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EHR Setup

EHR setup is required before beginning a Meaningful Use (MU) reporting period for EHR Modified Stage 2.  Configuration of items will determine what options are available when you enter patient data and calculations of percentages in Measure Reports and Clinical Quality Measures (CQMs)

Other Resources:

Admin Tasks

Turn on EHR features

In the Main Menu, click Setup, Advanced Setup, Show Features. Check the Medicaid, Public Health, and EHR boxes. Click OK twice, then exit and restart the program.

Security

Make sure every provider (dentist) has a username they can use to log on to Open Dental. Providers must be logged on for CPOE orders and Electronic Prescriptions.

  1. In the Main Menu, click Setup, Security
  2. Double click on a user.
  3. Select a provider from the list.
  4. Click OK to attach the user to the provider.

EHR Setup window 

a. EHR Provider Keys: For each EHR provider, enter the annual EHR Provider Key supplied by technical support.

b. Import Coding Systems: Import standardized medical and procedural coding systems that are used to validate data. We recommend importing all code systems (except CPT), but at a minimum import SNOMED CT, RxNORM, LOINC and CVX codes. These code systems are required for several EHR measures.

c. Set Your MU Stage: The stage setting determines which measures show on the EHR dashboard and in EHR measure reports. For 2017 the setting should be Modified Stage 2.

d. For CQMs: Set default Encounter codes, Set default Pregnancy codes.

  • Setting a default encounter code automatically triggers a CQM encounter when a procedure is set complete. This in turn affects CQM denominators. If you don't set a default, you will need to manually create encounters, or your CQM values will be zero.
  • The default pregnancy code is the default code assigned to patients who are excluded from a vital signs BMI exam due to pregnancy. Thus it excludes patients from some CQMs.

e. Set up OIDs: Set up a unique Object Identifier (OID). This is required when exporting summaries of care, medical laboratory orders, or CQMs. 

Set up the Master Lists:

 

a. Master Problem List:

  1. Make sure there are no duplicates.
  2. Associate all problems with a code (SNOMED CT recommended). This is required for problems to show on summaries of care.
  3. Create a 'None' problem to use when 'no problems known'. You may want to use SNOMED CT code 160245001 which has a description of 'No current problems or disability (situation)'. 

b. Master Medication List:

  1. Make sure there are no duplicates.
  2. Associate every medication with an RxNorm.
  3. Create a 'None' medication to use when 'no medications known'. 

c. Master Allergy List:

  1. Make sure there are no duplicates.
  2. Associate every allergy with an Allergy Type. This is required for allergies to show on summaries of care.
  3. Associate every medication allergy with a medication that has an RxNorm code.
  4. Create a 'None' allergy to use when 'no allergies known'. 

d. Set the indicator for "no problems", "no medications", "no allergies".
In Chart Module Preferences:

  • Select the 'None' allergy as the Indicator that patient has No Allergies.
  • Select the 'None' problem as the Indicator that patient has No Problems.
  • Select the 'None' medication as the Indicator that patient has No Medications.

Patient Specific Education

Define the conditions that trigger education resources and define the resources. See Set up Education Resources and Triggers.

Public Health Reporting

Contact your state early to determine if public health agencies have reporting requirements, such as paperwork or registration. Even if you qualify for an exclusion, additional steps may be required.

Provider Tasks

Clinical Decision Support

a. Configure Clinical Decision Support Rule(s) and define CDS Permissions.

b. If you will write more than 100 medication orders, enable eRx - comprehensive version to enable drug interaction checks (see E-Prescribing below). 

c. Save supporting documentation (e.g. screenshots) to prove CDS rules and drug interaction checks were implemented for the entire reporting period.

E-Prescribing

a. If you anticipate writing more than 100 permissable prescriptions, enable eRx - comprehensive version. eRx comprehensive includes drug formulary checks and drug interaction checks.

b. Set up Formulary Checks in the eRx interface (add insurance carriers to your healthplan list and attach carriers to patients).

Technical Tasks

Health Information Exchange

Determine how you will exchange summaries of care electronically with other providers. You have two options:

  1. Use Open Dental to securely email summaries of care. This requires obtaining, installing, and sharing email security certificate(s). See Encrypted Email.
  2. Contract with a Health Information Service Provider (HISP) to perform authentication, encryption, and trust verification on your behalf. You can then export summaries of care and use the HISP to send securely.

Patient Electronic Access

Set up the Patient Portal. You will need to provide patients with electronic access to the portal within 4 days of their first office visit during a reporting period.

Secure Messaging

Set up Secure Web Mail

 

Open Dental Software 1-503-363-5432