Qualifying for Incentive Payments with UniCharts EMR  
This guide assumes you have installed or upgraded to the "2011-2012 Certified UniCharts EMR version 3" of the program which encompasses 2011 to 2014 Stage 1 meaningful-use


There are 15 core and 10 menu-set meaningful use objectives defined by the CMS. The 15 core objectives all need to be met (or exclusion claimed) whereas you can choose any 5 out of the 10 menu set objectives as per your preference. The following is the description of all 25 objectives and how UniCharts EMR can help you achieve the required 20 objectives and qualify for stimulus money. The contents of this guide are as follows:

CORE OBJECTIVES


  1. Record Demographics

    Denominator:  The number of unique patients seen by the EP during the EMR reporting period.
    Numerator:  The number of patients in the denominator who have Date of Birth, Gender, Race, Ethnicity and Preferred Language recorded as structured data.
    Threshold:  Greater than 50%
    Exclusion:  N/A

    "How To" in UniCharts:  The fields for capturing Date of Birth, Gender, Race, Ethnicity and Preferred Language are all present on the GENERAL form of every chart. Just instruct your staff to always select appropriate values from the corresponding dropdown menus. As any blank value will count negatively in this measure, the option UNREPORTED should be selected if a patient refuses or a State forbids capture of race, ethnicity or language information.



  2. Medication Allergy List

    Denominator:  The number of unique patients seen by the EP during the EMR reporting period.
    Numerator:  The number of patients in the denominator who have at least one entry (or an indication that patient has no known medication allergies) recorded as structured data in their medication allergy list.
    Threshold:  Greater than 80%
    Exclusion:  N/A

    "How To" in UniCharts:  The EMR system looks for at least one entry in the KNOWN ALLERGIES block on the HISTORY form or selection of the option NO KNOWN ALLERGIES from within the corresponding favorite list.



  3. Maintain Problem List

    Denominator:  The number of unique patients seen by the EP during the EMR reporting period.
    Numerator:  The number of patients in the denominator who have at least one entry or an indication that no problems are known for the patient recorded as structured data in the problem list.
    Threshold:  Greater than 80%
    Exclusion:  N/A

    "How To" in UniCharts:  The system looks for at least one entry in the MASTER PROBLEM LIST block on the HISTORY form or selection of the option NO KNOWN PROBLEMS from within the corresponding favorite list.



  4. Active Medication List

    Denominator:  The number of unique patients seen by the EP during the EMR reporting period.
    Numerator:  The number of patients in the denominator who have a medication (or an indication that the patient is not currently prescribed any medication) recorded as structured data.
    Threshold:  Greater than 80%
    Exclusion:  N/A

    "How To" in UniCharts:  The system looks for at least one entry in the MASTER MEDICATION LIST block on the HISTORY form or selection of the option NO KNOWN MEDICATIONS from within the corresponding favorite list.



  5. Record Smoking Status

    Denominator:  The number of unique patients age 13 or over seen by the EP during the EMR reporting period.
    Numerator:  The number of patients in the denominator with smoking status recorded as structured data. Note that the frequency of updating smoking status is left to the provider. The EMR system looks at the SMOKING STATUS field within HEALTH MAINTENANCE section on the HISTORY form of charts to determine if the patient smoking status was recorded.
    Threshold:  Greater than 50%
    Exclusion:  Any EP who does not see patients 13 years or older.

    "How To" in UniCharts:  The EMR system looks at the SMOKING STATUS field within HEALTH MAINTENANCE section on the HISTORY form of charts to determine if the patient smoking status was recorded. Note that the frequency of updating smoking status is left to the provider.



  6. Record Vital Signs

    Denominator:  The number of unique patients age 2 or over seen by the EP during the reporting period.
    Numerator:  The number of patients in the denominator who have at least one entry of their height, weight and blood pressure recorded as structured data.
    Threshold: Greater than 50%
    Exclusion:  Any EP who does not see patients 2 years or older, or who believes all three vital signs have no relevance to their scope of practice.

    "How To" in UniCharts:  The fields for capturing height, weight and blood pressure are all present in the VITAL SIGNS block on every ENCOUNTER form. Note that if a patient has two encounters during the reporting period in which one encounter has blood pressure readings while the other has height and weight recorded, this patient will not be counted towards the numerator. All of these readings must be present within the VITAL SIGNS block on the same ENCOUNTER form to make it eligible.



  7. Medical Summaries on Visits

    Denominator:  The total number of visits to an eligible provider that occurred during the reporting period.
    Numerator:  The number of visits in the denominator on which a clinical summary of the encounter was provided to the patient within 3 business days.
    Threshold:  Greater than 50%
    Exclusion:  An EP that does not have any relevant encounters during the reporting period.

    "How To" in UniCharts:  The system determines the compliance by the user response to the dialog box presented on the print screen when CLINICAL SUMMARY button is clicked to generate and print/export the clinical summary. Please be aware that this measure takes into account the total number of visits instead of total number of unique patients. That is, if the same patient returns for a visit eight times during the reporting period, then you need to give him/her visit summary at least four times.



  8. Patient Requested Electronic Copies

    Denominator:  The number of patients of the EP who request an electronic copy of their health information during the reporting period.
    Numerator:  The number of patients in the denominator who receive a copy of their health information within 3 business days of the request.
    Threshold:  Greater than 50%
    Exclusion:  Any EP that has no requests from patients or their agents for an electronic copy of patient health information during the reporting period.

    "How To" in UniCharts:  The system determines the compliance by the user response to the dialog box presented on the print screen when CLINICAL SUMMARY button is clicked to generate and print/export the clinical summary. Note that denominator is based on the requests made by patients. If no patient requests electronic copy the denominator would be zero. Similarly, if the same patient has, say, three visits during the reporting period and requests copies on two of the visits, the denominator would be increased by two. Also note that system would ask for a password for encryption and you need to convey this password to the patient otherwise they will not be able to open the PDF or CCR summary file.



  9. CPOE for Medication Orders

    Denominator:  The number of unique patients with at least one medication in their medication list seen by the EP during the reporting period.
    Numerator:  The number of patients in the denominator that have at least one medication order entered using computerized provider order entry (CPOE).
    Threshold: Greater than 30%
    Exclusion:  Any EP who writes fewer than 100 prescriptions during the EHR reporting period.

    "How To" in UniCharts:  The EMR system considers locking of a MEDICATIONS/RX block on the ENCOUNTER form by the EP as computerized provider order entry. This implies that for determining CPOE the EMR counts unique patients that have at least one locked prescription during the reporting period.



  10. E-prescription

    Denominator:  The number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the reporting period. The EMR determines this figure by the number of locked MEDICATIONS/RX blocks on the ENCOUNTER forms by the EP during the reporting and the medications contained therein.
    Numerator:  The number of prescriptions in the denominator generated and transmitted electronically.
    Threshold: Greater than 40%
    Exclusion:  Any EP who writes fewer than 100 prescriptions during the EHR reporting period.

    "How To" in UniCharts:  The compliance is determined by the user response to the dialog box presented when user tries to close the window used to access external e-prescription website from within the EMR program. Note that this window is opened from the ERx button that exists on the print screen where prescriptions are prepared for printing or faxing. The e-prescribing workflow is described here in more detail.



  11. Clinical Decision Support

    Yes/No Attest:  This objective is reported to CMS through self-attestation. The EP must attest YES to having implemented one clinical decision support rule for the length of the reporting period to meet the objective. The drug interaction alerts cannot be used to meet the meaningful use objective for implementing one clinical decision support rule.
    Exclusion: None

    "How To" in UniCharts:  The EMR system allows an EP to implement any number of clinical decision support rules according to their workflow, patient population and quality improvement efforts. As drug interaction and formulary alerts cannot be used to meet the meaningful use objective for implementing clinical decision support rule, you should add a at least ONE rule under the type "Care Suggestion" to meet this objective. Once you add a care suggestion rule in customization area, its dialog box would show up every time you select its trigger which may either be a diagnosis or a medication, as shown in the below screenshot. The process of setting up rules is described here in detail.



  12. Drug Interaction Checks

    Yes/No Attest:  This objective is reported to CMS through self-attestation. The EP must attest YES to having enabled drug-drug and drug-allergy interaction checks for the length of the reporting period to meet this objective.
    Exclusion: None

    "How To" in UniCharts:  Just like the Care Suggestion rule implemented above, you can implement any number of Drug-Drug and Drug-Allergy interaction checks by setting up rules within the EMR system. However, if you prescribe a range of different medications we would then recommend not implementing drug interactions within the EMR software and using interaction checking functionality of the e-prescribing service instead. As comprehensive interaction checking functionality is provided by all e-Prescribing services, it would be easier to simply use that facility instead of setting up interactions within the EMR system. Just make sure interaction checking is enabled in the e-prescribing service for the length of the reporting period and it would be more than enough to meet this objective. On the other hand, if you are a specialist and deal with a selected few medications, you may consider setting up a few clincial rules for drug-drug and drug-allergy interactions to meet this objective.



  13. Electronic Exchange of Clinical Information

    Yes/No Attest:  This objective is reported to CMS through self-attestation. The EP must attest YES to having performed at least one test of certified EHR technology capacity to electronically exchange key clinical information with another provider prior to the end of the EHR reporting period to meet this objective.
    Exclusion: None

    "How To" in UniCharts:  The EMR system is capable of exporting patient data via CCR and PDF files and importing patient data via CCR and CCD files, all of which allow for the exchange of problem list data, medications, medication allergies, and diagnostic test results with other systems. To export CCR or PDF file out of the system, you just need to access the window shown in the screenshot of objective #8 titled Patient Requested Electronic Copies discussed above and select "Electronic copy is needed for other operational purposes" radio button. Once exported and saved on the hard disk, you may send the encrypted file to another provider through normal email or on a CD/USB flash drive. As for importing, the following screenshot shows where and how to import the CCR or CCD file that may be received from another provider through email or CD/USB flash drive. The system is capable of reading the XML based CCR/CCD files directly and also the password encrypted ZIPs containing the CCR/CCD files. Note that the use of test information about a fictional patient that would be identical in form to what would be sent to another provider about an actual patient would satisfy this objective. Also be aware that an unsuccessful test of electronic exchange of key clinical information will be considered valid for meeting the measure of this objective. Therefore you may safely report the objective to CMS through self-attestation after perfroming one test during the reporting period.



  14. Protect Electronic Health Information

    Yes/No Attest:  This objective is reported to CMS through self-attestation. The EP must attest YES to having conducted or reviewed a security risk analysis in accordance with the requirements and implemented security updates as necessary and corrected identified security deficiencies prior to or during the EHR reporting period to meet this objective.
    Exclusion: None

    "How To" in UniCharts:  The scope of this measure is beyond the EMR system itself. As far as EMR is concerned, the client side runs within a browser and, as such, does not store any data on the client computers that may be of concern. Furthermore, the EMR system already requires that each user consistently sign in with their own unique ID, permits administrator level user to access electronic health information during an emergency, and provides mechanism for installing SSL layer in case of using the system over the Internet. In addition, the administrator can define the automatic inactivity timeout duration after which a user is not able to perform any clinical task unless logged in again. It is an enhanced implementation in that no work or data is lost in case a session times out. The user is able to resume right from that point once he or she logs in again, as shown in the screenshot below. Other than these, there is no direct EMR functionality that impacts the completion of security risk analysis. We recommend availing services of local IT support or security consultant to review your server, network and firewall/antivirus configurations and correct any deficiencies whatsoever. Also, the ONC in collaboration with OCR and OGC has developed a Security Risk Assessment Tool to help guide providers through the security risk assessment process. Note that this tool is not required by HIPAA but just meant to assist providers perform a risk assessment as needed.



  15. Clinical Quality Measures

    Yes/No Attest:  This objective is reported to CMS through self-attestation for 2011. Eligible providers must implement 6 measures in total: 3 core measures (substituting the alternate core measures if necessary) and 3 additional measures.

    "How To" in UniCharts:  The EMR software supports all 44 clinical quality measures, providing the widest possible range to physicians to choose from. As far as the workflow is concerned, some of these measures are linked to data elements such as vital signs and smoking status etc while others are associated with designated ICD codes. Similarly, some of the measures are calculated without any user feedback while others prompt user to select appropriate option. In case of a prompt, the dialog box is presented to the user at the time of signing/locking the encounter form and user just needs to select appropriate option, as shown in the screenshot below. The process of setting up clinical quality measures is discussed here in detail.






MENU SET OBJECTIVES  (Choose 5 out of 10 - one of "Generate Immunization Registries Data" or "Generate Syndromic Surveillance Data" is required)


  1. Receive Structured Lab Test Results

    Denominator:  The number of lab tests ordered during the reporting period by the EP whose results are expressed in a positive or negative affirmation or as a number.
    Numerator:  The number of lab test results that are expressed in a positive or negative affirmation or as a number and are incorporated as structured data.
    Threshold:  Greater than 40%
    Exclusion:  An EP who does not order lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period.

    "How To" in UniCharts:  This objective requires that a HL7 lab interface be used to import incoming lab reports. The EMR system determines the type of tests ordered using the LOINC codes present in the incoming HL7 files. If no LOINC codes are present, the type is determined using an internal logic involving the test names. Similarly, the EMR software determines the type of test results using the LOINC codes present in the incoming HL7 files. If no LOINC codes are present, the type is determined using HL7 data types and their parsing outcomes, with only the HL7 data types of NM, SN and ST considered eligible for parsing. Now as you have to choose only five menu set objectives out of ten, you may skip this objective if you want. On the other hand, if you use Labcorp, OracleDiagnostics or PathLabs Inc you may consider purchasing an activation key for inbound HL7 interface. As we already have interfaces with these laboratories the cost of an activation key is one-time $500 only. Once you complete the purchase, we will send you a key that will activate our part of the interface within the EMR program. You will then have to ask your local lab representative to have their technician install their part of the interface. It will essentially be a small program that they will install on the computer on which EMR server is running (Labcorp uses a program called HyperSend for this purpose, for instance). This small program will periodically connect to the laboratory network and download results to a shared folder on the computer. Our interface will then automatically import these results, as they arrive, and generate neatly formatted reports on their basis as shown below. The process of acquiring lab interface is described here in detail.



  2. Send Patient Followup Reminders

    Denominator: The number of unique patients 65 years or older or 5 years or younger seen by the EP during the reporting period.
    Numerator:  The number of patients in the denominator who were sent the appropriate reminders.
    Threshold:  Greater than 20%
    Exclusion:  An EP who has no patients 65 years or older or 5 years or younger with records maintained using the EHR system.

    "How To" in UniCharts:  The EMR system provides an easy way to record patients to whom reminders were sent. The reminder status is recorded by clicking the small square icon under data entry pane on the SCHEDULE screen of the EMR system, as shown in the screenshot below. The dialog box will let you select the medium that was used to send the reminder. Selecting the first option "Print Mail" will also generate a reminder letter ready for printing. However, it is not necessary to send reminders by paper mail and you should remind a patient according to his/her contact preference saved on the General form of their chart (contact preference field is available within the Contact Information block on the General form of every chart). Note that most practices already remind patients for follow-up care and appointments by phone or other means. As such, they just need to record this action in the status dialog box to achieve this objective, specially if the patients's age is less than 6 or greater than 64 years. Also note that you can generate list of patients to be sent reminders on the basis of various criteria, including the "Next Due" date of a Health Maintenance item. But this is just a helper function and not a requirement, and you may continue using your own mechanism for selecting patients that are to be sent reminders. The process of generating reminder list through the EMR is discussed here in detail.



  3. Provide Timely Electronic/Online Access

    Denominator:  The number of unique patients seen by the eligible provider during the EMR reporting period.
    Numerator:  The number of patients in the denominator who have timely (available within 4 business days) electronic access to their health information online.
    Threshold:  Greater than 10%
    Exclusion:  Any EP that neither orders nor creates information that would be contained in the problem list, medication list, medication allergy list during the EHR reporting period.

    "How To" in UniCharts:  The system determines the compliance by the user response to the dialog box presented on the print screen when CLINICAL SUMMARY button is clicked to generate and print/export the clinical summary. Note that EP is not responsible for ensuring that 10 percent patients request access or have the means to access, only that 10 percent of all unique patients seen by the EP could access the information if they so desired. Also note that system would ask for a password for encryption and you need to convey this password to the patient otherwise they will not be able to open the PDF or CCR summary file. If you will be sending the file in an email, then you should either send the password in a separate email or convey it at the time of visit or on the phone.



  4. Give Patient Educational Handouts

    Denominator: The number of unique patients seen by the eligible provider during the EMR reporting period.
    Numerator:  The number of patients in the denominator who were provided patient specific education resources or material.
    Threshold:  Greater than 10%
    Exclusion:  N/A

    "How To" in UniCharts:  The system determines the compliance by the user response to the dialog box presented on the print screen when a user-defined custom document marked for the HANDOUTS folder for that patient is saved. Please note that educational handouts are first defined in the customization area as custom documents. The limit of custom documents in the standard version of our EMR software is eight which has been increased to twelve in certified version to accommodate the educational handouts. Once defined, the educational handouts become available on every encounter form along with other encounter-centric documents, ready to be printed and handed over to the patient. The process of defining patient educational handouts is discussed here in more detail.



  5. Reconcile Medications on Receiving Patients

    Denominator: The number of transitions of care during the EHR reporting period for which the EP was the receiving party of the transition.
    Numerator:  The number of transitions of care in the denominator where medication reconciliation was performed.
    Threshold:  Greater than 50%
    Exclusion:  An EP who was not the recipient of any transitions of care during the EMR reporting period.

    "How To" in UniCharts:  The system determines the compliance by the user response to the dialog box presented on the print screen when CONSULTATION NOTE for that patient is saved. Note that it is ok if patient has verbally told the past medications or have brought them written on a piece of paper. User just needs to reconcile that data with the master medication list on the History form and make adjustments if needed. If you or your staff has done the reconciliation, then YES should be selected as the answer. As for the cutout shown within the below screenshot, it is a helper function in case patient has brought past medication list as JPG or PDF file. It will allow your staff to import the file on History form and then reconcile by keeping both lists side by side.



  6. Give Summary of Care on Transferring Patients

    Denominator: The number of transitions of care and referrals during the EMR reporting period for which the EP was the transferring or referring provider.
    Numerator:  The number of transitions of care and referrals in the denominator where a summary of care record was provided.
    Threshold:  Greater than 50%
    Exclusion:  An EP who did not transferred a patient to another setting or referred a patient to another provider during the reporting period.

    "How To" in UniCharts:  The system determines the compliance by the user's response to the dialog box presented on the print screen when REFERRAL LETTER for that patient is saved. As the referral letter generated from the EMR already has complete clinical summary of the visit automatically appended to it, you just need to click YES and that's it. In case you want to send the summary in electronic format, go to the window shown in the screenshot of objective #8 titled Patient Requested Electronic Copies discussed above and select "Electronic copy is needed for other operational purposes" radio button. Once exported and saved on the hard disk, you may send the encrypted file to another provider through normal email or on a CD/USB flash drive.



  7. Enable Drug Formulary Checks

    Yes/No Attest:  The EP must attest YES to having enabled this functionality and having had access to at least one internal or external formulary for the entire reporting period to meet this objective.
    Exclusion: An EP who writes fewer than 100 prescriptions during the reporting period can be excluded from this objective and associated measure.

    "How To" in UniCharts:  Just like the Care Suggestion rule implemented above, you can implement any number of Drug-Formulary checks by setting up rules within the EMR system. However, as formularies often change we recommend not implementing formulary checks within the EMR software and using formulary checking functionality of the e-prescribing service instead. Just make sure formulary checking is available from your selected e-prescribing service for the length of the reporting period and it would be more than enough to meet this objective.



  8. Generate Patient Lists

    Yes/No Attest:  The EP must attest YES to having generated at least one report listing patients of the EP with a specific condition to meet this objective.
    Exclusion: None

    "How To" in UniCharts:  This objective does not dictate any specific report which must be generated as eligible provider is in the best position to determine what is most useful to their care efforts. The EMR system allows generation of patient lists based on problems, medications, lab results and other criterion on the PATIENT LISTS tab on the below screen. Not that you have generate just ONE list in the entire reporting period after which you may safely report the objective to CMS through self-attestation.



  9. Generate Immunization Registries Data

    Yes/No Attest:  The EP must attest YES to having performed at least one test of certified EHR technology’s capacity to generate electronic data for submission to immunization registries and follow up submission if the test was successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically) to meet this objective
    Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically.

    "How To" in UniCharts:  The EMR system allows generation of patient immunization data in HL7 format on the IMM REGISTRIES tab on the below screen. You need to perform just one test at the end of reporting period, and only if there is an immunization registry that has the capacity to receive the information.



  10. Generate Syndromic Surveillance Data

    Yes/No Attest:  The EP must attest YES to having performed at least one test of certified EHR technology’s capacity to generate electronic syndromic surveillance data for submission to public health agencies and follow up submission if the test was successful (unless none of the public health agencies to which the EP submits such information has the capacity to receive the information electronically) to meet this objective.
    Exclusion: An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period or if no public health agency has the capacity to receive the information electronically.

    "How To" in UniCharts:  The EMR system allows generation of patient surveillance data in HL7 format on the HEALTH SURVEILLANCE tab on the below screen. You need to perform just one test at the end of reporting period, and only if there is a public health agency that has the capacity to receive the information.







Which objectives should I select to report?

It is relatively easy to achieve CMS defined meaningful use than it appears at a first glance.

CORE OBJECTIVES: The providers have to report on all 15 core objectives. But this does not mean they have to perform a particular activity if that activity does not belong to their specialty-specific workflow. As you may have already noticed in the descriptions above, many of the 15 core objectives provide an exclusion option that may be used if the objective does not apply. If, for example, a provider does not write prescriptions or write fewer than hundred during the reporting period then he/she can claim exclusions on both "E-prescription" and "CPOE on Medication Orders" objectives. Similarly, the objective "Patient Requested Electronic Copies" depends on the patients' requests. If there are no such patient requests during the reporting period, then the provider will just report exclusion and it will be counted as if the objective was met.

MENU OBJECTIVES: The menu-set objectives are even more flexible than the core objectives mentioned above because you just have to select 5 out of 10 and then the exclusion clause still apply. The only additional binding is to select at least one of the two public-health menu objectives ("Generate Immunization Registries Data" and "Generate Syndromic Surveillance Data" discussed above) from the set of 10 menu objectives. But what if there are less than 5 objectives that relevant to your specialty? You will just claim exclusions to reach the total of five and that's it. If, for instance, there are only 3 objectives applicable to your specialty then you will select those 3 objectives plus any 2 objectives with exclusions. The general rule is to start with selecting one of the two public health menu objectives, move on to selecting the other menu objectives that are relevant to the scope of practice and, if the number does not reach five, continue to choose from the remaining menu objectives with exclusions until a total of five is reached. This however implies that the provider should not claim exclusion to a menu objective if there are remaining objectives that are relevant to their practice. Even though it is your discretion to select whatever objectives you like from the menu set, our recommendation would be as follows:

  • Selecting one of the two public health menu objectives:
    The two public-health menu objectives concern with "Immunizations" and "Syndromic Health Surveillance" data and require generation and, if possible, submission of that data to public health registries/agencies. And you must select and attest to at least one of them to show meaningful use. Now many a specialties, even if they administer immunizations, also deal with diagnosis codes that are relevant to syndromic surveillance for detecting early disease outbreaks. As such, you may consider choosing "Syndromic Surveillance" for attestation if it applies. This would allow you to claim exclusion because specifications of the electronic file to be submitted are not yet finalized and therefore registries are not able to accept data at this time. Note that as per CMS rules you still have to attest to one of the two public health objectives even if you belong to a specialty that does not collect either syndromic surveillance or the immunization related data. In this case again you may attest to "Syndromic Surveillance" option and then claim exclusion. Please see claiming exclusion in public health objectives for more.

  • Selecting four of the remaining eight menu objectives:
    • If you routinely refer your patients to another provider or care setting
      • If you are receiving lab results through EMR's incoming HL7 lab interface
        1. Give Summary of Care on Transferring Patients
        2. Receive Structured Lab Test Results
        3. Give Patient Educational Handouts
        4. Send Patient Followup Reminders
      • If you are not receiving lab results through the incoming HL7 lab interface
        1. Give Summary of Care on Transferring Patients
        2. Generate Patient Lists
        3. Give Patient Educational Handouts
        4. Send Patient Followup Reminders
    • If you routinely receive patients from another provider or care setting
      • If you are receiving lab results through EMR's incoming HL7 lab interface
        1. Reconcile Medications on Receiving Patients
        2. Receive Structured Lab Test Results
        3. Give Patient Educational Handouts
        4. Send Patient Followup Reminders
      • If you are not receiving lab results through the incoming HL7 lab interface
        1. Reconcile Medications on Receiving Patients
        2. Generate Patient Lists
        3. Give Patient Educational Handouts
        4. Send Patient Followup Reminders

      Note that above combinations are just suggestions. Some specialties receive patients from other providers and also refer patients to other providers. In this case, they may select both "Give Summary of Care on Transferring Patients" and " Reconcile Medications on Receiving Patients", and drop one from the above suggested list. Similarly, you may not select "Receive Structured Lab Test Results" even though you receive results through HL7 interface and choose "Generate Patient Lists" in its place.
TRACKING THE PERFORMANCE: Assuming you have decided on the objectives and have started meaningful use of the system as per instructions contained in this manual, you can track your performance on measurable objectives by going to the first tab on the reporting window, as shown below. We recommend visiting this screen at least once or twice every month to see the current performance and adjust the workflow if and as needed. Be aware that this screen is available only to the clinic administrator, the user with a level 5 privilege. Other users will not see the MU Reporting button altogether.



Note that the above screen will provide numerators/denominators for all core and menu objectives except 'clinical quality measures'. To track the performance of clinical quality measures objective, you need to visit the "Clinical Quality" tab and generate report on your six selected measures one by one. However, be aware that there are no thresholds set for CQMs and zero is an acceptable value for their denominators and/or numerators. Therefore it is more important to regularly track the performance of other objectives shown in the above screenshot and ensure they meet their predefined thresholds. You will nevertheless need the denominator, numerator and exclusions values of your selected six CQMs at the time of attestation, even if some of them are zero. To extract the values just visit "Clinical Quality" tab and generate report on the CQMs one by one as shown below. We recommend you write down the values of every measure on a piece of paper beforehand for easier reference during the attestation process. Please see attesting for clinical quality measures objective for more.





How do I register and attest with CMS?

The certified version of UniCharts EMR provides you with functionality that is needed to qualify for the EHR Incentive program. However, you are responsible for using it as per above instructions and also for signing up for either the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program and applying to receive your stimulus funds. Be aware that providers are required to show only three months of consecutive meaningful use, regardless of their stage of participation, during the year 2014. Also note that the information in this paragraph just provides an outline as per our understanding and you should consult CMS or visit their website for confirmation before making any decision in this regard. Furthermore, the timelines mentioned above apply to Medicare incentive program. If you plan to participate in Medicaid incentive program, it varies by the state and you should check your local agency for its details.

Refer to the CMS's Registration User Guide for Eligible Professionals for complete registration instructions.

Refer to the CMS's Attestation User Guide for Eligible Professionals for complete attestation instructions.

The CMS EHR certification number for UniCharts EMR software is 30000004SSZTEAY. In case you would like to reconfirm the certification number before submitting, please follow the instructions listed in the CMS "Attestation User Guide for Eligible Professionals" linked above. Also note that EMR certification number is not required when you initially register for Medicare and Medicaid EMR Incentive Program, but will be required when you reach the attestation stage later.

Note for Medicaid SLR attesters: Users registering/attesting with a Medicaid SLR may need to fill-out a form to confirm/report Medicaid patient volume (percentage) in their clinic during the period being attested. Although it would be best to calculate the percentage of Medicaid patients by gathering numbers for "All Payers Encounters" and "Medicaid Encounters" from the billing software or your biller as it would be most accurate, you may also use the EMR to pull out the numbers provided that you have entered data as per instructions provided here.

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