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Hello
working on my NCQA PCMH application. We ( a group of single / double doc practices in RI)
started working on this in 11.13 and I think either it's going to kill me or I am going to be able to submit in 6- 8 weeks
UNBELIEVABLE PIA, that application.
Wondering if any one has any shortcuts or tips for Standard 5 Element A 'test tracking and follow up'?
I asked tech support to delete the previous 5 years of ordered tests from the sql database up to the date I started tracking, 2.1.14. I think you need 3 months of tracked data to submit.
Do you guys really go through the tests ordered every week and contact all who haven't had their results in 2 weeks ? This last element is the straw that is breaking the camel's back.
If anyone has any other tips or tricks on making AC work for this certification would love to hear them . Or I am also happy to share what I've got so far.
Lynn
Solo, 2004, micropractice, RI

Congrats on signing up for the pain. PCMH is coming as a standard whether we like it or not. UHCs latest round of provider cuts basically spared PCMH practices. Round my parts it's payor expected in the next few years or you're out of the network.

I haven't done it yet, but am curious how you used AC for all the reports/tracked data. Was it sufficient? I think we need AC to support PCMH reporting functions in the near future.

Lynn,

What is a micropractice?

I use the order entry function of Ac
At checkout the staff changes the forder status to pending status
As results Icome overthe fax the staff change these to completed orders
The pending orders section then has to be worked once a month or twice a month for calling patients

I do not know how to handle the pending orders when patient's have refused testing
As they remain in the Pending section

The easiest way to recouncile orders is through the checkout box, which brings up the orders for one patient only.

See Charlie's message about Dr. Khans presentation about PCMH at ACUC Houston.

http://amazingcharts.com/ub/ubbthreads.php/topics/61441/Dr._Khan's_PCMH_Presentation_f#Post61441

or direct to the presentation at http://amazingcharts.com/fileadmin/...P_presentation_3-19_for_AC_V3_032114.pdf

It was awesome and made it seem doable although obviously involved.

Definitely work a review.

@Lynn and @beagle,

Recently at ACUC Southwest, Dr. Khan, a family practice physician, shared how his small practice became PCMH certified using Amazing Charts. We have his PowerPoint presentation for you to review his strategy to overcome all of the requirements. Please click the link for the slides. I hope this is helpful!
http://amazingcharts.com/fileadmin/...P_presentation_3-19_for_AC_V3_032114.pdf

Thanks Dante and Wendell
I looked at the presentation.
It's a different model practice than mine so I'm not sure it will apply much in my case.
In this case it's just me and a part time nurse/friend I hired as a consultant to do some of the nit picking brain numbing parroting back required and function as a 'team'
I'm aware of a few other micro or small practices who have used AC who have qualified for PCMH level 3: Greg Sharp in Colorado and Avery Wood in Vermont - both with major support from their state quality organizations.
Greg also used a program he wrote himself to reconcile all labs, orders, Xrays and EVERY LAST THING they'd ever done. I'm pretty sure I can't replicate his work . Avery I think just slogged through the order list which is what I think I have to do :-(
The devil resides deeply in the details of the application.
I definitely did use some AC features such as pulling lists of patient with various diagnoses and all of the meaningful use numbers that crosswalk with NCQA requirements.
Finding the HM module NOT SUFFICIENTLY engineered or user define-able to be useful for the PCMH quality improvement pieces - having to pull by hand and run through excel sheets.

Sunil - when you say you reconcile through the checkout page where exactly do you mean?
I only know to go through the VIEW orders section where I can select labs only and a week at a time.
For PCMH I'm do is forwarding the still pending labs to me and sending a reminder to the patient via email asking them to do and documenting that in the chart and thus getting it out the box.
For PCMH you don't actually have to fix many problems, you just have to show you HAVE a process to address them . Typical.
Anyway, it would be great to have more functionality in the health maintenance module
Or maybe there already is
I moved back from V 7.0.10 and have not as yet rechecked the HM funcationality . I hear some bugs have been culled, so it's worth another go.

John - a micropractice or "IDEAL MEDICAL PRACTICE" is a small or solo practice using tech to lower overhead/replace human staff to the point where you actually have time to talk to your patients. I have no staff and schedule 30 - 60 minute appointments, see 40 patients per week on the regular insurance model and make reasonable FP money.

Larry
some reports are up to speed ( the crosswalked MU ones) and some do not exist
Often if your EMR does not have a certain report, another option is to describe your process and show screenshots on how you do it.
I'm getting writers cramp!!!

Lynn

Lynn

Please search patient name or use name from scheduler Right click and the 1st choice is checkin/checkout
I am using 6.6.2 version of AC

Lynn,
Some time ago I posted a way to use the order section that might facilitate order tracking. I can find the link to it, but I doubt it would be very useful to you. More importantly, the word from AC is that due to MU2 requirements, the AC version slated for release in early summer has a re-worked order section that is supposed to track orders much more effectively.

Lynn, what website do you use for your Virtual Visits and the questionaire? Is it something custom, or does another company set up the framework and you just use it?

Wayne
using Paypal which redirects after $25 payment to
Instant Medical History ( medicalhistory.com )
which takes the problem history and then sends me a text message that a virtual visit has been done

great for UTIs, sinus, tick bite, poison ivy, shingles,
sometimes use for chronic review for medications if patient in Florida or away
do about 40 -50 / year pays for IMH + a new computer every year
convenient for patients and I don't have to work for free.

like it !

thank you!

well then it would be absolutely useful to have a feature where you can specify the date you want the order to be tracked, or move a currently tracked order to the future.

I often write orders to Gmail Boomerang, which sends the order reminder with the order attached to the patient on the future date when you want the lab done
cuts down on those countless requests for " i lost my order, can you write me another one? " which are so time consuming.

hoping for tech that helps and doesn't harm ! (sigh)

Instant Medical History! Ok. Thanks Lynn.

Lynn
It's facinating to see what you have done. Dr. Khan is an MD, MBA and has a full time office manager working on her Masters. I then got the impression he has a small staff of 2-4 but he did not go into details. He did say that the paperwork was a pain, but the process was useful.

I truly have not explored PCMH much in the last 10 years as it has grown from a concept toward a funtional practice model. Specifically, I have not explored the NCQA requirements that are now in place. I do feel that the concept has good clinical background, but the devil is in the details.

How well it will work in a micropractice would be mind boggling, since most of the reports need to be in the program or there will be a lot of tedious report generation, which you have documented here.

It might be interesting to know which reports need to be set up. Perhaps AC could bake this in the program. I do know that working on the orders module is on their nearer radar and it appears many of your issues relate to orders and management.

You have done tremendous work. I am going to forward this thread to Chris Tremblay, Director of Product Development, to see if they might be able to create a report set/wizard specifically designed around PCMH. Since you are right up the road from them, it might prove useful to all involved.

This is the type of useful thing that should be built into either AC or to a Patient Portal. I think RelayHealth would let you schedule a message for sending in the future, but I don't truly remember.

AC let's you schedule a message for email I think, but what happens is that you get a reminder to send the email, instead of the email going out. And it would be better to go through secure messaging.

OK
submitted for PCMH level 3 with 97/100 points (with help of fantastic BizMed free software)

will hear in 2 months but expect I will be able to pull a level 3 PCMH
will be ticked off if I dont!

took 6-8 months and about 10- 20 hours a week

AC in concert with Updox can do it.
You have to be liberal about your interpretations with some of the reports AND
You often have to take the searches out into excel sheets and work them by hand - they just do not do what they need to in AC
example - colon cancer screening due, hgbA1cs, aggregate LDL levels,
Templates made it easy to do some of the disease management / self management documentation

And some of the stuff just needs to be done outside of EMR ( practice improvement projects, open access stuff. patient experience of care surveys )

Updox is great for tracking referrals and ER / hospital episodes, easy to tag the in/outgoing faxes/direct emails with different color tags and then pull them

All in all I'd not recommend getting this certification unless you are going to get big money for it Didn't improve much in my practice and left me chronically annoyed for 8 months!

But nice to know it can be done with AC ...

Happy to be PCMH NCQA AC resource if anyone has to go down this path.

Now back on to Meaningless Use 2 ..... no rest for the wearied.

Lynn

Hi Lynn,

Congrats on submitting for PCMH level 3. I am curious what specifically you couldn't do in AC that you had to do in excel? Our office is looking into doing the certification as well.

Thanks

ok so we looked at mammogram screening rates, colonoscopy screening rates, kids vaccination rates,
for these - it is odd but it seems that the colonoscopy tracker essentially pulls ALL
people due for colonoscopy at ANY time ages 50-75 whether you mark it DONE or NOT
they tell me that is how the software works which is moronic but there you have it
the mammogram does not work on that principle seems to take people off the list if 'done' but then you cannont change the interval on that to q 1 year for high risk

I did not use the AC vaccine tracker because RI has a state wide vaccine registry which is easier than entering in all the kids that have transferred in and having to manually enter their information

then you cannot pull hemoglobin A1Cs and LDLs because half of these labs are not EDI
so you miss them
maybe if you have 100% EDI you can do it

my main beef with the done/not done HM items which should work but dont