PCC 7.0 is a special, optional software release, offered to PCC clients in the fall of 2015.
If your practice uses PCC EHR and needs a 90-day reporting period from 2015 in order to meet Meaningful Use for the ARRA program or for PCMH, you may elect to receive the 7.0 release.
All of the features described below will be part of the PCC 7.1 release, which will be installed for all clients later in 2015.
Contact PCC Support for information about the items below or about any PCC product or service.
- 1 New Patient Education Materials from the AAP
- 2 Direct Secure Messaging
- 3 Receive Direct Secure Messages, Including Inbound C-CDA For Transition of Care
- 4 Create a C-CDA Summary of Care Record
- 5 MyKidsChart Users Can Transmit a Visit Summary in C-CDA Format with Direct Secure Messaging
- 6 Meaningful Use Measures Report Update
- 7 Clinical Quality Measures Report Update
New Patient Education Materials from the AAP
You can now access AAP Pediatric Patient Education materials in PCC EHR, in addition to MedlinePlus materials.
When you wish to access handouts and other materials for a patient, click on the Reports menu and select Patient Education.
To find education materials, pick from a list of the patient’s problems and visit diagnoses, prescribed medications, and labs.
You can also use the “All Articles” navigation or the search field to find content.
One you’ve found a handout or other item you want to share with a patient, you can click Print in the site or in the PCC EHR window. You can also select the PDF version of a handout.
PCC 7.0 includes other new features in the Patient Education window:
Select From All Patient Diagnoses (or Problems, Medications, or Lab Tests): The pull-down menu in the Patient Education window now provides access to all patient diagnoses, and not just the patient’s Problem List items. Visit diagnoses, as well as problems, prescriptions, and lab tests are available when retrieving both AAP and MedlinePlus educational materials.
Pediatric Red Book Access and Other AAP Features: As part of PCC’s agreement with the AAP, the Patient Education tool also provides access to the Pediatric Red Book and other AAP resources. PCC will incorporate AAP Red Book access into other PCC services, but for now your clinicians can access and review the Red Book from the Patient Education tool.
You can also access the Pediatric Red Book, AAP Pediatric Coding Newsletter, and other resources by visiting PCCTalk.
Switch Between AAP Materials and MedlinePlus Materials
By default, PCC EHR will display the AAP Pediatric Patient Education library first. You can select the MedLinePlus library instead, and PCC EHR will remember your preference.
Both MedlinePlus and the AAP Pediatric Patient Education site begin on an “All Handouts” library page, making it easy to find relevant materials.
AAP Text Search vs. MedlinePlus Codes: When you select patient criteria from the pull-down menu, PCC EHR searches for that criteria in the AAP library. When you select patient criteria to search the MedlinePlus library, PCC EHR submits the actual SNOMED codes for each item. For this reason, you may find more exact matches in MedlinePlus.
How to Track Patient Education for Meaningful Use
If your practice is tracking the distribution of educational materials in order to meet Meaningful Use, you must select an item from the patient criteria on the drop-down list.
Then, you can use the “Print” button in the PCC EHR window or the printer icon on the page. You can also select the PDF version of a document and print that.
By selecting from the pull-down list to find patient relevant materials and then printing a version of the document, PCC EHR will track that you provided the education materials according to Meaningful Use guidelines.
Direct Secure Messaging
PCC EHR 7.0 includes Direct Secure Messaging. Direct Secure Messaging is a communication technology for the transmission and exchange of private health information. Your practice can use Direct Secure Messaging for transitions of care, and patient portal users can use Direct Secure Messaging to send their visit information to other medical practitioners.
Direct Secure Messaging Pilot Test: Direct Secure Messaging features are in pilot testing with the PCC 7.0 release. That means that just a couple of offices are trying the features in a live environment. PCC will extend Direct Secure Messaging support to all practices once the pilot is complete.
Activate Direct Secure Messaging For Your Practice
When you are ready to activate Direct Messaging for your practice, contact PCC Support. We will create your practice’s Direct Secure Messaging connection. PCC partners with Updox to manage the back-end of the service.
Create Direct Secure Messaging Accounts for Users
After Direct Secure Messaging is turned on for your practice, use the User Administration tool to create Direct Secure Messaging accounts.
Open a user account in PCC EHR’s User Administration tool, and then use the “Direct Secure Messaging” tab to create their account.
Who Needs a Direct Secure Messaging Account?: Direct Secure Messaging is optional, and PCC recommends you only create accounts for users who will communicate using Direct Secure Messaging, such as clinicians who transmit and receive electronic transition of care documents. PCC EHR supports Direct Secure Messaging, which is part of making PCC EHR a Meaningful Use certified EHR using the 2014-edition standards. However, your physicians may decide they prefer not to manage an additional communication channel.
After you create the account, you can see the user’s Direct Secure Messaging address as well as options to deactivate their account or set directory preferences.
The user’s Direct Secure Messaging account address also appears in the user’s My Account tool.
You can provide your address to patients or other medical practices, and they can use the address to send you transition of care documents.
Get Your Practice Registered with the DirectTrust Network
Once your practice’s Direct Secure Messaging service is turned on, you can send and receive direct messages to other users within the Updox network. However, in order to communicate with the full range of medical practices, at least one Direct Messaging user at your practice needs to be your practice’s legal representative for Direct Secure Messaging.
Only one Direct Secure Messaging user at your practice needs to complete the registration with the DirectTrust Network. Click on the blue link to get started.
The Updox website will walk the user through the process. The user will need to enter identifying information and answer demographic questions to verify their identity.
Once the process is complete, you will see the result in the User Administration tool, or in the My Account tool.
Once one user on your system has registered your practice with the DirectTrust Network, all Direct Secure Message users will have access to the Direct Secure Messaging trust network.
Can a Practice Send and Receive Direct Secure Messages Without Registering?: Your practice can elect not to have a user register with the DirectTrust Network (a process also known as “vetting” your practice’s account). You will still be able to send and receive messages, but you will be limited to other Direct Secure Messaging users who use the Updox service.
What if the Registered User Leaves Your Practice?: When you disable a user from PCC EHR, their Direct Secure Messaging account will be disabled. If the registered Direct Secure Messaging user is disabled, PCC EHR will send a message to Updox, the third-party vendor that manages Direct Messaging accounts. Your practice will no longer be registered. You will see the blue information message in the User Administration tool as shown above, and a different user can use the link in the User Administration tool or the My Account tool to register your practice.
Receive Direct Secure Messages, Including Inbound C-CDA For Transition of Care
Once your practice has activated Direct Secure Messaging, other medical practices can send Direct Secure Messages to users at your practice. Those messages can include transition of care C-CDA attachments and other documents.
When a Direct Secure Message arrives, it will appear on the Messaging queue. Double-click on a message to review it and associate it with a patient chart.
Similar to the process for importing an electronic lab result, you can review message information, including patient name, birthdate, and sex, and message details, if available. Use the panel on the right to associate the message with a patient’s chart. In most cases, PCC EHR does the work for you and suggests a matching patient. Otherwise, you can search for any patient.
Click “Select” to place the Direct Secure Message into the patient’s chart.
After you click “Select”, PCC EHR will open the Direct Secure Message as it appears in the patient chart. You can see the full message details and any attachments.
As you review a message, you can click to open message attachments and create and complete tasks. For example, you can click “View” to view a C-CDA document or other attachment.
You can also create a task for any user so they can follow up on the message.
Direct Secure Message Protocol: Your practice can customize the Direct Secure Message protocol in the Protocol Configuration tool. For example, you may want to add the patient’s Problem List, History, or Upcoming Appointments components to assist your workflow when you read and evaluate a Direct Secure Message.
For information about protocols in PCC EHR, you can read about Protocol Configuration.
Reconcile a C-CDA Document
If a Direct Secure Message includes a transition of care document in C-CDA format, you can import any Problems, Medication Allergies, and Medications from the C-CDA document into the patient’s chart record.
When you see an incoming C-CDA in a Direct Secure Message, you can click “Reconcile” to review and import patient data.
On the “Reconciliation – Import” screen, you will see three sections: Problems, Medication Allergies, and Medications. In each section, you will see both the information in the C-CDA and the information that is already in the patient’s chart. When you want to import information, select it in the “Add to EHR” column.
After you have reviewed each section (Problems, Medication Allergies, and Medications) and selected any items you wish to add to the patient’s chart in PCC EHR, click Next.
On the “Reconciliation – Review and Save” screen, you can review what the final result of the patient’s record will be. You will see what the patient’s new Problem List, PCC eRx Allergies, and Medication History will display after the import is complete.
Optionally, Click Edit: You can click “Edit” and modify the items on these lists before saving. If you have a duplicate entry, for example, you may want to edit and combine notes or delete an item.
Click “Save” to save your changes and import the data. You can also click “Cancel” to close the C-CDA without making any changes to the patient’s chart.
Last Reconciled: PCC EHR tracks when a user clicked the “Reconcile” button, whether or not they decided to import data to the chart. You will see a “Last Reconciled” attribution on the Direct Secure Message as well as in the patient’s Visit History. You can revisit the message and choose to reconcile the C-CDA data with the patient chart again at any time.
Match Medications and Medication Allergies in PCC eRx: After you reconcile and import Medications and Medication Allergies from a C-CDA, they are added to the patient’s chart record as free text. After three minutes, they are synced with PCC eRx, PCC’s ePrescribing system, found in the Prescriptions section of each patient’s chart. After the record has synced, you should open the patient’s Prescriptions screen and use the Find Match feature to associate the new records with actual drugs and drug allergies.
Create a C-CDA Summary of Care Record
The new Summary of Care Record report produces a C-CDA-formatted chart summary for a patient. Your practice can use the report as a transition of care document. Optionally, if your practice uses Direct Secure Messaging, you can transmit the report to another clinician or practice.
When you need to create a C-CDA summary of care, select “Summary of Care Record” from the Reports menu.
On the report screen, you can indicate whether or not you are creating the record for a referral or transition of care.
Use the options on the screen to print or save the record as a PDF or C-CDA document.
Transition of Care For Meaningful Use: If you have indicated that the record is being created for a referral or transition of care, PCC EHR will track that you have generated the C-CDA document and it will update your Meaningful Use reporting totals.
Health Information Summary Report Change: The PCC 7.0 update removed the outbound transition of care selection options from the Health Information Summary report. For a summary of care record, use the more complete and C-CDA formatted Summary of Care Record report. The Health Information Summary is a less formal chart summary for patient, family, and clinician use.
Transmit a C-CDA Transition of Care Document Using Direct Secure Messaging
If your practice uses Direct Secure Messaging, and you have a Direct Address configured for your user account, you can transmit a Summary of Care Record directly to another Direct Secure Messaging user, such as a specialist for a referral or another pediatric practice.
Select “Send via Direct Secure Message” and fill out the fields for the message.
Optionally, you can enter text and click “Search” to find a clinician by name or practice name.
You will see more results if a user at your practice is registered with the DirectTrust network.
MyKidsChart Users Can Transmit a Visit Summary in C-CDA Format with Direct Secure Messaging
Parents and other MyKidsChart users can download a C-CDA-formatted visit summary. Optionally, they can use your practice’s Direct Secure Messaging connection to send the visit summary directly to another Direct Secure Messaging user, such as another physician or medical practice.
When users want to save or send a visit summary in C-CDA format, they first select the patient and visit from their history.
At the bottom of the visit, they can choose to download or send the visit summary.
On the Direct Secure Email screen, the user can enter the Direct Secure Messaging address provided by the recipient. For example, a specialist might provide a parent with an address for the purpose of sending a visit summary directly to them.
After they enter an address, the user can optionally edit the default subject and message. Next, the user can choose whether to attach a C-CDA or PDF, and click “Send” to send the message and visit summary.
Direct Secure Messaging Required: MyKidsChart users can only send Direct Secure Messages if your practice has activated Direct Secure Messaging. Additionally, until a user at your practice registers with the DirectTrust Network, parents and families can only send messages to physicians and other practices within the Updox network. For more information, read the Direct Secure Messaging sections above.
Meaningful Use Measures Report Update
The Meaningful Use Measures report now has options for both 2014 and 2011 Meaningful Use guidelines, for both Stage 1 and Stage 2 applications.
When you want to check how well your clinicians meet Meaningful Use requirements, select the Meaningful Use Measures report from the Reports menu.
You can select either the 2014 or 2011 Meaningful Use rules by clicking on a tab at the top of the screen. Note that the 2011 Meaningful Use rules have been retired and that practices can no longer apply for the Medicaid EHR Incentive Program using the 2011 rules.
On the 2014 tab, you can select whether you are applying for Stage 1 or Stage 2, pick a reporting period, exclude Visit Reasons (such as lab-only, weight checks, or other visits where the physician doesn’t see the patient), select which professionals to include, and decide on report layout.
Provider of Encounter: 2014 Meaningful Use calculations use the “Provider of Encounter” for each visit. By default, the PoE is the scheduled physician, but your practice may change the provider at the top of the chart note. The 2011 calculations were based on the clinician who signed the visit.
After you make your selections, click “Generate Report”. Because Meaningful Use calculations look at a lot of patient data, the report may take a long time to run.
The report will display either the per-professional or aggregate results, typically indicated by a number of patients who meet the requirements (the “Numerator”) and the number of patients who meet certain rules and were seen during the reporting period (the “Denominator”). The final two columns display the percentage met by the physician and the typical required percentage for the Meaningful Use Measure.
Formatting and Exceptions: The Meaningful Use Measures report is formatted to help you fill out the ARRA application worksheet. Measures appear in the same order as the application, and extra lines are added to illustrate your numbers for each available exception.
How Is Each Line Calculated?: For more information on how each line of the Meaningful Use report is calculated, and what changes you can make in your PCC EHR workflow to improve your percentile score, you can watch PCC’s 2015 Meaningful Use Web Lab, and use the accompanying handout. Detailed written documentation is coming to PCC Learn later this fall.
Clinical Quality Measures Report Update
The Clinical Quality Measures report now has options for both 2014 and 2011 CQM guidelines.
When you want to check how well your clinicians meet Clinical Quality Measures, select the Clinical Quality Measures report from the Reports menu.
You can select either the 2014 or 2011 CQM rules by clicking on a tab at the top of the screen. Note that the 2011 CQM rules have been retired and that practices can no longer apply for the EHR Medicaid Incentive Program using the 2011 rules.
On the 2014 tab, you can limit the report to specific measures, pick a reporting period, select which professionals to include, and decide on report layout.
Provider of Encounter: 2014 Clinical Quality Measure calculations use the “Provider of Encounter” for each visit. By default, the PoE is the scheduled physician, but your practice may change the provider at the top of the chart note. The 2011 calculations were based on the clinician who signed the visit.
After you make your selections, click “Generate Report”. Because CQM calculations look at a lot of patient data, the report may take a long time to run.
The report will display either the per-professional or aggregate results, typically indicated by a number of patients who meet the requirements (the “Numerator”) and the number of patients who meet certain rules and were seen during the reporting period (the “Denominator”). Next, the “Performance Rate” column displays your practice’s percentage for the measure. The final two columns display the total number of patients who met certain CQM-specific exceptions or exclusions.
How Is Each Line Calculated?: For more information on how each line of the Clinical Quality Measure report is calculated, and what changes you can make in your PCC EHR workflow to improve your percentile score, you can read the 2011 Meet Clinical Quality Measures article. PCC will update that article later this fall, but the 2011 descriptions are still useful for understanding many of the measures.