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***RETIRED*** Meaningful Use - Stage 1

IMPORTANT NOTICE: MacPractice maintains this Stage 1 documentation for historical reference in the event that you need to review this for past Meaningful Use attestations or audits. Know that as of 2015, this is no longer a current list of measures that providers are expected to attest to. Current Medicaid Meaningful Use program requirements can be found here

 


On October 6, 2015, CMS finalized changes to the Meaningful Use program. Providers are no longer expected to meet Stage 1 or Stage 2 of Meaningful Use, as they were all moved to Modified Stage 2 regardless of how many years they had done Meaningful Use in the past.

This guide will walk you through each of the measures required for Stage 1 of Meaningful Use, including what was required, any corresponding Measure Calculation report, any exclusions, and each of the options within MacPractice for recording the necessary information.

Contact MacPractice Support if you wish to attest to Meaningful Use so that we may enable the appropriate Abilities.

Required Abilities

  • MacPractice version 5.0 or 5.1 (Only versions 2014 Certified for Meaningful Use)
  • *EMR/EHR Ability (Only way to record all structured data for Meaningful Use)
  • *PHI Portal set up (Core Measures 12 and 13)
  • *Comprehensive ePrescribe (Core Measures 2 and 4)
  • *Lab Requisition - either integration with an outside Lab company that sends structured data or the Other Labs ability (Menu Set Measure 8)
  • Secure Direct Messaging address configured and vetted
  • HL7 Syndromic Surveillance (Menu Set Measure 9)
  • Immunization Registry Export (Menu Set Measure 8)

* These are purchased abilities.

Actions outside of MacPractice
  • Security Risk Analysis (Core Measure 13)
  • Contact with a local Immunization Registry (Menu Set Measure 9)
  • Contact with a local Public Health Agency (Menu Set Measure 10)
External Information

Modified Stage 2 Attestation Worksheet (via CMS)

What You Need to Know for 2016 Fact Sheets

Specification Sheets

Attestation Worksheet

Alternate Exclusions and Specifications for 2016 Fact Sheet

Public Health Reporting in 2016 Tip Sheet

Security Risk Analysis Tip Sheet

Patient Electronic Access Tip Sheet

Guide for Eligible Professionals Practicing in Multiple Locations

CMS EHR Incentive Programs website

Core Measures
All providers attesting to Meaningful Use must meet all of the Core Measures, unless they qualify for any exclusions. The available exclusions for each measure are listed on the individual measures.

Core Measure 1 - Medications by CPOE

Measure
More than 30% of medication orders created are recorded using CPOE.

Exclusions
Any provider who writes fewer than 100 medication orders during the EHR reporting period.

MacPractice Report
CPOE Measure

How The most important factor in meeting this measure is to mark your MacPractice users as CPOE. To do this, go to the References ability and select Users in the sidebar and check Is CPOE, then enter the start and end dates. Because this report is based off of the user being a CPOE, MacPractice highly recommends that each person in your office has their own login user. It will not be acceptable to mark users such as Front Desk, Room 1, Room 2, Server, etc. as CPOE users, because the software has no way of knowing which person (CPOE or not) is logged into that computer.

The Start Date can be as far back as the day the user became a provider. If you have any questions on whether a user should legally be marked as CPOE, this needs verified with CMS.


Once CPOE is enabled for a user, medications entered by that user will increase percentages in the CPOE Measure report.

Denominator: All unique patients with an office visit within the filtered date range and any medications on file.

Numerator: Any medication order that was entered into MacPractice by a user that is marked as CPOE (with a start date before the date of the medication entry) Additionally, the First Record of Order checkbox must be checked in order for the medication order to be considered By CPOE.

There is also an Alternate Report for CPOE for Stage 1. You can choose to attest with either report, and will only need to meet the 30% threshold for one of them.

Alternate Denominator: All prescriptions entered in the ePrescribe ability (or manually in the Current Medications folder in the Rx ability with an Ordered date added) within the filtered date range with medication orders entered.

Alternate Numerator: Any medication order that was entered into MacPractice as the First Record of Order by a user that is marked as CPOE (with a start date before the date of the medication entry).

Core Measure 2 - Drug-Drug and Drug-Allergy checks

Measure
Implement drug-drug and drug-allergy interaction checks.

Exclusions
None

MacPractice Report
None

How
The use of Comprehensive ePrescribe is required to enable drug-drug and drug-allergy interaction checks in MacPractice. This must be purchased and the checks must be enabled through your entire reporting period. Attestation requires responding 'yes' to the question of whether drug-drug and drug-allergy interaction checks have been enabled. Even though you are just attesting "yes" to this fact, we advise saving a screen shot of an interaction check in case you are ever audited, since they will ask you for proof of this feature.

Core Measure 3 - Problem List

Measure
More than 80% of unique patients seen within the reporting period have at least one entry or an indication that no problems are known recorded as structured data.

Exclusions
None.

MacPractice Report
Patient Problem List Measure.

How
Denominator: All unique patients seen within the filtered date range.
Numerator: The patient has at least one entry of a problem or an indication that no problems are known recorded as structured data. This can be entered in three places:

Patients > Clinical tab


EHR form > Problem List


EMR form > Problem List

Core Measure 4 - ePrescribing (eRx)

Measure

More than 40% of all permissible prescriptions, or all prescriptions written by the provider are queried for a drug formulary and transmitted electronically using CEHRT.

Exclusions
  • Any provider who writes fewer than 100 permissible prescriptions during the EHR reporting period.
  • Any provider who does not have a pharmacy within their organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the provider's practice location at the start of his/her EHR reporting period.
MacPractice Report
Electronic Prescribing Measure

How
The use of ePrescribe in MacPractice will help you record these prescriptions.

Denominator: All prescriptions that meet one of the following conditions: a) Destination type is Electronic Retail or Electronic Mail Order and the DEA Schedule is None b) Destination type is Print and the DEA Schedule is None c) Destination type is Print, Fax or None and the pharmacy type is Electronic.

Numerator: Total prescriptions with the destination type of Electronic Retail or Electronic Mail Order.
 
Core Measure 5 - Medication List

Measure
More than 80% of unique patients seen within the reporting period have at least one medication entry, or an indication that no medications are being taken recorded as structured data.

Exclusions
None

MacPractice Report
Patient Medication List Measure

How
Denominator: All unique patients seen within the filtered date range.

Numerator: The patient must have any medication or prescription on their file, or be indicated as taking no medications (indicated by the No Medications box in an EHR or EMR form)

Adding a medication in the Rx Ability:


Adding medications or an indication that the patient is taking no medications in EHR:


Adding medications or an indication that the patient is taking no medications in EMR.


Core Measure 6 - Medication Allergy List
 
Measure
More than 80% of unique patients seen within the reporting period have at least one entry or an indication that no allergies are known recorded as structured data.

Exclusions
None

MacPractice Report
Patient Medication Allergy List Measure

How
Denominator: All unique patients seen within the filtered date range.

Numerator: The patient must have any allergy or an indication that they have no known allergies saved on their file. This can be recorded as structured data in three places; the Clinical tab of the Patients ability, an EHR form, and an EMR form.

Recorded in the Clinical tab:


Recorded in an EHR form:


Recorded in an EMR form:


Core Measure 7 - Record Demographics

Measure
More than 50% of all unique patients seen during the reporting period have preferred language, sex, race, ethnicity, and date of birth recorded as structured data.

Exclusions
None

MacPractice Report
Patient Demographics Measure

How
Record demographics in the Patient tab.


Denominator: All unique patients with an office visit within the filtered date range.

Numerator: Patients with all of the necessary demographic information recorded (date of birth, sex, preferred language and race/ethnicity).
 
Core Measure 8 - Record Vital Signs

Measure
More than 50% of all unique patients seen within the reporting period have height/weight (all ages) and blood pressure (patients 3 years old or older) recorded as structured data.

Exclusions
Providers who see no patients over 3 years old are excluded from recording blood pressure.

Providers who believe that either the height/weight, blood pressure, or both of these vitals have no relevance to their practice are excluded from recording them. (Providers should confirm this CMS if they are unsure, as MacPractice cannot help you determine if you are eligible for the exclusion.)

MacPractice Report
Patient Vitals Measure

How
Vitals can be recorded in three places; the Clinical tab of the Patient ability, on an EHR form, or on an EMR form for their visit.

Denominator: All unique patients over two years old with an office visit recorded on their ledger with a procedure date within the filtered date range.

Numerator: The patient must have height/weight (for all ages) and blood pressure (for patients three years old or older) recorded as structured data.

Recorded in the Patient ability on the Clinical tab:


Recorded in an EHR form:


Recorded in an EMR form:


Core Measure 9 - Record Smoking Status

Measure
More than 50% of unique patients 13 years old or older seen within the reporting period have smoking status recorded as structured data.

MacPractice Report
Patient Smoking Status Measure

Exclusions
Any provider who does not see patients 13 years old or older.

How
The smoking status of a patient can be recorded in two places; on the Clinical tab in the Patients ability or in an EHR form.

Denominator: All patients 13 years old or older with an office visit within the filtered date range.

Numerator: The patient must have any of the available smoking statuses on their record.

Record in the Patients ability:


Record in an EHR form:


Core Measure 10 - Clinical Decision Support Rule
 
Measure
Implement one clinical decision support rule.

Exclusions
None

MacPractice Report
There is no Measure Calculation report for this measure. Attesting to this is a simple yes/no answer that requires a Yes to be considered accepted.

How
Clinical decision support rules can be created and enabled in References > Clinical Decision Rule. You should enable at least one of these rules for the entire reporting period.

Core Measure 11 - Patient Electronic Access

Measure
More than 50% of all unique patients seen within the reporting period are provided timely (within 4 business days) online access to their health information.

Exclusions
Any provider who neither orders nor creates any of the information listed for inclusion as part of both measures, except for "Patient name" and "Provider's name and office contact information", may exclude this measure.

MacPractice Report
View, Download, Transmit

How
This measure will require the use of the Patient Portal set up for your MacPractice database. Without the Patient Portal on your MacPractice account, the act of exporting the summaries will not count.

Denominator: All unique patients seen within the filtered date range.
Numerator: The office must export a clinical summary to that patient via the patient portal within 4 days of their office visit procedure date, as well as within 4 days of any change to any clinical information on the patient's file.

***A New clinical summary must be exported to the portal within 4 business days each time any change to clinical information on a patient is made. This is not limited to office visits and can include things like adding an allergy, filling a prescription, changing an address, and so on. If you do not export the summary within 4 business days of any change, that patient will remain in you denominator and there will be no way to ever get them back into the numerator for that reporting period.***

The export of this summary can be done in several areas of MacPractice. If you would like to do it as part of billing, there is a simple checkbox that will prompt you to export the summary when you create an insurance claim.


With this box checked, you will get a second prompt after your claim printing window. From here, you can export to the portal and opt whether to physically print the summary as well.


You can also export summaries from the Clinical tab in the Patients ability. Select the incident that contains the office visit code in the ledger, then select To Patient from the Export Incident menu in the upper right corner of the Clinical screen. This will bring up the same clinical summary preview window shown above, where you can export and print the summary.



Finally, summaries can be created and exported in the EHR ability. Select the incident that includes the office visit code, then select To Patient from the Export Incident menu. You will see the prompt to export and print the summary.



The next step is vital and necessary regardless of how the clinical summary is exported. You must set up the patient with Portal Access in the Patient tab AND mark them as the Same Person as Patient. This must be done prior to or within four business days following the office visit or change to clinical information. If you are just exporting without setting up an actual Portal User for your patients, you are not really providing electronic access. This will require a work flow change for many offices, as this measure is time sensitive and you will not be able to go back and increase your percentage if this report does not meet the required 50% at the end of your attestation period.


Core Measure 12 - Clinical Summaries

Measure
Clinical summaries provided to patients or patient authorized representatives within three business days for more than 50% of office visits.

Exclusions
Providers who have no office visits within the reporting period.

MacPractice Report
Clinical Summaries Measure

How
Clinical summaries can be provided from any of the three places shown above in Core Measure 11 (the prompt after the claim creation window, the Clinical tab of the Patients ability, or in the EHR ability).

Denominator: All office visits. (This differs from other reports that include all unique patients. If a patient is seen multiple times within the reporting period, a summary must be created for each visit.) This report differs from Core Measure 11 in that you may opt to make a patient authorized representative a Portal User, so this could potentially be set up to allow parent access to children's clinical summaries via the portal. In addition to the export (and just like core Measure 11), you must also have a Portal User set up for the patient within three business days of their office visit if making the summary available via the portal. You also have the option to physically print the summaries for this measure, but since portal users are required for Core Measure 11, it is recommended to set up the portal users to meet both Core Measures 11 and 12 with one action.

Numerator: A visit summary must be created within three business days after the Procedure Date (NOT the Posted Date) of their office visit.

There are three options for exporting summaries to patients that will count for this report. Regardless of which option you choose for physically printing, a copy will be exported to the portal. If you choose to "Print" or "Don't Print (Patient Declined)" within this prompt, this will add the office visit to the numerator. If you choose "Don't Print", a portal user must be set up for the patient in order for a successful export to the portal to occur and for the visit to be added to your numerator.

Regardless of the method you use to generate the Clinical Summary, if you do it more than three business days after the patient's visit, it will not count. Weekends do not count as business days, and the date ofthe visit is also not counted as a full day. For example, if you have a visit Monday, you have Monday, Tuesday (1), Wednesday (2), and Thursday (3) to export the summary of the visit by 11:59pm.
 
Core Measure 13 - Protect Electronic Health Information

Measure
Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a) (1), including addressing the encryption/security of data stored in CEHRT in accordance with requirements under 45 CFR 164.312 (a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the provider's risk management process for EPs.

Exclusions
None

MacPractice Report
There is no Measure Calculation report in MacPractice for this measure. Attesting to this is a simple yes/no answer that requires a "yes" to be considered accepted.

How
This is not recorded in MacPractice. When attesting to this measure, it is a simple yes/no question (which must be answered with a "yes" to submit a successful and accepted attestation). MacPractice highly recommends hiring an outside IT or security company to perform a security risk analysis for your office that provides a report of this analysis. This analysis should include things outside of your MacPractice software such as network and building security. For this reason, this is not something that MacPractice can assist with. For suggestions on companies to assist with this, we suggest contacting your local MacPractice sales representative.

It is important to note that in audits that MacPractice has assisted with, this is the most common reason we have seen for failed audits. In the event your office does get audited, you must furnish proof of a Security Risk Analysis in the form of a report. For more information on what is accepted for a Security Risk Analysis, we suggest contacting CMS with any questions you may have, as we are unable to assist with this requirement in any way.

Additional Resources
The Office of the National Coordinator for Health Information Technology (ONC), HHS Office for Civil Rights (OCR), and HHS Office of General Counsel (OCG) have collaborated to create a number of tools, guides, and additional resources for security risk assessment:
 
Doing A Proper Risk Analysis video with Healthcare Scene
Security Risk Assessment Tool on healthit.gov
Security Risk Assessment Video in healthit.gov
Template for a Do It Yourself Security Risk Analysis

Menu Set Measures
Providers must attest to 5 of the 9 Menu Set Measures for Stage 1. One of the 5 that you choose must be a Public Health Measure, which are Menu Set Measures 8 and 9. You are allowed to choose something you are excluded from only after you have also chosen the measures you are able to meet.
 
Menu Set Measure 1 - Drug Formulary Checks

Measure

Enable the functionality for drug formulary checks for the entire reporting period.

Exclusions
Any provider who writes fewer than 100 prescriptions during the reporting period would be excluded from this requirement.

MacPractice Report
There is no Measure Calculation report for this measure. Attesting to this is a simple yes/no answer that requires a "yes" to be considered accepted.

How 
For this measure, you must have Comprehensive ePrescribe enabled for the entire reporting period, as this is how drug formulary checks are enabled in MacPractice. Even though you are just attesting "yes" to this fact, if you'd like proof of it in the form of a screenshot, please see our documentation on creating and enabling Formulary Checks here. We advise saving this screen shot in case you are ever audited, since they will ask you for proof of this feature.

Menu Set Measure 2 - Lab Results

Measure

More that 40% of all clinical lab tests results ordered by the provider during the reporting period whose results are either in a positive/negative or numerical format are incorporated as structured data.

Exclusions
Any provider who orders no lab tests where results are in either a positive/negative or numerical format during the reporting period. 

MacPractice Report
Lab Test Results Measure

How
This involves the use of Laboratory Orders. 

Denominator: All Orders set to the type of Laboratory set to the filtered provider with an Ordered Date within the filtered date range. 
Numerator: An order will be added to the numerator if it includes any form of coded structured data. (Most lab companies that MacPractice integrates with use some form of "structured data" in the returned results, but if you are unsure or notice that you are not meeting the required percentage for this report, please contact MacPractice Support and ask to speak with a Labs specialist.) Aside from integrating with an outside lab company, the only other way to add structured data for lab tests and results is with the use of LOINC codes added to Laboratory Orders via the Other Labs option. The tests and results would have to be entered in manually. An example of this is shown below.


Menu Set Measure 3 - Patient Lists

Measure

Generate lists of patients by specific conditions to sure for quality improvement, reduction of disparities, research, or outreach.

Exclusions
None

MacPractice Report
There is no Measure Calculation report for this measure. Attesting to this is a simple yes/no answer that requires a "yes" to be considered accepted.

How
Attesting to this measure is a simple yes/no answer. MacPractice has Clinical reports including the Patient Clinical Report and the Patients by Procedure & Diagnosis report that can be filtered by specific conditions. Simply running one of these reports means that providers can attest "yes" to this measure. We do recommend that you run a report like this during each of your attestation periods and save a copy, in case you are ever audited and they need proof of the date the report was run.


Menu Set Measure 4 - Reminders

Measure

More than 20% of all unique patients under 5 years old or older than 65 years old were sent an appropriate reminder within the reporting period.

Exclusions
Providers who do not see patients over 65 years old or under 5 years old.

MacPractice Report
Patient Reminder Measure

How
Denominator: All patents in your database under 5 or over 65 years old.

Numerator: The patient must be sent a Reminder for Preventive/Follow-up Care (Preventive/Recall Care in MacPractice DDS) with a date within the filtered date range. These can be recorded on the Communication tab on the Patient tab in the Patient ability. (Note that these MUST be set to the type of Reminder for Preventive/Recall Care, and not a reminder of Appointment. This is a change from previous Meaningful Use years when "reminders" were considered to be appointment reminders.)


Menu Set Measure 5 - Patient Specific Education Resources

Measure

More that 10% of unique patient seen within the reporting period have Patient Education recorded.

Exclusions
None

MacPractice Report
Patient Education Measure

How
Denominator: All unique patients seen within the filtered date range.

Numerator: The patient must have a Patient Education added to their account. Patient Education records can be added to a patient in two ways. The first involves creating custom Patient Education Resources in References. If your office has informative material such as a packet on teenage pregnancy, a chart in the office about heart disease, a video for patients to watch about diabetic friendly diets, and so on, these can be created as Patient Education Resources. These must be created with qualifications. In the example below, I have made a Teen Pregnancy Packet available for all female patients between the ages of 12 and 20.


Once the Patient Education Resources are created, they can be added to any patient who meets all of the qualifications on their Clinical tab in the Patients ability or in an EHR form.



In an EHR form-



In addition to creating Patient Education Resources in References, MacPractice has added an InfoButton Standard to Allergies, Problems, Medications, and Labs on a patient's clinical tab and EHR summary. Clicking this infoButton will search a preselected list of sites with potential educational information for the Allergy, Problem, Medication, or Lab result. You can select Gave Resource to Patient in the window that appears after clicking the InfoButton to add a Patient Education. This will add the education to the patient's file.


Menu Set Measure 6 - Medication Reconciliation

Measure

Mediation reconciliations are performed for more than 50% of transitions of care.

Exclusions
Providers who are not the recipient of any transitions of care during the reporting period.

MacPractice Report
Medication Reconciliation Measure

How
Denominator: Patient must have a referral of the type Transition From (indicating that they were transitioned into your office by another provider), an incident dated after the date of the Transition From referral date, and an office visit code in the ledger of that incident. The Incident Date is the date that the report filters from, so this date must fall within your filtered date range in order for the patient to be in your report.

Numerator: You must perform a medication reconciliation in EHR or EHR. You must be sure to go through the Reconcile process, and not just add Medications manually or check the No Medications checkbox.


Menu Set Measure 7 - Transition of Care Summary

Measure

Providers who transition or refer patients to another setting of care or provider provide a summary of care for more that 50% of these transitions of cares and referrals.

Exclusions
Any provider who transfers a patient to another setting or refers a patient to another provider less than 100 times during the reporting period.

MacPractice Report
Summary of Care Measure

How
Denominator: All instances of a referral of the type Transition To. This means that if you multiple Transition To referrals on the same patient, that patient's name will appear multiple times in the denominator.

Numerator: A Summary of Care document (CDA) must be made available for the referral. This can be done either on the Clinical tab in the Patient ability or in EHR. You must first select the incident itself that you wish to export and then either export it to an existing referral for the patient or add a new referral to the patient at that time.

Exported from the Clinical tab-



Exported from EHR-


Menu Set Measure 8 - Immunizations

Measure

Perform at least one test of the EHR's capability to submit electronic data to immunization registries and follow up if the test is successful.

MacPractice Report
There is no Measure Calculation report for this measure. Attesting to this is a simple yes/no answer that requires a "yes" to be considered accepted.

Exclusions
  • Providers who do not administer any of the immunizations to any of the populations for which data is collected by their jurisdiction's immunization registry or information system during the reporting period.
  • Providers who operate in a jurisdiction for which no immunization registry of immunization information system is capable of accepting the specific standards required for CEHRT at the start of the reporting period.
  • Providers who operate in a jurisdiction where no immunization registry or immunization information system provides information timely on capability to receive immunization data.
  • Providers who operate in a jurisdiction for which no immunization registry or immunization information system that is capable of accepting the specific standards required by CEHRT at the start of the reporting period can enroll additional providers.
How
Any provider that administers immunizations needs to have the Immunization Export ability turned on for their MacPractice account. Once this is done, an Export button will be seen in the Immunization tab of the Clinical tab in the Patients ability. When Immunizations are administered and recorded, it will automatically be sent to an Export folder that you create in Preferences> HL7. There is also an Export button on the Immunization that can be used to generate a file for any old immunizations that may have been administered prior to getting the Export folder created.


With the proper setup, the files will be automatically exported to a folder that you choose in Preferences. The following MUST be done on your Server computer. In the HL7 Preferences, use the green plus button to create a new path. Then set up a folder in the Server Path for Outgoing HL7 Messages. Once this is set, move the Outgoing tab and check the box next to Immunization Registry. 



Please note, MacPractice Support can only assist with configuring the exporting of Immunizations. It is up to you and your office staff to contact local immunization registries or immunization information systems to see if they can accept these files and if so, maintain contact and submission with them.
 
Menu Set Measure 9 - Syndromic Surveillance

Measure

Perform at least one test of the EHR's capability to submit electronic syndromic surveillance data to local Public Health Agencies and follow up if the test is successful.

Exclusions
  • Providers who are not in a category of providers that collect ambulatory syndromic surveillance information on their patients during the reporting period.
  • Providers who operate in a jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data in the specific standards required for CEHRT at the start of the reporting period.
  • Providers who operate in a jurisdiction where no public health agency system provides information timely on capability to receive syndromic surveillance data.
  • Providers who operate in a jurisdiction for which no public health agency that is capable of accepting the specific standards required by CEHRT at the start of the reporting period can enroll additional providers.
MacPractice Report
There is no Measure Calculation report for this measure. Attesting to this is a simple yes/no answer that requires a "yes" to be considered accepted.

How
There is a report in MacPractice designed to collect this format of data and generate the necessary files for submission to PHAs. This can be found in Reports under the Clinical folder. Running the Syndromic Surveillance Export report and using the Export button at the bottom will generate the files and save them in a folder that you set up in HL7 Preferences.


NOTE-MacPractice Support can only assist with exporting the data. You must contact local Public Health Agencies to see if they can accept these files and if so, maintain contact and submission with them.

CQM Reporting
In addition to the Core and Menu Set Measures, Meaningful Use requires that providers report on 9 CQMs (Clinical Quality Measures) electronically. These can be found in the Clinical Quality Measures (2014) folder in the Reports ability. Unlike the Core and Menu Set Measures, there are no required percentages for any of these reports, meaning you could have a 0% and this will not count against you or prevent you from achieving Meaningful Use; however, each report must have a denominator. They merely want to make sure that they are collecting this data from attesting providers.

For the most part, the Meaningful Use program is lenient in that they allow a provider to choose 9 of these reports that apply to their practice and have a denominator. There is one rule that they have made in order to collect a variety of data: Your chosen reports must be from at least 3 of the 6 different domains. A list of the domains and the measures that fall under each of them is at the end of this document.

Once you choose a report that applies to your practice and run the report for you attesting period, you will have the option to export these reports in either QRDA Category 1 or QRDA Category 3 files. Both file formats will be accepted by CMS for electronic upload and submission. The difference in the two is that QRDA Category 1 will create a file for each patient in the report, and QRDA Category 3 will create one file for the entire report data. Export either of these to a folder on your computer of your choosing, and then upload these files to CMS as part of your attestation.

Domains and Measures

Patient and Family Engagement Patient Safety Care Coordination Population/Public Health Efficient Use of Healthcare Resources Clinical Process/Effectiveness Configuration
Configure each provider that will attest to Meaningful Use.

In the User Reference for the provider, check the Is CPOE checkbox, and enter a start date prior to the reporting period. Select the year the provider started attesting to Meaningful Use. This will allow you to correctly configure the Reports ability.

In the Reports ability, select Measure Calculation in the sidebar. For each attesting provider, select the year of the report that you are running. This will enable boxes on the Supplemental Measure Data tab and the Measure Exceptions tab.

MacPractice assumes by default that you are recording all of your patient data within our software. If this is not the case, the Supplemental Measure Data gives you the option to record additional data that has not been entered in MacPractice, such as the number of labs, referrals, medications, prescriptions, and office visits.


The Measure Exceptions tab will allow you to set several exclusions for your provider. In the example below, taking Blood Pressure is not relevant to the scope of practice, so "Blood pressure has no relevance to this provider's practice" is checked. The Vitals report will calculate based on this.

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    Tiffany Yanagida

    all images are broken