Webinar 6:
Detailed Overview of PQRS &
CQM 2014
using DigiDMS EHR 2014 Edition
Tuesday, April 14, 2014 at 3:30 PM EST
Wedn...
Clinical Quality Measure (CQM)
Quick Facts
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
 EPs ...
Physician Qualitative Reporting System (PQRS)
Quick Facts
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare M...
PQRS
How to Report once or individual for 2014 Medicare
Quality Programs Reporting (PQRS & CQM)?
EHR* PM * Patient Portal ...
Requirements for Implementing
MU in 2014
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
1. Selec...
Step 1: Select CQM and PQRS
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
6
Step 1: Select Common CQM & PQRS
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
7
Certified PQRS...
Step 1: Option
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
1. Select CQM [for 90 Days of Your...
Step 2: Activate Alerts (Optional)
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
9
DigiDMS EHR ...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
10
Step 3: Verify Alerts (Optional)
DigiDMS EHR ...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
11
Step 4: Take Appropriate Actions
PQRS CMS IDNQ...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
12
Step 5: Review PQRS Code suggested by EHR)
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
13
Step 5: Review PQRS Code suggested by EHR)
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
14
Step 6: Verify CQM Performance
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
15
Step 7: Generate QRDA Report for submission
[ ...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
16
CQM Explanation – CQM 165
Percentage of patien...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
17
CQM Explanation – CQM 122
Percentage of patien...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
18
CQM Explanation – CQM 125
Percentage of women ...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
19
CQM Explanation
Please Refer DigiDMS EHR versi...
EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging
Questions & Answers
?
20
Thank You!
EHR * PM * Patient Portal * Direct Messaging * Secure Healthcare Messaging
21
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Webinar 6 : Detailed Overview of PQRS and CQM 2014 | DigiDMS.com

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DigiDMS is an integrated Medical Information Management Company, which offers Electronic Health Records (EHR), Medical Billing, and Transcription Services. Our EHR includes integrated Appointment Scheduling, Billing Modules, Electronic Medical Records, Online Prescriptions and accessibility of information anywhere, anytime. Our services have evolved to a level where we can be deemed a Virtual Secretary targeted for hospitals, clinics, and independent doctors.

The company is promoted by technical experts from diversified industries. In a relatively short span of 6 years, we have been able to transform 300+ medical offices nationwide into efficiency engines. Our strategy is to build productivity through the use of technology, highly trained personnel, and customized consulting services. With resources composed of 32+ employees nationwide and 175+ employees overseas, we have found a solution for all the problems in running a medical practice resulting in better clinical, revenue cycle, and employee management.

We are the sole proprietors of the Electronic Health Records software, the Medical Billing service, and the Transcription Service. This allows us to streamline all our respective services into one effective solution for running a medical practice.

Currently we are servicing clients in New Jersey, New York, Pennsylvania, Connecticut, North Carolina, Virginia, Florida, Indiana, Illinois, Texas, Tennessee and expanding throughout the United States of America.

Our offices are based in New Jersey, Texas and North Carolina.

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Webinar 6 : Detailed Overview of PQRS and CQM 2014 | DigiDMS.com

  1. 1. Webinar 6: Detailed Overview of PQRS & CQM 2014 using DigiDMS EHR 2014 Edition Tuesday, April 14, 2014 at 3:30 PM EST Wednesday, April 15, 2014 at 4:30 PM EST EHR * PM * Patient Portal * Direct Messaging * Secure Healthcare Messaging 1
  2. 2. Clinical Quality Measure (CQM) Quick Facts EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging  EPs will have to report using the new 2014 criteria regardless of whether they are participating in Stage 1 or Stage 2 of the EHR Incentive Programs.  All Medicare EPs have the option of submitting three months of CQM data online through the CMS registration and attestation system. Medicare EPs also have the option to submit a full year of data electronically using the QRDA format to receive credit for the EHR incentive Program and Physician Quality Reporting System (PQRS).  Medicaid EPs must submit their clinical quality measurement data to their State Medicaid Agency  Begining in 2014, EPs must select and report on 9 of a possible list of 64 approved CQMs for the EHR Incentive Programs. The 6 domains are:  Patient and Family Engagement  Patient Safety  Care Coordination  Population and Public Health  Efficient Use of Health Care Resources  Clinical Processes/ Effectiveness
  3. 3. Physician Qualitative Reporting System (PQRS) Quick Facts EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging  By submitting PQRS for year 2014, EPs can earn 0.5% incentive and avoid 2% adjustment for year 2016.  All Measure Groups are reportable via Registry only, meaning EP can not submit Group PQRS measures via claims in 2014.  For earning incentive and avoiding penalty, Total 9 individual measures out of 3 strategic national quality domain must be submitted for 50% of Medicare Part B and Railroad Medicare claims from Jan 1, 2014 to Dec 31, 2014.  Just to avoid penalty, Report at least 3 measures covering 1 NQS domain for at least 50% of the EP's Medicare part B FFS Patients satisfactorily.  PQRS data can be submitted via preferred methods of Claims, Stage 2 Certified EHR OR Registry. Refer PQRS guidelines by CMS for other reporting methods.  CMS Strongly encourages all EPs and practices to begin billing 2014 QDC codes with a $0.01 charge.  The RA/ EOB Denial code N365 is your indication that PQRS codes were received into the CMS National claims history (NCH) database.
  4. 4. PQRS How to Report once or individual for 2014 Medicare Quality Programs Reporting (PQRS & CQM)? EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging  Eligible Professionals (EPs) have a choice to report one time during the 2014 program year in order to become incentive eligible for 2014 PQRS, avoid 2016 adjustment, and satisfy the Clinical Quality Measure (CQM) component of the EHR Incentive Program. Refer PQRS guidelines by CMS to check one time reporting options available to individual Eligible Professional and Group of 2 or more Eligible Professionals.  To Report once and get qualified for PQRS and CQM incentive program, EP has to report at least 9 of the CQM out of 3 strategic National Quality Domain for entire year of 2014. EP will need IACS account to upload data files extracted from EHR CQM Reports. EPs will also have to attest for CQM at time of attestation using same report.  To Report individual for PQRS and CQM, EP will have to follow CQM reporting for the same 90 day period of Meaningful Use and use data at time of attestation. For PQRS, EP can submit data via claim or qualified registry.
  5. 5. Requirements for Implementing MU in 2014 EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 1. Select CQM for 2014, Select PQRS for 2014. You can choose common CQM and PQRS to meet both incentive program requirements. • Choose 9 OR more measures from at least 3 domains • Even If you are demonstrating for MU Stage 1, You will have to selct Stage 2 CQMs 2. Mark as “Implemented and Active” in DigiDMS  Patient Screening Module. [Optional ] 3. Verify Alert [Optional] 4. Take appropriate actions 5. Review PQRS codes suggested by system. 6. Verify CQM and PQRS Performance 7. Generate QRDA Report for CQM Attestation [Optional] 5
  6. 6. Step 1: Select CQM and PQRS EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 6
  7. 7. Step 1: Select Common CQM & PQRS EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 7 Certified PQRS CMS ID NQF Domain Title Yes 1 122 59 C,R ClinicalProcess/ Effectiveness Diabetes:HemoglobinA1c Poor Control Yes 2 163 64 C,R ClinicalProcess/ Effectiveness Diabetes:Low Density Lipoprotein(LDL)Management Yes 5 135 81 C,R ClinicalProcess/ Effectiveness Heart Failure (HF):Angiotensin-Converting Enzyme (ACE) Inhibitoror AngiotensinReceptorBlocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Yes 111 127 43 C,R ClinicalProcess/ Effectiveness Pneumonia VaccinationStatus for Older Adults Yes 112 125 31 C,R ClinicalProcess/ Effectiveness Breast Cancer Screening Yes 113 130 34 C,R ClinicalProcess/ Effectiveness ColorectalCancer Screening Yes 117 131 55 C,R ClinicalProcess/ Effectiveness Diabetes:Eye Exam Yes 119 134 62 C,R ClinicalProcess/ Effectiveness Diabetes:Urine Protein Screening Yes 163 123 56 C,R ClinicalProcess/ Effectiveness Diabetes:FootExam Yes 204 164 68 C,R ClinicalProcess/ Effectiveness Ischemic VascularDisease(IVD):Use of Aspirinor Another Antithrombotic Yes 236 165 18 C,R ClinicalProcess/ Effectiveness ControllingHigh Blood Pressure Yes 130 68 419 C,R Patient Safety Documentationof Current Medications in the Medical Record Yes 110 147 41 C,R Population/Public Health Preventative Care and Screening: Influenza Immunization Yes 128 69 421 C,R Population/Public Health Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Yes 134 2 418 C,R Population/Public Health Preventive Care and Screening: Screening for Clinical Depressionand Follow-Up Plan Yes 226 138 28 C,R Population/Public Health Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Choose 9 OR more measures from at least 3 domains
  8. 8. Step 1: Option EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 1. Select CQM [for 90 Days of Your Meaningful Use Demonstration] 2. Select PQRS [for Entire Year] 8 Choose CQM [64 CQM] Choose PQRS [284 Measures] Choose 9 OR more measures from at least 3 domains Report Separately for CQM at time of MU Attestation & PQRS via Claims
  9. 9. Step 2: Activate Alerts (Optional) EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 9 DigiDMS EHR  Patient Screening Module
  10. 10. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 10 Step 3: Verify Alerts (Optional) DigiDMS EHR  Patient Chart  Alerts
  11. 11. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 11 Step 4: Take Appropriate Actions PQRS CMS IDNQF Domain Title 226 138 28 C,R Population/ Public Health Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user Numerator: If Patient is a smoker Order 99406 : Counselling OR Order Medication
  12. 12. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 12 Step 5: Review PQRS Code suggested by EHR)
  13. 13. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 13 Step 5: Review PQRS Code suggested by EHR)
  14. 14. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 14 Step 6: Verify CQM Performance
  15. 15. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 15 Step 7: Generate QRDA Report for submission [ Optional ]
  16. 16. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 16 CQM Explanation – CQM 165 Percentage of patients 18-85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90mmHg) during the measurement period. Numerator: Systolic BP< 140 Diastolic BP<90 PQ RS CMS IDNQF Domain Title 236 16518 C,R Clinical Process/ Effectiveness Controlling High Blood Pressure
  17. 17. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 17 CQM Explanation – CQM 122 Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period. Numerator: HBA1C > 9.0% PQ RS CMS IDNQF Domain Title 1 12259 C,R Clinical Process/ Effectiveness Diabetes: Hemoglobin A1c Poor Control
  18. 18. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 18 CQM Explanation – CQM 125 Percentage of women 40-69 years of age who had a mammogram to screen for breast cancer. Numerator: HBA1C > 9.0% PQR S CMS IDNQF Domain Title 112 12531 C,R Clinical Process/ Effectiveness Breast Cancer Screening Please Refer DigiDMS HER version 14.0.10 OR Refer document links provided in earlier slide to refer details of other CQMs
  19. 19. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging 19 CQM Explanation Please Refer DigiDMS EHR version 14.0.10 OR Refer document links provided in earlier slide to refer details of other CQMs
  20. 20. EHR* PM * Patient Portal * Direct Messaging* Secure Healthcare Messaging Questions & Answers ? 20
  21. 21. Thank You! EHR * PM * Patient Portal * Direct Messaging * Secure Healthcare Messaging 21

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