Medication List, Medication Allergy List, Patient Lists, and Smoking Status

1. Configuring RPMS-EHR for Meaningful Use Resource Patient Management System Medication List, Medication Allergy List, Patient Lists, and Smoking Status

2. Presenters: Jason Loepp, RHIA HIM Director, Cherokee Nation Health Services Lisa Lyon, BSN, RN, CDE Clinical Informatics Coordinator, Cherokee Nation Health Services Toni Potts, BBA Clinical Applications Coordinator Manager, Cherokee Nation Health Services Jamie Tapp, PharmD Pharmacy Information Technology Analyst, Cherokee Nation Health Services Medication List, Medication Allergy List, Patient Lists, and Smoking Status

3. Training Objectives • Understand the objectives and the measures • List the options and variations for creating Medication List • Describe the components of the Medication List (Outpatient, Inpatient & Outside Meds) & show how they display in PCC • Describe the process for maintaining an active Medication List • Generate PLAL report for the purpose of removing allergies from the problem list and entering into the Adverse Reaction Tracking • List the options for creating patient lists (ICare, Diabetes Audit, Women’s Health, Immunization, PGEN/VGEN, QMAN, CRS, etc) • Review the new PCC Health Factor Mnemonics to capture Smoking Status Medication List, Medication Allergy List, Patient Lists, and Smoking Status

4. Medication List Objective and Measure Maintain an active medication list. More than 80 percent of all unique patients seen by the EP or admitted to the hospital’s inpatient or emergency department have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data. Medication List

5. MU Measure Type of Measure: Rate Medication List, Medication Allergy List, Patient Lists, and Smoking Status

6. RPMS Reporting Logic Denominator Inclusions: COUNT: each patient HAVING: one or more face-to-face visits with the provider during the EHR reporting period Medication List, Medication Allergy List, Patient Lists, and Smoking Status

7. RPMS Reporting Logic Numerator Inclusions: COUNT: each patient in the Denominator HAVING: documentation of No Active Medications on any visit during the EHR reporting period OR HAVING: a medication in the Prescription file WITH: an Issue Date equal to or less than 365 days before the start of the reporting period AND WITH: an Issue Date on or before the end of the reporting period AND NOT WITH: a Discontinued Date before the start of the reporting period Medication List, Medication Allergy List, Patient Lists, and Smoking Status

8. RPMS Reporting Logic Numerator Inclusions (cont): OR HAVING: an Outside Medication in the Pharmacy Patient file HAVING: a Documented Date on or before the end of the reporting period AND WITH: a status of Active OR HAVING: a Discontinued Date on or after the start of the reporting period. Medication List, Medication Allergy List, Patient Lists, and Smoking Status

9. RPMS Reporting Logic Measure Exclusion: None Medication List, Medication Allergy List, Patient Lists, and Smoking Status

10. Medication Allergy List Objective and Measure Maintain an active medication allergy list. More than 80% of all unique patients seen by the EP or admitted to the hospital’s inpatient or emergency department during the EHR reporting period have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data. Medication List, Medication Allergy List, Patient Lists, and Smoking Status

11. MU Measure Type of Measure: Rate Medication List, Medication Allergy List, Patient Lists, and Smoking Status

12. RPMS Reporting Logic Denominator Inclusions: COUNT: each patient HAVING: one or more face-to-face visits with the provider during the EHR reporting period Medication List, Medication Allergy List, Patient Lists, and Smoking Status

13. RPMS Reporting Logic Numerator Inclusions: COUNT: each patient in the Denominator HAVING: structured data present during the EHR reporting period WHERE: an active adverse reaction to a medication is recorded OR WHERE: a statement indicating no known allergies is recorded Medication List, Medication Allergy List, Patient Lists, and Smoking Status

14. RPMS Reporting Logic Measure Exclusion: None Medication List, Medication Allergy List, Patient Lists, and Smoking Status

15. Patient Lists Objective and Measure Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. Generate at least one report listing patients of the EP or hospital with a specific condition. Medication List, Medication Allergy List, Patient Lists, and Smoking Status

16. RPMS Reporting Logic Measure Inclusions: COUNT: the generation of one Patient List Report during the EHR reporting period (if count = 1, report “Yes,” if count = 0, report “No”) Medication List, Medication Allergy List, Patient Lists, and Smoking Status

17. RPMS Reporting Logic Measure Exclusion: None Medication List, Medication Allergy List, Patient Lists, and Smoking Status

18. Smoking StatusObjective and Measure Record smoking status for patients 13 years or older. More than 50% of all unique patients 13 years old or older seen by the provider or admitted to the hospital’s inpatient or emergency department during the EHR reporting period have smoking status recorded as structured data. Medication List, Medication Allergy List, Patient Lists, and Smoking Status

19. MU Measure Type of Measure: Rate Medication List, Medication Allergy List, Patient Lists, and Smoking Status

20. Important Note Smoking status must be recorded with one of the following National Tobacco Health Factors: • Current smoker, every day • Current smoker, some day • Current smoker, status unknown • Previous (former) smoker • Never smoked • Smoking status unknown Medication List, Medication Allergy List, Patient Lists, and Smoking Status

21. RPMS Reporting Logic Denominator Inclusions: COUNT: each patient who is 13 years old or older at the beginning of the EHR reporting period HAVING: one or more face-to-face visits with the provider during the EHR reporting period Medication List, Medication Allergy List, Patient Lists, and Smoking Status

22. RPMS Reporting Logic Numerator Inclusions: COUNT: each patient in the Denominator WHERE: structured data describing the patient’s smoking status is present during the EHR reporting period Medication List, Medication Allergy List, Patient Lists, and Smoking Status

23. RPMS Reporting Logic Measure Exclusion: • EPs who see no patients 13 years old or older are excluded from this measure. • Eligible hospitals or CAHs that admit no patients 13 years old or older to their inpatient or emergency department (POS 21 or 23) are excluded from this measure. Medication List, Medication Allergy List, Patient Lists, and Smoking Status

24. What HIM Needs to Know – Medication Lists • ORX Mnemonic should no longer be used as this places medications into PCC • Non-VA Meds application (outside medications) must be configured and optimized as this places medications into the Pharmacy application • Sites without a Pharmacy or with a COTS Pharmacy package will need to implement e - Prescribing Medication List, Medication Allergy List, Patient Lists, and Smoking Status

25. What HIM Needs to Know – Medication Allergy List • Medication order checks will not function unless Allergies are entered into the Adverse Reaction Tracking • PLAL Report must be run at least monthly for the purpose of removing allergies from the problem list and entering into Adverse Reaction Tracking • HIM Professionals assigned to enter allergies using the ALG Mnemonic into the Adverse Reaction Tracking must be assigned the GMRA User key • Remove “Allergies from Problem List” from all Health Summaries Medication List, Medication Allergy List, Patient Lists, and Smoking Status

26. What HIM Needs to Know – Patient Lists • Patient Lists may be generated from: • iCare • Immunization • Diabetes • Women’s Health • PCC Management Reports • CRS (Clinical Reporting System) • Clinical Reminders Reports • MU Reports Medication List, Medication Allergy List, Patient Lists, and Smoking Status

27. What HIM Needs to Know – Smoking Status Medication List, Medication Allergy List, Patient Lists, and Smoking Status

28. What HIM Needs to Know – Smoking Status (RPMS Roll & Scroll) • Health Factor: Smoking Status Unknown • Health Factor: Cessation-Smoker • Health Factor: Current Smoker, Every Day • Health Factor: Current Smoker, Some Day • Health Factor: Current Smoker, Status Unknown • Health Factor: Never Smoked • Health Factor: Previous (Former) Smoker • Health Factor: Ceremonial Use Only (Does Not Count Toward MU Measure) Medication List, Medication Allergy List, Patient Lists, and Smoking Status

29. Configuration • Most recent PCC patch Medication List, Medication Allergy List, Patient Lists, and Smoking Status

30. How-to Session • Create Medication List – Utilizing the EHR GUI Medication Tab & Reports Tab • Describe the components of the Medication List (Outpatient, Inpatient & Outside Meds) & show how they display in PCC • Describe the process for maintaining an active Medication List • Generate PLAL report for the purpose of removing allergies from the problem list and entering into the Adverse Reaction Tracking • List the options for creating patient lists (ICare, Diabetes Audit, Women’s Health, Immunization, PGEN/VGEN, QMAN, CRS, etc) • Document Smoking Status using the EHR GUI & PCC Data Entry Mnemonics Medication List, Medication Allergy List, Patient Lists, and Smoking Status

31. How-to SessionQuestions & Discussion Medication List, Medication Allergy List, Patient Lists, and Smoking Status