Five Secrets to Preventing Provider Cardiac Arrest Secondary to Meaningful Use 2 — There’s a Diagnosis Code for This!

Editor’s Note: This article was originally published in the 2015 Inaugural Issue of Alabama Medicine magazine

Kill two or three measures with one click. Clinical Decision Support Rules, PQRS and Clinical Quality Measures can be managed simultaneously.

Here’s an example of what I mean: Meaningful Use 2 requires the smoking status of all patients 13 years and older to be documented. The Physician Quality Reporting System also requires Providers who select this measure for reporting to screen patients for tobacco use who are 18 years or older and to provide them with cessation counseling if they are tobacco users.

Build a clinical support decision rule to remind you to record the tobacco status of patients 13 years of age (automatic pop-up). You’ve knocked out recording the smoking status of the patient and core measure number 5. The patient then tells you that he or she smokes two packs a day and loves it. At that point, you revel in the opportunity to save a life and conquer measure number 13. Suddenly, you realize that you have just performed PQRS measure number 226, and you do your proverbial happy dance.

If you get that queasy feeling of being “unsure” when you attest to performing a Security Risk Analysis, ask a professional for advice. You can be audited for up to six years – you may be all for doing it yourself to save money, but unless you are a physician as well as a Certified Information Systems Security Professional (CISSP), you could miss something critical. Additionally, the cost for inadvertently allowing a hacker to successfully hack in to your EHR, violate patient privacy, sell your patients’ information to the highest bidder, and give you five minutes of fame in the local news is much higher than the fee for allowing a truly certified professional to prevent this from happening.

Encourage secure messaging with patients by incorporating it into your workflow. The Provider is not the sole individual allowed to manage these messages. Imagine the angry patient who has been sitting in your exam room for 45 minutes, waiting to see you. Unfortunately, you did not anticipate six walk-ins that day and are running a little behind schedule. Fortunately for you, your clinical staff is utilizing the patient engagement template created specifically for this all too common occasion. Medical Assistant Molly walks into the exam room and pulls up the patient’s record. She explains kindly that Mr. Doe can now send the physician a secure message through the patient portal. Mr. Doe does not have an email or know how to set up his portal. No problem! She can assist with that as well. The MA then helps the patient send a secure message stating “Dear Dr. Awesome, thanks for showing me how to contact you via secure message.”

Sending information to a public health registry requires teamwork between both parties involved. Unlike Meaningful Use 1, failed testing does not meet the measure in Meaningful Use 2. Ongoing submission to a registry is the rule. Take heart. Most health departments have a special section set up on their websites for meaningful users. They have the ability to accept submission of things liked diabetes diagnoses, cancer cases and immunizations, and if they don’t, you are probably excluded from the measure. Contact the local health department and find out who is managing Meaningful Use on their end. There are forms to be filled out, calls to vendors and registries to be made, but in the end, Providers will be able to submit vital information to health departments electronically. Some EHRs have a one-directional interface. In this case, make sure the Practice Administrator submits the information at least weekly, and follows-up to insure effective transmission. A bi-directional interface allows for automated transmissions with limited time devoted to monitoring processes.

Qualified professionals can assist the Provider with CPOE. Some EHRs do not recognize orders placed by another “qualified professional” if they are not linked with the Provider. If the number of patients being prescribed medications or for whom labs/radiology are ordered is increasing daily — but the meaningful use stats are not adding up — the problem might be as simple as selecting the supervising provider.
In order to keep your clicking fingers from getting worn out, I suggest creating a “favorites” page of labs, medications and imaging most commonly ordered. This will cut down on the time it takes to rummage through the endless options available in EHRs.

The information in this article is not intended as tax or legal advice. Please consult your tax advisor for specific information regarding your individual situation.

Contributed by Patti G. Perdue, CPA.CITP, Jackson Thornton. Rebecca Hanif, CCS, CPCO, CPC, also contributed to this article. Jackson Thornton is a Certified Public Accounting and Consulting Firm and an official partner with the Medical Association.