Under the Merit-Based Incentive Payment System (MIPS) pathway of the MACRA Quality Payment Program, Promoting Interoperability (PI) 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:
- Promoting Interoperability Measures
- Promoting Interoperability (PI) 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 PI Transition Measure: Secure Messaging.
PI Transition Measures
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 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.
- 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.
- This measure is not required to achieve the PI base score, but may be selected to earn additional performance score credit.
- To earn performance score credit with this measure under the PI 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 2018 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 meeting the requirements of this measure in Practice Fusion, see the Practice Fusion Suggested Workflow section below.
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.
- Update your Patient communications settings to enable secure messaging under the Patient messages tab.
- 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.
- In the “To” drop down menu, select “Patient” from the drop-down menu before typing in a name. Once that search for and select the patient’s name 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” dropdown so that your patient recipient list will populate. Alternatively, ask patients to send you a message after they complete enrollment, and then send a reply to the patient acknowledging receipt.
Detailed information about the Practice Fusion Suggested Workflow
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.
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.
3. Reply to a secure patient message
Alternatively, you can ask patients to send you a message after they complete enrollment, and then send a reply to the patient. If a patient has sent you a message from his/her Patient Fusion account, you can access it from your Messages inbox. Click on the message to open it, then click Reply to compose your message and send it.
For more information, please see:
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.