Send a Direct Message

Now that you know how to receive and manage Direct messages from other practices, here's how and when to send them yourself.

1) The first step is to collect Direct addresses for the providers to which you commonly refer patients. Contact them for their Direct addresses and enter each address into the referring physician's entry in Rexpert. (Settings > People and Places > Referring Provider). Alternatively, log into the MD Toolbox site and look providers up in the listing. 
      a) To do this, go to Settings > People and Places > Referring Providers. Select the referring provider you are interested in and press this button: 

     b) This will take you to MD Toolbox. Log in using your username, password, and practice code. (Ask Client Services if you need help finding this information.)

Once logged in, press this button: 

     c) This will open up a screen as though you were going to send a new Direct message. You won't send this one, but we will be able to use the lookup facility to find referring provider addresses.

    d) Leave the To: field blank and ONLY press the little magnifying glass. 

     e) Type in the last name of the provider you're searching for and the state, and a list of matches will appear below. Copy the Direct address into the referring provider table in Rexpert (Settings > People and Places > Referring Provider).

     f)  Note that this search tool is finicky and will not return any more results if you close it after searching. Keep it open through as many provider searches as you can. If it starts returning 0 results, you'll have to log out and start again with the button on the referring provider screen in Rexpert.

2) To send a referral or transition of care by Direct message, go to AuroraEHR - Patient View, select the task Provider Orders/Notes and fill in the referral information. Then press Send CCD via Direct message to open the Direct Message screen. Check the information in the message and hit Send. You, the provider, should do this personally. Your Direct address will be automatically provided in the Sender field, but if any other staff members open the screen, it will be difficult as they are not set up with Direct addresses of their own.

3) For a second way to send a referral or transition of care by Direct message, go to AuroraEHR - Patient View, select an encounter to send a summary of, ensure that all the necessary tasks are completed, and open the Visit Summary task. Every box on the screen needs to be checked to include all the information Meaningful Use requires. Press the Send as Direct Message button to open the Direct Message screen. Again, you, the provider, should be the one opening this screen. Select the referring provider's code, add any comments desired, and press Send. Congratulations, you've sent your first Direct message!

Don't forget to check out the list of benefits of Direct messages we linked to last week. Sending and receiving these Direct messages is not just a chore to do so that you can gain some monetary benefits from Medicare: It is an important step that will directly benefit your practice and improve your patients' standard of care.

Written by Laura Rowe

Your Direct Messages

What do you do the first time another practice wants to send you a "Direct message"?  Or talks about "delivering the record electronically" or a "sending a CCD" or  "delivering a secure message"?

Meaningful Use, Objective 5, Health Information Exchange, requires providers who refer patients to each other to communicate the patient's records securely over the internet. Transmitting information this way carries many benefits, as listed here by our Direct message partner, MD Toolbox. Not only will you, the provider, be sending records when you refer someone, you will also be receiving messages for your new patients. Here's how to keep on top of the Direct messages you receive and manage the clinical information they contain.

1) There are two ways to check for Direct messages sent to you by other providers. First, go to AuroraEHR > Secure MD Toolbox Messages which will automatically check for new messages. Only messages sent to you personally will display. Alternately, go to AuroraEHR > EHR - Task View and under External Alerts, select my Direct (secure) messages. Select an appropriate date range and provider code and hit Refresh to see the list of Direct messages. Double click to open the message.

2) Once you access a Direct message from either screen, you need to connect it to the correct patient's account in AuroraEHR. Fortunately this process is quick and easy: Click on Add to Chart and the Add to Chart screen will open up, allowing you to select the appropriate patient account number and provider code. This will add the message as a Outside Report which is awaiting review.

3) In Outside Orders, you can press the View button to see the document in whatever format it was sent.  If the Direct message is a structured CCD and contains medications, allergies, or problems, press the Add to Chart button to open the Clinical Reconciliation screen, which allows you to combine the incoming information with anything your practice has already entered for the patient. 

Sending a Direct message from AuroraEHR is just as simple as receiving one. Stay tuned for our next blog post outlining the steps to sending a Direct message.


Written by Laura Rowe

2016 Meaningful Use Strategy

It's the beginning of the year and time to make a plan for meeting the 2016 Meaningful Use requirements! Here is a rundown of each objective and how to successfully meet it using AuroraEHR, Bridge, Rcopia, and other outside resources.

Please read these details carefully and take steps to ensure that they are all done in your practice. We recommend designating a person in each practice to run the MU reports (AuroraEHR > Meaningful Use Reports) at least once a month for every provider in your practice to make sure that you are meeting your goals, and to catch any problems early. Please contact Client Services with any questions regarding the following steps.

Objective 1: Protect Patient Health Information
As detailed in our previous blog post, this is a one-time action with updates as needed. Learn the basic process from the tipsheet provided by CMS, and then use this tool from CMS. It will walk you through how the requirements apply to your practice and list steps you need to take.

Objective 2: Clinical Decision Support
Measure 1: Interventions
Implement 5 clinical decision support interventions. If you are our client at the time of this blog post, your set-up is already done!
Measure 2: Drug/Drug and Drug/Allergy Checks
If you are entering all prescriptions in Rcopia, you are covered for this objective.

Objective 3: CPOE: Computerized Provider Order Entry
Measure 1: Medications
Do at least 61% of your medications through Rcopia.
Measure 2: Lab orders
Order at least 31% of labs (this includes pathology) through Outside Orders, printing an order slip.
Measure 3: Radiology orders
Order at least 31% of radiology orders through Outside Orders, printing an order slip.

Objective 4: Electronic Prescribing
If you are entering all medications in Rcopia, you are covered for this objective.

Objective 5: Health Information Exchange
1. Collect Direct addresses for referring providers and enter this information into the referring provider table.
2. Use the Visit Summary task, with every box checked, and select the Send as Direct Message button, OR
3. Use the Provider Orders/Notes task, selecting the Send CCD via Direct Message button.
4. Do this for more than 10% of transitions of care/referrals.
5. Review the following list and emphasize to all staff that the tasks for these categories must be completed for every encounter. To meet Objective 5, the record you send must include information from every one of these categories. If the AuroraEHR tasks for every one are completed, then checking all the boxes on the Visit Summary screen will cover this requirement.

• Patient Name
• Referring or transitioning provider's name and office contact information
• Procedures
• Encounter diagnosis
• Immunizations
• Laboratory test results
• Vital signs (height, weight, blood pressure, BMI)
• Smoking status
• Functional status, including activities of daily living, cognitive and disability status
• Demographic information (preferred language, sex, race, ethnicity, date of birth)
• Care plan field, including goals and instructions
• Care team including the primary care provider of record and any additional known care team members beyond the referring or transitioning provider and the receiving provider
• Reason for referral
• Current problem list
• Current medication list
• Current medication allergy list

6. Assign a staff member for each practice to daily monitor for messages coming in from other practices. Use the Secure MD Toolbox Messages or the AuroraEHR-Task View screen to check.

Objective 6: Patient Specific Education
Use the Patient Specific Education task for at least 11% of patients.

Objective 7: Medication Reconciliation
1. Use the task to check medications in Rcopia.
2. Then, in the Medications task, click the Reconcile with Rcopia button, which downloads from Rcopia and opens up the Clinical Reconciliation screen. Make sure you click through the screen, even if there are no medications entered in either Rcopia or AuroraEHR.
3. Do this for 51% or more of transitions of care.

• For surgery practices, every visit qualifies as a transition of care. 
• For all other types of practices, the patient's first visit to the practice qualifies as a transition of care.

Objective 8: Patient Electronic Access (VDT)
Measure 1: Timely Access
1. Collect an e-mail address for at least 51% of patients.
2. Complete all encounters within 4 business days. After the encounter is complete, AuroraEHR automatically sends the information to Bridge and Bridge takes care of notifying the patient.
3. For each encounter, you must complete the tasks for each category in the list below. Emphasize to all staff that right-clicking on a task to mark it as done without actually entering any information in it will lead to failing Meaningful Use. If a task is not completed, the encounter will not count towards meeting Objective 8.

• Problems
• Medications
• Allergies
• Care plan information

Measure 2: View, Download, or Transmit
At least one patient must actually view, download, or transmit their record from Bridge.

Objective 9: Secure Messaging
This is covered if your practice is set up with Bridge. Make sure a staff member is assigned in each practice to daily monitor the Bridge administrator account for incoming messages from patients.

Objective 10: Public Health Reporting
Measure 1: Immunization Registry
Measure 2: Syndromic Surveillance Reporting
Measure 3: Specialized Registry Reporting
Client Services will help you meet this objective on a case-by-case basis.

Beginning to follow the steps in this blog post immediately will set you up for success in Meaningful Use. Again, if you have any questions about what your practice needs to do for each provider to successfully attest to Meaningful Use, please contact Client Services. We are happy to help.

Written by Laura Rowe