I'VE SIGNED UP . . . WHAT HAPPENS NOW?

When your EHR is fully integrated with AOA MORE, you will receive an email  notification from the AOA with login instructions and information on how to view your data. You will also receive information from your EHR vendor on any specific updates or requirements needed to complete the process.

IMPORTANT: Continue to report PQRS data to CMS by traditional reporting methods (claims-based, EHR, web interface or qualified registry) until your AOA MORE dashboard shows 50% completion success on all 9 measures. Once integrated, your EHR vendor will push data into the registry from January 1, 2016 to allow for a complete reporting year.

2016 Reporting Year Information

For the 2016 Meaningful Use measure related  to use of a specialty registry, the CMS imposed deadline of February 29th for returning program participants has passed. For doctors new to the program, the deadline would be 60 days into the doctor's chosen 90-day reporting period.  The final reporting period of the year will begin on October 3, 2016 which would make December 1, 2016 the last day to register with MORE for the 2016 reporting period. For additional information on 2016 reporting, Click Here. 

Please note, legislation has been introduced in Congress that would make the reporting period for the EHR Incentive Program 90 days for ALL program participants. Look for updates in future AOA publications.

I missed the February 29 deadline for 2016 Meaningful Use registration with a specialty registry . . .  what can I do now?  Click Here. 

Doctors can enroll at any time for future reporting and outcomes benchmarking with peers. Additionally, by signing up for AOA MORE this year, doctors can meet the Meaningful Use specialized registry reporting measure for next year.  

2015 Reporting Year Information

Doctors who feel they were unable to meet the 2015 EHR Incentive Program requirements because of the late release of the program rules last year or due to a different hardship, such as financial distress or insufficient internet connectivity, need to submit their hardship application by July 1, 2016. For additional information on 2015 reporting, Click Here.

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EHR Participants

Click here for a list of current and prospective vendors.
Additional EHR vendors are being added with each new release of AOA MORE.  Enroll even if your vendor is not yet listed.

Additional EHR vendors will be added in future releases of MORE.

 

Resources

What is AOA More

 

Why do we need a registry

 

How to enroll

 

Frequently Asked Questions

What is a registry?
A registry is a private, secure database that will integrate data from a doctor’s electronic health record (EHR). A registry provides a systematic way of collecting patient data and reporting that data as needed.

What is the name of AOA’s registry?
AOA MORE (Measures and Outcomes Registry for Eyecare) by Prometheus l Research

How and why was AOA MORE developed?
The Registry project was initiated by the AOA Board of Trustees in response to the growing emphasis on quality reporting and measurements through registries as part of healthcare. We partnered with Prometheus Research because of their experience and reputation in developing high quality registries.

What other specialties are currently using registries?
Most health care professions are already using registries or are in development to build a registry. Some examples of professions already using registries include: cardiology, oncology, osteopathy, and ophthalmology.

Where can I find additional information about AOA MORE?
Visit aoa.org/MORE to find many valuable resources that will introduce you to the benefits of AOA MORE and explain how registries are being used in health care. There is additional contact information available at aoa.org/MORE should you not find all the answers you are looking for.

What are the values and benefits of participating in AOA MORE?
A registry will allow you to participate in the new value-based payment system that Medicare and other insurers are using. Your participation in a registry is one of the requirements for maximum reimbursement rates by Medicare. This new Merit-based Incentive Payment System (MIPS) includes PQRS, Meaningful Use, and other clinical quality improvement measures. AOA MORE will allow optometry, as a profession, to analyze clinical outcomes for the benefit of improving care over time. This can apply to glaucoma care, contact lens care, pediatric care and more.

AOA MORE will offer our profession the ability to track outcomes that can be analyzed and then improved by our profession. For example, amblyopia, diabetes and contact lens complications can all be studied by using a registry.

AOA MORE seamlessly integrates data from your electronic health record to allow PQRS reporting and benchmarking. Benchmarking is a privately viewed comparison of your care to the profession as a whole. For example, you can see your performance rates on PQRS measures compared to national averages or the number (%) of glaucoma patients you diagnose compared to national averages in optometry. You can also see the demographics of your patient population compared to the overall population numbers. AOA MORE will show many more levels of clinical and practice information with each new program release and we’ll welcome your feedback in what you would like to see moving forward.

The AOA has recognized the movement towards quality reporting and its value in healthcare. The AOA Board of Trustees believes its members deserve to be at the forefront of the new healthcare paradigm that is requiring registry use. AOA MORE is offered as a member benefit with no additional costs to members and will soon be available for a fee to non-members.

Will AOA MORE help advocacy efforts for the profession?
Yes! Optometrists provide a high level of eye health and vision care. AOA MORE will allow the profession to advocate on behalf of optometry. For example, with data from AOA MORE, we can advocate to the media and public about patient demographics and quality eye exams we collectively perform. AOA MORE will allow optometry to advocate to insurance regulators, state legislatures and to the public about the services and value of our profession.

How does “benchmarking” work?
ODs will be able to access statistics derived from their own patient base by viewing the AOA MORE dashboard. AOA MORE is preprogrammed to provide statistics on many topics including: your patient demographics compared to national averages; your most common diagnosis codes compared to national averages; and your most common medicines prescribed compared to national averages and only the national numbers are visible to AOA, your personal dashboard is private for your viewing only. In addition, ODs can access benchmarks that compare your patients and care to the profession as a whole. Initially, AOA MORE will show you benchmarks of PQRS measures, glaucoma measures and more. For example, you will see the % of glaucoma patients and glaucoma suspects you have seen in the past 12 months. These measures will be expanded in the future with more information about existing measures and additional measures, with each new release.

What dashboards are available?
AOA MORE will offer different dashboards to view your patient information. The PQRS dashboard provides your current year-to-date performance on PQRS measures. The Practice dashboard will allow you to view aggregate statistics about your patients (e.g., demographics, diagnoses, etc.) and the care provided to them, For example, you will be able to view the number and percentage of patients in the past 12 months with either glaucoma or suspected glaucoma, or the most common medications you prescribe compared to the national averages. AOA MORE will add a feature soon that allows you to easily see how many visual fields and OCTS were ordered for those glaucoma and suspected glaucoma patients compared to national averages. For each measure, you will be able to view these numbers and percentages both within and across service locations (if you are in multiple settings) as well as for the registry as a whole.

Is there a practice-level dashboard?
No. If you have multiple doctors in your practice, each doctor can only view their own patients. The viewing of dashboards is private for each doctor.

Will AOA MORE help with Maintenance of Certification?
In the future, AOA MORE will offer a service that enables providers to view their progress toward Maintenance of Certification. We are planning these services to be included in a later release.

How easy is it to use AOA MORE?
AOA MORE is simple to use because it integrates with your EHR. AOA MORE does not fetch data directly from your EHR; your EHR will "push" information to AOA MORE on a weekly basis. This will provide the data you view in your dashboard and reports. There is no manual entry required for AOA MORE.

How do I sign up for AOA MORE?
AOA members can go to www.AOA.org/MORE to sign up. You will need to log in to the AOA member section of AOA.org to sign up. If you are a non-member, the www.AOA.org/MORE site will announce when the AOA payment process is available.

What is the cost of AOA MORE?
AOA MORE is a member benefit to those that are current with their dues. Non-AOA members will pay $1,800 per year to use AOA MORE.

Are there prorated fees for non-AOA members?
No.

Who is eligible to use AOA MORE?
Any AOA Member OD using a participating partner EHR can sign up for AOA MORE.

I am in partial practice; do I have to pay full price?
AOA MORE is an AOA member benefit. There are no additional costs for AOA members. The fee for non-members will be $1,800 per year, regardless of the number of hours you work per week. The registry is being programed to accept non-member payments and once open, will be announced for enrollment.

What if I’m in multiple practices or locations?
Your Individual National Provider Identification (NPI) number is what ties you to the registry and it can be used with multiple locations. This occurs automatically if you use the same EHR installation in multiple locations under the same practice. However, if you work in multiple practices, each practice will need to sign up for the registry and authorize its EHR vendor to release data to the registry.

I am an associate in my practice (not an owner); can I sign up for AOA MORE?
Yes, associates can sign up for AOA MORE but they will need their practice’s owner to sign an agreement to authorize the associate OD to use AOA MORE. The owner is not required to use AOA MORE.

Do my patients need to sign anything to be in AOA MORE?
Patients do not need to sign additional forms, i.e., additional HIPAA disclosures. Because your EHR has coordinated with the registry to remove patient identifying information (patient name, etc.), additional forms are not necessary.

Is training required to use AOA MORE?
AOA MORE is set up to be intuitive. However, like most new things, there is some learning that needs to occur. www.aoa.org/MORE will have resources, including video education and screen shots to provide you with step-by-step instructions on the use of AOA MORE. Help is also available within AOA MORE. Most measures have a “how is this measure calculated” and a “HELP” dashboard displays when you are logged into AOA MORE.

What do I do if my vendor is not listed?
AOA MORE will be expanding to add additional EHR vendors. If your vendor is not currently integrated, please still sign up. When you register for AOA MORE, the form will ask you what EHR you are using, and we will track the demand of additional vendors going forward. In addition, we encourage you to let your vendor know your preference to participate in the registry.

What is PQRS?
PQRS is the Physician Quality Reporting System. Started by Medicare in 2007 as PQRI (Physician Quality Reporting Initiative), it requested reporting of codes on their claims to indicate that specific tests, counseling or documentation was performed during a patient encounter. For example, if you saw a patient with glaucoma and documented the cup to disc ratio, then you would report code: 2027F. This told Medicare that you properly documented the cup to disc ratio. While it may seem obvious that optometrists should document a cup to disc ratio on a glaucoma patient, evidence shows that many doctor specialists in many areas of medicine do not properly document their findings.

PQRS started as a voluntary program that gave doctors bonus money for complying. Now it gives financial penalties to doctors who do not participate.

What is an eCQM?
The short answer is: electronic Clinical Quality Measure. Optometrists will see eCQMs as part of Meaningful Use Stage 2 (MU2), Meaningful Use Stage 3 (MU3) and also with PQRS. eCQMs are essentially an internal component of your EHR that is sent to AOA MORE. It’s the internal communication that allows your EHR to communicate with AOA MORE.

Electronic Health Record vendors have internal counters to track eCQMs. For example, many vendors have a specific letter that, if you generate it for your patient, will pull all the diabetic retinopathy info from your fundus exam findings in your eye exam and populate the information into the diabetic retinopathy letter. That letter (after you generate it) is then counted toward your eCQM for sending the PCP a letter about your patient with diabetic retinopathy. AOA MORE tracks your eCQMs and allows reporting to CMS in that format.

I am using AOA MORE, do I still have to submit PQRS on my claims?
Your 2016 PQRS data will be the first time AOA MORE is able to submit to CMS on your behalf (reported by the end of February 2017). This is a change from previous AOA discussions and is based on CMS registry changes in October 2015. AOA MORE is allowed to submit your 2016 PQRS. By doing so, you will no longer have to report additional “claims-based” codes like 2027F, etc. As long as you are properly documenting in your EHR, AOA MORE is programmed to recognize your compliance with PQRS. Your AOA MORE dashboard will show you up-to-the-week reliable reports of your PQRS compliance, virtually ensuring your ability to adapt year round.

Each integrated EHR functions differently and you will want to understand from your EHR vendor how the “eCQMs” are identified (see eCQM question in this FAQ). Understanding how the eCQMs are identified will ensure that you are documenting the proper data fields to ensure you are PQRS compliant.

Keep in mind that AOA MORE is using eCQMs to tabulate PQRS because CMS is emphasizing eQCMs as the best standard for reporting. This is a different source than the more traditional standards of “claims-based” PQRS (doctor self-reported) and “EHR-based” PQRS (EHR reports). That means that the numbers you see in your AOA MORE dashboard may vary from reports you get from reports that you receive from your EHR. Registry-based PQRS varies somewhat from the traditional claims-based PQRS. The bulk of it is the same but the minor differences may cause EHR driven reports to vary from your AOA MORE dashboard.

What happens in 2016?
Starting in January 2016, AOA MORE will collect your PQRS data for one full year. This means in 2016, PQRS data will be sent to AOA MORE (automatically done through your EHR integration on a weekly basis).

If you join AOA MORE after January 1, it has been programmed to identify your PQRS documentation dating back to January 1 and you will still be able to submit one year of data (reporting for 2016 occurs by you any time during the first 60 days of 2017) even if you joined AOA MORE mid-year.

As long as you are using AOA MORE and submitting your data to AOA MORE, you will no longer need to do extra written codes (i.e., 2027F, 2019F, etc.)—MORE will do it for you and you will no longer have to report through your EHR system! You will be required to formally “agree to submit” this data to PQRS when it’s time to do so (for 2016 this occurs during the first 60 days of 2017), as that, too, is a requirement of CMS. AOA will notify doctors when it’s time to report and remind all AOA MORE users of the deadlines.

How do I submit my PQRS data into the registry?
Your EHR vendor will securely push your PQRS data to AOA MORE, which will then calculate your PQRS measures for you. Once the data is in the registry, you will simply review and formally approve the data for submission during the PQRS data submission period (typically January 1 to February 28 of the following year). Only then will AOA MORE submit the data to CMS on your behalf.

CMS is moving PQRS in the direction (for EHR users) of using eCQMs as the reporting mechanism to satisfy PQRS. The eCQMs will make documentation easier for ODs. If you have taken the recommended clinical actions (i.e., documented the optic nerve findings on a glaucoma patient), it will automatically generate the appropriate required eCQM/PQRS data. AOA MORE is designed with your EHR vendor so that eCQMs are submitted to meet PQRS needs. Most EHR vendors have a worksheet to explain what data fields in the EHR correlate to the eCQM. Your AOA MORE dashboards will give you a snapshot of how you are doing with these quality measures over time.

Will AOA MORE satisfy Modified MU Stage 2 Registry requirement?
AOA MORE is considered a “specialized registry” in the eyes of CMS. That means it will satisfy Modified Meaningful Use Stage 2 (MMU2). MMU2 is the new terminology that started in 2015 for anybody entering into or already in Stage 2.

Do the displayed PQRS performance rates include Non-Medicare patients?
When your practice authorizes your EHR vendor to release data to AOA MORE, it includes all patients regardless of their payer. Therefore, if you see Medicare patients in your practice and your practice’s EHR is sending data to the registry, then Medicare patients will be included in the calculation of PQRS measures prior to submitting the data to CMS.

..

How easy is it to use AOA MORE?
AOA MORE requires the use of one of our approved EHR vendors. The list of approved vendors is constantly expanding. AOA MORE has worked with EHR vendors to ensure that data entered into your electronic exam record flows accurately to AOA MORE. You will have to sign on with a user name and password to see data in AOA MORE and your data will only be visible to you and no one else. AOA MORE has a dashboard for you to view weekly updates on your progress. It will show you analysis of your glaucoma patients, laser patients, and more. It is intended to strengthen your patient care by providing you with frequent comparison feedback. Keep in mind, the comparisons you see are from across the nation.

Can you manually enter data into AOA MORE?
There is no plan to have manual data entry into AOA MORE. We view the success of AOA MORE to be that ODs can use their valuable time to see patients and not become data entry technicians and if you are allocating manual data entry to someone else, there is the potential of human error. By simply filling out your EHR exam form and having it linked to AOA MORE, you can participate with minimal effort.

Which EHRs are supported?
At launch in June 2015, AOA MORE will be supported by RevolutionEHR, Compulink and MaximEyes. The plan is to bring on additional EHR vendors as quickly as possible and there are many vendors already preparing to be part of the next release. If your vendor is not supported, please register with AOA MORE so we know which EHRs are most in demand.

What browsers are supported?
AOA MORE supports Google Chrome, Firefox, Safari, and Internet Explorer (version 8 or above).

How does data get from my EHR to AOA MORE?
Each week, the participating EHR vendors send clinical data from their systems to AOA MORE's receiving area. AOA MORE is not going into your EHR to get data. The information is “pushed” from your EHR to AOA MORE by systems your EHR vendor put into place. Data is encrypted using industrial-strength encryption and remain encrypted while in transit and at rest. Once the data has been validated and processed, it is imported into the registry where it is stored securely.

Who is Prometheus Research?
Prometheus Research is AOA’s partner in designing, building, and supporting AOA MORE and its many functions. They have spent the past decade building integrated registries to address the challenges of acquiring, integrating, and repurposing health data for biomedical researchers, academic health centers, philanthropic institutions, and professional societies. Staffed by a unique combination of clinical research informaticians and open-source software engineers, they stand apart from traditional “registry” companies with a partnership model that avoids software licensing fees and vendor lock-in strategies. Instead, they embrace the model in favor of empowering their clients to the point that they will no longer need most—if not all—of Prometheus’ expert data management consultation once the registry is completely built and running. Of course, Prometheus Research will continue to house and maintain the registry for AOA into the future and make improvements as needed.

What data is shared with AOA? Is it de-identified?
Only de-identified aggregate data is shared with the AOA. This data is used for benchmarking, i.e., the number of diabetic eye exams you performed last year compared to your peers. No individual patient data or doctor specific data can be seen by the AOA. Only individual doctors can see their own data.

How is data de-identified?
Prometheus Research and your EHR vendor have worked together to program AOA MORE. Data fields like a patient’s name, address, phone number, etc., are fields that will only be included in your reporting for reimbursements and are not included in the information to the AOA. The information about you and your practice are only used for you to see your dashboards and will not be visible to any reviewers or users of AOA MORE. It’s very important that your information stay private to you, and therefore AOA MORE will require that you enter a user’s name and password to view your data. All other viewing of data will be in aggregate/cumulative formats.

Single Sign On (SSO)
You can sign into AOA MORE using your AOA.org log in credentials. AOA employs Single Sign On to allow access to AOA MORE. SSO is a method by which one login ID works for multiple applications. In this instance, the same username and password that is used to access areas of AOA.org can also be used to access AOA MORE.

Do I need to install/download anything?
No. AOA MORE is configured at the level of the EHR vendor interface to retrieve the data from an individual provider's EHR. All set-up and configuration should be handled by EHR vendors and Prometheus Research for you. There are some vendors using software based systems versus cloud based systems, but they are required to do a central location of collection so your data can be pushed to Prometheus without you having to perform this step.

Can my staff (other than providers) access AOA MORE?
Yes, but only if you elect to provide access to any of your staff. Designated staff members may view your data in AOA MORE if you grant them access. Since you, the provider, grant these rights to the view the data, you may elect to revoke these rights to staff members at any time, but may require password changes, etc.

What information will be captured during this first release of AOA MORE?

Where do I learn MORE?
You can get additional information at aoa.org/MORE. There you will find FAQs, videos and other resources to teach you about AOA MORE and registry use in general.

Where do I go for technical support?
If you need technical support, first go to aoa.org/MORE.

I joined and cannot see my data in my AOA MORE dashboard. What happened?
If you have just signed up for AOA MORE, it will take 2-3 weeks for your registration and verification to be finalized. This critical time period is one where Prometheus tests that all data is being transmitted accurately from the EMR vendor. Once finalized, your data will be successfully “pushed” from your EHR to the registry and you can view AOA MORE dashboard statistics. After that, data is pushed once a week so you won’t see updates instantaneously. You will see them weekly.

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