PCMH2D

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The practice uses patient information, clinical data and evidence-based guidelines to generate lists of patients and to proactively remind patients/families and clinicians of services needed for:

At least three different preventive care services

Here are some examples of preventive care services that you may want to choose from depending on what's most important to your practice:

• Patients overdue for well visits (pick a specific age range)
• Asthma patients overdue for a seasonal flu shot.
• Patients overdue for developmental screening.
• Patients overdue for Newborn hearing screening.
• Pre-School Vision Screening in the Medical Home.
• Risky Behavior Assessment or Counseling by Age 13 Years.
• Sudden Infant Death Syndrome Counseling.

At least three different chronic or acute care services

Here are some examples of chronic care services that you may want to choose from depending on what's most important to your practice:

• ADHD patients overdue for checkup
• Asthma patients overdue for checkup
• Obesity patients overdue for checkup
• Patients with depression overdue for checkup
• Patients with allergic rhinitis overdue for followup

Description	Example/Screenshot/Documentation	Source	Date Added
This document will provide more details on the above listed preventive and chronic care services and how you could use Partner and/or PCC EHR to generate these lists of patients	Sample PCC EHR Meaningful Use Report	PCC EHR	03/21/13

Patients not recently seen by the practice

To identify patients who may have been overlooked and are in need of services, you would use the Partner recaller report to generate a list of patients who you haven't seen in a while. Use restriction of "Patient Last Visit Date"

Specific medications

You could use the "Patient Lists" functionality in PCC EHR to generate a list of patients given certain medications. This could be used to:

• Manage patients who were prescribed medications with potentially harmful side effects
• Identify patients who would have been prescribed a certain brand name drug versus a generic
• Notify patients about a medication recall