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EHR Stage 1 Meaningful Use FAQ

On October 7, 2015, CMS released a new Final Rule for the EHR Incentive Program. The rule makes the reporting requirements for meaningful use easier for 2015 through 2017. See Modified Stage 2.

The following questions pertain to EHR Stage 1.  This information is only a guide and we include useful links to information we have found.  We recommend that you always contact your state with any questions and for final recommendations.  See also:  EHR Frequently Asked Questions.

  1. Should I apply for the exclusion for Vital Signs?
    The exclusion for this measure states that if a EP believes the vital signs of height, weight, and/or blood pressure have no relevance to scope of practice, they may apply for an exclusion.  Several CQMs do rely on the capture of vital signs, so if you choose to exclude this measure, your CQM denominators may be zero.  However, zero is an acceptable value to report for the denominator of a CQM. https://questions.cms.gov/faq.php?id=5005&faqId=2865

  2. Do I need to use Electronic Prescriptions (eRx) if I plan to claim the exclusion?
    You must use eRx - Comprehensive version if you are trying to meet MU for electronic prescriptions or Formulary Checks. This will also enable automated Drug Interaction Checks in eRx, allowing you to meet that measure as well.

    If you plan to claim the exclusion, and do not want to use the eRx-Comprehensive version for interaction checks, you should only write paper Prescriptions and not enable eRx at all.  Use Open Dental's built-in Interaction Checks for the Drug Interaction Check measure.  Paper prescriptions will count towards the denominator only; not the numerator.  However, as long as you write less than 100 total prescriptions (thus meeting exclusion criteria), the percentage calculation will not matter.

    You should NOT use the Basic version of eRx for any reason, because you will not have interaction checks enabled for the reporting period.

  3. What is a Clinical Summary and how can I provide it to a patient?
    A clinical summary is a type of Continuity of Care document provided to a patient after a visit that summarizes care. For Stage 1 MU, the clinical summary must be provided to a patient within 3 days of an office visit.  There are several ways you can provide a clinical summary to a patient:
    a) Send the clinical summary to the patient's Portal.  Patient can then login to the portal (once they have Access) to view the clinical summary.
    b) Export the clinical summary, then provide to the patient using another method.
    c) Print the clinical summary and give it to the patient.

  4. What Public Health Menu Measure Should I Choose?
    EPs must choose 5 out of 9 menu measures, and at least one of the measures must be a public health measure. There are only two possible public health measures: 
    • Immunizations:  Perform at least one test of EHR system's ability to submit electronic data to immunization registry.  If an EP does not administer vaccines during the reporting period, or if their state is unable to accept electronic immunization records yet, they may qualify for an exclusion.
    • Syndromic Surveillance Data:  Perform at least one test of EHR system's ability to submit electronic syndromic surveillance data to public health agency.   If an EP does not collect reportable syndromic information on their patients during the reporting period, or their state is unable to accept electronic syndromic surveillance data from providers, they may qualify for an exclusion.

Most dentists do not administer vaccines or collect syndromic information, thus would be eligible for exclusions. If you can apply for the exclusion, we recommend it.  There may still be steps or registration that must occur prior to attestation.  Consult your state if you have questions. 

According to the CMS.gov website, if you can meet one of the measures, you should select and report on it.  If you can be excluded from both, you should claim an exclusion from only one public health objective and report on four additional menu objectives.  https://questions.cms.gov/faq.php?id=5005&faqId=2903 

  1. My Clinical Quality Measure values are 0.  Should I be worried?
    Open Dental reports on 9 CQMs.  We chose these CQMs because we believe they are most relevant to dental practices and dental workflow. 
    • Denominator is 0:  A possible reason is that CQM Encounters have not been generated. Encounters for CQMs are not the same as office visits. You must set a default SNOMED CT code to automatically generate a CQM encounter when a procedure is completed (see EHR Settings) or manually create CQM encounters. 
    • Numerator is 0:  Additional steps may be needed in your workflow, such as documenting interventions or Attesting that Medications are Current. See Clinical Quality Measure Descriptions for a full list.

    Some CQMs may not be applicable to your practice.  In these cases, according to the Meaningful Use for Specialists Tipsheet (PDF), "zero is an acceptable value for the CQM denominator, numerator, and exclusion fields and will not prevent you from demonstrating meaningful use or receving an incentive payment."

 

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