The objectives for eligible providers (EPs), which are most relevant for patient engagement and the promotion of health literacy, include:
Providing Clinical Summaries at Each Visit
Measure: Clinical summaries provided to patients within three business days for more than 50% of all office visits.
While the measure sets the threshold of 50% of all patients, CMS states that a clinical summary should be provided at all office visits. Research suggests that immediately after a visit, patients forget somewhere between 40% and 80% of the medical information they receive, and of the information remembered, about half is remembered incorrectly. Providing a written after-visit summary with key health information, a summary of issues discussed at the visit, and instructions for self-care and follow-up in combination with the verbal information delivered during the visit can have a greater impact on a patient’s understanding of their disease state and instruction for care than verbal information alone.
Note that the summary can be delivered by paper or electronic means (e.g., patient portal or secure e-mail).
Sending Patient Reminders for Preventative/Follow-up Care
Measure: More than 20% of all unique patients 65 years or older or five years old or younger were sent an appropriate reminder during the EHR reporting period, per patient preference.
It is important to note that the patient reminders referred to in this objective are not simply appointment confirmations sent to the patient as a reminder for an already-scheduled appointment. This objective focuses on sending patients in specific age groups reminders that alert patients to recommended tests, preventative services, or other care. To be most effective, these alerts should be relevant, targeted to unique patients, and based on the medical condition, age, gender, and/or other factors related to clinical guidelines (See Table 1). Using the EHR to query your patient data and identify those who need to respond to care recommendations is key for automating this process. Once the alert or reminder has been conveyed to the patient, then your practice can schedule the patient for an appointment, as appropriate.
These reminders can be sent via mail or through electronic means such as patient portal, secure e-mail, or even text message, if appropriate. The rule states that reminders should be sent “per patient preference,” which refers to the identification of a patient’s preferred means of communication and not inquiries as to whether a patient would like to receive service reminders.
Table 1: What’s Included in the After-visit Summary?
CMS states that, at a minimum, the after-visit summary should include the following:
- The patient name;
- Provider’s office contact information;
- Date and location of visit;
- An updated medication list and summary of current medications;
- Updated vitals;
- Reason(s) for the visit;
- Procedures and other instructions based on clinical discussions that took place during the office visit;
- Any updates to a problem list;
- Immunizations or medications administered during the visit;
- Summary of topics covered/considered during the visit;
- Time and location of next appointment/testing if scheduled or a recommended appointment time if not scheduled;
- List of other appointments and testing the patient needs to schedule, with contact information;
- Recommended patient decision aids;
- Laboratory and other diagnostic test orders;
- Test/laboratory results (if received before 24 hours after the visit); and
- Symptoms.
These elements are included as part of EHR certification and the capabilities are included in certified EHR technology. However, rheumatology providers are encouraged to work with their EHR vendors in order to make capabilities as relevant to their individual practices as possible.
