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Product Information Notice: Transition of Care

Dear Centricity™ Practice Solution and Centricity EMR Customers:

 

We would like to direct your attention to a potential issue affecting the transmission of Summaries of Care and the reporting of these transmissions for Meaningful Use Measure 5 – Health Information Exchange (formerly Summary of Care). Although the majority of our customers use the EzAccess Patient Portal (highlighted throughout in red), we are providing all Summary of Care workflow updates in this communication.

 

GE Healthcare has identified issues that, under certain circumstances, may result in

1)       incomplete transmission of some Summaries of Care  and

2)       artificially low or high Summary of Care percentages in the Clinical Quality Reporting (CQR)     Meaningful Use Dashboard.

Each user may be affected differently depending on individual workflows and products utilized.

 

Affected Users

This situation affects Centricity Practice Solution and Centricity EMR customers on versions 12.0.x and 9.8.x who use the following workflows to send Summaries of Care:

  • Centricity Clinical Messenger – possibly affected by incomplete transmissions also likely net under reporting
  • SM-ToC Encounter Form – likely net under reporting
  • Surescripts Automated Clinical Messenger – potentially net over reporting
  • Qvera Interface Engine- potentially over reporting
  • EZAccess Summary of Care workflow-believed not to be impacted

 

Issue Description

If you are an affected customer, then the CQR Meaningful Use dashboard likely will not reflect the Summaries of Care actually sent by your practice.  In some cases a Summary of Care may not have been sent.

 

Incomplete transmissions:

 

For the Centricity Clinical Messenger workflow, incomplete transmissions may have occurred. As a result, the target recipient may not have actually received the Summary of Care and the CQR Meaningful Use Dashboard may display Summary of Care percentages that, while accurate, are lower than expected.

 

This issue arises because those recipients selected from the Surescripts Directory who do not have a Surescripts-issued “Direct address” are sent a notice that contains a link to the Summary of Care rather than the full Summary of Care attachment (the expected workflow). Because an order was created but a compliant transmission was not sent, CQR will log the Summary of Care denominator without crediting the corresponding numerator.

 

The other workflows are not affected by this issue.

 

Low or high transmission reporting:

 

The Centricity Clinical Messenger, the SM-TOC Encounter Form, and, to a lesser extent, the Surescripts Automated Clinical Messenger workflows result in Summary of Care percentages in CQR that are artificially low.  This issue arises because CQR logs the denominator for a compliant transmission without adding to a corresponding numerator, and as a result, orders will appear as unmet.

In a minority of cases for all four workflows, Summary of Care percentages in CQR may be artificially high. This situation occurs when providers “Complete” referral orders on the same day as they are ordered. In this case, the CQR denominator display is not increased as it should be.

 

Believed to not be impacted:

 

The EzAccess Patient Portal engaged in Transition of Care testing with GE last week based on GE’s guidance and the recommended Transition of Care workflow with EzAccess was logging data correctly.

 

Recommended Actions

Short-term:

 

Until you upgrade (information on upgrade timing is below), we recommend that you take the following actions for the affected workflows for sending Summaries of Care to ensure complete transmission and prepare your database for the long-term corrections:

  • Centricity Clinical Messenger – we recommend that you continue to use this workflow with the following modifications:

Until you upgrade, when sending Summaries of Care to recipients without a “Direct address” with the format user@domain.direct.ci.net selected from the Surescripts Directory, users should instead save the contact to the Personal Address Book and select the recipient from there for a successful transmission.

 

Note: GE Healthcare recommends that users identify and consider resending Summaries of Care that did not transmit properly and that are unread when such a transmission remains clinically appropriate. Such transmissions will be counted for the Meaningful Use measure. We are working on ways to help identify these Summaries of Care.

 

We do not recommend resending Summaries of Care that did not transmit properly if they were read by the recipient. In these cases, GE is exploring a way to add these to your numerator count per the revised approach to HIE in the recent CMS Meaningful Use Final Rule.

 

Please be aware that any artificially low net Summary of Care percentages in the CQR dashboard, if present, will remain artificially low until you can apply the upgrades.

  • SM-ToC Encounter Form – we recommend that you discontinue use of this workflow until you upgrade.

To ensure better recovery of historical transmission data, werecommend that you use the Centricity Clinical Messenger workflow with the modifications listed above until you upgrade your products.

 

Please be aware that any artificially low net Summary of Care percentages in the CQR dashboard, if present, will remain artificially low until you can apply the upgrades.

  • Surescripts’ Automated Clinical Messenger (ACM) – we recommend that you continue to use this workflow.

Please be aware that any artificially high net Summary of Care percentages in the CQR dashboard, if present, will remain artificially high until you can apply the upgrade.

  • Qvera Interface Engine – we recommend that you continue to use this workflow

Please be aware that any artificially high Summary of Care percentages in the CQR dashboard, if present, will remain artificially high until you can apply the upgrade.

  • EZAccess Summary of Care workflow– we recommend that you continue to use this workflow and still upgrade to Service Pack 11 as a precaution

Please be aware that any artificially high Summary of Care percentages in the CQR dashboard, if present, will remain artificially high until you can apply the upgrade.

 

If you are using one of the affected workflows, you will need to upgrade Centricity Practice Solution or Centricity EMR as described in the next section and resend data to CQR prior to attestation in order for your data to display accurately in CQR.

 

Permanent Fix:

 

A permanent fix will be released with an upgrade to both Service Pack 11 and Centricity Clinical Messenger & Patient Portal v6.4.15.  These upgrades will resolve Summary of Care counts in the future and will provide you credit for Summaries of Care sent prior to your upgrade.

 

We expect the upgrades will be available in mid to late November.

 

Contact Information
Helping you deliver high quality of care is our top priority. If you have any questions on the information in this communication, please contact Quatris Support immediately by calling emailing support@quatris.com or calling 817-282-0300 or logging a ticket via our customer portal.

 

Sincerely,

Quatris Health

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