HIE: Receive and Incorporate

This measure reports the percentage of visits in which a patient is seen for the first time or referred into the practice and the receiving provider incorporates an electronic summary of care document/continuity of care document (CCD) from the referring provider into the patient’s chart.

Measure Overview
Denominator The number of visits for which the EP was the recipient of the transition or referral and an electronic summary of care document/continuity of care document (CCD) is available for the patient.
Numerator The number of visits in the denominator where the EP received and incorporated an electronic summary of care document into the patient’s record.
Medicaid Goal

Must Exceed 40%

See the following sections for more information on the HIE: Receive and Incorporate measure:

Denominator Criteria

The denominator counts visits where the patient is either a new patient or a patient who had a transition of patient care or referral into the practice. Additionally, an electronic summary of care document/continuity of care document (CCD) for the patient must be available. Both must occur during the measurement period set in Prime Suite Reporting 2019.

To qualify a visit for the denominator:

1. The patients must have a visit during the measurement period, which must be a referral into the practice or the patient’s first time seeing the provider. This can be indicated by either of the following:
  • The Plan or E&M section of the Note includes a new patient E&M code for the patient. New patient E&M codes include codes in the range of 99201-99205 or 99381-99387. The codes must be added at the same time or after the start of the visit.
  • The Inbound Referral/Transition check box is selected under Referrals in the Plan section of the Note. This must be selected at the same time or after the start of the visit.
2. A summary of care document (also known as a CCD or continuity of care document) was received or is available. This document must be linked to the patient's qualifying visit. This can be indicated by either of the following:
  • The Outside summary of care available check box is selected under Referrals in the Plan section of the note.

The Outside summary of care available check box should only be selected after the start of the visit and when the practice has verified that an outside summary of care document is available. Selecting this box indicates that the practice verified the existence of this document.

  • A summary of care document/CCD has already been imported into the Reference Documents section on the patient’s Facesheet. The date of import for this document must occur during the measurement period, but before the end of the visit.

Numerator Criteria

The numerator actions must be completed during the calendar year that the measurement period begins in to qualify. For example, if the measurement period begins on 3/3/2019, the numerator must be met during the period that begins on January 1, 2019 and ends on December 31, 2019.

Visits that qualified for the denominator qualify for the numerator if all the following are true:

  • The CCD is in the Reference Documents section of the patient’s Facesheet. If you are using an outside summary of care document, you must import to Reference Documents prior to reconciling.
  • The document is linked to the qualifying visit when acknowledging or automatically reconciling the data.
  • The document’s data has been either reconciled or acknowledged after the start of the visit but during the calendar year.
    • When reconciling the document, you have the qualifying visit selected in the top left of Prime Suite for the reconciliation to be associated with the visit.
    • The provider that acknowledges the document must be the same as the provider on the visit.

If the summary of care document is deleted from the patient’s Reference Documents, the visit will be removed from the numerator.

Measure Changes for 2019

Name Changes

The measure name changed from Request/Accept Summary of Care to Receive and Incorporate.

Measure

None

Workflow

Importing the Electronic Summary of Care Document

Previously, the practice could save the CCDA document as a Clinical Document, which had to be linked to the qualifying encounter.

For 2019, you must save the CCDA document as a Reference Document. Reference Documents do not need to be linked to a visit when they are saved. However, you must link the document to a visit when acknowledging it or automatically reconciling data.

Reconciling Data Automatically by Importing

In the Clinical Reconciliation window, you must select at least one item under Demographics, along with any items from the Allergy, Medications, or Problem List, before selecting the Import button.

Setup Requirements

See the following sections for this measure's setup requirements:

Setting the Reconcile Reference Documents User Right

Users must have the Reconcile Reference Documents user right assigned before they can automatically reconcile CCDAs. To grant users this permission, follow these steps:

1. Select SystemUser Rights. The User Rights window opens.
2. Select System under Modules on the left-hand side.
3. Select Reference Documents under System Categories.
4. Select the check box for Reconcile Reference Documents.
5. Select Save under Category Actions on the left-hand side to save your changes.

Adding the Reference Documents Section to the Facesheet

The Reference Documents section allows you to receive CCDA documents from external sources and add them to a patient’s Facesheet without importing the information directly into the chart. Although you can add documents to the Reference Documents when the section is not included on the Facesheet, it does make the process easier.

1. Open the Chart menu and select User Settings Admin.
2. Select the Facesheet & History tab.
3. Scroll down to Facesheet Sections.
4. Select the Reference Documents check box.
5. Select Save.
6. On the Facesheet, select Customize Facesheet and select the Reference Documents check box to add this section.

Configuring the Method by Which Your Organization Will Import CCDs

You must configure the method by which your organization will import CCDs. You can set this by following these steps:

1. Open the System menu and select System Defaults.
2. Select the Chart Defaults tab.
3. Scroll down to the External Document Default Actions section and select the Action Admin link.

4. Select CCD in the File Type list.
5. Select from the following radio buttons in the Action section:
  • Auto-import as Reference Document: Selecting this option imports all CCDs to the Reference Documents section of the Facesheet. This gives users the ability to electronically reconcile each CCD. Additionally, this setting prevents users from skipping reconciling and saving the CCD directly to the chart.
  • Manual Document Import: Selecting this option allows users to either save CCDs to the Reference Documents section of the Facesheet or directly into the chart. This option should be selected if users should have the option of reconciling a CCD.
  • Auto-import as Clinical Document: Selecting this option saves all CCDs directly into the patient’s chart. With this selection, there is no opportunity to electronically reconcile the information contained in the CCD.

The Auto-import as Clinical Document option will not qualify visits for this measure.

6. Select OK to save your changes or select Cancel to return to the Chart Defaults tab without saving the changes.
7. Select Save on the Chart Defaults tab to save all the changes made. Alternatively, select Cancel to discard your changes.

HIE: Receive and Incorporate Workflows

The sections below provide detailed workflows for the following:

Importing Summary of Care Documents

You can import CCDs in Prime Suite using Document Import. This feature can be used for importing CCDs from outside sources or for electronically received CCDs.

Note that depending on your organization's selected method for importing CCDs, electronically received CCDs may bypass Document Import completely. You must select Manual Document Import in External Document Admin for electronically received CCDs to be available in Document Import. If you select Auto-import as Reference Document or Auto-import as Clinical Document, Prime Suite automatically imports the CCDs directly to the Reference Documents section of the Facesheet. If using either auto import option, you can skip the Document Import and proceed to Acknowledging and Reconciling Data below.

If a CCD is unable to be matched to a patient, the document must be imported using Document Import no matter the method selected by your organization for importing CCDs.

1. Open the System menu and select Document Import.
2. Verify that Document Import is selected under Chart Actions. If it is not, select the Document Import link.
3. The Document Import page displays if a patient is already selected. Otherwise, search for and select the applicable patient.
4. Select one of the following options in the Select Document field:
  • New Import: Select this option to import a file from the local computer. See Using the New Import option for steps on how to use this feature.
  • Select from Document List: Select this option to import a file that was electronically brought into Prime Suite. See Using the Select from Document List below for steps on how to use this feature.
  • From Clinical Device: This option will not qualify visits for this measure.

Using the New Import Option

With the New Import option on the Document Import page, you can import a document from your local computer by following the steps below:

1. Select the document icon in the area below the Select Document options to open the Import Document dialog box.
2. Navigate to and select the file you want to import. The document is added to the Select Document list.

You can only import CCD documents to the Reference Documents list.

3. Select where the document will be saved depending on your system's setup:
  • If your system is setup to Manually import CCDs, you have the option to select where the document will be saved. You must select Facesheet Reference Documents List. The Clinical Document List will not qualify for this measure.
  • If your system is setup to auto-import the CCD, you will not have the option to select where the document will be saved.

4. Scroll down in the Document Import window.

5. Select Do Not Create Task if you do not want to create a task for this import. Otherwise, select Clinical Reconciliation in the Select Task Type list to import a reference document.
6. Update the date in the Select Date field, if needed. This field defaults to the current date.

Regardless of the date set in this field, the date the document is added to the Reference Documents is used to determine whether the item qualifies for the measure.

7. Update the Document Name, if needed, by selecting the Override check box and entering the new name. The default Document Name is Document.
8. Select Save.

Using the Select from Document List

Available documents display in the Select Document list. You can use the filter icon to view only CCDs. After you have located the CCDs within the list, the management of those documents is the same as described previously for the Document Import page.

After selecting the Select from Document List option, continue with the following steps:

1. Select the filter icon next to Document Name in the heading of the field.

2. Select DataShare (CCD, CDA) and/or Uploaded and the desired Sort By category.
3. Select Save. Prime Suite returns to the Document Import Screen, and the CCDs associated with the patient display on the Document List.
4. Select the appropriate CCD in the list.
5. Select the Do Not Create Task check box if you do not want to create a task for this import. Otherwise, select Clinical Reconciliation in the Select Task Type list to import a reference document.
6. Update the date in the Select Date field, if needed. This field defaults to the current date.

Regardless of the date set in this field, the date the document is added to the Reference Documents is used to determine whether the item qualifies for the measure.

7. Update the Document Name, if needed, by selecting the Override check box and entering the new name. The default Document Name is Document.
8. Select Save.

Acknowledging and Reconciling Data

After importing a CCD into the patient’s Reference Documents, you must do one of the following:

If manually reconciling the CCD, the visit must be linked to the patient’s chart and the provider must be the user to select Acknowledge on the Reference Document. Additionally, the provider must be logged onto Prime Suite as himself or herself. With the visit still linked, the Clinical Reconciliation boxes must be selected in the note.

When data from the summary of care/CCD needs to be included in the patient’s chart, you must also ensure the patient’s demographic information is updated. If no demographic information needs to be updated and imported, you must select Select All in the Demographics section. Otherwise, the patient will not qualify for the numerator.

Acknowledging Data in the CCDA

1. Link the visit prior to doing the acknowledgment. You should use the visit associated with the transition of care.
2. Select the imported document in the Reference Documents section of the patient’s Facesheet to open it in the Reference Document Viewer.

3. Link the visit to the CCDA before acknowledging by following these steps:
a. Select Select Visit to open the Visit Search window. The patient’s identification number displays in the Patient ID field.
b. Select Search to find all of the patient's visits.
c. Select the visit associated with the transition of care.
d. Select OK to confirm that you want to associate the selected visit with the document and return to the Reference Document Viewer.

This must match the currently linked visit.

4. Select Acknowledge after comparing the data in the CCD to the data in the patient’s chart. The next time you view the document in the Reference Document Viewer, the date and time the document was acknowledged is updated.

You can select Reconcile to compare the information in the patient’s chart to the information in the CCD. If you find that no changes are needed, you can cancel out of the reconcile process and select Acknowledge instead.

Reconciling Data in the CCDA

1. Link the visit prior to doing the reconciliation. You should use the visit associated with the transition of care.
2. In the Reference Documents section of the patient's Facesheet, select the CCDA you want to reconcile to load it in the Reference Document Viewer.

Verify that the VisitID number in the Reference Document Viewer matches the Visit ID number in the Global Visit buffer before Reconciliation/Incorporation.

3. Link the visit to the CCDA before starting the reconciliation:
a. Select Select Visit to open the Visit Search window. The patient’s identification number is displayed in the Patient ID field.
b. Select Search to find all of the patient's visits.
c. Select the visit associated with the transition of care, and then select OK to confirm that you want to associate the selected visit with the document and return to the Reference Document Viewer.

This must match the currently linked visit.

4. Select Reconcile to open the Clinical Reconciliation dialog box. This dialog box includes sections that allow you to compare content from the CCD with content from the patient’s chart.

Data from the patient’s chart displays in the From Patient’s Chart Facesheet column on the left-hand side. Data from the CCD displays in the From Clinical Summary column on the right-hand side. If information from the CCD differs from the patient’s chart, the new information displays as a selectable hyperlink in red text.

If you find the data from the CCD is already in the patient’s Facesheet, you can close the Clinical Reconciliation page and select Acknowledge at the bottom of the Reference Document Viewer.

5. New patient information on the CCDA indicated by a red hyperlink must be mapped to an existing item on the patient's facesheet or imported without mapping to be included in the patient's chart. Select the red hyperlink for a new item to open the Facesheet Section Search dialog box.

6. Map the selected item from the CCD to an item on the Patient’s Facesheet by selecting an item in the Current Facesheet column. Alternatively, you can select Import without mapping in the Search Results column.
7. Repeat Steps 5-6 for any new items on the CCD indicated by a red hyperlink to either map the item or import the item to the patient’s Facesheet without mapping.
8. Use the check boxes in the From Clinical Summary pane of each section to select the data to import into the patient’s chart. To include all the information from the clinical summary in the patient’s chart, select the Select All check box.

The Select All check box will not automatically import the new information for the patient in the CCDA indicated by red hyperlinks. You must select these and choose how to import this information.

9. Select at least one item under Demographics in the Clinical Reconciliation window before selecting the Import button. If no demographic information needs to be updated, you must select the Select All check box in the Demographics section.

If you do not update any demographic information or select the Select All check box, the referral will not qualify for the numerator.

10. After selecting all of the desired information to import, select Import.

The selected data is imported into the patient chart and the Medication List, Allergy List, and Problem List. This data will be marked as Reconciled in the database.

11. Select OK to dismiss the success notification message once the import completes.