EHR technology is expected to allow the use of clinical decision support to improve performance on high priority health conditions.
Medicaid Promoting Interoperability Objective and Calculation
Clinical decision support is designed to alert the EP to information based on data in the EHR to improve performance on high priority health conditions.
- The provider must have implemented at least five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. Absent four clinical quality measures related to an EP’s scope of practice or patient population, the clinical decision support interventions must be related to high priority health conditions. RevolutionEHR provides rules to satisfy this requirement without any new ones being built by the EP.
- The provider must have enabled and implemented functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
EXCLUSION: For the second measure, any EP who writes fewer than 100 medication orders during the EHR reporting period.
Promoting Interoperability Discussion
Clinical Decision Support (CDS) is a process designed to aid directly in clinical decision making, in which characteristics of individual patients are used to generate patient-specific interventions, assessments, recommendations, or other forms of guidance that are then presented to the provider.
RevolutionEHR developed the Clinical Decision Support process to analyze the details of the patient record specific to the certification standards. In the current state, RevolutionEHR does not allow users to create clinical decision support rules based upon examination test results.
RevolutionEHR provides five CQM-relevant clinical decision support rules by default. Establishing additional rules in RevolutionEHR is done by any user with administrative privileges. Under Administration, the System Rules section includes a Clinical Decision Support setup screen. An example of a rule might include a reminder that a patient should undergo a dilated fundus examination if the patient’s diagnosis list includes a diagnosis of diabetes.
After rules are established, they will only display within the patients' encounters if the Clinical Decision Support screen is added to the encounter templates for the practice. The Clinical Decision Support screen could be added in the Assessment/Plan workflow step, and might be best located after the Assessment screen where the Today’s Diagnoses entries are added to the encounter. All setup must be done prior to the first day of the provider’s Medicaid PI reporting period, since this objective requires that this rule be in place for the entire reporting period.
RevolutionEHR provides drug-drug and drug-allergy checks through its integration with RXNT. RXNT’s drug interaction protocol meets the certified standards for this functionality.
Meeting this objective is easy provided users do not deactivate the vendor-delivered CDS-relevant rules and are customers of RXNT or other certified electronic prescribing systems. Attestation is simply stating that the five rules have been in place during the entire reporting period and that the provider has enabled the functionality for drug-drug and drug-allergy interaction checks.