in order to demonstrate meaningful use. For many of the core and menu objectives, exclusions were provided that would allow providers to achieve meaningful use without having to meet those objectives that were outside of their normal scope of clinical practice. Under the Stage 1 criteria, EPs had to meet 15 core objectives and 5 menu objectives that they selected from a total list of 10. Eligible hospitals and CAHs had to meet 14 core objectives and 5 menu objectives that they selected from a total list of 10. Stage 2 retains this core and menu structure for meaningful use objectives. Although some Stage 1 objectives were either combined or eliminated, most of the Stage 1 objectives are now core objectives under the Stage 2 criteria. For many of these Stage 2 objectives, the threshold that providers must meet for the objective has been raised. We expect that providers who reach Stage 2 in the EHR Incentive Programs will be able to demonstrate meaningful use of their Certified EHR Technology for an even larger portion of their patient populations. Stage 2 Meaningful Use Objectives Some new objectives were also introduced for Stage 2, and most of these were introduced as menu objectives for Stage 2. As with the previous stage, many of the Stage 2 objectives have exclusions that allow providers to achieve meaningful use without having to meet objectives outside their normal scope of clinical practice. To demonstrate meaningful use under Stage 2 criteria: EPs must meet 17 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 20 core objectives. Eligible hospitals and CAHs must meet 16 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 19 core objectives. Clinical Quality Measures Although clinical quality measure (CQM) reporting has been removed as a core objective for both EPs and eligible hospitals and CAHs, all providers are required to report on CQMs in order to demonstrate meaningful use. Beginning in 2014, all providers regardless of their stage of meaningful use were to report on CQMs in the same way. EPs must report on 9 out of 64 total CQMs. Eligible hospitals and CAHs must report on 16 out of 29 total CQMs. CMS has identified two recommended core sets of eCQMs—one for adults and one for children—that focus on high-priority health conditions and best-practices for care delivery. 9 eCQMs for adult populations that meet all of the program requirements 9 eCQMs for pediatric populations that meet all of the program requirements In addition, all providers must select CQMs from at least 3 of the 6 key health care policy domains recommended by the Department of Health and Human Services’ National Quality Strategy. The 6 NQS domains are: Patient and Family Engagement Patient Safety Care Coordination Population/Public Health Efficient Use of Healthcare Resources Clinical Process/Effectiveness Answer the following questions directly on this document. Determine if the following providers are considered “Eligible Professionals” for Medicare or Medicaid. Answer Yes or No next to each one. Doctor of Biology – _____ Neurologist – _____ Maxillofacial surgeon – _____ Acupuncturist who is often referred to by a chiropractor in rural Colorado – _____ Family Nurse Practitioner – _____ Physician Assistant working in a VA (Veterans Administration) Hospital ER – _____ Nurse midwife certified to work and care for patients in rural Texas – _____ Registered Nurse managing a free clinic in downtown Chicago – _____ Pharmacist – _____ Family medical doctor – _____ In your own words, explain the difference between Clinical Quality Measures and the National Quality Standards. Below are the nine recommended CQMs (out of 64) for the adult patient. Using the documents listed in the Student Instructions above, write a brief description on each CQM. Controlling High Blood Pressure Use of High-Risk Medications in the Elderly – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention – Use of Imaging Studies for Low Back Pain – Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan – Documentation of Current Medications in the Medical Record – Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up – Closing the referral loop: receipt of specialist report – Functional status assessment for complex chronic conditions – Look at the following charts in the EHR. As you are looking through each chart, think of the nine recommended CQMs and answer the questions. Meridith Dewietz – Documenting Current Medication in the Medical Record. Does her chart have all of the medications the patient is taking listed? Look at the Orders tab and the Notes to determine if the medications are documented. Does each medication include the medications’ name, dosage, frequency and route of administration? Prescriptions: Over-the-counter medications: Herbals: Vitamin/mineral/dietary (nutritional) supplements: Anna Merritt – Documenting Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention. What is documented in the chart about the patient’s smoking status? Melinda Goble – Documentation of Current Medications in the Medical Record. Are all of the patient’s known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements listed in the medical record with the medications’ name, dosage, frequency and route of administration? Now that you have a better understanding of Clinical Quality Measures and you have reviewed three charts in Neehr Perfect, you have seen that, even with this small number of charts, not all nine recommended core CQMs are addressed in each chart (Dewietz, Merritt and Goble). Write an office (or clinic) policy based on the following scenario. You are the HIT manager for a busy, multi-physician clinical practice. The group has been using outpatient EHRs for 4 years and has been part of the Meaningful Use Incentive Program for 3 years. You have successfully met Stage 1 and are now in Stage 2. Part of your success has been the routine audits of medical records. However, as the practice has grown, so has the number of medical records. The clinical staff is short-handed and has admitted to not being able to document as they used to. You and your staff of two HIT professionals are not able to meet the demands of auditing the charts and will be hiring a third person to work with you. Among your many duties is keeping policies and procedures up-to-date. It has been brought to your attention that there is not an updated policy in place for how frequently to audit the medical records in the EHR, who performs the audits, and what needs to be in the medical record when gathering the data for reporting to CMS. Using the Eligible Professionals Guide to Stage 2 of the EHR Incentive Programs, write a policy that will address the auditing of the medical records. You may choose to write your policy on a separate word document. Submit your work Document your answers directly on this document as you complete the activity. When you are finished, save this document and upload it to your Learning Management System (LMS). If you have any questions about submitting your work to your LMS, please contact your instructor. References 2014 Clinical Quality Measure (CQMs) Adult Recommended Core Measures. (January 2013). Centers for Medicare and Medicaid Services. Retrieved January 13, 2015 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_CQM_AdultRecommend_CoreSetTable.pdf Centers for Medicare and Medicaid Services. Retrieved December 21, 2014 from http://www.cms.gov/About-CMS/About-CMS.html eHealth University, An Introduction to EHR Incentive Programs for Eligible Professionals: 2014 Clinical Quality Measure (CQM) Electronic Reporting Guide (September 2014). Centers for Medicare and Medicaid Services. Retrieved December 29, 2014 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM2014_GuideEP.pdf Eligible Professionals Guide to Stage 2 of the EHR Incentive Programs (September 2013). Centers for Medicare and Medicaid Services. Retrieved January 13, 2015 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf National Quality Strategy. Agency for Healthcare Research and Quality. Retrieved December 29, 2014 from http://www.ahrq.gov/workingforquality/about.htm Stage 2 Eligible Professional (EP) Meaningful Use Core and Menu Measures Table of Contents. (October 2012). Centers for Medicare and Medicaid Services. Retrieved January 13, 2015 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf

    Neehr Perfect Intelligence: Meaningful Reason Property 2 – Clinical Tendency Estimates (control Capoperative Negotiatives)

    Overview

    This intelligence convergencees on Meaningful Reason Property 2 and is intended control the included and past EHR reasonr. The intelligence reasons online instrument from the CMS website, endurings from the Neehr Perfect EHR and aggregateureing base in this intelligence. This Meaningful Reason intelligence convergencees on Clinical Tendency Estimates, Kernel Externals and Menu Externals control the capoperative negotiative.

    Prerequisites

    1. Completion of Scavenger Hunts Levels I – III
    2. Completion of Neehr Perfect Intelligence: Reporting in the EHR
    3. Completion of Neehr Perfect Intelligence: Meaningful Reason Property 1 control Producers
    4. Completion of Neehr Perfect Intelligence: Meaningful Reason Property 2 CQM control Hospitals (Optional)

    Student instructions

    1. If you feel questions encircling this intelligence, content contiguity your teachingist control countenance.
    2. Muniment your responses quickly on this muniment as you perfect the intelligence. When you are perfect, reserve this muniment and upload it to your Learning Management Lifehod (LMS). If you feel any questions encircling submitting your fruit to your LMS, content contiguity your teachingist
    3. Screen displays are granted as a conduct and some basis (e.g. dates and times) may modify.   

    Additional instrument

    1. Go to the website CMS.gov (Centers control Mediheed & Medicaid Services) to discbalance the subjoined muniments:
      1. Property 2 Capoperative Negotiative (EP) Meaningful Reason Kernel and Menu Estimates Toperative of Aggregateureings located at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf
      2. Capoperative Negotiatives Conduct to Property 2 of the EHR Rousing Programs.  http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf
      3. 2014 Clinical Tendency Estimate (CQMs) Adult Recommended Kernel Estimates located at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_CQM_AdultRecommend_CoreSetTable.pdf

    Objectives

    1. Decipher what each Kernel External and Menu External is control Property 2 of Meaningful reason, control twain producers and hospitals.
    2. Differentiate among kernel estimates, clinical tendency estimates and generally-knconfess tendency cunning domains.
    3. Identify the divert online instrument and muniments kindred to Meaningful Reason Property 2.
    4. Identify who qualifies as an capoperative producer.
    5. Analyze the application of connectoperative convocation kernel estimates on enduring heed.
    6. Develop a cunning control auditing charts amid.

    Glossary

    Clinical tendency estimates (CQMs): Tools that aid estimate and mark the tendency of vigor heed services granted by capoperative negotiatives, capoperative hospitals and hazardous vestibule hospitals (CAHs) amid our vigor heed lifehod. These estimates reason basis associated with producers’ power to transmit excellent-tendency heed or describe to hanker arrange goals control tendency vigor heed. CQMs can transmit operative, trustworthy, causative, enduring-centered, impartial and restraintthcoming heed. Although CQM declarationing has been removed as a kernel external, EPs are quiet required to declaration CQM basis in arrange to decipher meaningful reason.

    Capoperative Negotiative (EP):

    • EPs beneath the Mediheed EHR Rousing Program include:
      • Doctors of salve or osteopathy
      • Doctors of dental surgery or dental salve
      • Doctors of podiatry
      • Doctors of optometry
      • Chiropractors
    • A hospital-inveterate EP furnishes actually thorough of his or her Medicare-covered negotiative services in a hospital inenduring or pitch opportunity elucidation. Hospital-inveterate EPs are connectoperative capoperative control rousing payments. EPs beneath the Medicaid EHR Rousing Program include:
      • Physicians (chiefly teachers of salve and teachers of osteopathy)
      • Dentists
      • Nurture practitioners
      • Knhold nurture midwives
      • Physician aggregateys practicing in a Federally Qualified Vigor Center led by a physician aggregatey or Pastoral Vigor Clinic

    Generally-knconfess Tendency Cunning (NQS): Generally-knconfess Tendency Cunning pursues three indelicate favor. These favor conduct and assess topical, specify, and generally-knconfess efforts to reform vigor and the tendency of vigor heed. NQSs convergence past on the enduring’s demands.

    1. Reform Heed: Reform the balancethorough tendency, by making vigor heed past enduring-centered, genuine, vestibuleible, and trustworthy.
    2. Healthy People/Healthy Communities: Reform the vigor of the U.S. population by helped proven interventions to oration behavioral, collective and, environmental determinants of vigor in anatomy to transmiting excellenter-tendency heed.
    3. Affordoperative Heed: Reduce the absorb of tendency vigor heed control living-souls, families, employers, and legislation.

    Generally-knconfess Tendency Cunning (NQS) domains: Generally-knconfess Tendency Cunning domains, which enact the Department of Vigor and Human Services’ NQS priorities control vigor heed tendency reformment.

    The intelligence  

    The EHR Rousing Programs endure of 3 propertys of meaningful reason. Each property has its confess fixed of requirements control meaningful reason. Property 2 convergencees on past clinical procedures, including:

    • Measures convergenceed on past impenetroperative vigor instruction change (HIE)
    • Additional requirements control e-prescribing and incorporating lab results
    • Electronic transmission of enduring heed summaries athwart multiple elucidations
    • Increased enduring and rise promise

    Control EPs, Property 2 means:

    • Innovating Criteria – Starting in 2014, producers severicipating in the EHR Rousing Programs who feel life Property 1 control brace or three years aggregateure demand to as meaningful reason Property 2 criteria.
    • Improving Enduring Heed – Property 2 includes innovating externals to reform enduring heed through reform clinical sentence help, heed coordination, and enduring promise.
    • Saving Money, Time, Lives – With Property 2, EHRs aggregateure:
      • Reserve our vigor heed lifehod money
      • Reserve teachers and hospitals time
      • Reserve lives

    Review of Kernel and Menu Externals

    Property 1 certain a kernel and menu texture control externals that producers had to thorough in arrange to decipher meaningful reason. Kernel externals are externals that thorough producers must as. There are to-boot a predetermined enumerate of menu externals that producers must choice from a inventory and as in arrange to decipher meaningful reason.

    Control numerous of the kernel and menu externals, exclusions were granted that would thoroughow producers to thorough meaningful reason extraneously having to as those externals that were extraneously of their ordinary drift of clinical performance. Beneath the Property 1 criteria, EPs had to as 15 kernel externals and 5 menu externals that they choiceed from a aggregate inventory of 10. Capoperative hospitals and CAHs had to as 14 kernel externals and 5 menu externals that they choiceed from a aggregate inventory of 10.

    Property 2 retains this kernel and menu texture control meaningful reason externals. Although some Property 1 externals were either in-single or eliminated, most of the Property 1 externals are now kernel externals beneath the Property 2 criteria. Control numerous of these Property 2 externals, the origin that producers must as control the external has been eminent. We await that producers who strain Property 2 in the EHR Rousing Programs aggregateure be operative to decipher meaningful reason of their Knhold EHR Technology control an smooth larger fpossession of their enduring populations.

    Property 2 Meaningful Reason Externals

    Some innovating externals were to-boot introduced control Property 2, and most of these were introduced as menu externals control Property 2. As with the anterior property, numerous of the Property 2 externals feel exclusions that thoroughow producers to thorough meaningful reason extraneously having to as externals extraneously their ordinary drift of clinical performance.

    To decipher meaningful reason beneath Property 2 criteria:

    • EPs must as 17 kernel externals and 3 menu externals that they choice from a aggregate inventory of 6, or a aggregate of 20 kernel externals.
    • Capoperative hospitals and CAHs must as 16 kernel externals and 3 menu externals that they choice from a aggregate inventory of 6, or a aggregate of 19 kernel externals.

    Clinical Tendency Estimates

    Although clinical tendency estimate (CQM) declarationing has been removed as a kernel external control twain EPs and capoperative hospitals and CAHs, thorough producers are required to declaration on CQMs in arrange to decipher meaningful reason. Beginning in 2014, thorough producers unobservant of their property of meaningful reason were to declaration on CQMs in the identical coercionm.

    • EPs must declaration on 9 extinguished of 64 aggregate CQMs.
    • Capoperative hospitals and CAHs must declaration on 16 extinguished of 29 aggregate CQMs.

    CMS has verified brace recommended kernel fixeds of eCQMs—single control adults and single control children—that convergence on excellent-priority vigor conditions and best-practices control heed transmity.

    • 9 eCQMs control adult populations that as thorough of the program requirements
    • 9 eCQMs control pediatric populations that as thorough of the program requirements

    In anatomy, thorough producers must choice CQMs from at minuteest 3 of the 6 guide vigor heed cunning domains recommended by the Department of Vigor and Human Services’ Generally-knconfess Tendency Cunning. The 6 NQS domains are:

    1. Enduring and Rise Promise
    2. Enduring Trustworthyty
    3. Heed Coordination
    4. Population/Public Vigor
    5. Causative Reason of Vigorheed Instrument
    6. Clinical Arrangement/Effectiveness

    Response the subjoined questions quickly on this muniment.

    1. Particularize if the subjoined producers are considered “Capoperative Negotiatives” control Mediheed or Medicaid. Response Yes or No proximate to each single.
      1. Teacher of Biology – No
      2. Neurologist – Yes
      3. Maxillofacial surgeon – Yes
      4. Acupuncturist who is constantly connectred to by a chiropractor in pastoral Colorado – Yes
      5. Rise Nurture Practitioner – Yes
      6. Physician Aggregatey fruiting in a VA (Veterans Government) Hospital ER-Yes
      7. Nurture midwife knhold to fruit and heed control endurings in pastoral Texas – Yes
      8. Registered Nurture managing a exempt clinic in downtconfess Chicago –Yes
      9. Pharmacist – Yes
      10. Rise medical teacher – Yes
    1. In your confess opinion, decipher the distinction among Clinical Tendency Estimates and the Generally-knconfess Tendency Standards.

    Clinical Tendency Estimates connects to a mechanism control evaluating the arrangement of matter and the extinguishedcome of enduring heed opportunity Generally-knconfess Tendency Standards connect to a benchmark control the excellence of the heed and restraintthcoming childhood teaching.

    1. Begentle are the nine recommended CQMs (extinguished of 64) control the adult enduring. Using the muniments inventoryed in the Student Instructions balancehead, transcribe a smthorough term on each CQM.
      1. Powerful Excellent Blood Hurry

    It seeks to estimate the clinical arrangement operativeness in powerful the blood hurry of endurings among the ages of 18-85 years.

    1. Reason of Excellent-Careason Medications in the Antiquated

    It seeks to evaluate antiquated endurings’ trustworthyty when it comes to excellent concernason medication.

    1. Preventive Heed and Screening: Tobacco Reason: Screening and Cessation Intervention

    It seeks to assess the quantity of tobacco reason by endurings time-honored 18 years and balancehead and present the certain counselling if a special is verified as a tobacco reasonr.

    1. Reason of Imaging Studies control Gentle End Refusal

    It favor at assessing the percentage of endurings who feel gentle end refusal and did connectoperative vestibule the shadow studies amid 28 days behind diagnosis.

    1. Preventive Heed and Screening: Screening control Clinical Lowering and Follow-Up Plan

    It favor at identifying the endurings who experience from clinical lowering and seize direct possession.

    1. Documentation of Current Medications in the Medical Annals

    It involves sentence instruction relating a enduring medical narrative and heed as well-behaved-behaved as annals it control unconstrained follow-up and advenient connectence.

    1. Preventive Heed and Screening: Body Mass Index (BMI) Screening and Follow-Up

    It favor at checking whether the endurings BMI is amid the ordinary parameters and provoke an possession in the smootht the BMI of the endurings falls extraneously the ordinary parameters.

    1. Closing the connectral loop: reception of speciainventory declaration

    It boosts enduring heed coordination in the smootht the enduring is connectred to another vigor heed producer.

    1. Functional condition impost control close continuous conditions

    It seeks to evaluate the percentage of endurings with nucleus insufficiency and occupy their rise members in smootht there is demand control advance medical heed.

    1. Look at the subjoined charts in the EHR. As you are looking through each chart, gard of the nine recommended CQMs and response the questions.
      1. Meridith Dewietz – Munimenting Current Medication in the Medical Annals. Does her chart feel thorough of the medications the enduring is portico inventoryed? Look at the Arranges tab and the Connectablees to severicularize if the medications are munimented. Does each medication include the medications’ designate, dosage, quantity and passage of government?    

    Prescriptions:

    Over-the-counter medications:

    Herbals:

    Vitamin/mineral/dietary (nutritional) supplements:

                The chart shows the inventory of thorough the medication that the enduring is portico and to-boot each medication contains the medication’s designate, dosage, quantity and passage of government.

    1. Anna Merritt – Munimenting Preventive Heed and Screening: Tobacco Reason: Screening and Cessation Intervention. What is munimented in the chart encircling the enduring’s smoking condition?

    The enduring is 13 years and balancehead and reasons tobacco past than unintermittently amid 24 hours.

    1. Melinda Goble – Munimentation of Current Medications in the Medical Annals. Are thorough of the enduring’s knconfess prescriptions, balance-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements inventoryed in the medical annals with the medications’ designate, dosage, quantity and passage of government?

    The endurings knconfess prescriptions, balance the counters, herbals and nutritional supplements are inventoryed and a minute instruction encircling the medication fond.

    1. Now that you feel a reform beneathstanding of Clinical Tendency Estimates and you feel reviewed three charts in Neehr Perfect, you feel seen that, smooth with this smthorough enumerate of charts, connectoperative thorough nine recommended kernel CQMs are orationed in each chart (Dewietz, Merritt and Goble). Transcribe an service (or clinic) cunning inveterate on the subjoined scenario.

    You are the HIT supervisor control a diligent, multi-physician clinical performance. The assembly has been using extinguishedenduring EHRs control 4 years and has been sever of the Meaningful Reason Rousing Program control 3 years. You feel consummationfully life Property 1 and are now in Property 2. Sever of your consummation has been the rule audits of medical annalss. However, as the performance has developed, so has the enumerate of medical annalss. The clinical staff is short-handed and has admitted to connectoperative nature operative to muniment as they reasond to. You and your staff of brace HIT negotiatives are connectoperative operative to as the demands of auditing the charts and aggregateure be hiring a third special to fruit with you. Among your numerous duties is care policies and procedures up-to-date. It has been brought to your vigilance that there is connectoperative an updated cunning in locate control how constantly to audit the medical annalss in the EHR, who performs the audits, and what demands to be in the medical annals when bunch the basis control declarationing to CMS. Using the Capoperative Negotiatives Conduct to Property 2 of the EHR Rousing Programs, transcribe a cunning that aggregateure oration the auditing of the medical annalss. You may adopt to transcribe your cunning on a disconnected message muniment.

    CLINICAL POLICY

    Three months medical annalss be presented through the CMS registration and Attestation Lifehod control auditing purposes. The audit of the medical annalss should be dsingle by the HIT supervisor upon dependence. The medical annals should produce a minute anatomy on how the tendency estimates feel life at minuteest three of the Generally-knconfess Tendency Cunning domain.

    Submit your fruit

    Muniment your responses quickly on this muniment as you perfect the intelligence. When you are perfect, reserve this muniment and upload it to your Learning Management Lifehod (LMS). If you feel any questions encircling submitting your fruit to your LMS, content contiguity your teachingist.   

    References

    2014 Clinical Tendency Estimate (CQMs) Adult Recommended Kernel Estimates. (January 2013). Centers control Mediheed and Medicaid Services. Retrieved January 13, 2015 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_CQM_AdultRecommend_CoreSetTable.pdf  

    Centers control Mediheed and Medicaid Services. Retrieved December 21, 2014 from http://www.cms.gov/About-CMS/About-CMS.html  

    eVigor University, An Introduction to EHR Rousing Programs control Capoperative Negotiatives: 2014 Clinical Tendency Estimate (CQM) Electronic Declarationing Conduct (September 2014). Centers control Mediheed and Medicaid Services. Retrieved December 29, 2014 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM2014_GuideEP.pdf

    Capoperative Negotiatives Conduct to Property 2 of the EHR Rousing Programs (September 2013). Centers control Mediheed and Medicaid Services. Retrieved January 13, 2015 from  http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf   

    Generally-knconfess Tendency Cunning. Agency control Vigorheed Research and Tendency. Retrieved December 29, 2014 from http://www.ahrq.gov/workingforquality/about.htm  

    Property 2 Capoperative Negotiative (EP) Meaningful Reason Kernel and Menu Estimates Toperative of Aggregateureings. (October 2012). Centers control Mediheed and Medicaid Services. Retrieved January 13, 2015 from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf