2017 ACI Transition Measure: Secure Messaging

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)This measure is not required to achieve the ACI base score, but may be selected to earn additional performance score credit. For more information on ACI scoring methodology, please click here.

Objective:

Secure Messaging

Measure:

Secure Messaging                   
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology (CEHRT) to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative), during the performance period.

Scoring Information:

  • Required for Base Score (50%): No
  • Percentage of Performance Score (up to 90%): Up to 10%
  • No bonus points available

Reporting Requirements

  • Numerator: The number of patients in the denominator for whom a secure electronic message is sent to the patient (or patient-authorized representative), or in response to a secure message sent by the patient (or patient-authorized representative), during the performance period.
  • Denominator: Number of unique patients seen by the MIPS eligible clinician during the performance period.

Additional Measure Information
To earn performance score credit with this measure under the ACI performance category, a MIPS eligible clinician must meet the numerator requirements for as many denominator eligible patients as the clinician deems appropriate during his or her selected 2017 performance period. Each 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, 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. 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 ensure that you gain numerator credit for this measure within the Practice Fusion EHR.

  1. Update your Patient communications settings to enable secure messaging under the Patient messages tab.
  2. Ensure that the patient you wish to message has enrolled in their Patient Fusion (patient portal) account - only patients with active patient portal accounts will be able to receive and send secure messages.
  3. Send the patient a secure message from the Messages section of your Practice Fusion EHR account, ensuring that you have “Patient” selected in the “To” drop-down so that your patient recipient list will populate.

1. Update your Patient communications settings
To get started, an account administrator must first enable secure messaging by clicking Settings in the upper right-hand corner of the EHR and selecting Patient Communications from the Patient engagement section.

Within the Patient Communication Settings, select the Patient Messages tab. To opt in to patient messaging, turn on the "Enable secure messaging" toggle button. Enabling or disabling patient messaging will update this setting for the entire practice. This setting must be enabled and stay enabled for the duration of your performance period to gain credit for this measure in Practice Fusion.

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2. Send a secure message
After you enroll a patient in their PHR, the patient will need to complete their registration and log in to their Patient Fusion account in order to utilize the secure messaging feature, which allows them to send secure messages to your practice. We recommend that patients use Chrome or Firefox as their web browser when accessing their PHR for optimal functionality.

To send a secure message to a patient, navigate to the Messages section and click New Message. Select "Patient" in the To field and begin typing a patient's name. The recipient list will only show patients who have completed patient portal registration. Once you have composed your message, click Send.

For more information, please see:

FAQ
In order to get performance score credit for this measure, do my patients need to message me and do I have to respond to my patient messages?
During the selected performance period, a secure message must be sent to at least one patient who was seen by the MIPS eligible clinician during the performance period in order to get numerator credit for this measure. Alternatively, the clinician can get credit for messaging a particular patient by responding to a secure message sent by the patient (or patient authorized representative) during the performance period.

Data Validation
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.  

More information

  • Review the CMS specifications for more information about this measure.
  • For more information on the Merit-based Incentive Payment System (MIPS) program, you can visit Practice Fusion’s Quality Payment Program Center.
  • CMS also provides further resources about the Quality Payment Program here.

Quality Payment Program

  1. 2018 Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  2. What is the MIPS Dashboard watch list and how do I use it?
  3. How does the MIPS Dashboard work?
  4. What is the Promoting Interoperability (formerly Advancing Care Information) performance category in MIPS?
  5. 2018 What is the Quality performance category in MIPS?
  6. 2018 What are Improvement Activities in MIPS?
  7. Which Improvement Activities qualify for the Promoting Interoperability performance category bonus in 2018?
  8. What is the Cost performance category of MIPS and how is it scored in 2018?
  9. How is the MIPS Final Score Calculated in 2018?
  10. What is a MIPS eligible clinician in 2018?
  11. MIPS for Small, Rural and Underserved Practices
  12. 2018 PI Transition Measure: Medication Reconciliation
  13. 2018 PI Transition Measure: Electronic Prescribing (eRx)
  14. 2018 PI Transition Measure: Secure Messaging
  15. 2018 PI Transition Measure: Security Risk Analysis
  16. 2018 PI Transition Measure: Health Information Exchange
  17. 2018 PI Transition Measure: Immunization Registry Reporting
  18. 2018 PI Transition Measure: Specialized Registry Reporting
  19. 2018 PI Transition Measure: Syndromic Surveillance Reporting
  20. 2018 PI Transitional Measure: View, Download, or Transmit (VDT)
  21. 2018 PI Transition Measure: Provide Patient Access
  22. 2018 PI Transition Measure: Patient-Specific Education
  23. What is the Practice Fusion QCDR?
  24. 2017 Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  25. How do I report my 2017 MIPS data to CMS using the Practice Fusion QCDR?
  26. What is the Advancing Care Information (ACI) Performance Category for MIPS and how is it scored?
  27. 2017 ACI Transition Measure: Security Risk Analysis
  28. 2017 ACI Transition Measure: Electronic Prescribing (eRx)
  29. 2017 ACI Transition Measure: Provide Patient Access
  30. 2017 ACI Transition Measure: Health Information Exchange
  31. 2017 ACI Transition Measure: View, Download, or Transmit (VDT)
  32. 2017 ACI Transition Measure: Patient-Specific Education
  33. 2017 ACI Transition Measure: Secure Messaging
  34. 2017 ACI Transition Measure: Medication Reconciliation
  35. 2017 ACI Transition Measure: Immunization Registry Reporting
  36. 2017 ACI Bonus Measure: Syndromic Surveillance Reporting
  37. 2017 ACI Bonus Measure: Specialized Registry Reporting
  38. What is the Improvement Activities Performance Category for MIPS?
  39. What are the Quality performance category reporting requirements for MIPS?
  40. What is the difference between the two Advancing Care Information measure sets available in 2017?
  41. What are Alternative Payment Models (APMs) and Advanced APMs?
  42. What is Comprehensive Primary Care Plus (CPC+)?
  43. Which Improvement Activities Qualify for the Advancing Care Information (ACI) Bonus Score in 2017?
  44. How do I contact CMS about the Quality Payment Program?
  45. How do I indicate interest in the Practice Fusion QCDR and get my MIPS estimated scores?
  46. Chronic Care Management FAQs
  47. How do I export a JSON file for 2017 MIPS reporting?
  48. How is the MIPS Final Score Calculated in 2017?

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