Medical Director's Corner

Volume 1, Issue 5

Medical Director's Corner: Just so YOU know

Dear friends and colleagues,

In this issue, we will talk about easy ways to improve data quality in C-CDAs (Consolidated Clinical Document Architecture), and I'll also provide a quick update on 2018 (Year 2) MIPS information.

C-CDAs: As you may be aware, Rochester RHIO is receiving C-CDAs from many different sources in our health care community. Four EHRs ( eClinicalWorks , Medent , STI , and Greenway Health ) and two Patient Care Coordination Platforms (Netsmart, Virutal Officeware) are already connected with Rochester RHIO and C-CDAs are flowing in from 78 practices and over 320 physicians in our region.

I am currently communicating with participating practices, confirming and letting them know that contributed C-CDA data points feeding through their EHR vendors are complete, without any gaps, and meet the Common Clinical Data Set.

When gaps are identified, we've found the most common ones include empty fields in Demographics like Race, Ethnicity, and Preferred Language. Gaps in clinical data also often include Medication Allergy, Smoking Status (either in its own field or as part of social history), Immunization Status (by specialists), and minimal entry in the Care Plan field.

Gaps in clinical data elements are quality gaps by New York State. With a bit of effort towards cleaning up documentation and ensuring that the proper data elements are filled, quality gaps can easily be corrected.

Some of you may not know that lab results are reported to Rochester RHIO using LOINC codes by EHR vendors. These codes are part of the C-CDA. Verify with your EHR vendor that your office EHR version complies with the LOINC codes needed to send your labs to Rochester RHIO.

MIPS 2018 (Year 2) has started. It is too late to create a virtual group because the deadline has passed.

For 2018, points allotted:

Quality: 50
Cost: 10
Improvement activity: 15
Promoting interoperability: 25 points for total of 100 points.

2018 threshhold for money adjustment went up from 3 in 2017 to 15.

2018 participant categories remain the same:

MD/DO/DPM/DDS/DC
PA/NP/CRNA/Clinical Nurse Specialist

Special Status for Exclusion can be claimed by:

Nonpatient facing doctors like Pathologist, Radiologist, Anesthesiologist, Nuclear Medicine Specialist
Small practice
Rural practice
Practices located in a doctor shortage area
Hospital-based practices
Ambulatory surgery-based practices

But, if these practices participate, then they can earn double points for promoting interoperability!

2019 (Year 3) will not only have Medicare option, but an all-payer option, which will incude Medicare, Medicaid, commericial insurances, private payers, Medicare Advantage, and medical homes.