2018 ACI Transition Measure: Electronic Prescribing (eRx)

Note: Access to the EHR features described in this article may differ for practices who have already purchased a Practice Fusion EHR subscription plan. Please contact Practice Fusion Customer Service for additional information.

Under the Merit-based Incentive Payment System (MIPS) pathway of the MACRA Quality Payment Program, Advancing Care Information (ACI) is one of the four performance categories that will be considered and weighted for scoring an eligible clinician’s performance under MIPS.

In 2018, there are 2 measure set options for submission depending on the Certified EHR Technology (CEHRT) edition a clinician is using:

  • Advancing Care Information Measures           
  • Advancing Care Information (ACI) Transition Measures

Depending on the CEHRT Edition, there will be different objectives from which the MIPS eligible clinician may choose to report. This article outlines the measure details and specifications for the 2018 ACI Transition Measure: Electronic Prescribing.         

Measure Set

ACI Transition Measures

Objective:

Electronic Prescribing

Measure:

Electronic Prescribing                   
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.

Scoring Information:

  • Required for Base Score: Yes
  • Percentage of Performance Score: None
  • Eligible for Bonus Score: No

Measure Requirements
  • Numerator: The number of prescriptions in the denominator generated, queried for a drug formulary, and transmitted electronically using CEHRT.

  • Denominator:  

    • A) The number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the performance period; or

    • B) The number of prescriptions written for drugs requiring a prescription in order to be dispensed during the performance period.

           Note: When reporting on the e-Prescribing measure, an eligible clinician will have the option to include or not include controlled substances that can be electronically prescribed in the denominator for the e-Prescribing measure calculation.

  • Measure Exclusion: Any MIPS eligible clinician who writes fewer than 100 permissible prescriptions during the performance period. A MIPS eligible clinician may claim this exclusion if the exclusion criteria are met, but is not required to do so and may report on the measure if he or she chooses.

Scoring Requirements

  • To earn base score credit for this measure, a MIPS eligible clinician will be required to meet the numerator requirements for at least one denominator eligible prescription. Prescriptions are added to the denominator when they are recorded, printed, or e-prescribed in the patient’s chart. For information on meeting the measure requirements in Practice Fusion, see the Practice Fusion Suggested Workflow section below.

  • A drug formulary is a list of preferred medications based on a patient's insurance and allows providers to save prescription costs for patients. Practice Fusion automatically enables drug formulary query functionality for all clinicians who are enabled for e-prescribing through the Practice Fusion EHR.

Measure Requirements: Practice Fusion Suggested Workflow
Practice Fusion suggests the following workflow to help ensure that you meet the workflow requirements for this measure within the Practice Fusion EHR. See the
Detailed Information about the Practice Fusion Suggested Workflow section below for screenshots of each step.
  1. Using the steps detailed in How do I send an eRx (e-prescription)?, use the Plan section in the patient encounter or the Medications section of the patient Summary to start the patient prescription workflow.

  2. Complete the appropriate details for the prescription (e.g. sig, start date, etc.). If you choose to print the prescription without sending it electronically, the prescription will be added to the measure denominator and will not count towards the measure numerator.

  3. Once you have completed the required fields in each step of the e-prescribing workflow, select the pharmacy you wish to send the order to and click Send eRx.

Detailed information about the Practice Fusion Suggested Workflow

1. Initiate the patient prescription workflow

  • If adding a medication from the patient encounter, select Record in the Plan section.

  

  • If adding a medication from the patient Summary, click the (+) symbol next to the Medications section header.

2. Complete your prescription details
Use the workflow detailed in
How do I send an eRx (e-prescription)? to complete your prescription. Make sure that a valid start date has been selected and that all required fields are filled out. If you choose to print your prescription without transmitting it electronically, it will be added to your measure denominator and will not count towards the measure numerator.  

3. Once you have completed all the required fields, review your prescription summary, confirm that your prescription summary is accurate and select a pharmacy to fill the order. Click Send eRx.

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

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

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