For 2021 reporting, you can obtain the PI data in DrChrono and enter that information into your Healthmonix MIPSpro dashboard.
Promoting Interoperability consists of several required objectives and 1 bonus.
- e-prescribing
- Health Information Exchange
- Provider to Patient Exchange
- Security Risk Analysis
- Public Health and Clinical Data Exchange (must select 2)
You can access your PI dashboard in your DrChrono account by going to Clinical > MIPS/MACRA
Select the full year for 2021 or the date range for the 90 day period. Next select the provider(s) for reporting.
The table will populate with the data from your account. You can enter this data into your Healthmonix account.
After logging into your Healthmonix MIPSpro account, select Promoting Interoperability.
Select Data Entry and then Go To Page.
Click Update next to the measure to enter the data.
Enter the numerator and denominator from your DrChrono account and Save. Repeat for the other measures.
E-Prescribing
In DrChrono, the denominator is the total number of prescriptions you have generated. The numerator is the number of prescriptions you have sent electronically from DrChrono with the Send Prescription button.
Description
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified electronic health record technology (CEHRT).
Numerator - The number of prescriptions in the denominator generated, queried for a drug formulary, and transmitted electronically using CEHRT.
Denominator - The number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the performance period; or number of prescriptions written for drugs requiring a prescription in order to be dispensed during the performance period.
Exclusions - Any MIPS eligible clinician who writes fewer than 100 permissible prescriptions during the performance period.
Definition of Terms & Additional Information
Prescription – The authorization by a MIPS eligible clinician to a pharmacist to dispense a drug that the pharmacist would not dispense to the patient without such authorization.
Permissible Prescriptions – All drugs meeting the current definition of a prescription as the authorization by a clinician to dispense a drug that would not be dispensed without such authorization and may include electronic prescriptions of controlled substances where creation of an electronic prescription for the medication is feasible using CEHRT and where allowable by state and local law.
Bonus -
Query of Prescription Drug Monitoring Program
If you participate in a Prescription Drug Monitoring Program (PDMP) you can earn a bonus towards your total PI score. In DrChrono, if you utilize our partner Appriss Health and have electronically prescribed at least one schedule II opioid and used our Appriss Health integration to conduct a PDMP query, you could qualify for the bonus.
In your Healthmonix MIPSpro PI dashboard, you can attest by selecting Yes or No and clicking Save.
Description
For at least one Schedule II opioid electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a PDMP for prescription drug history, except where prohibited and in accordance with applicable law.
Numerator - The number of Schedule II opioid prescriptions in the denominator for which data from CEHRT is used to conduct a query of a PDMP for prescription drug history except where prohibited and in accordance with applicable law.
Denominator - Number of Schedule II opioids electronically prescribed using CEHRT by the MIPS eligible clinician during the performance period.
Definition of Terms & Additional Information
Opioids – Schedule II controlled substances under 21 CFR 1308.122, as they are recognized as having a high potential for abuse with potential for severe psychological or physical dependence.
Permissible Prescriptions – All drugs meeting the current definition of a prescription as the authorization by a provider to dispense a drug that would not be dispensed without such authorization and may include electronic prescriptions of controlled substances where creation of an electronic prescription for the medication is feasible using CEHRT and where allowable by state and local law.
PDMP – an electronic database that tracks prescriptions of controlled substances at the State level.
Support Electronic Referral Loops by Sending Health Information
The denominator is determined by the total number of referrals you have sent with e-fax and direct messaging. The numerator is the number of referrals sent via Direct Messaging.
Description
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider — (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.
Numerator - The number of transitions of care and referrals in the denominator where a summary of care record was created using CEHRT and exchanged electronically.
Denominator - Any MIPS eligible clinician who transfers a patient to another setting or refers a patient fewer than 100 times during the performance period.
Exclusions - Any MIPS eligible clinician who transfers a patient to another setting or refers a patient fewer than 100 times during the performance period.
Definition of Terms & Additional Information
Transition of Care – The movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory, specialty care practice, long-term care, home health, rehabilitation facility) to another. At a minimum this includes all transitions of care and referrals that are ordered by the MIPS eligible clinician.
Referral – Cases where one provider refers a patient to another, but the referring provider maintains his or her care of the patient as well.
Summary of Care Record – All summary of care documents used to meet this objective must include the following information if the MIPS eligible clinician knows it:
- Patient name
- Demographic information (preferred language, sex, race, ethnicity, date of birth)
- Smoking status
- Current problem list (eligible clinicians may also include historical problems at their discretion)*
- Current medication list*
- Current medication allergy list*
- Laboratory test(s)
- Laboratory value(s)/result(s)
- Vital signs (height, weight, blood pressure, BMI)
- Procedures
- Care team member(s) (including the primary care provider of record and any additional known
care team members beyond the referring or transitioning clinician and the receiving clinician)* - Immunizations
- Unique device identifier(s) for a patient’s implantable device(s)
- Care plan, including goals, health concerns, and assessment and plan of treatment
- Referring or transitioning clinician’s name and office contact information
- Encounter diagnosis
- Functional status, including activities of daily living, cognitive and disability status
- Reason for referral
*Note: A MIPS eligible clinician must verify that the fields for current problem list, current medication list, and current medication allergy list are not blank and include the most recent information known by the MIPS eligible clinician as of the time of generating the summary of care document or include a notation of no current problem, medication and/or medication allergies.
Current problem lists – At a minimum a list of current and active diagnoses.
Active/current medication list – A list of medications that a given patient is currently taking.
Active/current medication allergy list – A list of medications to which a given patient has known allergies.
Allergy – An exaggerated immune response or reaction to substances that are generally not harmful.
Care Plan – The structure used to define the management actions for the various conditions, problems, or issues. A care plan must include at a minimum the following components: problem (the focus of the care plan), goal (the target outcome) and any instructions that the provider has given to the patient. A goal is a defined target or measure to be achieved in the process of patient care (an expected outcome).
Support Electronic Referral Loops by Receiving & Incorporating Health Information
The denominator is determined by the number of new patient encounters that are designated as a Transition of Care in the appointment window.
The numerator is determined by the import and data reconciliation of C-CDA information for the transition of care patients.
Description
For at least one electronic summary of care record received for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, or for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician conducts clinical information reconciliation for medication, medication allergy, and current problem list.
Numerator - The number of electronic summary of care records in the denominator for which clinical information reconciliation is completed using CEHRT for the following three clinical information sets: (1) Medication – Review of the patient’s medication, including the name, dosage, frequency, and route of each medication; (2) Medication allergy – Review of the patient’s known medication allergies; and (3) Current Problem List – Review of the patient’s current and active diagnoses.
Denominator - Number of electronic summary of care records received using CEHRT for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, and for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient.
Exclusions -
1. Any MIPS eligible clinician who is unable to implement the measure for a MIPS performance period in 2019 would be excluded from having to report this measure. Or
2. Any MIPS eligible clinician who receives fewer than 100 transitions of care or referrals or has fewer than 100 encounters with patients never before encountered during the performance period.
Definition of Terms & Additional Information
Transition of Care – The movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory, specialty care practice, long-term care, home health, rehabilitation facility) to another. At a minimum this includes all transitions of care and referrals that are ordered by the MIPS eligible clinician.
Referral – Cases where one provider refers a patient to another, but the referring provider maintains his or her care of the patient as well.
Current problem lists – At a minimum a list of current and active diagnoses.
Active/current medication list – A list of medications that a given patient is currently taking.
Active/current medication allergy list – A list of medications to which a given patient has known allergies.
Allergy – An exaggerated immune response or reaction to substances that are generally not harmful.
Care Plan – The structure used to define the management actions for the various conditions, problems, or issues. A care plan must include at a minimum the following components: problem (the focus of the care plan), goal (the target outcome) and any instructions that the provider has given to the patient. A goal is a defined target or measure to be achieved in the process of patient care (an expected outcome).
Provide Patients Electronic Access to Their Health Information
The denominator is the number of unique patients you have seen for appointments in DrChrono for the measurement period.
The numerator is made up of:
- The number of patients with in the reporting period who have been sent an invitation to OnPatient within 4 days of the appointment
- Patients with appointments in the reporting year who have already been invited to OnPatient
For information on inviting patients to OnPatient see our article here.
Description
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient’s health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programming Interface (API) in the MIPS eligible clinician’s certified electronic health record technology (CEHRT).
Numerator
The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party and to access using an application of their choice that is configured meet the technical specifications of the API in the MIPS eligible clinician’s CEHRT.
Denominator
The number of unique patients seen by the MIPS eligible clinician during the performance period.
Definition of Terms & Additional Information
API or Application Programming Interface – A set of programming protocols established for multiple purposes. APIs may be enabled by a health care provider or provider organization to provide the patient with access to their health information through a third-party application with more flexibility than is often found in many current “patient portals.”
Provide Access – When a patient possesses all of the necessary information needed to view, download, or transmit their information. This could include providing patients with instructions on how to access their health information, the website address they must visit for online access, a unique and registered username or password, instructions on how to create a login, or any other instructions, tools, or materials that patients need in order to view, download, or transmit their information. Information that must be made available to patients:
- Patient name
- Provider’s name and office contact information
- Current and past problem list
- Encounter diagnosis
- Procedures
- Laboratory test results
- Current medication list and medication history
- Current medication allergy list and medication allergy history
- Vital signs (height, weight, blood pressure, BMI, growth charts)
- Smoking status
- Immunizations
- Functional status, including activities of daily living, cognitive and disability status
- Unique device identifier(s) for a patient’s implantable device(s)
- Demographic information (preferred language, sex, race, ethnicity, date of birth)
- Care plan field(s), including goals, health concerns, assessment, plan of treatment and instructions
- Any known care team members including the primary care provider (PCP) of record
Timely Access – CMS defines “timely” as within 4 business days of the information being available to the MIPS eligible clinician.
Unique Patient – If a patient is seen by a MIPS eligible clinician more than once during the performance period, then for purposes of measurement, that patient is only counted once in the denominator for the measure. All the measures relying on the term ‘‘unique patient’’ relate to what is contained in the patient’s medical record. Not all of this information will need to be updated or even be needed by the MIPS eligible clinician at every patient encounter. This is especially true for patients whose encounter frequency is such that they would see the same MIPS eligible clinician multiple times in the same performance period.
Security Risk Analysis
Description
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician’s risk management process.
*This measure remains part of the requirements for the Promoting Interoperability performance category, but will no longer receive points towards the total PI score.
Reporting Requirements
To meet this measure, MIPS eligible clinicians must attest YES to conducting or reviewing a security risk analysis and implementing security updates as necessary and correcting identified security deficiencies.
Public Health and Clinical Data Exchange
You must choose 2 options from the list for your 2021 reporting and complete them within your Healthmonix account. Click on the measure to learn more.