Some of the most challenging activities in the NY Medicaid EHR Incentive Program involve health information exchange, patient portal usage, and public health reporting. Read below for tips and strategies implemented by NYC REACH members to meet these program requirements.

Dr. Sabina Awwal of Hillside Medical Care excelled in meeting requirements related to patient portal access and health information exchange (HIE) during a 90-day electronic health record (EHR) reporting period in 2018. Dr. Awwal provided timely online health information access to 92% of patients and ensured 16% of patients viewed, downloaded, or transmitted their health information. For 74% of outgoing transitions of care, she used her EHR to transmit summaries of care to a receiving provider.

Health Information Exchange Tip: Work with external partners.

Identify your most common external partners and target them for HIE. This saves staff time spent faxing or otherwise sending referral documentation. How to do this:

• Run a report to identify the health networks and providers the organization refers to most frequently.
• Identify the best method to exchange information. This may depend on both providers’ EHR systems. The best method may be a health information service provider (HISP), a HISP connected to the EHR, or a feature built into the EHR.
• Obtain direct addresses or other contact information from receiving providers.
• Test the process! Send a referral to a provider and follow up via phone or regular email to ensure the practice received it. Request they do the same.

Dr. Awwal asked her staff to figure out which of her colleagues use the same EHR (eClinicalWorks) so they could work together to optimize its functionality. “My staff contacted them to explain how P2P works, and why they should use it,” she noted. “After those conversations, their staff activated P2P and we started sending each other referrals easily.”

Tip on Patient Portal Usage: Assist patients in the waiting room.

• At each visit, ask if the patient has logged into the patient portal. If not, help them log in and explain how to use it. If possible, show them specific features, such as where to find their immunization history.
• While the patient is waiting, ask them to sign into the kiosk or tablet to update their information, or just to check their username and password work. If no kiosk is available, suggest the patient use their smartphone.
• Provide Wi-Fi in the waiting room if possible.
• Explain that educational materials in the waiting room are also on the portal.

Dr. Awwal assigned staff to speak to patients about the portal. “The staff have a separate laptop they use to log patients in,” she explained. It’s a tedious process, but the only way we could reach the measure. We talked to their families in the waiting room too, and if they were patients as well, we had them log in to their own accounts.”

Public Health Reporting Tip: Choose an appropriate registry.

• When seeking outside registries, check for one that has made a public declaration of readiness before the first day of the provider’s EHR reporting period.
• Check with specialty societies to see if they have lists of appropriate registries available.
• Refer to the CMS Centralized Registry Repository for a list, however, note that registries on this list have not been vetted for program compliance.
• If no registry is available, save dated correspondence or documentation as proof of exclusion for audit preparation.

Tip on EHR Functionality: Run an EHR “system check.”

Providers sometimes find the features they assume are activated in their EHR have not been activated yet, or were deactivated during an upgrade. Complete a “system check” to make sure everything is functioning properly.

• Confirm that all electronic clinical quality measures (eCQMs) are set up correctly in the Meaningful Use dashboard report.
• Check other important features such as Rx eligibility check, drug interaction check, and the clinical decision support system.
• Make sure your EHR’s Application Programming Interface (API) is activated. Once confirmed, take a screenshot with the date and time and save it for your records. Providers must activate this feature to meet program requirements, although patients are not required to use it.
• If your practice is new to using APIs, contact your EHR vendor for guidance.