Chart(x) E.H.R. 3.0

Using Chart(x) for CQM - PQRS Measures

Chart(x) E.H. R. users are to use this checklist for training and ongoing use to validate the Meaningful Use of the Chart(x) application to properly recored the necessary patient
clinical information necessary to submit Clinical Quality Measurement reports for MU or any other quality program using NQF of PQRS reporting.
 

Stage 1 Percentage Based Clinical Quality Measures

 
 
Status
Title
Description
NQF & PQRI
 
Chart(x) Guidelines
 
Hypertension: Blood Pressure Measurement (Core)
 
 
Percentage of patient visits for patients aged 18 years and older with a diagnosis of hypertension who have been seen for at leasat 2 office visits, with blood pressure (BP) recorded.
 
NQF 0013
 
 
In Chart(x) E.H.R. enter BP on Triage Screen and Diagnosis (Reason) code for hypertension.
 
Weight Assessment and Counseling for Children and Adolescents (Alternate Core
 
 
Percentage of patients 2-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or OB/GYN and who had evidence of BMI percentile documentation, counseling for nutrition and counseling for physical activity during the measurement year.
 
 
 
NQF: 0024
In Chart(x) E.H.R. from the Triage Screen enter all patients
height and weightt. BMI is calculated automatically.
Create a Clinical Decision Support Rule to remind
providers to provide educational resources to patients
with BMI's greater than 25.
Access Patient Handouts from the Educatoin Resources
or from pre-printed documents.
Click on the Education Resources Provided tick box
on the top right corner of the triage or charting screen.
 
 
Adult Weight Screening and Follow Up (Core)
Percentage of patients aged 18 years and older with a calculated BMI in the past six months or during the current visit documented in the medical record AND if the most recent BMI is outside parameters, a follow up plan is documented.
 
 
NQF 0421
In Chart(x) E.H.R. from the Triage Screen enter all patients
height and weightt. BMI is calculated automatically.
Create a Clinical Decision Support Rule to remind
providers to provide educational resources to patients
with BMI's greater than 25.
Access Patient Handouts from the Educatoin Resources
or from pre-printed documents.
Click on the Education Resources Provided tick box
on the top right corner of the triage or charting screen.
 
Smoking and Tobacco Use Cessation, Medical assistance a. Advising Smokers and Tobacco Users to Quit, b. Discussing Smoking and Tobacco Use Cessation Medications, c. Discussing Smoking and Tobacco Use Cessation Strategies (Other Measures)
Percentage of patients 18 years of age and older who were current smokers or tobacco users who were seen by a practitioner during the measurement year and who received advice to quit smoking or tobacco use or whose practitioner recommended or discussed smoking or tobacco use cessation, medications, methods or strategies.
 
NQF: 0027
 
In Chart(x) E.H.R. create a clinical decision support rule to remind providers to give patients resources or advice on smoking cessation to all active smokers.
 
In Chart(x) E.H.R. from the Past Medical History screen, Social History/Smoking Status/Actve Smoker provide educational resources. After providing resources or advice check on the Educational Resoureces Provided tick box on the top right corner of the Triage or Chart Screen.
 
 
 
Preventive Care and Screening Measure Pair:
a. Tobacco Use Assessment
b. Tobacco Use Cessation Intervention (Core)
 
 
Percentage of patients aged 18 years and older who have been seen for at least 2 office visits who were queried about tobacco use one or more times within 24 months.
b. Percentage of patients aged 18 years and older identified as tobacco users within the past 24 months and have been seen for at least 2 office visits, who received cessation intervention.
 
NQF: 0028
 
In Chart(x) E.H.R. create a clinical decision support rule to remind providers to give patients resources or advice on smoking cessation to all active smokers.
 
In Chart(x) E.H.R. from the Past Medical History screen, Social History/Smoking Status/Actve Smoker provide educational resources. After providing resources or advice check on the Educational Resoureces Provided tick box on the top right corner of the Triage or Chart Screen.
 
Childhood Immuniization Status (Alternate Core)
Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP), three polio (PV), one measles, mumps and rubella (MMR): two H influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); two hepatitis A (Hep A) two or three rotavirus (RV) and two influenza (flu) vaccines by their second birthday. The measure calculates a rate for each vaccine and nine separate combination rates.
 
NQF: 0038
 
 
In Chart(x) E.H.R. from the Triage or Provider screens use the Show Immunizations function to view past immunizations and add new immunizations. The manufacturer, drug, and cpt codes are linked.
 
Note: Do not create immunization orders by adding exam codes. Always use the immunization module.
 
Use Patient Lists from the Patient control tab to create a list of patients with immunization records.
 
Use Clinical Summaries for individual patient records.
 
Preventive Care and Screening: Influenza immunizations for Patients 50 years old. (Alternate Core).
Percentage of patients aged 50 years and older who received an influenza immunization during the flu season. (September through February).
NQF: 0041
In Chart(x) E.H.R. from the Triage or Provider screens use the Show Immunizations function to view past immunizations and add new immunizations. The manufacturer, drug, and cpt codes are linked.
 
Note: Do not create immunization orders by adding exam codes. Always use the immunization module.
 
Use Patient Lists from the Patient control tab to create a list of patients with immunization records.
 
Use Clinical Summaries for individual patient records.
 
Asthma Pharmacologic Therapy
Percentage of patients aged 5 through 40 years
with a diagnosis of mild, moderate, or severe
persistent asthma who were prescribed either the
preferred long-term control medication (inhaled
corticosteroid) or an acceptable alternative
treatment.
NQF 0047
PQRI 53
 
 
In Chart(x) E.H.R. after selecting diagnosis check off the appropriate tick box for diagnosis status as:
  • Mild
  • Moderate
  • Severe
  • Persistent
 
 
Low Back Pain: Use of Imaging Studies (Other Measures)
Percentage of patients with a primary diagnosis of low back pain who did not have an imaging study (plain x-ray, MRI, CT scan) within 28 days of diagnosis.
NQF: 0052
In Chart(x) E.H.R. add diagnosis of Low Back Pain and Exam Codes(CPT)  for Diagnostic Imaging including MRI, CT, and X-Ray.
 
This may be done during the order, triage, charting, and updating the past medical history.
 
Asthma Assessmment
Asthma Assessment Percentage of patients aged 5 through 40 years
with a diagnosis of asthma and who have been
seen for at least 2 office visits, who were
evaluated during at least one office visit within 12
months for the frequency (numeric) of daytime
and nocturnal asthma symptoms.
NQF 0001
PQRI 64
 
 
 
In Chart(x) E.H.R. after selecting diagnosis check off the appropriate tick box for diagnosis status as:
  • Mild
  • Moderate
  • Severe
  • Persistent
 
Us of Appropriate Medications for Asthma
Percentage of patients 5 - 50 years of age who
were identified as having persistent asthma and
were appropriately prescribed medication during
the measurement year. Report three age
stratifications (5-11 years, 12-50 years, and total).
NQF 0036
 
 
 
In Chart(x) E.H.R. create Patient Lists from Patients control drop down menu.
 
In Chart(x) E.H.R. check Persistent Diagnosis status when adding/editing the diagnosis.
 
Appropriate Testing for Children with Pharyngitis
Percentage of children 2-18 years of age who
were diagnosed with pharyngitis, dispensed an
antibiotic and received a group A streptococcus
(strep) test for the episode.
NQF 0002
PQRI 66
 
In Chart(x) E.H.R. add reason code for Pharyngitis.
 
In Chart(x) E.H.R. add exam code for A Strepococcus (strep test)
 
In Chart(x) E.H.R. E-Prescribing Module order Antiobiotic.
 
Diabetes: Hemoglobin A1c Poor Control
Percentage of patients 18 - 75 years of age with
diabetes (type 1 or type 2) who had hemoglobin
A1c > 9.0%.
NQF 0059
PQRI 1
In Chart(x) E.H.R. add reason code for typ 1 or type 2 diabetes.
 
In Chart(x) E.H.R. View Labs order, edit, view labs.
 
In chart(x) E.H.R. Patient Lists create list for patients with diagnosis pos for type 1 or 2 diabetes, age range 18-75 yrs, lab result A1c> 9.0%.
 
Diabetes: Low Density Lipoproteirn (LDL) Management and Control
Percentage of patients 18-75 years of age with
diabetes (type 1 or type 2) who had LDL-C < 100
mg/dL).
NQF 0064
PQRI 2
In Chart(x) E.H.R. add reason code for typ 1 or type 2 diabetes.
 
In Chart(x) E.H.R. View Labs order, edit, view labs.
 
In chart(x) E.H.R. Patient Lists create list for patients with diagnosis pos for type 1 or 2 diabetes, age range 18-75 yrs, lab result LDL-C<100 mg/dL.
 
Diabetes Urine Screening
Percentage of patients 18 - 75 years of age with
diabetes (type 1 or type 2) who had a
nephropathy screening test or evidence of
nephropathy.
NQF 0062
PQRI 119
In Chart(x) E.H.R. add reason code for typ 1 or type 2 diabetes.
 
In Chart(x) E.H.R. add exam code for hephropathy screening or positive lab test result for nephropathy.
 
In chart(x) E.H.R. Patient Lists create list for patients with diagnosis pos for type 1 or 2 diabetes, age range 18-75 yrs, lab result pos for nephropathy.
 
Diabetes Foot Exam
Diabetes: Foot Exam The percentage of patients aged 18 - 75 years
with diabetes (type 1 or type 2) who had a foot
exam (visual inspection, sensory exam with
monofilament, or pulse exam).
NQF 0056
PQRI 0056
In Chart(x) E.H.R. add reason code for typ 1 or type 2 diabetes.
 
In Chart(x) E.H.R. add exam code for a foot exam, sensory exam, or pulse exam.
 
In Chart(x) E.H.R. enter blood pressure (BP) on Triage Vitals screen.
 
Diabetes Hemoglobin A1c Control Atc<8.0%
The percentage of patients 18-75 years of age
with diabetes (type 1 or type 2) who had
hemoglobin A1c <8.0%.
NQF 0575
In Chart(x) E.H.R. add reason code for typ 1 or type 2 diabetes.
 
In Chart(x) E.H.R. View Labs order, edit, view labs.
 
In chart(x) E.H.R. Patient Lists create list for patients with diagnosis pos for type 1 or 2 diabetes, age range 18-75 yrs, lab result <8.0% hemoglobin.
 
Diabetes: Blodd Pressure Management (Other Measures)
Percentage of patients 18-75 years of age with diabetes (type 1 or type 2 ) who hd blood pressure <140/90 mmHg.
 
 
NQF: 0061
In Chart(x) E.H.R. add reason code for typ 1 or type 2 diabetes.
 
In Chart(x) E.H.R. enter blood pressure (BP) on Triage Vitals screen.
 
 

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