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.
ACI Transition Measures
Numerator: The number of prescriptions in the denominator generated, queried for a drug formulary, and transmitted electronically using CEHRT.
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.
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.
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.
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.
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.
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.
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.