Test Procedure for §170.302.n Automate Measure Calculation The EHR needs to calculate all the percentages needed to qualify for meaningful use. Or, if it does not automatically calculate, then to be able to calculate based on data entered into the EHR. Most of this looks straight forward if not tedious, but the percentage of clinical labs tests presents some difficulties. We have to map the requests vs those received.
Note for demographics you'll have to make sure that the preferred language, race and ethnicity are all recorded for it to count as being recorded.
50% of the way thru the automatic measure calculation which requires more sql coding. Some of my scores are close to 100%, but others are very low .. no doubt because the language and ethnicity are new fields in the database!
http://healthcare.nist.gov/docs/170.302.m_EducationResources_v1.1.pdf Some EHRs solve this issue by maintaining an extensive list of handouts. You then complete the task by printing out such a handout. At present we have the ability to trigger a chickenscript for medications and disease conditions. I can add something similar for laboratory tests. However, I think we should move to a default action. I propose using http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm for Drug data, http://wiki.medpedia.com/Rheumatoid_arthritis for disease information, and http://www.labtestsonline.org/ for investigations. There might be an option to use your own links. Once you click on the link, this fufills this meaningful use requirement.
The automatic measure calculation is also done .. except for counting eRx which we can't do yet. You'll need server 98 and 43 client. Reports/Meaningful Use/run report
http://healthcare.nist.gov/docs/170.302.f.3_growthcharts_v1.1.pdf The growth charts do not require BMI testing, though the automatic measure calculation requires this ( for hospitals and not EPs though ). Anyway, I have now added BMI charts for ages 2-20 male/female in English/Spanish and French. I have also recalibrated the charts as some were a couple of mm out in the vertical axis.
http://xw2k.nist.gov/healthcare/docs/170.302.a_DrugDrugDrugAllergy_v1.1.pdf This requires the EMR to generate drug interaction alerts in real time when added via CPOE. We now have a working drug interaction webservice which is based on the FreeDiams engine. More information to follow. Note that this requires the use of RxNorm identifiers as I do not wish to use the FDA database.
Build 44 includes the ability to check for drug interactions. We now need to scan for interactions as drugs are added ...., and have a way to disable this as well.
I've added an index on the atc_ids and this has improved the speed 4x. Now to see if I can make it faster by doing lookups in memory instead of using sql.
SQL looks to be faster probably because of the indices ... so doing a check on 8 drugs takes about 2 seconds vs 8 seconds thru memory based lists.
Graham any progress on Medicare certification for meaningful use? We don't have much time left if we want to participate for this year. Oct. 3 is the deadline to start reporting to earn 2011 incentive.
I'm in a waiting list ... Has anyone done any testing on the meaningful use aspects of Synapse? I've had no feedback on this.
I've tried running the report a couple of times. It seems to be working fine. However, without e-prescribing and certification at this point, looks like it's unlikely we will be able to report for this year. US users who want to participate this year will have a problem. I wonder if anyone else is considering an alternative EHR.
This forum does not seem to be as active as before. One clarification: I was previously misinformed. I was just told that even if you start reporting in 2012, you still only need to report 90 days for your year 1. So Synapse still has one year time to get e-rx and certificate done. I am looking at Practicefusion, I like it. However it's designed mostly for primary care and can't generate customazied consult letter. Otherwise, it looks a perfect choice for a solo practitioner or small practice: web/cloud based, no server or database to maintain, fairly easy to use. And, it's free and certified.
Two months left for starting reporting for 2012. I told my office staff to learn Practicefusion. I'm thinking to use Practicefusion to fulfil meaningful use requirement and keep Synapse for the rest for now. I'm not sure which direction I'm heading. If Synapse can eventually be certified by Medicare, the decision will be much easier. Otherwise, I may come back to Synapse after meaningful use period is over, or move everything over to Practicefusion.
Update my meaningful use status: finished attestation for 90 days for 2012 using Practicefusion, accepted by Medicare. Now I'm debating whether to keep using Synapse or migrate everything to Practicefusion. Currently I still use Synapse to generate consult letter as well as documents management, since Practicefusion can not do customized letter. For the new year, I'm looking these options: 1. Keep Synapse for letter generation and documents, use Practicefusion for meaningful use, the way I'm doing now. 2. Tolerate Practicefusion's ugly consult printout, migrate completely to Practicefusion. However, I also don't like to upload everything to Practicefuson's server, e.g. intake and scanned forms, letters. 3. Migrate to Practicefusion but use an alternative document management software locally, I am looking at FileCenter, which appears to work better than Paperport. Please let me your thoughts.
Qilin, there just hasn't been the interest in Synapse users to go for meaningful use for me to consider spending the $20k to get certified. So I put in all the functionality but stopped there.
