aoa more enable - practice director

PracticeDirectorandAOAMORERegistryGuide

PracticeDirectorSupport844-574-2020 1

TableofContentsAOAMOREEnrollment………………………………………………………………………………………………………2AOAMOREPracticeDirectorVersion………………………………………………………………………………….2-3PracticeDirectorUpdateInstructions……………………………………………………………………………….3-4AOAManagementSetup……………….…………………………………………………………………………………...5-6AOASubmissionTrialandProductionSubmissionRun………………………………………………………7-12 TrialSubmissionRun…………………………...………………………………………………………………7-9 ProductionSubmissionReport..……………………………………………………………………………9-12MIPSQualityMeasures…………………………………..…………………………………………………………….13-17 GuidelinesforenteringQualityData……………………………………………………………………15-17


2PracticeDirectorSupport844-574-2020 2

CompleteenrollmentwithAOAMOREifyouhavenotalreadydonesobygoingtotheAOAMOREwebsitewww.aoa.org/moreWhenthewebsitelaunchesselecttheENROLLbuttonlocatedontherightsideofthescreenFollowthepromptstocompleteregistrationIfyouhavequestionsonwhetherornotyouhaveregisteredoronhowtoregisteryoucanclicktheHELPDESKbuttonandamemberoftheAOAMOREteamwillfollowupwithyou

PracticeDirectorVersions5.1.63andaftercontainaccesstoAOAMORE.ToverifyyourversionfromPracticeDirector:SelectHelpSelectAboutPracticeDirectorTheAboutdialogwillopenVerifythatBuild#isequalorgreaterthan5.1.63



• Ifthebuild#isequalorgreaterthan5.1.63youcancompletetheAOAManagementsetupwithinPracticeDirector

• Ifthebuild#islessthan5.1.63youcanruntheCDUtoupdatePracticeDirectortothemostrecentversion

InstructionsforRunningCDUYouwillinstalltheupdateonyourserverbylaunchingtheCDU.PleasenotewehavemadeimprovementstothereliabilityandstabilityoftheCDUtoreduceerrorswhenrunningintheoffice.Inordertoruntheupdateyoumustbeloggedinasanadministrator.LocatetheCDUicononyourserver.OnceyouhavelocatedtheCDUiconfollowthestepsbelow:Thepasscodeforthisupdateis:MoreUpdateDirectionsforallOperatingSystems:Windows8/Windows7/WindowsVista/WindowsServer2012/WindowsServer2008R2/WindowsServer2008:1. LocatetheClient-DrivenUpdatericononyourdesktop.2. Right-clickontheicon.3. SelectRunAsAdministrator.YouwillneedtoruntheClient-DrivenUpdaterasan

administrator.4. Click'Update'andenterthepasskeysuppliedabove.5. Waitforconfirmationsoftwarewasupdatedsuccessfully

WindowsXP/WindowsServer2003:1. LocatetheClient-DrivenUpdatericononyourdesktop.2. DoubleclickontheicontolaunchtheClient-DrivenUpdater.3. Click'Update'andenterthepasskeysuppliedabove.4. Waitforconfirmationsoftwarewasupdatedsuccessfully

RunningtheClient-DrivenUpdaterwillshutdownthePDserverandinstallthelatestPracticeDirectorsoftware.Oncetheupdateiscompleted,yourPDservicewillberestartedautomatically.Pleaseallowatleast5minutesforittocompleteitsstartupcycle.AfterPracticeDirectorhasstarted,youcanlogintoPDattheworkstationsandusethenewversion.



Mac:

1. LocatetheClient-DrivenUpdatericononyourdesktop.2. ClickontheicontolaunchtheClient-DrivenUpdater.3. Provideyouradministratorpasswordtoinstallthesoftware4. Click'Update'andenterthepasskeysuppliedabove.5. Waitforconfirmationsoftwarewasupdatedsuccessfully6. Use'StartPDServer'applocatedin'/Applications/WilliamsGroup'

RunningtheClient-DrivenUpdaterwillshutdownthePDserverandinstallthelatestPracticeDirectorsoftware.Oncetheupdateiscompleted,youwillneedtorestartthePDserver(StartPDServer.app).Pleaseallowatleast5minutesforittocompleteitsstartupcycle.AfterPracticeDirectorhasstarted,youcanlogintoPDattheworkstationsandusethenewversion.IfyouhaveanyissueswithrunningtheClient-DrivenUpdater,pleasecallourSupportLineat402-454-7173pleasegivethesupportrepresentativetheerrorcodeyoureceivedinordertoscheduleamanualupdate.Ifyouhaveanyquestionsregardingtheupdate,pleasecontactthePracticeDirectorSupportTeamat402-454-7173orsupport@practicedirector.com



AOAManagementSetupOnceyouareonversion5.1.63orgreateryoucansetupPracticeDirectortocommunicatewithAOAMORERegistry.TheinformationbelowisalsocoveredinTrainingVideo28.1AOARegistryMenuItems,locatedattraining.practicedirector.com.YoucancontactPracticeDirectorSupportifyouareunsureofyourUsernameandPassword.LogintoPracticeDirector

SelectEHROptionsSelectAOARegistrySelectAOAManagement

TheAOAManagementdialogwillopen(Allfieldsarerequiredforsubmission)

1. PracticeDirectorwillkeepthefirstfourdatesupdatedforyou.AtthistimeAOAMOREisonlyaccepting2016data.



2. ClickonthelookuptoselectanyAOAprovidertobetheLegalAuthenticator.TheauthenticatorassumeslegalresponsibilityofthegeneratedQRDACategoryIfilesbeingsubmittedtotheAOARegistry.Selectthedatethattheselectedprovidertookresponsibility.

3. ClickonthelookuptoselectanyAOAprovidertobetheCustodian.ThecustodianrepresentstheorganizationthatisinchargeofmaintainingthegeneratedQRDACategoryIfilesbeingsubmittedtotheAOARegistry

4. SubmissionDate&Time-FortheDayyoucanselectbetweenWednesdayorThursdayforsubmission.AOArequirestheAOARegistryEndDatetobepriortotheweeklysubmissiondeadline.AOAreleasestheweeklyproviderwhitelistonWednesdayatnoonandtheAOAweeklysubmissiondeadlineisFridayat5:00pm.ThedefaultselectionisWednesday.Youmayspecifyanytimeforsubmissionafter6:00pmonWednesdayorThursday.

5. SelectEnable6. SelectSave

OncesavedyourinformationwilltransfertoAOAMORERegistryperyoursetupspecifiedinAOAManagement.



AOASubmissionTrialandProductionSubmissionRunPracticeDirectorhasgiventheusertwooptionsforverifyinginformationthathasbeenorwillbetransmittedtotheAOA.AOATrialSubmissionRunwillallowyoutoviewandorsavetheresultsofthedatathatwouldbesentintheSubmissionRun.ThiswillallowyoutoverifythatallanticipatedpatientsaregoingtobetransmittedtoAOA.IfanyproblemsaredetectedyoucanresolvethembeforetheProductionrunoccurs.TrialSubmissionRunSelectEHROptionsSelectAOARegistrySelectAOATrialSubmissionRun

1. Provider–selectthedesiredproviderfromthedropdown2. Thedatefieldsarepre-populatedwiththedatessetupinAOAManagement,youcan

overrideanydatebyclickingonthecalendar3. Destination–Leaveempty(thisisforthePracticeDirectorsupportteamto

troubleshootfileproblemsifneeded).4. SelectOKtosave

YouwillseetheAOATrialSubmissionRundialogshowingtheprogress.YoucanwaitorselectRuninBackgroundsothatyoucancontinuetowork



Oncetheruniscompletetheresultswilldisplayonthescreenorinthetray(ifyouselectedRuninBackground)



1. TheProvider,eCQMReportingPeriod,andAOARegistryReportingPeriodwilldisplay2. EachNQFwilldisplaywiththenumeratoranddenominatorcountsthatwillbesentto

AOAMOREintheProductionRun ToseethepatientsthatmakeupthecountsyoucangotoEHROptions>AOA Registry>AOAeCQMVerificationReport

3. Ifthereareanypatientsthatwillnotpushuptheirnamesandtheissuewillbelisted,ifnoproblemsyouwillsee“NoproblematicpatientQRDAIdatawasdetected”

4. Youwillseealistofpatientsthathavebeenseenbytheprovidersincethelastsubmission.

5. YoucanselectSavetoSavethereportlocallyandthenyoucanprintfromthesavedlocationifdesired

ProductionSubmissionRunReport TheProductionSubmissionRunReportisusedtoviewwhatwassenttotheAOAduringtheweeklyrun.TheReportwillshowyouifthereareanypatientsthatwerenottransmittedandwilllistthereasonwhy.Youcanusethisreporttofixthedatabeforethenextscheduledupload.ToruntheProductionSubmissionRunReportSelectEHROptionsSelectAOARegistrySelectAOAProductionSubmissionRunReports



TheAOAProductionSubmissionRunReportdialogwillopen

IntheupperlefthandsideofthescreenyouwillseealistofProviderNamesandtheSubmittedDate.TheuserisabletosortbytheProviderandortheSubmittedDatebyclickingontheheader.*NoteRunInformationisonlyretainedfor90daysToviewdetailsaboutaspecificProviderandSubmittedDate,selectthedesiredinformation.Onceselecteddataabouttherunwilldisplayontherightsideofthescreen



1. TheProvider,eCQMReportingPeriod,andAOARegistryReportingPeriodwilldisplay2. AlistofeachNQFwilldisplayalongwiththesubmittedNumeratorandDenominator

counts ToseethepatientsthatmakeupthecountsyoucangotoEHROptions>AOA Registry>AOAeCQMVerificationReport

3. Thisarealistsanypatientsthathaderrorsandcouldnotbesubmitted.BeforethenextAOAsubmissionyouwillwanttoresolvetheerrors

4. SelectSavetosavethereportlocally.Oncesavedlocally,theinformationcanbeprinted



MIPSQualityMeasure(NQF/CQM/eCQM/PQRS)In2017DoctorsofOptometrymustreporton6QualityMeasures.WithPracticeDirectorandAOAMOREyoucansubmityourQualitymeasuresthroughtheAOAMORERegistry.Youmustincludeoneoutcomesmeasure(ifyoucannotreportanoutcomesmeasure,youmustreportonehighprioritymeasure).Youmustreporton50%ofyourpatientsacrossallpayers.PracticeDirectorandAOAMOREarestructuredtoreportonthefollowingmeasures:

MeasureName MeasureDescription eMeasureID NQF PQRS Additional

Info

Diabetes:EyeExam

Percentageofpatients18-75yearsofagewithdiabeteswhohadaretinalordilatedeyeexambyaneyecareprofessionalduringthemeasurementperiodoranegativeretinalexam(noevidenceofretinopathy)inthe12monthspriortothemeasurementperiod

CMS131v5

55

2022For2024For2026For3072F

DiabeticRetinopathy:

CommunicationwiththePhysician

ManagingOngoingDiabetes

Care

Percentageofpatientsaged18yearsandolderwithadiagnosisofdiabeticretinopathywhohadadilatedmacularorfundusexamperformedwithdocumentedcommunicationtothephysicianwhomanagestheongoingcareofthepatientwithdiabetesmellitusregardingthefindingsofthemacularorfundusexamatleastoncewithin12months

CMS142v5

89

5010F+G8397orG8398

BonusPointsHighPriority

PrimaryOpen-AngleGlaucoma(POAG):Optic

NerveEvaluation

Percentageofpatientsaged18yearsandolderwithadiagnosisofprimaryopen-angleglaucoma(POAG)whohaveanopticnerveheadevaluationduringoneormoreofficevisitsw/in12months

CMS143v5

86

2027F

DiabeticRetinopathy:

DocumentationofPresenceorAbsenceof

MacularEdemaandLevelofSeverityofRetinopathy

Percentageofpatientsaged18yearsandolderwithadiagnosisofdiabeticretinopathywhohadadilatedmacularorfundusexamperformedwhichincludeddocumentationofthelevelofseverityofretinopathyandthepresenceorabsenceofmacularedemaduringoneormoreofficevisitswithin12months

CMS167v5

88

None



MeasureName MeasureDescriptioneMeasure

ID NQF PQRSAdditional

Info

Diabetes:HemoglobinA1c(HbA1c)PoorControl(>9%)

Percentageofpatients18-75yearsofagewithdiabeteswhohadhemoglobinA1c>9.0%duringthemeasurementperiod

CMS122v5

59

3064For3046F8Por3044For3045F

BonusPoints,

Outcome&High

Priority

PreventiveCareandScreening:TobaccoUse:ScreeningandCessation

Intervention

Percentageofpatientsaged18yearsandolderwhowerescreenedfortobaccouseoneormoretimeswithin24monthsANDwhoreceivedcessationcounselinginterventionifidentifiedasatobaccouser

CMS138v5

28

4004For1036F

ControllingHighBloodPressure

Percentageofpatients18-85yearsofagewhohadadiagnosisofhypertensionandwhosebloodpressurewasadequatelycontrolled(<140/90mmHg)duringthemeasurementperiod

CMS165v5

18

G8752orG8753

BonusPoints

Outcome&High

Priority

ClosingtheReferralLoop:Receiptof

SpecialistReport

Percentageofpatientswithreferrals,regardlessofage,forwhichthereferringproviderreceivesareportfromtheprovidertowhomthepatientwasreferred

CMS50v5

N/A

None


DocumentationofCurrent

MedicationsintheMedicalRecord

Percentageofvisitsforpatientsaged18yearsandolderforwhichtheeligibleprofessionalatteststodocumentingalistofcurrentmedicationsusingallimmediateresourcesavailableonthedateoftheencounter.ThislistmustincludeALLknownprescriptions,over-the-counters,herbals,andvitamin/mineral/dietary(nutritional)supplementsANDmustcontainthemedications'name,dosage,frequencyandrouteofadministration.

CMS68v6

419

G8427orG8430orG8428




GuidelinesforenteringQualitydatawithinPracticeDirectorforComplianceUserswillcontinuetodocumentthesemeasuresastheyalwayshaveinthePracticeDirectorEHR.InsuranceBillerswillNOTselectthePQRScodesforclaimssubmissionontheInvoiceScreen(thisisdifferent).Werecommendcompletingasmanymeasuresasyoucan,CMSwilltakeyourtop6scoringmeasures.Theguidelinesbelowwillnotshowallcodingpossibilities.Toseethefulllistingofcodesets,pleaseseetheMeasuresHelptabwithinEHROptions>AOARegistry>AOAeCQMHelpEachofthesemeasuresarealsoreviewedinourtrainingvideoslocatedat:training.practicedirector.comNQF0018Hypertension:BPMeasurement(onlyifBPcontrolledthenumeratorwillbepopulated)Video28.6

• Patientage19–85duringmeasureperiod• Hasancompletedofficevisitsrecorded(Medical99xxx)duringmeasurementperiodin

Coding/Final• HypertensiondiagnosisrecordedinCoding/Final<=6monthsstartafterstartof

measurementperiodinCoding/Final• OrDiagnosisofEssentialHypertensionendsbeforethestartofthemeasurementperiod• RecordcontrolledrangeofSystolic<140andDiastolic<90BPinVitalssectionofthe

EHR

NQF0028PreventiveCareandScreening:TobaccoUse:ScreeningandCessationInterventionVideo28.7

• Patientage18yearsandolder• Atleast2officevisitsrecorded(Medical99xxxor92xxx)inCoding/Final• SmokingstatusselectedinRespiratorysectionofROS

o Ifanon-smoker,thisisallthatisneededo Ifacurrentsmoker,willneedaCessationCounselingcoderecorded(99406or

99407)

NQF0050ClosingofReferralLoop:receiptofspecialistreportVideo28.5

• Anypatientwhohasbeenreferredout,regardlessofage• Medicalor92002,92004,92012,and92014coding• Referralsavedtoexam• CompletethereferralloopbyimportingthereferralreportbackintotheEHR.



NQF0419DocumentationofCurrentMedicationintheMedicalRecordVideo28.11

• Patients18yearsandolder• Atleast1officevisitrecorded(92xxx)inCoding/Final• AddallcurrentmedicationstotheERxportal• ChecktheDocumentedallcurrentmedicationsboxinCurrentMedicationsectionof

EHR

NQF0086POAG:OpticNerveEvaluationVideo28.8

• Patients18andolder• Atleast2officevisitsrecorded(99xxxor92xxx)inreportingperiodinCoding/Final• POAGdxcoderecordedinCoding/Final• OpticNerveHeadEvaluationrecorded(2027F)inCoding/Final• CuptoDiscRatioresultsrecordedinDiscAssessmentsection• AppearancerecordedinDiscAssessmentsection

NQF0088DiabeticRetinopathyExaminationVideo28.9

• Patient18yearsandolder• Atleast2officevisitsrecorded(99xxxor92xxx)withinreportingperiodinCoding/Final• DiabeticRetinopathydxrecordedinCoding/Final• MacularorFundusExamrecorded(2021F)inCoding/Final• PDEHRMacularEdemaandRetinopathySeverity(Severitycannotbenormal)fields

populatedinthePosteriorSegmentsection.

NQF0089DiabeticRetinopathyCommunicationVideo28.10

• Patients18yearsandolder• NQF0088ismet• CreateReferralletterandsavetoEHR,includingPosteriorSegmentsectioninreport• Findingcommunicatedtophysicianrecorded(5010F)inCoding/Final

NQF0055DiabetesEyeExam

Video28.2

• Patients18-75• PatienthasadiabetesdiagnosisinCoding/Final• Hashadaretinalordilatedeyeexamduringthereportingperiod,oranegativeretinal

examwithnoevidenceofretinopathy12monthsprior• 92xxxcodesdonotcount



• PDFundoscopysectionofexamcompleted(dilatedmethod,etc)• 2022F,2024F,2026For3072FenteredinCoding/Final

NQF0059Diabetes:HemoglobinA1CPoorControl

Video28.3

• Patients18-75yearsold• PatienthasdiabetesdiagnosisinCoding/Final• HashadhemoglobinA1C>9%duringthereportingperiod• ResultsfromhemoglobintestenteredasLabResultinPracticeDirector.Usingthe

followingLOINCcodes4549-2,17856-6,4548-4,17855-8• LabResultsshowthatA1Cisstillnotcontrolledandisstill>9%• Youwantthismeasuretohavesmallpercentage

ImportantInformationaboutCQMNumeratorCountsAsofOctober1,2016,theICD10listwasupdatedfordiagnosingpatients.However,thevaluesetsusedtodetermine/calculatetheClinicalDecisionSupportinterventionsandtheClinicalQualityMeasureshaveNOTbeenupdatedtoincludethenewlyreleasedICD10codes.Becauseofthis,bothyoursysteminterventionsmaytriggerandyourCQMcountsmayhavelowernumerators.Wehavecontactedthegoverningbodiesaskingforthenewvaluesets.Wehavenotyetreceivedresponses.Oncethenewvaluesetsarereleasedandimplemented,thesystemwillaccuratelyincludeallentereddata/patientsinthesecounts/interventions.Pleasecontinuetoenteryourexamdataasneeded.UnderstandingthatifyouenteredanewPOAGorDiabetesICD10,thosewillgetcountedcorrectlyassoonaswereceivetheupdatedvaluesets.

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