There’s lots of stuff. Here’s a quick summary:
-Patient Specific Education AMC measure completed
-Clickable entry placed in main encounter screen
-Medications Reconciliation AMC measure completed
-Clickable entry placed in main encounter screen
-Escribe Reporting AMC measure completed
-Clickable entry placed in prescription editing screen
-Send Summary to Referral AMC measure completed
-Clickable entry placed in Patient Transactions
-Can be tracked at Reports->Clinic->AMC Tracking
-Provide Clinical Summary for Each Office Visit AMC measure completed
-Clickable entry placed in main encounter screen
-Can be tracked at Reports->Clinic->AMC Tracking
-Use CPOE for Medication Orders AMC measure completed
-Timely electronic access AMC measure completed
-Note it relies on the existance of a patient portal
-New Patient Portal Authorization in the patient
demographics->Choices section.
-New column in the patient_data table to hold the
Patient Portal Authorization.
-Patient Record Request AMC Measure completed
-The request can be submitted from the
Patient/Client->Records->Patient Record Request page.
-The request can be tracked on the
Reports->Clinic->AMC Tracking page.
-Lab Results AMC Measure completed
-Need to manually enter the non-electronic labs in the
report at Reports->Clinical->Automated Measures (AMC)
-Mechanism to deal with miscellaneous AMC rules added
-amc_misc_data sql table to store elements
along with accompanying functions.
-Three CDR reports (standard,CQM,AMC) are now controlled
by three separate globals in Administration->Globals->CDR.
-Added a tracking report for applicable measures:
-Administration->Clinic->AMC Tracking
-Controlled by a global in Administration->Globals->CDR.
-Following measures are tracked here:
-Send Summary to Referral AMC measure
-Provide Clinical Summary for Each Office Visit AMC Measure
-Patient Record Request AMC Measure
-Added prompting for pertinent AMC information at various place.
-Controlled by a global in Administration->Globals->CDR.
We started our testing on AMC. We would like to get clarified on few questions.
1. Once the patient is created and entered medical problems, allergies, medications (those were in patient summary screen), the count is not added up in AMC report. Only when an encounter is created for that patient, the count for these are increased including demographics count. Is this expecting behaviour?
2. I have entered medications for two patients in prescription screen with one patient has eprescribing check box activated. We expected in AMC report to show 2 patient in denominator with count 1 in numerator which should result in 50%. Because, two medications were entered totally and with that one is eprescription, so it should be 50%. But in the report (Generate and transmit permissible prescriptions electronically) it showed 1 in denominator, 1 in numerator and 100%.
3. when will the medication reconciliation checkbox in main encounter screen of the patient will get enabled? Out of two patients created, it is enabled for one patient and other not. Did we miss something?
4. I sent reminders for two patients via email and reminders are successfully sent. But the count is not incremented in AMC report. It still states 0 in both numerator and denominator.
We keep you posted for additional queries. Just curious to know more about AMC tracking and standard measures.
1.Yes. These require being seen by the provider. So, basically needs to have an encounter within the report dates.
2. This works for me. Note here that in your case total patients should be 2. The denominator and numerator are counting prescriptions within report dates (escribe is calculated by each prescription, not patient).
3. If you click “Transition/Transfer of Care?” then you are supposed to do a Medication Reconciliation. So, it is only enabled if that is clicked.
4. Refer to the chart in the above link. Note this measure is only pertinent for patients with age >= 65 or <= 5.
Hope this helps. Feel free to ask anything else. Thanks for testing it.
Thanks for your clarifications. Yet one more question
How the denominator and numerator are calculated for “Incorporate clinical lab-test results into certified EHR technology as structured data” ?
What we thought is, once the procedure order is saved denominator will get incremented and once when the result for that order is entered manually/electronically the numerator is counted. Is our assumption correct?
This was a tough one to intepret (since only like 2-3 sentences describing it in the above link table). My interpretation was this:
Denominator is all labs results (both within the EHR as structured data and outside the EHR; could be in a paper chart or stored as docs in the documents). Since counting the results outside the EHR is impossible, this is why the user is asked to provide this number (The Number labs:(Non-electronic) entry on the AMC Report. Then the Numerator is all lab results within EHR as structured data. I went the manual route because it looks like this is ok to do from reading the link above if unable to automatically gather the data. May want to run my (and yours) interpretation through NIST. If acceptable, your route would be better, because we could then automatically calculate it (ie. wouldn’t need to manually ask for data).
-brady
It is stated in the rule that “More than 40% of all clinical lab test results ordered by the EP or by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency department (POS 21 or 23) during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data”,
so we think, the denominator should be the number of orders placed and numerator should be number of lab test results incorporated with orders.
Tony, could you please confirm with ICSA labs that which interpretation is correct?
Hi,
There are potential flaws in both mine and your interpretations; a rather difficult rule. Again, your interpretation would be nice, because then wouldn’t need to ask for a manual count of the non-electronic lab results. Will await Tony’ thoughts after he runs by ICSA before spending more time on it.
-brady
-Patient Record Request AMC Measure completed -The request can be submitted from the Patient/Client->Records->Patient Record Request page. -The request can be tracked on the Reports->Clinic->AMC Tracking page.
Seems odd to have it on the navigation menu, -vs- on the demog page or patient context popup. The message is not clear, should at least say “records requested for: PATIENT LAST/FIRST PID etc.” then, as an enhancement it should post a patient note addressed to some user to follow up on the request and indicate that the request was fulfilled. The other option would be to use a patient notes category called “record request” to do this.