More then 50% of the patients transitioned out or referred by the EP to another provider or setting of care during the reporting period were provided with a summary of care.
Denominator
Count of clinical encounters (of any type) associated with the EP marked as outbound transition of care generated within the reporting period.
Numerator
Portion of the denominator where printing of a Chart Summary report or the create of a CCDA file via the Export Medical Summary report was done. (Either the Summary of Care Record for Care Co-ordination provided physically or Summary of Care Record for Care Co-ordination provided electronically check box in Clinical Encounters is selected.)
Measure 2: Provide Summary Of Care With A Direct Message
More then 10% of the patients transitioned out or referred by the EP to another provider or setting of care during the reporting period were provided with a summary of care with a direct message to the recipient.
Denominator
Count of clinical encounters (of any type) associated with the EP marked as outbound transition of care generated within the reporting period.
Numerator
Portion of the denominator where the creation of a CCDA file via the Export Medical Summary report was done. (The Summary of Care Record for Care Co-ordination provided
electronically check box in Clinical Encounters is selected).
Measure 3
Conduct at least one electronic exchange of summary of care with a provider or facility that uses a different EHR OR with a CMS test EHR during the reporting period.
Performance metric
Chapter 15 - Core Objective 15 - Summary of Care Record Configuration
If providers choose to conduct a test exchange of the electronic summary of care with a CMS test EHR to meet Measure 3 successfully, they should refer to the CMS website for details on the process.
Configuration
Access levels
Operators who print the Chart Summary report must have appropriate access to do so.
Access Levels > Reports > Records Reports > Chart Summary Report Operators who generate the CCDA files must have appropriate access to do so.
Access Levels > Reports > Records Reports > Export Medical Summary
Steps to access and edit access levels have not changed since previous versions of the product.
Follow the same steps as before.
Configuration notes
The Chart Summary report layout and format cannot be modified.
The CCDA export format cannot be modified.
PPart.ini edits
The following setting in the PPart.ini file controls the presence of the On Behalf of button on the New Message screen.
Figure 83. New Message screen
To display the On Behalf of button:
1. Go to /PPart > PPart.ini.
2. Locate the [RelayHealth] section.
Setting up a direct message account with RelayHealth and acquiring direct message addresses Chapter 15 - Core Objective 15 -
3. Set DirectActivated=ON.
Figure 84. DirectActivated= setting 4. Save and close the file.
5. Restart the application.
Setting up a direct message account with RelayHealth and acquiring direct message addresses
To meet Measure 2 of this objective, the electronic summary of care must be sent to the recipient provider or facility (for example, specialist or hospital) using a direct message account and a direct address. A direct address is similar to a regular e-mail address with extra encryption standards as required by CMS since sensitive information including PHI is included in the electronic summaries of care.
NOTE: The process described below is required for all providers attesting for Stage 2, regardless of the patient portal being used (Web View or RelayHealth). This is an additional account that is REQUIRED to meet this objective successfully, separate from the patient portal itself.
Contact your account manager or VAR to complete this process. There is an annual cost associated with this service. Your account manager or VAR will provide you with the details.
Include DIRECT ACCOUNT and your organization name in the subject line when using e-mail contact (for example, DIRECT ACCOUNT - FARMVILLE FAMILY MEDICINE).
Include the following information in your call or e-mail message:
• Organization/practice name • Organization ID
• Name, phone number and e-mail address for primary contact person
• Names and e-mail addresses of all providers and operators who require a direct access (to send and receive messages)
Chapter 15 - Core Objective 15 - Summary of Care Record Direct exchange via RelayHealth (external systems)
• This certificate is different than the one given to you if you have the RelayHealth patient portal.
Direct exchange via RelayHealth (external systems)
This feature on the External Systems menu helps the integration of the RelayHealth Direct Account Certificate obtained from Digi-Cert mentioned above.
To set up Direct Exchange via RelayHealth:
1. Select Maintenance > Setup > External Systems. The External Systems screen appears.
Figure 85. External Systems screen
2. Select Direct Exchange via RelayHealth and click the Edit button. The Direct Exchange via RelayHealth screen appears.
Figure 86. Direct Exchange via RelayHealth screen 3. Select the Schedule Active check box.
Entry of direct addresses Chapter 15 - Core Objective 15 - Summary of Care Record
4. Enter a date in the Beginning field and the desired interval in the Runs Every field. The utility will run at the designated interval to import and export direct messages to and from the EHR (similar to an e-mail server).
5. The Logging Detail field defaults to Detail. The Detail option includes the download date, time, external system name, and the content type. For more information on the other options available for this field, see the Direct Exchange via RelayHealth screen topic in the online help.
6. Click the Choose Certificate button and follow the prompts to select the RelayHealth digital certificate saved as per instructions (in the online help).
Entry of direct addresses
Operator Maintenance
You can add direct addresses obtained for providers and operators from RelayHealth to their profiles so that they are readily available on the Messaging screen.
To add a direct address to a profile:
1. Select Maintenance > Setup > Operators.
2. If asked, enter your password.
3. Click the OK button. The Operator screen appears.
4. Select an operator from the list and click the Edit button. The Operator Maintenance Edit screen appears.
Chapter 15 - Core Objective 15 - Summary of Care Record Entry of direct addresses
Referring sources
If referring sources (potential recipients of the summaries of care generated by the providers) have direct addresses, you can add the direct addresses to their profiles so they are readily available on the Messaging screen.
To add a direct address to a profile:
1. Select Maintenance > Referring Sources. The Referring Source Maintenance Select screen appears.
2. Select the referring source and click the Edit button. The Referring Source Maintenance Edit screen appears.
Figure 88. Referring Source Maintenance Edit screen 3. In the Contact Preference field, select Direct.
4. In the Direct field, enter the direct address.
5. Click the OK button to save.
Entry of direct addresses Chapter 15 - Core Objective 15 - Summary of Care Record
Patients
If patients (potential recipients of the summaries of care generated by the providers) have direct addresses, you can enter the direct addresses on the Patient screen so they are readily available on the Messaging screen.
Figure 89. Patient Edit screen
Chapter 15 - Core Objective 15 - Summary of Care Record End user training
End user training
Measure 1: Generate Summary of Care Record
To generate a printed summary of care:
1. Select Reports > Patient Records > Print Chart Summary. The Print Chart Summary screen appears.
Figure 90. Print Chart Summary screen 2. Leave the Single Patient option selected.
3. McKesson recommends that you do not select the Print first page data only and Limit first page data check boxes because they might inadvertently eliminate some required data elements.
4. Select the Fax check box to fax the report directly.
5. If you want to print the summary to file, select the Print to file check box.
6. Click the OK button. If you selected the Print to file check box, the Render to file screen appears. Otherwise, skip to step 8.
Figure 91. Render to file screen
Measure 1: Generate Summary of Care Record Chapter 15 - Core Objective 15 - Summary of Care Record
7. Select the desired format and click the Browse button to enter an appropriate name and to choose a destination folder.
8. Look up and select the appropriate patient.
9. Refer to the following table for your next step.
Figure 92. Clinical Encounter Not Found screen
10. The default option is Yes. Do not change this option. Click the OK button.
11. On the next screen, indicate if you want to print any images associated with the most recent progress note that will print as part of the summary. The system generates the report and then prints it to paper, faxes it, or saves it to file. If you selected the Fax check box, a screen appears where you can enter the recipient’s name and fax number.
Is there an existing outbound clinical encounter for the current date and current provider?
Then the system...
Yes generates the report, then prints it to paper,
faxes it, or saves it to file.
If you selected the Fax check box, a screen appears where you can enter the recipient’s name and fax number.
This is the last step.
No prompts you to create a clinical encounter on
the Clinical Encounter Not Found screen.
Continue to step 10.
Chapter 15 - Core Objective 15 - Summary of Care Record Measure 1: Generate Summary of Care Record
This process updates the appropriate clinical encounter to indicate that a printed summary of care document was provided by automatically selecting the Summary of Care Record Provided for Care Coordination Physically check box on the Clinical Encounter screen.
Figure 93. Clinical Encounter Edit screen
To generate an electronic summary of care record:
1. Select Reports > Patient Records > Export Medical Summary. The Export Medical Summary screen appears.
Figure 94. Export Medical Summary screen 2. In the Purpose field, select Transfer of Care.
3. In the Document Type field, select CCDA - Summary of Care.
4. Enter the date range and a password, if desired.
Measure 1: Generate Summary of Care Record Chapter 15 - Core Objective 15 - Summary of Care Record
5. Click the OK button.
6. Look up and select the appropriate patient.
7. Refer to the following table for your next step.
Figure 95. Clinical Encounter Not Found screen
8. The default option is Yes. Do not change this option. Click the OK button. The Save As screen appears.
Is there an existing outbound clinical encounter for the current date and current provider?
Then this screen appears...
Yes Save As.
Continue to step 9.
No Clinical Encounter Not Found screen.
Continue to step 8.
Chapter 15 - Core Objective 15 - Summary of Care Record Measure 1: Generate Summary of Care Record
9. Select a destination folder for the generated file and enter an appropriate name. Click the Save button. The Export Medical Summary Detail Selection screen appears.
McKesson recommends that system administrators agree on a predetermined destination folder on a shared drive and a standard naming convention for all CCDAs generated. This ensures that all operators name and save the files in a standardized manner, which makes searching for and accessing these files easier in the future.
Figure 97. Export Medical Summary Detail Selection screen
10. By default, all data in the various sections of the chart are set to be included in the file. Clear the check boxes for any data types or individual data elements that are not desired. You can expand data type to see individual data elements by clicking the plus sign (+) symbols.
11. Click the OK button.
End user notes Chapter 15 - Core Objective 15 - Summary of Care Record
This process updates the appropriate clinical encounter to indicate that an electronic summary of care document was provided by automatically selecting the Summary of Care Record Provided for Care Coordination Electronically check box on the Clinical Encounter screen.
Figure 98. Clinical Encounter Edit screen
End user notes
If passwords are used to encrypt the CCDA, send them to the recipient separately from the CCDA itself. This ensures better security.
The format and contents of a printed Chart Summary report cannot be modified.