Objective 6: Coordination of Care through Patient Engagement

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Updated: 11/18/2021
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Medicaid Promoting Interoperability - Stage 3

Objective:	Use certified electronic health record technology (CEHRT) to engage with patients or their authorized representatives about the patient’s care. An EP must attest to all three measures and meet the threshold for two measures for this objective. If the EP meets the criteria for exclusion from two measures, they must meet the threshold for the one remaining measure. If they meet the criteria for exclusion from all three measures, they may be excluded from meeting this objective.
Measure 1 - Engage:	More than 5% of all unique patients (or their authorized representatives) seen by the eligible professional (EP) actively engage with the EHR made accessible by the EP and either: (1) View, download, or transmit to a third party their health information; or (2) Access their health information through the use of an Application Programming Interface (API) that can be used by applications chosen by the patient and configured to the API in the EP’s CEHRT; or (3) A combination of (1) and (2).
Denominator:	The number of unique patients seen by the MIPS eligible provider during the performance period. Create a note detailing the patient’s office visit.
Numerator:	The number of unique patients (or their authorized representatives) in the denominator who have taken the action to view online, download, or transmit to a third party the patient’s health information during the performance period and the number of unique patients (or their authorized representatives) in the denominator who have accessed their health information through the use of an API during the performance period. Share the following instructions with all patients who are invited to enroll in the Patient Portal: Patients or their authorized representative must log into the Patient Portal at https://portal.kareo.com. Click on Health Records > Actions. Then, select the option to View Health Records, Download Health Records, or Send to New Doctor. OR Patients or their authorized representative must log into the Patient Portal at https://portal.kareo.com. Click on the patient’s name > My Account. Then, under the API Access Key section, click the Get Key.
Measure 2 - Secure Message:	For more than 5 percent of all unique patients seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient or their authorized representative.
Denominator:	The number of unique patients seen by the MIPS eligible provider during the performance period. Create a note detailing the patient’s office visit.
Numerator:	The number of patients in the denominator for whom a secure electronic message is sent to the patient (or patient-authorized representative) or in response to a secure message sent by the patient (or patient-authorized representative), during the EHR reporting period. Provider must send a message via the Patient Portal.
Measure 3 - Incorporate:	Patient generated health data or data from a nonclinical setting is incorporated into the CEHRT for more than 5 percent of all unique patients seen by the EP during the EHR reporting period.
Denominator:	The number of unique patients seen by the MIPS eligible provider during the performance period. Create a note detailing the patient’s office visit.
Numerator:	The number of patients in the denominator for whom data from non-clinical settings, which may include patient generated health data, is captured through the CEHRT into the patient record during the EHR reporting period. Patient or patient’s authorized representative sends an email via the patient’s patient portal account and includes an attachment. The attachment is automatically saved in the Documents section of the patient’s chart. Data from a Non-Clinical Setting: This includes, but is not limited to, social service data, data generated by a patient or a patient’s authorized representative, advanced directives, medical device data, home health monitoring data, and fitness monitor data.
Exclusions:	An EP may exclude from the measure if he or she has no office visits during the EHR reporting period OR Conducts 50% or more of his or her patient encounters in a county that does not have 50% or more of its housing units with 4Mbps broadband availability according to the latest information available from the FCC on the first day of the EHR reporting period.
Attestation:	An EP must submit the numerators and denominators generated by the Medicaid Promoting Interoperability dashboard.
Audit Documentation:	We recommend that a copy of your Medicaid PI report is placed in your audit folder and retained for a minimum of 6 years after your attestation. Your audit folder should provide necessary verification if you are selected for a CMS Incentive Program audit.