eMDs Meaningful Use
Skip Rhudy
Live Oak Family Health, PA
Applied Medical Computing
www.appliedmedcomputing.com
Who is Skip Rhudy?
Skip worked at Charles Schwab & Company, Inc for the last
decade building high end trading platforms and working on
Security Infrastructure and Security Architecture for Schwab.
He was the system architect for StreetSmart Edge, Schwab’s
latest high end trading platform.
Skip started working at Live Oak Family Health PA in October
2010 and transitioned out of Schwab by April 2011. He does
eMDs and general IT support for Live Oak and other practices
in Seguin.
Prerequisites
 Register with EHR incentive website
(http://www.cms.gov/EHRIncentivePrograms )
 Be enrolled in Medicare FFS, MA, or Medicaid (FFS or
managed care)
 Have a National Provider Identifier (NPI) and have an
active account in the National Plan and Provider
Enumeration System (NPPES).
 Be enrolled in Provider Enrollment, Chain, and Ownership
System (PECOS)
(slide courtesy Dr Helmrick & Mr Love)
Prerequisites
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Install or upgrade to eMDs 7.0 or higher
Install Surescripts
Install RxHub
Optional: Patient Portal
Configure eMDs to record MU data
Disclaimer
• The following information shows how Live Oak Family Health
PA is attempting to implement Medicare Meaningful Use with
eMDs. Live Oak is still learning how to do MU
• Following this information does not guarantee your
implementation will give the same results because your
environment may be set up differently and may require more
configuration steps
Testing
• With IT systems in general, testing is as critical as
configuration
• This is especially true when configuring eMDs to do
Meaningful Use
• You must test your configuration by running reports, at least
on a monthly basis
• Use the report results to find and address issues in
configuration and usage and correct the issues
Live Oak Implementation
• Installed eMDs 7.0
• Training: watched Meaningful Use videos on
eMDs Support Center site.
• Configured eMDs to do Meaningful Use
• Discovered installation issues with 7.0 that
caused smoking status data problems
• Installed Crystal Reports Meaningful Use
updates and ran initial reports
Install eMDs 7.0
• Have to be running eMDs 6.3 or higher
• Have to be using SQL 2005 or higher
• Unblock templates or smoking status menus
on templates will fail to install correctly and
will require database table surgery to fix.
Training Videos on Support Center
• https://supportcenter.e-mds.com/ics/support/default.asp?deptID=3222
• Go to the Video Learning Library
• Select Meaningful Use (Core)
• Select Meaningful Use (Menuset)
*Note that eMDs does not number Meaningful Use Core or Menu Set the same as CMS
HOWTO: eMDs MU Core
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Computerized Provider Order Entry (CPOE): proper config (licensure tab for clinical staff)
e-Prescribing: requires Surescripts, proper config, and correct eMDs usage (training vid)
Report ambulatory clinical quality measures: run reports & provide results to CMS
Implement one clinical decision support rule: use Rule Manager to set up, schedule task to run rule
Provide Patients with an electronic copy of their health information on request: correct eMDs usage,
export to a file (USB or CD/DVD) email (3 business days)
Provide clinical summaries for patients for each office visit: correct eMDs usage (training vid)
Drug-drug and drug-allergy interaction checks: proper config, correct eMDs usage (chart training)
Record demographics: proper config (training vid), correct eMDs usage (training vid)
Maintain an up-to-date problem list of current and active diagnoses: correct eMDs usage (training vid,
chart training)
Maintain active medication list: correct eMDs usage (training vid, chart training)
Maintain active medication allergy list: correct eMDs usage (training vid, chart training)
Record and chart changes in vital signs: correct eMDs usage (training vid, flowsheet training)
Record smoking status for patients 13 years or older: correct eMDs usage, no template blocking during
7.0 install, template updates for 7.0 (training vid)
Capability to exchange key clinical information among providers of care and patient-authorized
entities electronically: correct eMDs usage (training vid that doesn’t work)
Protect electronic health information: IT Security analysis/upgrade (TBD), correct eMDs usage (training
vid that doesn’t work) (45 CFR 164.308(a)(1) )
HOWTO: eMDs Menu Set
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Drug-Formulary checks: RXHub, proper config
Incorporate clinical lab test results as structured data: various lab interfaces (CPL, Quest,
LabCorp, GRMC), proper config, correct eMDs usage (training vid)
Generate lists of patients by specific conditions: preferred reminder in demographics, eMDs
Registry Processor, correct eMDs usage (training vid)
Send reminders to patients per patient preference for preventive/follow up care: Registry
Processor, correct eMDs usage (training vid)
Provide patients with timely electronic access to their health information: Patient Portal,
correct eMDs usage (training vid) (4 business days)
Use certified EHR technology to identify patient-specific education resources and provide to
patient, if appropriate: correct eMDs usage (training vid)
Medication reconciliation: correct eMDs usage (training vid)
Summary of care record for each transition of care/referrals: correct eMDs usage (training vid)
Capability to submit electronic data to immunization registries/systems: eMDs Interface Engine,
ImmTrac, proper config, correct eMDs usage (training vid), one test, follow up submission if test
is successful
Capability to provide electronic syndromic surveillance data to public health agencies: eMDs
Interface Engine, proper config, correct eMDs usage (training vid), one test, follow up submission
if test is successful
ImmTrac Austin
Texas
Registry: ImmTrac
Main Contact: Thomas Colvin
Phone: 512.458.7111 x6454
E-mail: thomas.colvin@dshs.state.tx.us
Technical Contact: Kevin Allen
Phone: 512.458.7111 x6603
Fax: 512.458.7790
E-mail: kevin.allen@dshs.state.tx.us
http://www.cdc.gov/vaccines/programs/iis/contact-state.htm#t
Configure eMDs
• Make sure audit is turned on
• Make sure all Formulary checks are on
• Make sure you are sending electronically;
eMDs recommends selecting “electronic” as
the default
• Make sure you set up a clinical decision
support rule and run it (eMDs support site has
a document showing how to set up a task to
do it)
Audit/HIPAA turned on
Formulary/Surescripts
(Chart/File/Options)
Formulary/Surescripts
CMS Menu Set 1
Formulary/Surescripts
CMS Core 7
CMS Menu Set 1
Formulary/Surescripts
CMS Core 7
CMS Menu Set 1
CMS Core 2
Clinical Quality Measures
MU Crystal Reports
MU Crystal Reports
Live Oak MU Core Results
Measure
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Jan – March
Computerized Provider Order Entry (CPOE):
94% (30%)
e-Prescribing:
71% (40%)
Report ambulatory clinical quality measures: Created Reports
Implement one clinical decision support rule: Ran Rules
Patient Health information on request:
Enabled
Patient clinical summaries for each visit:
05% (50%)
Drug-drug and drug-allergy interaction checks: Enabled
Record demographics:
47% (50%)
Problem list of current and active diagnoses:
80% (80%)
Maintain active medication list:
98% (80%)
Maintain active allergy list:
99% (80%)
Record and chart changes in vital signs:
92% (50%)
Record smoking status 13 years or older:
22% (50%)
Exchange key clinical information electronically: Enabled
Protect electronic health information:
No RA
March-May
Live Oak MU Core Results
Measure
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Jan – March
Computerized Provider Order Entry (CPOE):
94% (30%)
e-Prescribing:
71% (40%)
Report ambulatory clinical quality measures: Created Reports
Implement one clinical decision support rule: Ran Rules
Patient Health information on request:
Enabled
Patient clinical summaries for each visit:
05% (50%)
Drug-drug and drug-allergy interaction checks: Enabled
Record demographics:
47% (50%)
Problem list of current and active diagnoses:
80% (80%)
Maintain active medication list:
98% (80%)
Maintain active allergy list:
99% (80%)
Record and chart changes in vital signs:
92% (50%)
Record smoking status 13 years or older:
22% (50%)
Exchange key clinical information electronically: Enabled
Protect electronic health information:
No RA
March-May
99% (30%)
72% (40%)
Created Reports
Ran Rules
Enabled
53% (50%)
Enabled
80% (80%)
83% (80%)
99% (80%)
99% (80%)
93% (50%)
53% (50%)
Enabled
Work in Progress
Live Oak MU Menu Set Results
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Measure
Jan – March
Drug-Formulary checks:
Clinical lab results as structured data:
Lists of patients by specific conditions:
Patient reminders by preference :
Timely electronic health information:
Patient-specific education resources:
Medication reconciliation:
Summary of care:
Submit immunization data:
Submit syndromic surveillance data:
Enabled
41% (40%)
Enabled
00% (20%)
No Patient Portal
00% (10%)
00% (50%)
00% (50%)
Not tested
Not tested
March - May
Live Oak MU Menu Set Results
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Measure
Jan – March
March - May
Drug-Formulary checks:
Clinical lab results as structured data:
Lists of patients by specific conditions:
Patient reminders by preference :
Timely electronic health information:
Patient-specific education resources:
Medication reconciliation:
Summary of care:
Submit immunization data:
Submit syndromic surveillance data:
Enabled
41% (40%)
Enabled
00% (20%)
No Patient Portal
00% (10%)
00% (50%)
00% (50%)
Not tested
Not tested
Enabled
63% (40%)
Enabled
00% (20%)
No Patient Portal
01% (10%)
40% (50%)
44% (50%)
Not tested
Not tested