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 four performance categories that will be considered and weighted for scoring an eligible clinician’s performance under MIPS. 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.
Patient Electronic Access
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
- Numerator: The number of unique patients in the denominator (or their authorized representatives) who have viewed online, downloaded, or transmitted to a third party the patient’s health information during the performance period.
- Denominator: Number of unique patients seen by the MIPS eligible clinician during the performance period.
Practice Fusion Suggested Workflow
Practice Fusion suggests the following workflow to ensure that you meet the requirements of this measure within the Practice Fusion EHR.
- Determine whether the patient has already been enrolled in Patient Fusion. If they have, you will not need to do anything else to meet this measure (as long as the patient’s PHR access has not been revoked).
- If the patient has not been enrolled in the PHR, enroll the patient in Patient Fusion (the patient portal) from the patient’s chart.
- Ensure the patient completes their Patient Fusion registration and logs into his or her account during the 2017 performance period.
2. Enroll the patient in Patient Fusion (Patient Portal)
In order for a patient to view, download, or transmit his or her health information, he or she must first be enrolled in the Patient Portal. To enroll a patient in the Patient Portal, you may use the Invite to patient portal link located in the patient’s chart header or opt to turn on the auto-invite feature in your Patient communications settings. For detailed instructions on Patient Portal (i.e. PHR) enrollment, please click here.
3. Patient Fusion registration
After you invite your patient (or their authorized representative) to access his or her PHR, the patient will receive a registration email to the email address on record in his or her patient profile. They can then complete the registration process on their computer or mobile device to gain access to their Patient Portal account. For detailed instructions on how the registration process looks for each patient, please click here. Once registered, your patients must log into their Patient Portal at least once during the 2017 calendar year in order for you to gain credit for this measure.
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 the 2017 calendar year, regardless of the clinician’s selected performance period (i.e. 90 days or full year).
- 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. (Note: Only the MIPS eligible clinician who signs the note will gain credit towards this measure.)
- For information on earning numerator credit for this measure, see the Practice Fusion Suggested Workflow section above.
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.