Clinical Lab Test Results Configuring RPMS-EHR for Meaningful Use Resource Patient Management System

Presenters: Angela Kihega, RHIT Oklahoma City Area HIM Consultant Andrea Scott, MBA, BS Navajo Area Clinical Applications Coordinator Clarence Smiley, MPH, MT IHS OIT Laboratory Consultant Clinical Lab Test Results

Eligible Professionals Medicare-only Eligible Professionals Could be eligible for both Medicare & Medicaid incentives Medicaid-only Eligible Professionals

Eligible Hospitals Hospitals only eligible for Medicare incentive Could be eligible for both Medicare & Medicaid (most hospitals) Hospitals only eligible for Medicaid incentive

Medicare-Medicaid EHR Incentive Programs A “meaningful user” must: Use a certified EHR product Meet core objectives and at least 5 “menu” objectives At least one “menu” objective must address public health Report quality measures

What are the Requirements of Stage 1? Eligible Professionals must complete: 15 core objectives –6 total Clinical Quality Measures (CQM) –(3 core or alternate core, and 3/38 from menu set) 5 objectives out of 10 from menu set –1 must be public health Eligible Hospitals must complete: 14 core objectives –15 CQM 5 objectives out of 10 from menu set –1 must be public health

Objective and Measure Incorporate clinical lab-test results into certified EHR technology as structured data. More than 40% of all clinical lab test results ordered by the provider or by an authorized provider of the hospital for patients admitted to its inpatient or emergency department during the EHR reporting period, the results of which are either in a positive/negative or numerical format, are incorporated in certified EHR technology as structured data. Clinical Lab Test Results

Training Objectives Understand the objective and the measure Compare and contrast Laboratory Package, Reference Lab Interface, Point of Care lab & PCC Data Entry of structured laboratory data Discuss the unintended consequences of entering laboratory results into PCC data entry in the Electronic Health Record environment Clinical Lab Test Results

MU Measure Type of Measure: Rate Clinical Lab Test Results The number of lab test results whose results are expressed in a positive or negative affirmation or as a number, which are incorporated as structured data. >40 % The number of lab tests ordered by the provider during the EHR reporting period whose results are expressed in a positive or negative affirmation or as a number.

RPMS Reporting Logic Denominator Inclusions: COUNT: each V LAB entry ordered by an eligible provider during the EHR reporting period WHERE: the lab test is NOT a Pap Smear, determined by using the BGP PAP SMEAR TEST lab taxonomy AND WHERE: the result of the test is not equal to “canc” (canceled) AND WHERE: (EPs only) the ordering provider on the V LAB entry is the provider for which the report is being run Clinical Lab Test Results

RPMS Reporting Logic Numerator Inclusions: COUNT: each test in the denominator WHERE: the status flag is resulted WHERE: Results does not equal “comment” OR WHERE: Results = “comment” AND WHERE: Comments does not equal null Clinical Lab Test Results

RPMS Reporting Logic Measure Exclusion: EPs who order no lab tests having results that are displayed in either a positive/negative or numeric format during the EHR reporting period are excluded from this measure. Clinical Lab Test Results

How to meet the measure Data Innovations in-house interface is not required for in- house labs. If not using, order labs using RPMS EHR but manually enter test results into RPMS Lab package Use Bi-directional Reference Lab Interface for labs that are performed by a reference lab (e.g. Quest, LabCorp, etc.) If NOT using the bi-directional interface for Send-out labs, order labs using RPMS EHR but manually enter test results into RPMS Lab package Configure the EHR Point of Care lab button Software Requirements: EHR v1.1 patch 8, PCC patch 6,Lab Package v5.2 (patch 1027, 372 or 334) Clinical Lab Test Results

EHR RPMS LIS GIS Reference Laboratory File (LA7 Message Queue) File 63 (Lab Data File) OE/RR PCC Database (V Lab) RPMS Results viewed in EHR Lab Tab Structured Data CPOE

Objective and Measure (must Pick 1 Stage 1 Public Health ObjectivesStage 1 Public Health Measures Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable lw and practice Performed at least one test of the certified EHR technology’s capacity to submit electronic data to immunization registries and follow-up submission if the test is successful (unless none of the immunization registries to which the EP, eligible hospital or CAH submits such information have the capacity to receive such information electronically Hospitals Only: Capability to submit electronic data on reportable (as required by state or local law) lab results to public health agencies and actual submission in accordance with applicable law and practice Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practiceactual submission in accordance with applicable law and practice Performed at least one test of certifiedEHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which the EP, eligible hospital or CAH submits such information have the capacity to receive such information electronically)

Objective and Measure Capability to submit electronic data on reportable (as required by State or local law) lab results to public health agencies and actual submission according to applicable law and practice. Performed at least one test of certified EHR technology’s capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an eligible hospital or CAH submits such information has the capacity to receive the information electronically). Clinical Lab Test Results

Training Objectives Understand the objective and the measure Capability to submit electronic data on reportable (as required by State or local law) lab results to public health agencies and actual submission according to applicable law and practice. Clinical Lab Test Results

MU Measure Performed at least one test of certified EHR technology’s capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an eligible hospital or CAH submits such information has the capacity to receive the information electronically). Lab Results into EHR

How to Meet the Measure Ensure the facility is transmitting the revised RPMS Reportable Labs Export to the IHS Division of Epidemiology and Disease Prevention. Sign up to receive an export file receipt notification Software Requirements: PCC Patch 6 PCC Reports (APCL) Version 3.0 Patch 27 Clinical Lab Test Results

Area MU Coordinators AreaMU Coordinator Phone Number AberdeenCAPT Scott Anderson (605) Alaska Richard Hall Kimi Gosney Erika Wolter (907) (907) (907) AlbuquerqueJacque Candelaria (Acting) (505) Bemidji Jason Douglas Alan Fogarty (218) (218) BillingsCAPT James Sabatinos (406) CaliforniaMarilyn Freeman (916) , ext. 362 NashvilleRobin Bartlett (615) NavajoLCDR Andrea Scott (928) OklahomaAmy Rubin (405) PhoenixCAPT Lee Stern (602) Portland CAPT Leslie Dye Donnie Lee, MD (503) (503) TucsonScott Hamstra, MD (520) Area MU Coordinators

Area MU Consultants(contractors) AreaMU Consultants Phone Number Team Lead (ABQ)JoAnne Regional Consultant #1 Troy Regional Consultant #2 Melissa AberdeenCarol AlaskaKaren Sidell Audra Hill (907) AlbuquerqueTroy BemidjiSusanna BillingsJeremy CaliforniaTim NashvilleRobin NavajoDonna OklahomaUrsula PhoenixRick PortlandAngela TucsonRick

Clinical Lab Test Results How-to Session Questions & Discussion