Under the Merit-based Incentive Payment System (MIPS) pathway of the MACRA Quality Payment Program, the Advancing Care Information (ACI) category replaces the Medicare EHR Incentive Program (Meaningful Use). ACI is one of the three performance categories that will be considered and weighted for scoring an eligible clinician’s performance under MIPS (four categories will be included starting in 2018). A clinician’s score for the Provide Patient Access measure is dependent on the clinician meeting the measure’s base score requirements. This measure may also be selected to earn additional performance score credit. For more information on ACI scoring methodology, please click here.
Patient Electronic Access
Provide Patient Access
- Numerator: The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party.
- Denominator: The number of unique patients seen by the MIPS eligible clinician during the performance period.
Additional Measure Information
To earn base score numerator credit for this measure, at least one patient seen by the MIPS eligible clinician during the performance period must be provided timely access to view online, download, and transmit to a third party their health information within 4 business days of the patient’s relevant encounter. Every patient who is seen by the MIPS eligible clinician during the clinician’s selected performance period will count towards the measure denominator. To gain denominator credit within the Practice Fusion EHR, those patients must have at least one signed encounter note with a date of service from within the performance period and an encounter type of Office Visit, Home Visit, Nursing Home Visit, or Telemedicine Visit. Only the MIPS eligible clinician who signs the note receives credit.
To earn further numerator credit for the performance score component of this measure, the MIPS eligible clinician may complete the numerator requirements detailed above for as many additional denominator eligible patients as the clinician deems appropriate during his or her selected 2017 performance period. For information on earning numerator credit for this measure, see the Practice Fusion Suggested Workflow section below.
Practice Fusion Suggested Workflow
Practice Fusion suggests the following workflow to help ensure that you gain numerator credit for this measure within the Practice Fusion EHR.
- From the patient chart, use the Invite to Patient Portal link in the patient header to begin the Patient Fusion (patient portal) enrollment process. Ensure that you complete this process for the patient within four business days of the date of service on the patient encounter.
- Ensure that you have entered a valid email address and phone number for the patient or for their patient-authorized representative before sending the invitation email.
- Confirm that the information you have entered in the invite window is correct prior to clicking Invite.
1. Open the patient chart and click the Invite to Patient Portal link in the patient’s chart header.
2. Enter the patient's email address and phone number, then click Invite to patient portal. You may also invite a patient-authorized representative such as a family member, caregiver, or guardian to access the patient's health record by clicking Add Users.
3. You will be prompted to review the information, then confirm the invitation by clicking Invite.
Anyone in your practice who is enabled to manage patient portal access can enroll patients in the Patient Portal. The clinician who signs the patient encounter will still gain credit towards this measure.
Patient Portal auto-invite
If you would like to automatically invite all patients you see to join the Patient Portal, you can opt to use the auto-invite feature. Please note that in order to effectively use the auto-invite feature for this measure, you must ensure the following:
- Your chart notes are signed within 4 business days of the chart note’s date of service.
- The patient is between 18-85 years of age.
- The patient has a valid email address and phone number entered in their profile.
For more detailed information on enabling the auto-invite feature, please click here.
What if a patient has more than one office visit during the performance period?
If a patient has multiple encounters notes from during the selected performance period, numerator credit can be achieved for this measure as long as the patient is invited to enroll in their Patient Portal within 4 business days of any one of those encounters. The patient will be included in the denominator after the first encounter during the performance period.
What if the patient was enrolled in the Patient Portal prior to the performance period?
If a patient has been granted access to their Patient Portal account prior to his or her first encounter of the performance period, measure credit will be accounted for once the chart note for the first encounter has been signed.
CMS has published guidance to help providers better understand the documentation they should retain around meeting MIPS requirements. CMS calls this guidance "MIPS Data Validation Criteria" because it describes the types of documentation that would validate the data the provider submits to CMS at the end of the performance period. You can learn more about this by reviewing CMS’ MIPS Data Validation Fact Sheet and you can see the specific documentation guidelines applicable to the ACI Transition Measures in CMS’ MIPS Data Validation Criteria for ACI Transition Measures.