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GE HealthcareQuality Reporting with Centricity PracticeSolutionVersion 12.0 or higherRevised August 2017Centricity Practice SolutionDOC1761591 2017 General Electric Company
All information is subject to change without notice. This information is the confidentialand proprietary information of General Electric Company.Unauthorized duplication is strictly prohibited.Centricity is a trademark of General Electric Company.
IntroductionCentricity Practice Solution version 12.0 or higher includes Objective and Clinical Quality Measure reportingbased on final ONC 1 criteria and CMS2 requirements. The release is ONC-ACB certified 2014 edition ONCcertification criteria.Complete and Modular EHR Certification InformationCentricity Practice Solution version 12.0 was certified as a Complete EHR and Modular EHR for Ambulatory.Please click the following link to see the full disclosure of this ucts/Categories/Healthcare IT/HITECH.For additional certification information, see the ONC’s “Comprehensive List of Certified Health InformationTechnology” here: https://chpl.healthit.gov/#/search.Enter Centricity for Product name and search for the largest R# for your version. There are multiple options perR#/version. The difference between them is one will represent full certification and other(s) will represent modularcertification. Choose details and look for additional software notes to identify the right one.1Office of the National Coordinator for Health Information Technology2Centers for Medicare and Medicaid Services1
What's New in this RevisionThis page highlights the changes made in this revision of the Quality Reporting Guide.Click the measure or topic title to go to the topic.August 2017 RevisionClinical Quality MeasuresThere are 5 CQMs that were recently upgraded for year 2017 reporting:nnnnnCMS90 Functional Status Assessment for Complex Chronic ConditionsCMS117 / NQF0038 Childhood Immunization StatusCMS135 / NQF 2907 Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or AngiotensinReceptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)CMS136 / NQF 0108 ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/HyperactivityDisorder (ADHD) MedicationCMS144 / NQF 2908 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction(LVSD)CMS155 / NQF0024 Weight Assessment and Counseling for Nutrition and Physical Activity for Children andAdolescentsAdded in Workflow: Please record the observation term DIET COUNSEL on the Risk Factors-CCC form.CMS158 / NQF 0608 Pregnant Women that had HBsAG testingnAdded to Measure Data Requirements table in Initial Population: Patient Characteristic Sex: Female.CMS160 / NQF 0712 Depression Utilization of the PHQ-9 ToolnAdded this Note in Calculation: It is not the order date, but the order end date that is important for thismeasure. For example, if the visit is on April 30th and the order end date is in May, then the patient wouldbe included in denominator 2.n Added the months included for each Denominator.CMS164 / NQF 0068 Ischemic Vascular Disease (IVD): Use of Aspirin or Another AntiplateletnnUpdated in Measure Data Requirements table in in Numerator: Medication, Active: Aspirin and Other Antiplatelets, GE Preferred Terms column - Medications with RX Norm codes in the value set.Previous RevisionsThis page highlights the changes made to the previous revisions of the Quality Reporting Guide.Click the measure or topic title to go to the topic.Note. The year 2016 Objective Measures for Stage 2 are now located in a separate book section labeled "2016Measures" in this guide's Table of Contents.July 2017 RevisionACI Transition Objectives and MeasuresHealth Information Exchange (TOC)Please see the Setup, workflows, and best practices section for revisions regarding setup and workflows.Patient Electronic Access - View, Download or TransmitnnUpdated Numerator: CQR Insight Tab: Event Source is ACTIVITY LOG EVENT. It includes Activitylog type PatientViewChart . (View, Download, and Transmit all show as PatientViewChart. All downloadand transmit workflows require the viewing of a chart. By only counting the view of the chart, our calculation accurately reflects all three).2
nAdded this sentence in Note in Workflows: You may use Qvera C-CDA Import-Export Package to enablea patient to access their C-CDA through an HIE or other portal application.Note. Patient Electronic Access - Provide Patient Access objective is now on a separate topic in thisGuide.Secure Electronic MessagingnnAdded Software list in Requirements: CPS 12.0.13Revised Workflows: If using Centricity Clinical Messenger, you can send a message to the patient or thepatient-authorized representative configured in registration using the Messaging tab or SM-CVS / SMBasic encounter forms.Meaningful Use - Modified Stage 2 (Medicaid)Stage 2: 08 Patient Electronic Access Part 1 & 2Updated Measure 2 description for View, Download, or Transmit to reflect threshold of more than 5 percentfor an EHR reporting period in 2017.Stage 2: 09 Secure Electronic MessagingnnUpdated Measure description to reflect threshold of more than 5 percent for an EHR reporting period in2017.Clinical Quality MeasuresThere are 15 CQMs that were recently upgraded for year 2017 reporting:nnnnnnnnnnnnnnnCMS56 Functional Status Assessment for Total Hip ReplacementCMS65 Hypertension: Improvement in blood pressureCMS66 Functional Status Assessment for Total Knee ReplacementCMS123 Diabetes: Foot ExamCMS134 Diabetes: Medical Attention for Nephropathy*CMS142 Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes CareCMS145 Coronary Artery Disease (CAD): Beta-Blocker Therapy - Prior Myocardial Infarction (MI) or LeftVentricular Systolic Dysfunction (LVEF 40%)CMS146 Appropriate Testing for Children with PharyngitisCMS153 Chlamydia Screening for WomenCMS154 Appropriate Treatment for Children with Upper Respiratory Infection (URI)CMS155 Weight Assessment and Counseling for Nutrition and Physical Activity for Children and AdolescentsCMS158 Pregnant Women that had HBsAG testingCMS160 Depression Utilization of the PHQ-9 ToolCMS164 Ischemic Vascular Disease (IVD): Use of Aspirin or Another AntiplateletCMS169 Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance useNote. * CMS134 was inadvertently included in the list of CQMs previously upgraded for the CQR 1.5.8release.CMS50 Closing the Referral Loop: Receipt of Specialist ReportnPlease see the Workflow Considerations and Explanations section for revisions regarding workflows.May 2017 RevisionEligible Clinicians (EC)n Added User Management content regarding EC license or credential information.Seen bynAdded instructions for adding Service Orders for encounters in the Objectives and Clinical Quality Measures sections.3
Mapping datanAdded the following paragraphs:In addition to the primary code for a term, some measures require coded results from the observationand values. When you map a code, the mapping tool will display the value set of result codesassociated with that term. In most cases, you will want to select one or more specific values to map toa term and a result code.Some observation terms may have a wide variety of values that should all be mapped to a target code,except when the value negates the meaning of the code. For example, an observation value such as“patient refused,” or “medical reason,” indicates that the procedure was not done. These terms can beexcluded in the data mapping tool or mapped to a specific result code with a negation reason whenavailable.ACI Transition Objectives and MeasuresHealth Information Exchange (TOC)Patient Electronic Access - Parts 1 & 2Secure Electronic MessagingAdded Third Party Software list in Requirements.Medication Reconciliationnand Stage 2: 07 Medication ReconciliationAdded in Denominator: CQR Insight Tab: Event Source is ACTIVITY LOG EVENT. It includes Activitylog type InitiatedTOCWithPatient.MU Activity Log: Event ID is 4.n Added in Numerator: CQR Insight Tab: Event Source is ACTIVITY LOG EVENT. It includes Activitylog type ReconciledTOCMedications. MU Activity Log: Event ID is 13.Patient Electronic Access - Parts 1 & 2nand Stage 2: 08 Patient Electronic Access Part 1 & 2Updated Denominator: CQR Insight Tab: Event Source is SeenBySharedDenominator. It includesEvent Date (clinical date), and Event Attributes.n Updated Numerator: CQR Insight Tab: Event Source is ACTIVITY LOG EVENT. It includes Activitylog type PatientGrantedChartAccess; CQR Insight Tab: Event Source is ACTIVITY LOG EVENT. Itincludes Activity log type PatientDeniedChartAccessSecure Electronic Messagingnand Stage 2: 09 Secure Electronic MessagingnAdded in Denominator:CQR Insight Tab: Event Source is SeenBySharedDenominator. It includes EventDate (clinical date), and Event Attributes (Order Id).Clinical Quality Measures"CMS2 / NQF 0418 Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan" onpage 139Updated in Workflow: If your organization records patient data differently from what GE maps by default,please create custom mapping according to your workflow (Requires SP13 or higher). The table belowshows the relationship between the value sets and their result attribute value sets. Please refer to Mappingdata for more details.CMS117 / NQF0038 / PQRS 240 Childhood Immunization StatusnnAdded in Workflow: If your organization records patient data differently from what GE maps by default,please create custom mapping according to your workflow (Requires SP13 or higher). The table belowshows the relationship between the value sets and their result attribute value sets. Please refer to Mappingdata for more details.nUpdated Measure Data Requirements table in Numerator: See the Diagnosis, Active: Anaphylactic Reaction section for data elements added in the Workflow Incorporation column.4
Updated Measure Data Requirements table in Numerator: Added to Laboratory Test Result section:n “with Result: Seropositive” and “Seropositive Value Set”n “with Result: Positive Finding” and “Positive Finding Value Set”CMS131 / NQF 0055 / PQRS 117 Diabetes: Eye ExamnnAdded in Workflow: If your organization records patient data differently from what GE maps by default,please create custom mapping according to your workflow (Requires SP13 or higher). The table belowshows the relationship between the value sets and their result attribute value sets. Please refer to Mappingdata for more details.Updated Measure Data Requirements table in Numerator: Physical Exam, Performed: Retinal or DilatedEye Exam with Result: Negative Finding - GE Preferred Terms column: Observation terms: DIAB EYEEXD, DIAB EYE EX, DMEYEEXMRES, PQRI MEAS117 with value "normal", "no retinopathy", "no diabetic retinopathy", "no dm retinopathy", or "negative".CMS138 / NQF 0028 / PQRS 226 Tobacco Use Screening and Cessation InterventionnAdded Note in Workflow: If you use a different observation term to track Smoke Status, remember to mapit to Tobacco Non-User or Tobacco User, and Tobacco Use Screening.n Updated Measure Data Requirements table in Denominator Exceptions: Diagnosis: Limited Life Expectancy - GE Preferred Terms column: Search for Problems with one of the following: Bad prognosis, Earlystage terminal illness, Late stage terminal illness, Illness terminal, Pre-terminal, Terminal illness.CMS142 / NQF 0089 / PQRS 19 Diabetic Retinopathy: Communication with the Physician Managing OngoingDiabetes CarenUpdated Measure Data Requirements table in Numerator: Communication: From Provider to Provider:Level of Severity of Retinopathy Findings - GE Preferred Terms column: LVLSVRETINOP with value"mild", "moderate", "proliferative", "severe" or "very severe"n Updated Measure Data Requirements table in Numerator: Communication: From Provider to Provider:Macular Edema Findings Present - GE Preferred Terms column: MACULEDEMA with value "present"n Updated Measure Data Requirements table in Numerator:Communication: From Provider to Provider:Macular Edema Findings Absent - GE Preferred Terms column: MACULEDEMA with value "absent"CMS147 / NQF 0041 / PQRS 110 Preventive Care and Screening: Influenza ImmunizationnnnAdded in Workflow for Flu Vaccine: If you use custom observations to record contraindications for reasonsnot given, you will have to add mapping for each reason with a result code for medical reason or patientreason not done.Updated Measure Data Requirements table in Denominator Exceptions: Diagnosis: Allergy to eggs - GEPreferred Terms column: Problem: Allergy to eggs Z91.012.March 2017 Revision 2ACI Transition Objectives and MeasuresThe ACI Transition Objectives and Measures are available for participants of the CMS Merit-based IncentivePayment System (MIPS) program. Please see this new section, "MIPS and ACI Overview and ACI Objectives".Stage 2 Functional MeasuresThis section has been renamed to Meaningful Use - Modified Stage 2 (Medicaid).Clinical Quality MeasuresThere are two CQMs added for year 2017 reporting:CMS137 / NQF 0004 Initiation & Engagement of Alcohol & Other Drug Dependence TreatmentCMS159 / NQF 0710 Depression Remission at Twelve MonthsFebruary 2017 RevisionIntroduction5
nAdded the following sentences in the Certification section, last paragraph: The difference between them isone will represent full certification and other(s) will represent modular certification. Choose details and lookfor additional software notes to identify the right one.Stage 2 Functional MeasuresStage 2: 08 Patient Electronic Access Part 1 & 2Added Note in Setup, workflows, and best practices: This measure requires use of a third party vendor.The setup and workflows necessary to meet this measure will be influenced by your chosen vendor andyou may need to reference their documentation or support resources.n Corrected in Workflow Measure 1: Replaced "AddtoChart" with "Add from Chart".Stage 2: 09 Secure Electronic MessagingnnnnnnnRemoved the following Note in Objective: The CQR portal displays Objective 9 with the 2015 rule, whichcounts messages sent to patients. It has not been updated to the 2016 rule.Added in Denominator: CQR Insight Tab: Data Object is SeenBySharedDenominator. It includesPID,PVID, eventDate (Clinical datetime), SDID, and document summary.Added in Numerator: CQR Insight Tab: Event Source is ACTIVITY LOG EVENT. It includes Activitylog type SendSecureMessageToPatient, Delivery method, Contact Method, TOC Reconciled, Order Idand SDID (Document ID). MU Activity Log: Event ID is 522.Updated Note in Setup: GE supports auditing of provider-to-patient secure messaging with CPS 12.0.13 orhigher, and a separately-licensed Centricity Clinical Messenger v7.0.9 (SMPP, SureScripts Portal) or otherthird party that states they can supply MU Event ID 522 for a secure message sent to the patient. It isexpected that all third party solutions will limit how far back in history they can count provider-to-patientsecure messages. Check with your messaging vendor in order to identify patients that should count for thismeasure.Added Note in Workflow: If secure message is sent by an EP directly, only that EP will get credit. Ifsecure message is sent by a non-EP, all EPs with an office visit in the reporting period for the patient willget credit. An “EP” is defined for secure message as an active provider in CQR that has measures selected. Conversely, a non-EP is anyone that has no stage or measures selected.Added in Workflow: Added a link in the Note for CMS FAQ12825 - "Per CMS FAQ12825".Clinical Quality MeasuresThere are no updates to the Clinical Quality Measures.January 2017 - No RevisionThere was no revision for January 2017.December 2016 RevisionClinical Quality MeasuresA new book section has been added in this guide's Table of Contents: 2017 CMS Clinical Quality Measures.Some of the existing 44 Clinical Quality Measures that GE currently supports for reporting year 2016 wereupgraded to the measure versions applicable to reporting year 2017, while retaining measure versions applicableto reporting year 2016.The existing CQMs for reporting year 2016 are now located in the book section: 2016 CMS Clinical QualityMeasures."CMS2 / NQF 0418 / PQRS 134 Preventive Care and Screening: Screening for Clinical Depression and Follow-UpPlan" on page 273Changed Observation Term: DEPSCREEN, PHQ-9 SCORE. Removed "and" and replaced with comma."CMS22 / PQRS 317 Preventive Care and Screening: Screening for High Blood Pressure and Follow-UpDocumented" on page 277n6
Added phrase: Second Hypertensive BP Reading: Patients with second elevated reading of systolic BP 140 mmHg OR diastolic BP 90 mmHg and follow up lifestyle recommendations AND one or more of theSecond Hypertensive Reading Interventions OR referral to Alternative /Primary Care Provider. SecondReading means, within one year prior to current reading, the latest previous reading was hypertensive."CMS56 / PQRS 376 Functional Status Assessment for Hip Replacement" on page 250nDenominator Exclusion: Patients with multiple trauma at the time of the total hip arthroplasty or patientswith severe cognitive impairment. For example, if choosing "dementia, severe", GE recommends you enterthe problem through “*Smart List” with text “dementia, severe”. The entries “dementia, severe” should showup as you type. The SNOMED codes that qualify for this value set will be automatically mapped if youchoose one of these.n Workflow Considerations, replaced middle paragraph: There are a few scenarios where using a diagnosiscan place the patient in the denominator or exclusion population. CMS provides a diagnosis value set thatcontains only SNOMED codes. To enter the diagnosis that meets your criterion, GE recommends youenter the problem using the “*Smart List”. Eligible entries should display as you type. Appropriate diagnosisare "Total hip arthroplasty, left", "Hx of hip replacement, total", "Total hip arthroplasty, bilateral"."CMS66 / PQRS 375 Functional Status Assessment for Knee Replacement" on page 254nnnDenominator Exclusion: Patients with multiple trauma at the time of the total hip arthroplasty or patientswith severe cognitive impairment. For example, if choosing "dementia, severe", GE recommends you enterthe problem through “*Smart List” with text “dementia, severe”. The entries “dementia, severe” should showup as you type. The SNOMED codes that qualify for this value set will be automatically mapped if youchoose one of these.Workflow Considerations, replaced middle paragraph: There are a few scenarios where using a diagnosiscan place the patient in the denominator or exclusion population. CMS provides a diagnosis value set thatcontains only SNOMED codes. To enter the diagnosis that meets your criterion, GE recommends youenter the problem using the “*Smart List”. Eligible entries should display as you type. Appropriate diagnosisare:n Hx of knee replacement, totalTotal knee arthroplasty, bilateralS/P arthroplasty kneetotal replacementHx of total knee replacement, leftTotal knee replacement, rightTotal knee replacements, bilateralTotal knee replacement, leftHx of total knee replacementHx of total knee replacement, rightTotal knee arthroplasty, left"CMS69 / NQF 0421 / PQRS 128 Body Mass Index (BMI) Screening and Follow-Up" on page 282Added the following text to the numerator: If your patient's BMI is out of range, it is required that you apply adiagnosis of "Overweight" or "Underweight" or the SNOMED for "Overweight" or "Underweight", to thepatient during the visit."CMS135 / NQF 0081 / PQRS 5 Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor orAngiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)" on page 376nnDeleted: This SNOMED diagnosis code mapping requires June 2014 Full Knowledgebase Update and alsorequires June 2014 Diagnosis and Procedure Codes update.November 2016 RevisionCentricit
GEHealthcare QualityReportingwithCentricity Practice Solution Version12.0orhigher RevisedAugust2017 CentricityPractic
