Quality Management Reporting

1. Display the Quality Management Reporting page: On the Main Menu, click Quality > Under REPORTS, click Quality Management.

Select programs and measures

2. Programs and measures — Select the programs and measures to report on. You can filter the list of programs and measures using the text box.
   If you select more than one measure, the report results include providers who are enrolled in any one of those measures (not only providers who are enrolled in all selected measures).
   Note: To run a report on archived data, select the Show archived option below the list of programs and measures.

Select departments and providers

3. Departments — When you select a department, all providers who have ever seen patients in that department are automatically selected in the Providers list, even if the providers have not seen patients in the selected departments during the current program year.
   Note: If you manually deselect one of these providers in the Providers list, athenaOne deselects the department in the Departments list.
4. Only include patients with an encounter in the selected department(s) — Because providers can see patients in multiple departments, you can use this option to include only patients who have had an encounter in the departments selected in the Departments field.
   • Select the Only include patients with an encounter in the selected department(s) option to include in the report only those patients ever seen in the selected departments.
     Important: Any patient who had an encounter with any provider in the selected departments in any year — not only during the current program year — is included in the report.
   • If you do not select the Only include patients with an encounter in the selected department(s) option, any patient who is attributed to a selected provider is included in the report results.

5. Providers — Select the providers to include in the report. By default, all provider usernames are displayed. You can select the Specialty or TIN option to select providers from those categories (click the plus (+) icon to display the list of providers under a specialty or TIN).
   You can also filter the list of providers by provider name using the text box.
6. Exclude measures with zero patients — Select this option to exclude measures with zero patients from the report, even if a provider is enrolled in that measure. This option is selected by default.
7. Exclude inactive patients — Select this option to exclude inactive patients from the report results and any exported .csv files (you mark a patient as inactive using the Status menu on the patient Quickview).
   Note: In accordance with CMS and other quality program sponsors, inactive patients are included in athenahealth certified eCQMs and in quality program submission data.

Select patient demographic information

If you do not see the following fields, click Show patient filters (to the right of the Export Report button).

8. Sex — Select Female or Male to include only female or male patients in the report.
9. Age range — Specify an age range to include only patients in that age range in the report.
10. Race — Select a race to include only patients of that race in the report.
11. Ethnicity — Select one or more ethnicities to include only patients of those ethnicities in the report. Click the plus icon to add another ethnicity.
12. Language — Select a language to include only patients with that language in the report.

Select diagnoses

13. Diagnoses — Select one or more diagnoses to filter the report based on a patient's problem list. Click the plus icon to add another diagnosis.
    Note: If you select more than one diagnosis, the report includes a list of patients who have one or more of the selected diagnoses (not only patients who have all the selected diagnoses).

Select insurance information

14. Insurance category — To filter the report for patients with specific insurance categories, click Selected and select the categories from the list.
15. Insurance product type — To filter the report for patients with specific insurance product types, click Selected and then select the types from the list.

Save the report filters and run the report

16. To save your selected filters for future reports:
1. In the Saved Selections text box at the top right of the page, enter a unique name for the saved report filters.
2. Click the Save button.

This action saves the filter selections, not the report data. The new linked report name appears below the Saved Selections text box. You see only the saved selections that you created. athenahealth recommends that you save a report before running it.

17. Click Run Report. Report results appear under the Report Summaries heading.

Print or export the report results

18. By default, the results are grouped by program name. You can toggle between Group by Program and Group by Provider.
19. To print the report summary as it appears on your screen, click Print report summary (next to the Report Summaries heading).
    Note: From the print summary view, you can also save the summary.
    
20. To export the measure totals to a .csv file, click Export Measure Totals to CSV (below the Report Summaries heading).
    This report generates provider-level data for measure status and denominator and numerator totals. You can use this report for internal benchmarking and for benchmarking against external targets.
    
21. To export the full report to a .csv file, click Export full report to CSV (below the Report Summaries heading).
    This report generates patient-level data for all measures for the selected providers. You can use this report for population management and to support care managers working with large patient populations.
    
22. To view information about specific patients included in the report for a measure, click a linked number in the Satisfied, Not Satisfied, or Total column.
    The report expands to display patient details for the selected measure.
    
• To print all patient information, click the Print report link.
• To export all patient information to a .csv file, click the Export to CSV link.
23. To change the report criteria and re-run the report, click Change report criteria at the top of the page.

You can create a quality management report and export it to a .csv file without displaying the report in athenaOne, and you can schedule the report for the next day. We recommend running large reports offline to give athenaOne more time to compile the report data.

1. Display the Quality Management Reporting page: On the Main Menu, click Quality > Under REPORTS, click Quality Management.
2. Select filters as described in To run a Quality Management report.
3. Save your selected filters for future reports. In the Saved Selections text box at the top right of the page, enter a unique name for the saved report filters, and click the Save button.
4. Click Export Report (next to the Run Report button).
   When you click this button, the report is not displayed on the Quality Management Reporting page.
   The Export to CSV window appears.
5. Scope — Select one of these options:
• Measure totals — Export measure totals only.
• Full patient data — Export data for the full patient list.
6. Schedule — Select one of these options:
• Run now — Run the report immediately.
• Schedule for tomorrow — Run the report offline.
  Reports that you run offline appear in your Report Inbox the next day.
7. File name — You can name the report before exporting it.
8. Click Export to CSV.
   

To work through a list of patients in a specific report without losing the original report shown in the Workspace:

1. Display the Quality Management Reporting page: On the Main Menu, click Quality > Under REPORTS, click Quality Management.
2. Run the desired report.
3. In the report results, click a linked number under the Satisfied or Not Satisfied column for the appropriate program or measure row. The list of patients expands in the Workspace just below that row.
4. Click any link in the sub-report (links to patients, documents, encounters, etc.). The corresponding worklist of patients appears in the Task Bar.
5. Click a patient name to open the patient's chart in the Workspace.
6. To return to the quality management worklist, click the Return to QM Report button at the top right of the page.
   athenaOne displays the worklist in the left panel, focused on the patient you're viewing.
7. To return to the original report results, click BACK TO REPORT at the top of the Task Bar.

1. Display the Quality Management Reporting page: On the Main Menu, click Quality > Under REPORTS, click Quality Management.
2. In the Programs and measures section, select the clinical quality measure (CQM) for the patient list that you want to generate:
   1. Expand the program for which the provider is generating the list (for example, MIPS - Quality Program 2021 (EHR and Registry)) by clicking the plus sign [+].
   2. Select the measure for the patient list (for example, Screening for Tobacco Use).
3. In the Providers section, select the provider whose patient list you want to generate.
4. Exclude inactive patients — Select this option to exclude inactive patients from the patient list (you mark a patient as inactive using the Status menu on the patient Quickview).
5. You can filter the patient list by the following criteria:
• Sex
• Age range
• Race
• Ethnicity
• Language
• Diagnoses

Note: If you do not see these fields, click Show patient filters (to the right of the Export Report button).

6. Click Run Report.

The report shows you the patients for whom the selected measure was "Satisfied" and the patients for whom the measure was "Not Satisfied."

Test patients are patient records created strictly for testing purposes and do not represent a real person's chart. To remain compliant with government regulations for quality programs, make sure that you report and submit data for real patients only.

Note: In accordance with CMS and other quality program sponsors, inactive patients are included in athenahealth certified eCQMs and in quality program submission data on the MIPS Dashboard, the Pay for Performance Dashboard, the eCQM Data page, the Quality Management Reporting page, and in UDS reports.

You can use the Test Patients Identification page to find test patients and mark dummy patients as test patients. Use this page to make sure that test patients are not included in quality reporting when you create test claims, encounters, problems, or diagnoses within the test patient chart.

Note: Patients marked as test patients on the Test Patients Identification page are not included in quality program submission data on the MIPS Dashboard, the Pay for Performance Dashboard, the eCQM Data page, the Quality Management Reporting page, or in UDS reports. (Quality measures appear on the Quality tab of the test patient's chart for testing purposes only.)

Because providers can see patients in multiple departments, the options that you select on the Quality Management Reporting page can affect the report results. When you select specific departments using the Departments field, all providers who have ever seen patients in the selected departments are automatically selected in the Providers list, even if the providers have not seen patients in the selected departments during the current program year.

Note: If you manually deselect one of these providers in the Providers list, athenaOne deselects the department in the Departments list.

Using the Only include patients with an encounter in the selected department(s) option, you can compare the report results of different departments, for example, if you want to compare the population of diabetes patients in different departments.

• Select the Only include patients with an encounter in the selected department(s) option to include in the report only those patients ever seen in the selected departments.
  Important: Any patient who had an encounter with any provider in the selected departments in any year — not only during the current program year — is included in the report.
• If you do not select the Only include patients with an encounter in the selected department(s) option, any patient who is attributed to a selected provider is included in the report results.

In the following example, a quality program is configured to use the rendering provider model for provider attribution. In this model, a patient is attributed to the rendering provider for an eligible encounter during the reporting period or lookback time frame. (For more information about provider attribution models, see the Quality Program Provider Attribution Rules page.)

1. On the Quality Management Reporting page, you select the Blue Hill department in the Departments field.
2. All providers enrolled in quality management programs who see patients in the Blue Hill department are selected in the Providers field, including Dr. Chris Smith, who sees patients in the Blue Hill department and in the Off-Hours Clinic.
   
3. The setting of the Only include patients with an encounter in the selected department(s) option affects the report results as follows:
   • If you do not select the Only include patients with an encounter in the selected department(s) option, Dr. Smith's patients who had encounters in the Blue Hill department or in the Off-Hours Clinic are all included in the report results.
   • If you select the Only include patients with an encounter in the selected department(s) option, only patients of Dr. Smith who had encounters in the Blue Hill department are included in the report results (patients who had encounters with Dr. Smith in the Off-Hours Clinic are not included in the report).

The report results appear under the Report Summaries heading. Each measure has a summary row with links to print or export the detailed report for each measure. The summary rows include the following columns:

• Type — Type of measure.
• Goal — For some programs only, this column indicates the percentage of a provider's results that must be satisfied for the provider to receive payment for that measure. Only certain programs, such as PI Medicaid and MIPS, show threshold values in this column.
• Satisfied — Total number of patients that satisfied the measure requirements.
  Note: Patients excluded from a measure are not included in the calculation of the Satisfied results.
• Not Satisfied — Total number of patients that did not satisfy the measure requirements.
• Total — Total number of patients eligible for the measure.
  Note: Patients excluded from a measure are not included in the calculation of the Total results.
• Excluded — Total number of patients who were excluded from the measure for an eligible reason.
• Status — Status of the measure.

Program column reference

 

When you display the report results by program (using the Group by Program option), the first row for a program includes the following information about that program.

• Program — The name of the program.
• Reporting period — The program's reporting period date range.
  Note: For programs with multiple intra-year submissions (for example, quarterly), the reporting period changes every quarter.
• Submit date — The date that program data will be sent to the third-party adjudicator or program sponsor (for applicable programs).
  Note: Generic guideline programs with data submission show N/A.
• Providers — The number of providers in the practice who are enrolled in the program.

Programs are sorted first by the Reporting period end date and then alphabetically.

 

To view information about specific patients included for a measure, click a linked number in the Satisfied, Not Satisfied, or Total column. The report expands to display patient details for the selected measure.

Note: Patients excluded from a measure are not included in the calculation of the Total and Satisfied results.

You can print or export the patient information for the measure by clicking the Print report or Export to CSV link in the row for the measure.

The following information is provided in the on-screen report and in the printed report. (The exported report includes this information, along with additional information about the provider, the patient, and insurance.)

• Patient ID (link takes you to the patient chart)
• Patient last name and first name
• Date of birth (DOB)
• Age
• Sex
• Phone number
• RAF score (see Patient Risk Adjustment (HCC/RAF) for more information)
• GAP score (see Patient Risk Adjustment (HCC/RAF) for more information)
• Last and next appointments
• Result status
• Result
• Satisfied date
• Supporting documentation, when available (links to documents, encounters, or Health History entries that helped us determine the measure's status)

Report data is current as of the day you run the report, not as of when you created the saved report.

You can toggle between Group by Program and Group by Provider. The default display, Group by Program, groups by Program, Measure, and then Provider. In this view, you can compare providers to each other and view the performance roll-up for each measure. Click Group by Provider to group by Provider, Program, and then Measure.

Click a linked number in the Total column to see the individual patients listed. (The patient list is paginated.) Click a linked patient ID to view the patient chart, or click a linked medication, lab result, etc., to view the associated result for the measure.

• For Chronic measures that could apply to multiple providers who saw the same patient (for example, Mammogram), we "de-duplicate" those patients when aggregating to that measure and label it as a patient count. Therefore, the sum of each provider does not always equal the total for the measure.
• For Episodic measures that always apply to one provider (for example, URI episode), athenaOne counts the number of encounters and labels it as an encounter count.

Tip: You can use the Quality Management Reporting page to submit data for a Quality Management program that athenaOne does not support. To do this, run a Quality Management report for a given measure, download the results to a CSV file, and use the CSV columns to filter the results to show only the patients that qualify for the desired insurance plan.

You can use the Pay for Performance Data Aggregation page to aggregate data for Medicaid PI behavioral/administrative measures (only) from other EHR systems. The data entered on this page is aggregated with measure data currently in athenaOne.

To aggregate quality data for other programs and measures, use the eCQM Data page.

Important: Reports generated on the Quality Management Reporting page do not include the aggregated counts.