IMPORTANT NOTICE: MacPractice maintains this Stage 2 documentation for historical reference in the event that you need to review this for past Meaningful Use attestations or audits.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 2 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.
- MacPractice version 5.0 or 5.1 (Only versions 2014 Certified for Meaningful Use)
- *EHR Ability (Only way to record all structured data for Meaningful Use)
- *PHI Portal set up (Core Measures 7, 8, and 17)
- *Comprehensive ePrescribe (Core Measures 2 and 6)
- *Lab Requisition, either integration with an outside Lab company that sends structured data or the Other Labs ability (Core Measures 1 and 10)
- Secure Direct Messaging address configured and vetted (Core Measure 15)
- HL7 Syndromic Surveillance (Menu Set Measure 1)
- Immunization Registry Export (Core Measure 16)
* These are purchased abilities.
- Security Risk Analysis (Core Measure 9)
- Contact with a local Immunization Registry (Core Measure 16)
- Contact with a local Public Health Agency (Menu Set Measure 1)
CMS EHR Incentive Programs website
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.
Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional that can enter orders into the medical record per state, local, and professional guidelines.
More than 60 percent of medication orders created by the EP during the EHR reporting period are recorded using computerized provider order entry.
Any EP who writes fewer than 100 medication orders during the EHR reporting period.
More than 30 percent of laboratory orders created by the EP during the EHR reporting period are recorded using computerized provider order entry.
Any EP who writes fewer than 100 laboratory orders during the EHR reporting period.
More than 30 percent of radiology orders created by the EP during the EHR reporting period are recorded using computerized provider order entry.
Any EP who writes fewer than 100 radiology orders during the EHR reporting period.
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 licensed healthcare professional. If you have any questions on whether a user should legally be marked as CPOE, CMS has created an FAQ over this topic.
￼Once a user is marked as CPOE, prescriptions, labs orders, and radiology/imaging orders entered by that user will increase your percentages in the CPOE Measure report.
For Medication orders -
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.
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).
For Laboratory and Radiology/Imaging orders -
Denominator: The number of orders created with the types Laboratory and Radiology/Imaging respectively.
Numerator: Orders created by a CPOE user (with a CPOE start date before the Ordered Date). The "First record of order" box must be checked on the orders themselves, which should happen by default when the orders are created.
Core Measure 2 - ePrescribing (eRx)
- 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.
Electronic Prescribing Measure
The use of ePrescribe in MacPractice will help you record these prescriptions properly.
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.
There are two reports for Stage 2. Providers can choose to attest with numbers from either report, and are not required to submit both. The first report will only count permissible prescriptions. The second report counts controlled substances in the denominator. Even if you prescribe controlled substances, you are still allowed to attest with numbers form the first report that does not include them.
Core Measure 3 - Record Demographics
More than 80% of all unique patients seen during the reporting period have preferred language, sex, race, ethnicity, and date of birth recorded as structured data.
Patient Demographics Measure
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 4 - Record Vital Signs
More than 80% 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.
- 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 exception CMS if they are unsure, as MacPractice cannot help you determine if you are eligible for the exception.)
Patient Vitals Measure
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 5 - Record Smoking Status
More than 80% of unique patients 13 years old or older seen within the reporting period have smoking status recorded as structured data.
Patient Smoking Status Measure
Any provider who does not see patients 13 years old or older.
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.
Recorded in the Patients ability -
Recorded in an EHR form -
Core Measure 6 - Clinical Decision Support Rule
- Measure 1: Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point of patient care for the entire reporting period. If not related to clinical quality measures, the clinical decision support interventions must be related to high-priority health conditions.
- Measure 2: Implement the functionality for drug-drug and drug-allergy interaction checks for the entire reporting period.
There are no exclusions for the first measure. For the second measure, a provider who writes fewer than 100 medication orders during the reporting period is excluded.
This measure has no report. If both measures are implemented, the provider will simply attest "yes" to these.
For the first measure, clinical decision support interventions can be created and enabled in References> Clinical Decision Rule.
For the second measure, The use of Comprehensive ePrescribe is what allows a user 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 to answer "yes" in your attestation.
Core Measure 7 - Patient Electronic Access
- Measure 1: 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.
- Measure 2: More than 5% of all unique patients seen within the reporting period (or their authorized representative) view, download, or transmit their health information.
- 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 both measures.
- Any provider who conducts 50% or more of his or her patient encounters in a county that does not have 50% or more of housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the EHR reporting period may exclude only the second measure.
View, Download, Transmit
Both measures 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: Measure 1: For measure 1, a patient is added to the numerator if the office exports 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 miss exporting 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 weather 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.
Measure 2: The patient (or their authorized representative) must log into the Patient Portal with the username and password created by the office and either view, download, or transmit their clinical summary.
Core Measure 8 - Clinical Summaries
Clinical summaries provided to patients or patient authorized representatives within one business day for more than 50% of office visits.
Providers who have no office visits within the reporting period.
Clinical Summaries Measure
Clinical summaries can be provided from any of the three places shown above in Core Measure 7 (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 7 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 7), you must additionally have a Portal User set up for the patient on the same day as 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 7, it is recommended to set up the portal users to meet both Core Measures 7 and 8 with one action.
Numerator: A visit summary must be created within three business days after the procedure 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 "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.
Core Measure 9 - Protect Electronic Health Information
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.
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.
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.
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
More that 55% 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.
Any provider who orders no lab tests where results are in either a positive/negative or numerical format during the reporting period.
This involves the use of Laboratory Orders.
Denominator: All Orders set to the type of Laboratory 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 LOINC codes to Laboratory Orders is to use the Other Labs option and add these manually. An example of this is shown below.
Core Measure 11 - Patient Lists
Generate lists of patients by specific conditions to sure for quality improvement, reduction of disparities, research, or outreach.
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.
Core Measure 12 - Preventive Care
More than 10% of all unique patients who have had 2 or more office visits with the provider within the 24 months before the beginning of the EHR reporting period were sent a reminder, per patient preference when available.
Any provider who has no office visits in the 24 months before the reporting period.
Patient Reminder Measure
Denominator: All patents who have at least two office visit codes in their ledgers, both with procedure dates within the 24 months prior to the start date of the report.
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.)
In addition, if you've set a Communication Preference for the patient, you must also use that Method for the Communication. (If they have no Communication Preference set, the Method can be set to any selection and still count for the numerator.)
More that 10% of unique patient seen within the reporting period have Patient Education recorded.
Any provider who has no office visits within the reporting period.
Patient Education Measure
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 the Clinical tab -
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 educaiton to the patient's file.
Core Measure 14 - Medication Reconciliation
Mediation reconciliations are performed for more than 50% of transitions of care.
Medication Reconciliation Measure
Providers who are not the recipient of any transitions of care during the reporting period.
Denominator: Patient must meet one of the following conditions:
A) An incident with the First Encounter box checked, which also must include an office visit code.
B) Electronic receipt of a transition of care document to your office from another office using an EHR capable of sending these. The document must then be tied to an incident, and that incident's ledger must also include an office visit code.
C) A patient coming into your office with a list of their current medications, which will then need to be entered in as a list to reconcile. (For this case, the act of entering in a list to reconcile and reconciling will add the patient to the denominator and numerator at the same time.)
Numerator: You must perform a medication reconciliation in EHR or EMR. You must be sure to go through the Reconcile process, and not just add Medications manually or check the No Medications checkbox.
Core Measure 15 - Summary of Care
- Measure 1: Providers who transition or refer patients to another setting of care (or provider) must provide a summary of care for more that 50% of these transitions of cares and referrals.
- Measure 2: Providers who transition or refer patients provide summaries of care electronically for more than 10% of such transitions.
- Measure 3: Providers conduct one or more successful electronic exchanges of a summary of care document with a recipient who has EHR technology that was developed and designed by a different EHR technology developer than the sender's EHR technology OR conducts one or more successful tests with the CMS designated test EHR during the reporting period.
Any provider who transfers a patient to another setting or refers a patient to another provider less than 100 times during the reporting period is excluded from all three measures.
Summary of Care Measure
Denominator: All instances of a referral of the type Transition To. This means that if you multiple Transition To referrals on the same patient, they will appear multiple times in the denominator.
Numerator: Measure 1: 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-
Measure 2: A patient will be added to the numerator of the report if you transmit the summary to a direct address.
Measure 3: The third measure is a simple yes/no answer of performing a test of sending a CDA file electronically either to another provider with a different certified EHR software or to a testing tool set up for providers who have no providers that they refer patients to who also use certified EHR technology and are capable of receiving these files electronically.
Core Measure 16 - Immunization Registries Data Submission
Successful ongoing submission of electronic immunization data to an immunization registry or immunization information system for the entire reporting period.
- 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.
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.
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.
Core Measure 17 - Use Secure Electronic Messaging
A secure message was sent using the electronic messaging function of MacPractice by more than 5% of unique patients (or their authorized representative) seen during the reporting period.
Providers who have no office visits within the reporting period OR providers who conduct 50% or more of their encounters in a county that does not have 50% or more of housing units with 3Mbps broadband availability according to the latest information available form the FCC on the first day of the reporting period.
Secure Electronic Messaging Measure
This measure requires the setup and use of the Patient Portal.
Denominator: All unique patients that were seen within the filtered date range.
Numerator: A patient will be added to the numerator if they log into their patient portal account (must be set up in the office) and send the office a message. Patients can be set up with a Patient Portal User on the Portal Access tab. Once this is set up, they will be able to use their chosen username and password to log in to your office's Patient Portal. There are several places within the portal with a link to message the office. Any one of these will send a message to the Messages ability and count the patient in the numerator of this report.
NOTE: The message that the patient or their authorized representative sends the office MUST be sent to a user in MacPractice that is a provider. (They must select a provider's user in the To section of their message.) Messages sent to front desk staff, billing staff, and so on do not count towards the numerator of this report.
Menu Set Measures
Menu Set Measure 1 - Syndromic Surveillance Data Submission
Successful ongoing submission of electronic syndromic surveillance data from MacPractice to a public health agency for the entire reporting period.
- Providers who do not 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.
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.
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 setting up data export for this measure. It is up to you and your office staff to contact local Public Health Agencies to see if they can accept these files and if so, maintain contact and submission with them.
Menu Set Measure 2 - Electronic Notes
Enter as least one electronic progress note created, edited, and signed by the provider for more than 30% of unique patients with an office visit within the reporting period.
Electronic Notes Measure
Denominator: All unique patients seen within the filtered date range.
Numerator: The patient will be added to the numerator of this report if they have an EHR or EMR from that was created, edited, or signed by a provider user. This report is based off is the user logged in to MacPractice. The only way for the system to know that the provider was the one editing the form is by the user that is logged in being marked as a provider. For this reason, we highly encourage one user per person in your office (ie no Room 1, Front Desk, Server Room, etc. users shared by multiple people).
Menu Set Measure 3 - Imaging Results
Of all tests ordered by the provider (within the reporting period), where the result included images, more than 10% of those images are accessible through CEHRT.
Imaging Results Measure
Providers who order fewer than 100 tests whose result is an image during the reporting period OR providers who have no access to electronic imaging results at the start of the reporting period.
Denominator: All instances of a Radiology/Imaging orders.
Numerator: An order will be added to the numerator if it has attachments added that are marked as the Type of Imaging Result.
Menu Set Measure 4 - Family Health History
Structured Family Health History data can only be recorded in the proper EHR box for Family History.
Denominator: All unique patients seen within the filtered date range.
Numerator: Patient must have at least one condition recorded for at least one first degree relative (mother, father, sister, brother, daughter, or son) in their EHR.
Menu Set Measure 5 - Report Cancer Cases
Successful ongoing submission of cancer case information from MacPractice to a public health central cancer registry for the entire reporting period.
***MacPractice does not currently have the ability to generate the necessary electronic files for reports of cancer cases. This is something that we may consider in the future, but it is not currently possible to choose to attest to this Menu Set Measure using MacPractice.
Successful ongoing submission of specific case information from MacPractice to a specialized registry for the entire reporting period.
***MacPractice does not currently have the ability to generate the necessary electronic files for reports of specific cases. This is something that we may consider in the future, but it is not currently possible to choose to attest to this Menu Set Measure using MacPractice.
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, and then upload these files to CMS as part of your attestation.
Domains and Measures
- Functional status assessment for hip replacement
- Functional status assessment for knee replacement
- Oncology: Medical and Radiation Pain Intensity Quantified
- Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures
- Child and Adolescent Major Depressive Disorder: Suicide Risk Assessment
- Documentation of Current Medications in the Medical Record
- Falls: Screening for Future Fall Risk
- Use of High-Risk Medications in the Elderly
- Childhood Immunization Status
- Chlamydia Screening for Women
- Maternal depression screening
- Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
- Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
- Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
- Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
- Appropriate Treatment for Children with Upper Respiratory Infection (URI)
- Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
- Anti-depressant Medication Management
- Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/ Progesterone Receptor (ER/PR) Positive Breast Cancer
- Breast Cancer Screening
- Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
- Cervical Cancer Screening
- Children who have dental decay or cavities
- Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients
- Colorectal Cancer Screening
- Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%)
- Dementia: Cognitive Assessment
- Depression Remission at Twelve Months
- Diabetes: Eye Exam
- Diabetes: Foot Exam
- Diabetes: Hemoglobin A1c Poor Control
- Diabetes: Low Density Lipoprotein (LDL) Management
- Diabetes: Urine Protein Screening
- Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
- Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
- Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
- Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
- Hemoglobin A1c Test for Pediatric Patients
- HIV/AIDS: Medical Visit
- HIV/AIDS: Pneumocystis jiroveci pneumonia (PCP) Prophylaxis
- HIV/AIDS: RNA controls for Patients with HIV
- Hypertension: Improvement in blood pressure
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
- Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control
- Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
- Pneumonia Vaccination Status for Older Adults
- Pregnant women that had HBsAg testing
- Preventive Care and Screening: Cholesterol Fasting Low Density Lipoprotein (LDL- C) Test Performed
- Preventive Care and Screening: Risk-Stratified Cholesterol Fasting Low Density Lipoprotein (LDL- C)
- Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists
- Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation
- Use of Appropriate Medications for Asthma
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.