This is the second in the series of how our practice is getting the work of MU done. The first of the series can be found here.
Starting with Core Set Item #7:
7. Record demographics as structured data. We have been doing this for a long time but MU requires us to add race and “ethnicity.” Isn’t ethnicity the same as race but more specific? If you have the latter you don’t need the former. Furthermore we have had patients push back on asking this question. Some find this question offensive. They shouldn’t; since many diseases are race / ethnicity – specific the question is medically appropriate. Fortunately MU considers the term “undetermined” as acceptable for this data point.
8. Record vital signs as structured data. This conflicts with lower level CPT E/M coding with does not require vital signs. Once again the left hand of government doesn’t know what the right is doing. Nobody thought it through.
9. Record smoking status. No problem here. Medically appropriate for all specialties.
10. Quality measures. These are poorly designed and confusing. There are 2 redundant measures both dealing with tobacco use and cessation, and these are both redundant (but not identical) to core set #9. Weight screening is reasonable enough but the follow-up requirements are ambiguous and burdensome. Are we really supposed to bombard our local dietician with weight loss consultations?
11. Decision support rule. We will configure our EMR to prompt for hearing loss screenings in patients over 50 years old. Fair enough.
12. Provide an electronic copy of health information to the patient upon request. Who are they kidding? This should have been delayed to Phase two. Qualified EMRs can do this easily enough but the product is exported to your remote server desktop; it is cumbersome to copy from there. We have had few such requests from patients; I wonder if those few are asking just to prove a point. I don’t know that for sure.
13. Provide clinical visit summaries. Again should have been delayed to Phase two.
14. Exchange key clinical information between systems. This one is unbelievable. Fortunately, as I understand it, you only have to do it once. You are supposed to upload all or part of someone’s chart (or perhaps a test chart or other hypothetical data) to portable media, go to someone else’s EMR and try to upload the data. Doesn’t matter if you succeed or not. Am I misunderstanding this one? If anybody has a better handle on this one please leave a comment.
15. HIPAA security risk analysis. Although I hate paying for it I must admit that is a good idea.
The last installment will cover the Menu Set Measures.