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MIPS Participation Status Letter

The Centers for Medicare & Medicaid Services is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System. MIPS is an important part of the new Quality Payment Program. In late April through May, practices will get a letter from the Medicare Administrative Contractor that processes Medicare Part B claims. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number or TIN in a practice. Read More →

ChartMaker® 2016 Software Release 6.2.1

Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.2.1). To read a full list of enhancements, view the Release Notes.
Manage Direct Messaging Addresses

Where can I find it?

Clinical: To-Do > Direct Messaging > Manage Direct Addresses

What do I need to know?

The system has been updated with a new Direct Address Manager dialog that offers you the ability to administer not only which users can send and reply to direct messages, but also determine which specific addresses they can use when sending and replying to them. This allows you to limit who can send messages, and for whom, to ensure that only the appropriate users are sending direct messages for appropriate addresses.

Only users authorized with the Manage Direct Addresses privilege (configured via Edit > System Tables > User) will be allowed access to the Direct Address Manager dialog.

The system will default with the Use Simplified Direct Messaging option selected, which allows all active users to send direct messages for all valid direct message addresses in the practice. Likewise, when this option is selected, the Users and Associated Addresses sections will be disabled.

 

When the User Simplified Direct Messaging option is deselected (unchecked), the Users and Associated Addresses sections will become active, allowing you to assign specific direct message addresses for users.

To assign an address for a user, highlight a user in the Users section, select the applicable addresses in the Available Addresses column, and then click the > button. The selected addresses will then appear in the Assigned Addresses column, and these are the addresses that will be available in the From field of the New Direct Message dialog when sending and replying to direct messages.

Assigned Addresses can be removed for the selected user by highlighting the applicable address, and then clicking the < button.

When the User Simplified Direct Messaging option is deselected, if a user is not assigned an address, they will not be allowed to send or reply to direct messages. This is how the administrators would limit who cannot send and reply to direct messages.

How do I use it?

You will need to be authorized with the Manage Direct Addresses privilege (configured via Edit > System Tables > User) to access the Direct Address Manager dialog. Authorized users can access the Direct Address Manager dialog by clicking To-Do > Direct Messaging > Manage Direct Addresses... Configure the address information as desired, and then click OK to save your changes.

Export Patient Data

Where can I find it?

Clinical:
Chart > Export > Patient Data
Chart > Export > To HIE

What do I need to know?

The Export Patient Data dialog has been redesigned and updated with ability to export a Clinical Summary document for a single patient using the Note Selection (Clinical Summary) option; or export a Continuity of Care Document (CCD) for a single patient, or for multiple patients using the Date Range option. Do note, however, when accessing this dialog when a patient’s chart is opened, that patient will default as the selected patient and you will not be able to export CCDs for multiple patients, just for the selected patient.

When the Note Selection (Clinical Summary) option is selected, the Patient section allows you to search for and select the patient for whom you would like to export a Clinical Summary. The Options section allows you to select the Note for export, view Previous Summaries for the selected patient, configure the user Preferences for the clinical summary, Password protect file, as well as Close window after Save/Print. These options work as they did in previous versions of Clinical, however, when the Password protect file option is selected, a Document Encryption dialog will appear allowing you to enter and verify a document password after the Save or Print button is clicked.

When the Date Range option is selected, you can configure a From and To date for the date range you would like to capture in the exported document. The Patient section allows you to search for and select patients for whom you want to include in the CCD. Patients are selected by highlighting applicable patients in the search results (upper) pane, and clicking the Add selected patients button. Likewise, patients can be removed from the selected patients (lower) pane, by highlighting the applicable patient(s), and then clicking the Remove patients button.

The Options section allows you to select the Provider, Document Type, Password protect file, as well as Close window after Save/Print. These options work as they did in previous versions of Clinical, however, when the Password protect file option is selected, a Document Encryption dialog will appear allowing you to enter and verify a document password after the Save or Print button is clicked.

Due to the changes made to the Export Patient Data dialog, as well as to streamline functionality, the HIE Export options have been moved to a separate HIE Export dialog (accessed via Chart > Export > To HIE). The Patient List, Provider Selection, HIE Selection, and Note Selection options work, and will become active, as they did in previous versions of Clinical.

 

How do I use it?

Upon upgrade, click Chart > Export > Patient Data to export patient data to a file or to print that data. Configure the various options for the patient data you want to export, and then click the Save or Print button. Click Chart > Export > To HIE to export patient data to a Health Information Exchange. Configure the various options for the patient data you want to send, and then click the Send button.

Schedule Patient Data Export

Where can I find it?

Clinical: Chart > Export > Schedule Patient Data

What do I need to know?

The system has been updated with a new Schedule Patient Data Export dialog (accessed via Chart > Export > Schedule Patient Data) that gives you the ability to configure scheduled exports of patient data. You can Add multiple exports as your needs dictate, modify the configurations of those exports via the Properties button, and Remove export configurations when they are no longer needed.

When adding, or modifying, scheduled export configurations via the Add and Properties button, you will access a Schedule Patient Export dialog that allows you to configure the various parts of the scheduled export from General information, to the Schedule parameters, to the Patient Selection process, to Information Selection of data to be sent, to a Summary of the scheduled export configuration.

In the General stage, you can Name the export configuration you are adding or modifying, as well as configuring the Status to enable or disable the export. The Output directory field displays the location where the generated export file will reside when finished.

In the Schedule stage, you can choose when you would like to Start the export, whether it starts Now, or Later at a selected date and time. You can also determine the Frequency in which the export will be performed: One Time or Recurring. When the Recurring option is selected, you can choose whether the export will occur Daily, Weekly, or Monthly.

When Daily option is selected, you can choose to export every user-configured number of days, or every weekday. When the Weekly option is selected, you can choose to export every user-configured number of weeks. When the Monthly option is selected, you can choose to export every user-configured number of months, or on a specific day of the week for every user-configured number of months.

In the Patient Selection stage, you can choose patients by Provider or Patient’s name. When the Provider option is selected, you can select the applicable provider, and then select patients based on patients seen in the last user-configured days, months, years, or a selected date range. When the Patient’s name option is selected, you can search for and select applicable patients in the system.

In the Information Selection stage, you can the amount of information to be included in the export. Here you can select to include all information from the last visit, all information from all visits, all information for the user-configured number of last days, months, or years, or for a selected date range.

In the Summary stage, you will be able to review the scheduled export configuration. If the information appears correct, you can click the Finish button. The scheduled export will become active and you will be returned to the Schedule Patient Data Export dialog where you can add, modify, and remove scheduled exports as needed.

How do I use it?

Upon upgrade, click Chart > Export > Schedule Patient Data to add, modify, or remove a scheduled export. Once the Schedule Patient Data Export dialog has been accessed, click the Add button to create a new scheduled export, configure the General information, the Schedule parameters, the Patient Selection process, Information Selection of data to be sent, and then when finished in the Summary section, click the Finish button.

To modify a scheduled export, highlight the applicable export in the Schedule Patient Data Export dialog, and then click the Properties button. You can then click through the various sections, making the applicable changes, and when finished, click to the Summary section, and click the Finish button.

To remove a scheduled export, highlight the applicable export in the Schedule Patient Data Export dialog, and then click the Remove button. At the confirmation dialog, click the Yes button.

Import Patient Data

Where can I find it?

Clinical: Chart > Import > Patient data and Chart Notes

What do I need to know?

The Import Document dialog has been updated with an Import Configuration section that allows you to select, via the Configure button, what sections of the imported document, and the order they will appear, in the chart note.

After the Configuration button is clicked, a CDA Section User Preferences dialog will appear allowing you to select which sections you want to be displayed, as well as the order in which those sections should appear. Only those sections that have a check in the Display column will initially appear in the chart note. To change the order of a section, highlight the applicable section, and then use the Move Up and/or the Move Down buttons to modify that sections position.

Whenever a user modifies the preference settings in the CDA Section User Preferences dialog and saves those changes by clicking the OK button, the system will save these user-specific preferences, and the selected sections to display and order will default when importing subsequent documents for the user.

After the parameters are configured for the imported document and the Finished button has been clicked, the patient’s chart will open with the Clinical Document embedded in the note with a new display widget. The new display widget has a Configure display button and Print button at the top left of the display widget that allows you to override the display configuration for this specific note, if desired, and print the information in the imported document per the display parameters selected.

When you click the Configure display button, a CDA Section User Preferences dialog will appear allowing you to select which sections you want to be displayed, as well as the order in which those sections should appear. Do note, only those sections contained within the imported document will be displayed as selectable options. Also, any modifications made in the CDA Section User Preferences, accessed via the display widget, will be for that specific note only and will not affect any default settings configured in the Import Document dialog.

How do I use it?

Upon upgrade, click Chart > Import > Patient data to import a document, and when in Import Document dialog, click the Configure button to choose the type of data and the order that information will be displayed, and then click the OK button. You can then continue with the import. After a document has been imported, you can click the Configure display button in the top left of the display widget to modify what information and the order that information appears.

Vitals Widget Updated to calculate Body Surface Area

Where can I find it?

Clinical: Chart Notes

What do I need to know?

The Vital Signs Entry dialog has been updated with a BSA section, when configured to display via the Template Editor, below the BMI section, that will automatically calculate the Body Surface Area, when the Height, or Length, and Weight is entered in the Vital Signs Entry dialog. The BSA will be recalculated whenever a modification is made to the Height, Length, or Weight fields. Likewise, the system will display the BSA in red to warn when the calculated value is outside the preconfigured high and low warning limits. When a BSA is configured, it will be outputted in the chart note and will be tracked in the History tab.

 

How do I use it?

Upon upgrade, you will need to access the Template Editor, select the applicable chart template with the Vitals widget you would like to display the Body Surface Area, right-click on the Vitals button, and select Edit Properties… In the Vital Signs Preferences dialog, highlight the Body Surface Area (BSA) option, check the Show vital sign option, and then configure the Settings preferences as needed. When finished, click the OK button and be sure to save the chart template. The BSA will then be calculated in the Vital Sign Entry dialog whenever Height, or Length, and Weight is entered for the patient.

STI Quality Reporting Registry (STI MIPSPRO)

Where can I find it?

Clinical: Once enrolled and activated, the system will automatically upload patient information from your system to STI MIPSPRO, and will continue to upload data on a nightly basis throughout the reporting period.

What do I need to know?

The system has been updated to send patient data to the STI Quality Reporting Registry (STI MIPSPRO) that allows MIPS Eligible Clinicians (ECs) to easily track and report their MIPS quality measures. With STI MIPSPRO, ECs can continually follow their progress throughout their MIPS performance period and make any necessary changes before submitting their data.

With the STI MIPSPRO you can select the various quality measures your office wants to qualify for (at least 6, but you can select as many as 50 measures), and then as your data is transferred from Clinical to STI MIPSPRO you have access to CMS Performance and Quality Score reports that present an overview of your progress, and STI MIPSPRO will also determine the best 6 measures to determine your MIPS Quality Score.

In addition to performance and quality reports you have access to detailed raw patient and visit data to view how measures are determined at the visit level and how those measures are either met or not. See Figure 26. Throughout the reporting period you can make modifications to patient chart notes in the Clinical system when needed, and that information gets updated within the STI Quality Reporting Registry daily, just as any new data gets updated daily.

And once your reporting period is over, and you have sufficiently tracked your reporting, STI MIPSPRO will be there to provide data validation and finalize your data for review and attest your Quality reporting data.

How do I use it?

To utilize the STI Quality Reporting Registry (STI MIPSPRO), there is an enrollment process and additional fees per provider. The fee is waived for MIPS Assistance Program clients. See the Quality Reporting Registry (MIPSPRO) enrollment form on our website here, http://sticomputer.com/quality-registry-enrollment/, for enrollment details and pricing. Once you are enrolled and activated for STI MIPSPRO you will be provided with access information to the registry and further instructions for use.

ChartMaker® 2016 Software Release 6.2.0

Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.2.0). To read a full list of enhancements, view the Release Notes.
Allergy Widget Updated

Where can I find it?

Clinical: Chart Notes

What do I need to know?

The Active Allergies dialog (in previous versions Active Allergy dialog) has been redesigned to provide increased speed and performance, ease of use, as well as enhance the overall user experience.

The updated Active Allergies dialog contains buttons for adding (Add), removing (Remove), reviewing an individual allergy (Review), and reviewing all allergies (Review All). The column headings have also been updated to better identify the information being displayed, and new columns have been added for Reaction SNOMED and Severity, which allow you to configure applicable SNOMED codes for the reaction, as well as the severity of the allergic reaction (Fatal, Life threatening severity, Mild, Mild to moderate, Moderate, Moderate to severe, and Severe) respectively.

You can add SNOMED codes for the reaction by clicking the Add or Edit button in the Reaction SNOMED column. This will open the Selected SNOMEDs dialog where you can select among the Reactions listed with their accompanying SNOMED codes, or you can click the Search button and search for specific SNOMED codes as needed.

The Select Allergy dialog, accessed when clicking the Add button to add a new allergy, has also been updated. A new Allergy Type field allows you to select Drugs, Groups, or Ingredients when searching for allergies. Likewise, you have the ability to select a Search Type (Contains, Equals, or Starts With) for your search. The Search Type field defaults to the Starts With option. Once the applicable allergy is located you can select that allergy by either double-clicking that allergy, or highlighting it and then clicking the Select button.

When removing allergies for a patient, by highlighting the applicable allergies and clicking the Remove button, a new Remove Reason dialog will appear that allows you to configure a reason you are removing the allergy. If multiple allergies were selected, the reason entered will be used for all of those selected allergies.

When you have finished configuring allergy information in the Active Allergies dialog, you must press the OK button to activate these changes. If you click the Cancel button or close of out of the dialog, your additions and modifications will not be saved. Once the OK button has been clicked, the updated allergy information, along with any configured SNOMED codes, will appear in the patient’s History tab. Likewise, the Audit Trail will be updated with applicable allergy events.

How do I use it?

In a chart note, click the Allergy widget to open the dialog. Enter applicable information and click OK to save your changes.

ChartMaker® PatientPortal now includes Prescription Saving Materials

Where can I find it?

ChartMaker® PatientPortal: Messages > Prescription Savings

What do I need to know?

The system has been updated so that whenever a patient is registered and activated for the ChartMaker® PatientPortal, any applicable patient saving (ScriptGuide and eCopay) materials, generated when prescribing or renewing a medication, will be automatically uploaded to the patient’s PatientPortal account and the patient will receive an email notification once they arrive.

In the PatientPortal site, the Home screen will show the number of unread prescription savings. Likewise, the Message tab has been updated to have an Inbox and Prescription Savings options.

When the Prescription Savings option is accessed, the patient saving (ScriptGuide and eCopay) materials will be listed in date order of when they were received. The right side will show an image of all pages for the savings material. The patient has the option to print and to delete these as desired. The PatientPortal will also run a nightly process to purge any savings material that is older than 30 days from the date it was received

How do I use it?

Upon upgrade, whenever a medication is prescribed or renewed for a patient that includes any patient savings materials, and that patient is registered and activated for the ChartMaker® PatientPortal, the system will automatically upload those materials to their PatientPortal account. There is no additional user intervention needed.

Screening Widget Updated

Where can I find it?

Clinical: Chart Notes

What do I need to know?

The Screening widget has been updated with ability to access questionnaires for the Quick Depression Assessment Panel (PHQ9) questionnaire, and the Generalized Anxiety Disorder (GAD7) questionnaire.

Currently, there are three questionnaires available to configure for patients: the Social, Psychological and Behavioral questionnaire, the  Quick Depression Assessment Panel (PHQ9) questionnaire, and the Generalized Anxiety Disorder (GAD7) questionnaire. Depending how the screening button is configured in the template editor, all three questionnaires can be accessed in Screening dialog via corresponding buttons at the top of the dialog; or any combination, up to the three available, of those questionnaires could be available via the Screening button.

The Quick Depression Assessment Panel (PHQ9) questionnaire is accessed by clicking the corresponding button at the top of the dialog. After the questionnaire is accessed, you can configure the answers for the various questions (Not at all, Several days, More than half the days, Nearly every day, and Declined to specify).

The first nine questions have a measured Total Score based on the answered questions above that allows you to quickly determine the severity of the screening and thereby offer further testing or treatment as needed. If you click the Total Score link, additional information is provided that displays how the scoring is conducted and providing further information.

The Generalized Anxiety Disorder (GAD7) questionnaire is accessed by clicking the corresponding button at the top of the dialog. After the questionnaire is accessed, you can configure the answers for the various questions (Not at all, Several days, More than half the days, Nearly every day, and Declined to specify).

The seven questions have a measured Total Score based on the answered questions above that allows you to quickly determine the severity of the screening and thereby offer further testing or treatment as needed.

For each of the questionnaires, you have the ability to determine how this information is outputted to the note. You can choose only to output only the Title, to output the configured information in List format, or to output the configured information in Paragraph format. When information is configured in the Screening dialog, the applicable LOINC codes will be attached to the options selected and the information will also appear in the History tab for the patient.

How do I use it?

Upon getting the upgrade, in the Template Editor, you have the ability to configure which questionnaires you want to be accessible in each Screening widget that is  added to applicable chart note templates. Once the widget has been added to a template, simply click the Screening button from inside a chart note to access the Screenings dialog. Then select from the applicable questionnaire, configure the applicable options, and then click the OK button once finished.

Direct Messaging Updates

Where can I find it?

Clinical: To-Do > Direct Messaging > Send Message and the To-Do List.

What do I need to know?

The New Direct Message dialog has been updated with a CC field allowing you to carbon copy recipients when sending and replying to direct messages. The CC field functions in the same manner as the To field.



The Direct Message dialog has been updated with a Reply All button allowing you to reply to all recipients included in a multi-recipient direct message. When the Reply All button is used, all recipients in the message will appear in the To: and CC fields respectively.

The system has also been updated so that when adding a patient to a direct message, the patient’s first name, last name, date of birth, gender, and zip code will be required and sent with the direct message. If this information is missing from the patient’s record, a warning message will be generated indicating that the patient cannot be attached to the direct message due to the missing information.

 

How do I use it?

Upon upgrade, the CC field and the Reply All button will appear in the applicable Direct Messaging dialogs. When using the CC field, you select recipients in the same manner as you would select recipients in the To field. The Reply All button works in a similar manner as the Reply button, but will include all the recipients included in the original message.

Patient Previous Name, Sexual Orientation, & Gender Identity

Where can I find it?

Practice Manager > Patient tab > More Patient

Clinical> ID tab > Additional Info

What do I need to know?

In Clinical, the Additional Patient Information dialog has been updated with a First, a Middle, and a Last name field where you can view or configure any previous name that the patient may have previously had. Information added or modified in the previous First, Middle, and Last Name fields will be updated in the Audit Trail. Likewise, whenever a previous First and Last name is entered, the previous name information will be included in any Transition of Care (CCDA) documents exported from the system.

The Sexual Orientation and Gender Identity sections of the Additional Patient Information dialog have also been updated so that the various orientation and identity options match the SNOMED-CT code descriptions associated with those options. Likewise, when you hover over these orientation and identity options with your mouse pointer, a tool tip pop-up will display the SNOMED code associated with that option.

In Practice Manager, the More Patient Information dialog has been updated with a Previous First Name field, and a Previous Middle Name field, where you can view or configure any previous first and/or middle name that the patient may have previously had.  Information added or modified in the Previous First, Middle, and Last Name fields will be updated in the Audit Trail. Likewise, whenever a previous first and last name is entered, the previous name information will be included in any Transition of Care (CCDA) documents exported from the system.

The Sexual Orientation and Gender Identity sections of the More Patient Information dialog have also been updated so that the various orientation and identity options match the SNOMED-CT code descriptions associated with those options. Likewise, when you hover over these orientation and identity options with your mouse pointer, a tool tip pop-up will display the SNOMED code associated with that option.

How do I use it?

In Clinical, access the patient's ID Tab, and then click the Additional Info button. Enter applicable information and click OK to save your changes. In Practice Manager, access the patient in the Patient screen, and then click the More Patient button. Enter applicable information and click Save to save your changes.

Quick Tips: Patient Billing

With higher deductibles, the result becomes higher patient bills. To create a more efficient workflow, use the new "advanced selections" button on the Patient Billing tab. Here you can pull a batch of balances over a certain dollar amount. Likewise you can filter batch of bills that are due over 120 days. With many options to select from, this will allow you to give full attention to a smaller group of bills.

One additional tip that will help you to to reduce the number of calls needed to explain these bills with patients is to add quick notes (MSG dropdown) to any balance dropping to patient. Add more pre-set notes to that MSG dropdown by clicking Administration, Code Tables, Codes then double-click Bill Statement Message. Once you're done, be sure to Save All.

Re-linking Your EPCS Token

If you are currently using Electronic Prescriptions for Controlled Substances (EPCS), you may come across a new update that will be need to addressed. This change comes from more stringent federal EPCS certification requirements. Starting in ChartMaker Medical Suite Version 6.2.0, each provider must be linked to the correct digital certificate provided with each Identrust EPCS token. Going forward, if a provider was linked to a non-digital signature certificate they will now need to be re-linked following the steps listed below.

Please note that going forward only one provider can be linked to an Identrust EPCS token. Additional tokens will need to be purchased in the event that additional providers will need EPCS privileges in ChartMaker Medical Suite.

 

The following pertains to existing prescribers after they upgrade:

  • If you were initially linked to the certificate with the digital signature there will be no change to your workflow.
  •  

    • If a token had been linked to a provider using the non-digital signature certificate, when you go to use EPCS, you will be presented with a warning dialog indicating that in order to continue you will need to re-link your token. When you go to the Token Linkage dialog they will only be able to select the correct certificate. This is a one-time event that you will encounter.

    • If a token has been linked to two users, one to each certificate, there will be a warning displayed if one of the users attempts to sign an EPCS prescription. The message will explain that multiple providers are linked to the token and only one is now permitted. They will be advised to return to the EPCS token linkage dialog to resolve the problem.

    • A similar message will be displayed to the user trying to link to the same token as another user.

     

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