Home Forums Discussions Meaningful Use How to fulfill reporting on quality measures

Can anyone assist in giving me a direction to go in on meeting the requirements to report quality measures to CMS or states?

I am a rheumatologist in Kentucky. I do osteoporosis management, and would suppose I could report on DEXAs, but really do not know how to get started, where I enter data, who to report to, and how to report the data.

Any links to other discussions or instructions would be greatly appreciated. This is really the only criteria for meaningful use that is holding me up.

Thanks!

-Lee Colglazier

Lee,

I presume that you are referring to the "Core CQM" and "CQM option" requirements to meet MU for year one.

As you can see in the AC Meaningful Use wizard, you must collect MU data for 3 (of 6) Core CQM and 3 (of 38) optional CQM categories over the 3 month MU qualification period.

As a rheumatologist, you should be able to easily meet the 3 Core CQMs:
1. Recording patient's BP for 2 visits in 90 days -- this could easily be done by staff, probably you do this anyway for your patients starting NSAIDs.
2. Recording tobacco use (2 visits in the 90 days), and one of these visits, in Decision Support, double click on "Counseling to Prevent Tobacco Use and Tobacco-Caused Disease in Adults", enter a comment and Save. I am sure the DMARD patients increase their infection risks by smoking.
3. Recording adult weight (1 visit in 90 days, if BMI <22 or >30, must record visit with V65.3 code for weight counseling). I don't know about you, but all my DJD patients seem to be obese.

As far as the 3 of 38 optional CQM categories, with probably little modification of your office practices, you could probably meet some of these:

(the first two are easy, you have already collected the info for core CQM above)
-- NQF 0018: Record blood pressure for one visit
-- NQF 0027: Enter current smoking status in the dropdown above Social History. In Decision Support on the first tab (Health Maintenance Due) double click "Counseling to Prevent Tobacco Use and Tobacco-Caused Disease in Adults", enter a comment and Save.

(others that may be appropriate to rheumatology patients)
-- NQF 0052: Patients 18-49 years old, onset LBP within 6 months, have not had an imaging study within the 1st 28 days of diagnosis. My thought is that this applies to you, not the referring PCP.
-- NQF 0056: You likely see diabetics with foot arthritis. To qualify, enable this HM Due alert by selecting the Risk Factor button on Most Recent Encounters and select Diabetes from the Past Medical History Section and Save. Then select the Decision Support button and on the first tab (HM Due) double click on Recommendations for Diabetic Foot Care, enter comments and Save.
-- NQF 0062: Again, your diabetics on NSAIDs would qualify you for the nephropathy category. Patients have to be seen for 2 visits in 90 days or be taking a diabetes med. In Most Recent Encounters select the Decision Support button and on the first tab (HM Due) double click on Screening for Diabetic Nephropathy, enter comments and Save.

Remember, you only need 3 of the 38 optional categories, and even 1 patient would qualify you for each NQF (unlike the Core & Menu MU criteria, there is no threshold).

Wow, thanks John!

You put a lot of work into that answer, thanks for taking the time. I will read over it and post back once we get it to work.

Thanks again, that was a lot of help!

-Lee

John,

I read it all over, and yes, those options will work great.

One more question, do I need to then report the quality measures to CMS? Or just be able to report them? If I have to report them, how and when do I do that?

Thanks again!

-Lee Colglazier
Rheumatology, Crestview Hills KY

Having just done all the Attestation stuff for Meaningful Use, I was ready for a question like yours.

Again, I am assuming you are doing all this for year one Meaningful Use ($18,000, if you have enough Medicare folks). If yes, you have to collect the NQF data above on patients for 90 days using AC, and then log onto the CMS EHR Incentive website, and fill in the data. Then you will be approved for payment. I suggest going ahead and registering for the EHR incentive, year one here, so you can look through the steps that you need to complete.

Fortunately, Amazing Charts keeps good running totals of your efforts. At the top of each encounter note, the green button for Meaningful Use gives you completion data on the patient that you are working on, and also the grand total, both for the 15 Core and 10 Menu categories, some of which have thresholds. The CQMs we discussed above can be monitored by running the Meaningful Use report (same window, far left).

Have your main data person in the office sit through the excellent Amazing Charts video tutorials on Meaningful Use, it really helps with the little details.