Blog

ChartMaker® 2016 Software Release 6.2.4

Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.2.4). To read a full list of enhancements, view the Release Notes.
Facesheet: Health Alerts Update

Where can I find it?

Clinical: Facesheet - Health Alert

What do I need to know?

The Health Alert button in the Facesheet has been updated so that whenever button becomes active (highlighted), indicating that a procedure is due per the Flow Sheets, you can now click the Health Alert button to access a Health Alerts dialog that will display the Flow Sheet name, and underneath any procedures that are due for that flowsheet.

How do I use it?

Upon upgrade, the new functionality for Health Alerts will be available. When the Health Alert button becomes active, simply double-click it to access the Health Alerts dialog that will outline any procedures that are due.

New Infobutton

Where can I find it?

Clinical: Chart > Infobutton & Alert Manager

What do I need to know?

A new Infobutton dialog has been created that allows you to research and retrieve diagnostic and therapeutic information concerning a patient via MedlinePlus. The Infobutton dialog is accessed through the Chart menu when in a patient’s chart (Chart > Infobutton), or via the  button located at the bottom-left of the decision support Alert Manager dialog.

After the Infobutton dialog has been accessed, you can then configure the various parameters to search, locate, save, and print applicable diagnostic and therapeutic information as needed. In the Patient Search Criteria section of the Infobutton dialog, you can refine you search by the patient’s Age, Birth Date, Birth Sex, Race, Ethnicity, Sexual Orientation, Gender Identity, as well as Diagnoses, Medications, Procedures, and Lab Results. When selecting diagnoses, medications, procedure, and lab results the corresponding drop-down lists will populate with information from the patient’s chart.

After the search criteria has been selected, you can click the Search button, and the system will retrieve any applicable information from MedlinePlus. You can then scroll through the information in the various tabs below, click the various links in the pages as needed, and then once the desired information has been located, you can save or print that information using the corresponding buttons. Any information saved will appear as a hyperlink in the Saved Information section. You can then access that information as needed by double-clicking the link, and the information will open in a tab below. When that information is no longer needed, you can delete it by highlighting the item in the Saved Information section, and then clicking the Delete button.

How do I use it?

Upon upgrading the ChartMaker Medical Suite, the various methods of accessing and searching for information via the Infobutton dialog as described above will be available. You can save, print, and maintain information as outlined.

 

Medication History Updates

Where can I find it?

Clinical: Chart > Medication History

What do I need to know?

The system has been updated with a Medication History dialog that allows you to import Medication History for a patient from the SureScripts Network into the patient’s chart, and then reconcile that information with any medications currently in the patient’s chart. The Medication History dialog is accessed through the Chart menu when in a patient’s chart (Chart > Medication History). The medication history information is also available through the Medication History button in the Prescribe Medication dialog, however, you are not able to import and reconcile medications when accessing via the Prescribe Medication dialog, it is view only from this area.

Do note, to access Medication History for a patient, the patient must have given medication history consent and it must be configured in the Consent dialog for that patient (i.e., in ID Tab > Consent or Medication History Consent button in Prescribe Medication dialog).

When accessing the Medication History dialog, you may first receive a series of dialogs indicating that the system is gathering the information, or that the Medication History is pending for the patient. Likewise, you may also receive dialogs that indicate that there is no history information available for the patient, or that history information could not be retrieved. See below for examples of these types of messages.

In the Medication History dialog, the patient basic demographic information will be listed, along with medication history for that patient. Beside the Medication History title, at the top of the dialog, the number of medication occurrences will appear in parentheses.

At the bottom of the dialog there is a Filter By section that allows you filter the medication history by Medication, Prescriber, and Last Fill Date. After the filter items are configured as desired, simply click the Filter button. You can then view the medication by scrolling through the Medication section, Reconcile the medications, or Print the medication history. When reconciling and printing, only those medications that are included in the filter criteria will be included.

After the Reconcile button has been clicked, a Clinical Information Reconciliation (CIR) dialog will appear that allows you to view and reconcile the various medications, broken into the patient’s Current Chart Medications, Available Medications from Surescripts Medication History, and a Final Merged List. Each list will show the available medication (name, start and last modified dates, last fill date, and sig information) detail.

Medications in the Available Medications from Surescripts Medication History list are color-coded to denote the level of medication information available and the ability of importation. You can click the Legend option for a complete listing. Medications can be moved individually by clicking the Add button, or in bulk using the Add All button. Each medication also includes a Skip checkbox that can be manually selected, but will be turned on if the medication already exists, has an end date that has passed, or if there isn't enough information to import the medication. Medications that have been added will show in the Final Merged List and labels will be updated to show their status as added.

New medications added to the Final Merged List can be edited by using the Change button (except for controlled substances which cannot be changed during the import process). This will open the Prescribe Medication dialog with as much of the available information found in the Surescripts Medication History pre-filled. The Prescribe Medication dialog will also show the original name, dates, and text from the import at the bottom of the dialog for reference.

An added medication can be removed from the list and existing medications can be discontinued on either the final or current list. If a medication is discontinued, the End Medication dialog will appear and then the medication will be marked as ended.

After all the applicable medications have been reconciled, you can Confirm the import. The system will then import the medications in the Final Merged List, and after confirmation messages have been satisfied, you will return to the Clinical Information Reconciliation (CIR) dialog with the medication information updated. An Auto-generated drug log will be created listing the drug details for each medication imported. Likewise, the patient’s facesheet will be updated with the medications imported, and the medications will appear in the patient’s History tab.

How do I use it?

Upon upgrade, the Medication History functionality will be activated. When in a patient's chart click Chart > Medication History to view, import, and reconcile medication information from the SureScripts Network for that patient. (Do note, the patient must have given medication history consent and it must be configured in the Consent dialog to access the medication history.) The work-flow will be similar to that described above. 

 

New Care Plan Widget

Where can I find it?

Clnical: Chart Notes

What do I need to know?

A new Care Plan widget is available to add to chart note templates, via the Template Editor, that allows you to add Health Status, Impressions, Health Concerns, and Goals regarding a patient's health care.

When the Care Plan widget is accessed, a Care Plan dialog will appear allowing you to add, edit, and delete care plan information for the patient.

The Health Status drop-down list will contain pre-configured status items along with the corresponding SNOMED codes. You can select an item or leave this field blank. When a health status is selected, it will appear in the History tab along with the SNOMED description and code.

The Impressions field allows you to enter any free-text impressions or assessments.

The Heath Concerns section allows you to add chart diagnoses that are of concern via the Add Diagnoses button, or additional health concerns in free-text format via the Add Additional Health Concerns button. When adding diagnoses, an Add Diagnoses as Health Concerns dialog will appear listing any active, inactive, or pre-existing diagnoses that are in the patient’s chart; you can simply check any diagnoses you want to include as health concerns. When adding additional health concerns, an Add Health Concern dialog will appear allowing you to add a free-text description of the concern. After diagnoses and additional health concerns have been added, you can edit and remove items by highlighting the applicable items, and using the Edit and Remove button.

The Goals section allows you to add, edit and remove health goals for the patient via the Add Goal, Edit, and Remove buttons. When adding and editing goals, the Add Goal dialog will appear allowing you to select from user-created list of common goals, or to enter or modify a free-text goal for the patient. Likewise, the Initiated By field allows you to associate who initiated the goal: Provider, Patient, or Both. Common goals can be maintained via the Goal Maintenance dialog accessed by Edit button. Goals added in the Goals Maintenance dialog can be shared with other users in the system, as desired. When a new goal is added, it will appear in the patient’s History tab with the text of the goal.

In addition, in the Note output field you can determine how this information is outputted to the note. You can choose to output the configured information in List format, Paragraph format, or No Output.

When creating a note with a Care Plan button, if the patient already has a Care Plan from a previous note, all the previously entered information will automatically be pulled into the new note. When opening the Care Plan dialog, you can view, edit, and remove items done previously. A patient will only have one active care plan at any time, and this information will be included when generating Transition of Care documents for the patient.         

How do I use it?

Upon getting the upgrade, a Care Plan option will be available in the Template Editor to add the Care Plan widget to applicable chart note templates. Once the widget has been added to a template, simply click the Care Plan button from inside a chart note to access the Care Plan dialog.  Then select and enter the applicable information and options as needed, and then click the OK button once finished.

Medicaid EHR Incentive Program Will Continue through 2021

The Centers for Medicare & Medicaid Services (CMS) would like to remind eligible professionals (EPs) and eligible hospitals that the Medicaid EHR Incentive Program, which is administered voluntarily by states and territories, will continue through 2021.

To participate in the program in 2017, EPs and eligible hospitals must attest to:
• Modified Stage 2 objectives and measures, or
• Stage 3 objectives and measures

To learn more, visit the 2017 program requirements page on the EHR Incentive Programs website. For state-specific information and resources, review the Medicaid State Information page.

Incentive Payment Information
• There are no payment adjustments in the Medicaid EHR Incentive Program.
• EPs and eligible hospitals who meet program requirements can continue to attest to their state

Medicaid agencies to receive yearly incentive payments
• The incentive payment is a fixed amount for each year of participation.
• EPs and eligible hospitals can receive incentive payments for six years nonconsecutively. EPs and eligible hospitals who began the program in 2016 must participate consecutively to receive the full payment amount over six years.
• Eligible hospitals that are eligible to participate in the Medicare and Medicaid EHR Incentive Programs may attest under Medicare to avoid a payment adjustment.

Please note: 2016 was the last year EPs and eligible hospitals could begin participation in the Medicaid EHR Incentive Program. Medicaid EHR Incentive Program and the Merit-based Incentive Payment System (MIPS) MIPS does not replace the Medicaid EHR Incentive Program. If a provider plans to participate in the Medicaid EHR Incentive Program through their state and they are also a Medicare Part B clinician who is eligible for MIPS, they will also need to participate in the MIPS program to avoid a negative MIPS payment adjustment.

For More Information
• Visit the EHR Incentive Program website
• Email your question to EHRInquiries@cms.hhs.gov
• To learn more about MIPS, visit qpp.cms.gov

CMS News Updates

Quality Payment Program Hardship Exception Application for the 2017 Transition Year Is Now Open
The Quality Payment Program Hardship Exception Application for the 2017 transition year is now available on the Quality Payment Program website. MIPS eligible clinicians and groups may qualify for a reweighting of their Advancing Care Information performance category score to 0% of the final score, and can submit a hardship exception application, for one of the following specified reasons:

• Insufficient internet connectivity
• Extreme and uncontrollable circumstances
• Lack of control over the availability of Certified EHR Technology (CEHRT)

There are some MIPS eligible clinicians who are considered Special Status, who will be automatically reweighted (or exempted in the case of MIPS eligible clinicians participating in a MIPS APM) and do not need to submit a Quality Payment Program Hardship Exception Application. For more information about the Quality Payment Program hardship application process, visit the Quality Payment Program website.

EHR Incentive Program Hardship Exception Application
Eligible professionals (EPs) who are first-time participants in the Medicare EHR Incentive Program in 2017 are also eligible to apply for a one-time hardship exception. Applications are due by October 1, 2017.
A first-time EP may apply for this one-time significant hardship to avoid a 2018 payment adjustment if:
• The EP is a first-time participant in the EHR Incentive Program in CY 2017 and intends to participate in the Medicare EHR Incentive Program in CY 2017, and:

• The EP is transitioning to MIPS for the 2017 performance period, and
• The EP intends to report on measures specified for the Advancing Care Information performance category under the MIPS in 2017.

Visit the EHR Incentive Programs website and download the instructions on how to apply for this EHR Incentive Programs hardship application.

For more information, contact:
• Quality Payment Program Service Center at 1-866-288-8292 or TTY: 1-877-715-6222 or QPP@cms.hhs.gov.
• Electronic Health Record (EHR) Information Center at 1-888-734-6433 (press 1).

ChartMaker® 2016 Software Release 6.2.3

Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.2.3). To read a full list of enhancements, view the Release Notes.
Audit Trail Updates

Where can I find it?

Clinical: Chart > Audit > Audit Trail

Practice Manager: Administration > Utilities > Audit > Audit Trail

What do I need to know?

The Audit Trail has been updated to track when user privilege information is modified in Clinical and the PCADMIN module.

When an user privilege event occurs in Clinical, the Event column will display Modified; the Group column will display User; the Audit Trail Description will display Privilege changed: [Privilege Modified]; the Old Value and New Value will contain the applicable privilege settings; and the User Name will be listed in the Metadata column.

When a user privilege event occurs in PCADMIN, the Event column will display Modified; the Group column will display User; the Audit Trail Description will display Privilege changed: [Privilege Modified]; the Old Value and New Value will contain the applicable privilege settings; and the Practice ID and User Name will be listed in the Metadata column.

How do I use it?

Upon upgrading the ChartMaker Medical Suite, the system will automatically track any changes to user privileges in Clinical and PCADMIN, and display them in the Audit Trail as outlined above. No user intervention is needed.

Faxing: Open Text Fax Appliance Updates

Where can I find it?

Clinical: Chart Notes & Organizer - accessed via Chart > Fax

What do I need to know?

The system has been updated so whenever you access the Fax dialog when faxing a note or notes, all of the referring physicians in the Patient referring physicians tab will be defaulted into the Selected recipients column. Likewise, the Patient referring physicians tab has been updated with a select all button (>>) and a deselect all button (<<) to easily toggle all patient referring physicians to selected or to deselected as needed. Do note the select all and deselect all buttons are only available in the Patient referring physicians tab.

How do I use it?

Upon upgrade, if using an Open Text Fax Appliance, these updates will automatically appear when accessing the Fax dialog.

 

Mobile App: Charge Capture Update

Where can I find it?

Mobile App: Charge Capture

What do I need to know?

The Dx Search functionality has been updated so that when searching for diagnoses by code the system will navigate the result to the exact category searched for. Any sub-categories will then be listed below. Likewise, above the search results you can then tap the < option to navigate to broader categories that the search criteria fall under.

          

How do I use it?

Upon upgrading the ChartMaker Medical Suite, as well as the Mobile App, these changes do not require intervention on the user's part in order for them to be displayed. You do, however, need to be enrolled for the Mobile App. If you are not yet enrolled, you can enroll here.

Scan Manager Updates

Where can I find it?

Clinical: Chart > Scan Documents or Notes > Scan Documents

What do I need to know?

The Scan Management dialog has been updated with a Scan as Educational Materials option that allows you to tag scanned documents for a patient as education materials. Once the scanned documents tagged as educational materials have been brought into the chart, they can then be sent to the patient portal for the patient. Per MIPS 2018 and Meaningful Use Stage 3/ONC 2015 requirements providers will only receive credit for educational materials sent electronically to the patient via the patient portal. This option allows you to still receive credit for any hard-copy educational materials given to the patient during their visit.

In addition, the Scan as Lab Result and the Scan as a Progress Note not created in Clinical options have been removed since they are no longer needed. Likewise, the Scan as… options have been reordered alphabetically.

How do I use it?

Upon getting the upgrade, when accessing the Scan Manager, the new options will appear as outlined above. You can configure the options as applicable when scanning documents.

Ransomware Campaign

The U.S. government is aware of an international ransomware campaign that may be affecting Healthcare and Public Health Sector assets in addition to other Sectors. You may forward this message broadly with no restrictions.

You may send additional questions to cip@hhs.gov

HHS/ASPR Critical Infrastructure Protection Program

If you are the victim of a ransomware attack

If your organization is the victim of a ransomware attack, HHS recommends the following steps:

  1. Please contact your FBI Field Office Cyber Task Force (www.fbi.gov/contact-us/field/field-offices) or US Secret Service Electronic Crimes Task Force (www.secretservice.gov/investigation/#field) immediately to report a ransomware event and request assistance. These professionals work with state and local law enforcement and other federal and international partners to pursue cyber criminals globally and to assist victims of cyber-crime.
  2. Please report cyber incidents to the US-CERT (www.us-cert.gov/ncas) and FBI’s Internet Crime Complaint Center (www.ic3.gov).
  3. **NEW**If your facility experiences a suspected cyberattack affecting medical devices, you may contact FDA’s 24/7 emergency line at 1-866-300-4374. Reports of impact on multiple devices should be aggregated on a system/facility level.
  4. For further analysis and healthcare-specific indicator sharing, please also share these indicators with HHS’ Healthcare Cybersecurity and Communications Integration Center (HCCIC) at HCCIC@hhs.gov

Mitigating against this threat

  • Educate users on common Phishing tactics to entice users to open malicious attachments or to click links to malicious sites.
  • Patch vulnerable systems with the latest Microsoft security patches: https://technet.microsoft.com/en-us/security/bulletins.aspx
  • Verify perimeter tools are blocking Tor .Onion sites
  • Use a reputable anti-virus (AV) product whose definitions are up-to-date to scan all devices in your environment in order to determine if any of them have malware on them that has not yet been identified. Many AV products will automatically clean up infections or potential infections when they are identified.
  • Monitor US-CERTfor the latest updates from the U.S. government. See below for current reporting.
  • Utilize HPH Sector ISAC and ISAO resources. See below for further information.

US-CERT Resources

Multiple Petya Ransomware Infections Reported

06/27/2017 12:56 PM EDT

Original release date: June 27, 2017 US-CERT has received multiple reports of Petya ransomware infections occurring in networks in many countries around the world. Ransomware is a type of malicious software that infects a computer and restricts users' access to the infected machine until a ransom is paid to unlock it. Individuals and organizations are discouraged from paying the ransom, as this does not guarantee that access will be restored. Using unpatched and unsupported software may increase the risk of proliferation of cybersecurity threats, such as ransomware.

Petya ransomware encrypts the master boot records of infected Windows computers, making affected machines unusable. Open-source reports indicate that the ransomware exploits vulnerabilities in Server Message Block (SMB). US-CERT encourages users and administrators to review the US-CERT article on the Microsoft SMBv1 Vulnerability and the Microsoft Security Bulletin MS17-010. For general advice on how to best protect against ransomware infections, review US-CERT Alert TA16-091A. Please report any ransomware incidents to the Internet Crime Complaint Center (IC3).

Sector ISAO and ISAC resources

National Health Information-Sharing and Analysis Center has shared the following TLP-White Message and will continue to share information at nhisac.org.

HITRUST has shared the following Threat Bulletin for distribution.

ONC and OCR resources

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