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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.

     

    ChartMaker® 2016 Software Release 6.1.9

    Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.1.9). To read a full list of enhancements, view the Release Notes.
    Medications - Rx Cancel

    Where can I find it?

    Clinical: Medications List section of the Facesheet and the To-Do List.

    What do I need to know?

    You now have the ability to electronically send a cancel request for a prescription to applicable pharmacies. This allows you to cancel prescriptions where an adjustment in dosage is needed, or for medications that are not providing the desired efficacy, or for medications causing certain side-effects, or for similar reasons that require a cancellation of the current medication. A new Cancel Prescription option has been created and is accessed via context menu when clicking the asterisk (*) button next to the medication in the Medication List of the patient’s facesheet.

    rxcancel_med_context_menu

    Once the cancel request is initiated, a Cancel Prescription dialog will appear allowing you to review the medication information, the patient, prescriber, as well as select the applicable pharmacy, and then send the cancellation request. Do note, however, that only pharmacies that have the Cancel service level will populate the Pharmacy field when canceling a prescription. You have the ability to view those excluded pharmacies via the View excluded pharmacies button. Likewise, you also have the ability to manage the patient’s pharmacies, similar to when confirming prescriptions, via the Manage patient pharmacies button. After the information has been verified and a pharmacy has been selected, you can send the cancel request by clicking the Send button.

    rxcancel_dialog

    The pharmacy will either approve or deny the request. Notification of the pharmacy response will come via a To-Do List message and any additional details, such as the reason why the request was denied, if any of the medication was dispensed, or any other applicable information provided by the pharmacy regarding the prescription. Do note, however, when a prescription has been successfully canceled, you will need to manually discontinue the medication for the patient via their patient chart.

    rxcancel_todolist_response

    How do I use it?

    Upon upgrade, the user will see the new Cancel Prescription option available in medication context menu in the patient's facesheet for medications that have been prescribed. You can then initiate the RxCancel functionality as described above.

    Medication – Rx Change – General Change Request

    Where can I find it?

    Clinical: The To-Do List and Medications List section of the Facesheet

    What do I need to know?

    You now have the ability to electronically receive prescription change requests from pharmacies, and the ability to process and reply to those requests. When a pharmacy sends a prescription change request, a To-Do List message will populate the user’s To-Do List with a Subject of Electronic Prescription: Change Request.

    rxchange_gen_todolist

    If you view the message (by double-clicking the message, or by highlighting it, and then clicking the View button), the patient’s chart will open and any medications that have a change request will be highlighted and a [CHANGE] prefix will be attached to them in the Medication List of the patient’s facesheet.

    rxchnage_gen_fs_med

    A new Process Change Request option has been created and is accessed via context menu when clicking the asterisk (*) button next to the medication in the Medication List of the patient’s facesheet.

    rxchange_med_context_menu

    Once the change response is initiated, a General Change Response dialog will appear that allows you toggle between the original prescribed medication (indicated by a [Original Medication] prefix) and the requested changes. In the General Change Response dialog, you can view the medication information, prescriber information, Patient demographics, pharmacy information, as well as options for approving, denying, providing a denial reason, and adding any applicable comments.

    NOTE: When processing a change request, a Prior Authorization Change Response dialog will appear for those change requests where a prior authorization was not received. For details on this type of Rx Change see the next update entry below.

    rxchange_gen_change_response_org

    After you toggle the medication in the initial medication drop-down list, any changes will be highlighted in the applicable fields where changes are taking place. If the actual medication is different from the original medication prescribed, then the medication itself will become highlighted.

    You have the ability to add or modify the Quantity, Days Supply, Substitution, Directions, Notes to Pharmacist, Diagnosis, Effective Date, and Refills for the medication, as well as viewing medication information via the Medication info button.

    You can then Approve or Deny the change request by clicking the corresponding button. When denying a change request you must select a Denial Reason or enter a Comment as to why the request is being denied.

    Do note, that when a change response involves a controlled substance, the various EPCS warnings and signing protocols will be activated, similar to electronically prescribing a controlled substance. You will be required to check the Ready to sign option, insert the IdenTrust USB token, as well as enter your token passcode prior to being able to approve the request.

    Once the request has been approved or denied, the response will then be sent to the pharmacy. If the change request was approved, the system will automatically discontinue the original mediation and generate a new medication drug log comprised of the changes, while also updating the patient’s facesheet. Likewise, applicable changes will be made in the History tab and the Audit Trail.

    rxchange_gen_change_response_changed

    How do I use it?

    Upon upgrade, the RxChange functionality will be activated. An Electronic Prescription: Change Request message will appear in your To-Do List when an applicable pharmacy sends you a change request, and the work-flow will be similar to that described above.

    Medication – Rx Change – Prior Authorization Change Request

    Where can I find it?

    Clinical: The To-Do List and Medications List section of the Facesheet

    What do I need to know?

    When a pharmacy sends a change request where a prior authorization was not received, the system will generate a to-list message similar to a general change request, and you will process the change request in a similar manner (clicking the asterisk (*) button next to the medication in the Medication List of the patient’s facesheet, and then clicking Process Change Request). However, instead of General Change Response dialog, a Prior Authorization Change Request dialog will appear.

    In the Prior Authorization Change Response dialog, you can view the medication information, pharmacy information, prescriber information, patient demographics, as well as options for approving, denying, adding an approval number, providing a denial reason, and adding any applicable comments.

    You can then Approve or Deny the change request by clicking the corresponding button. When denying a change request you must select a Denial Reason or enter a Comment as to why the request is being denied.

    Once the request has been approved or denied, the response will then be sent to the pharmacy.

    rxchange_prior_auth_change

    How do I use it?

    Upon upgrade, the RxChange functionality will be activated. An Electronic Prescription: Change Request message will appear in your To-Do List when an applicable pharmacy sends you a change request, and the work-flow will be similar to that described above.

    Medication – Rx Change – Unmatched Change Request

    Where can I find it?

    Clinical: The To-Do List

    What do I need to know?

    You now have the ability to process an unmatched change request that is sent from a pharmacy. When a pharmacy sends a prescription change request, and the system is unable to match that request to an existing patient, a To-Do List message will populate the user’s To-Do List with a Subject of Electronic Prescription: Unmatched Change Request.

    rxchange_unmatched_todolist

    If you view the message (by double-clicking the message, or by highlighting it, and then clicking the View button), a Match Change Request dialog will appear allowing you to deny the request, or to match that request with an existing patient. In the Change Request Information section of the Match Change Request dialog, the patient, medication, pharmacy, and prescriber will be listed for the unmatched patient sent from the pharmacy.

    As when processing a General Change Request, or a Prior Authorization Change Request, you have the ability to deny this request by selecting a Denial Reason, or entering a Comment, and then clicking the Deny Request button.

    To match this information to an existing patient in the system, you can search for the patient in the Select Patient field, highlight the applicable patient in the list, and then in the Select Patient Medication section, highlight that patient’s medication that you want to match the request to, and then click Match button.

    Once the unmatched change request has been matched to an existing patient, you can access the patient’s chart and the medication will be highlighted and a [CHANGE] prefix will be attached in the patient’s facesheet. You can process the change request in a similar manner as a general change request or prior authorization change request outlined above.

    rxchange_match_change_request

    How do I use it?

    Upon upgrade, the RxChange functionality will be activated. An Electronic Prescription: Unmatched Change Request message will appear in your To-Do List when an applicable pharmacy sends you an unmatched change request, and the work-flow will be similar to that described above.

    Dashboard Updates: Meaningful Use Stage 2 2017

    Where can I find it?

    Clinical: Reports > Meaningful Use… > Dashboard

    What do I need to know?

    The Meaningful Use Dashboard has been updated with a Stage 2 2017 option in the Stage field, thereby allowing you to select and run queries specific to the changes reflected in this stage for 2017, and provide accurate statistics for applicable attestation requirements.

    mudashboard2017

    In addition, five CQMs have been removed and are no longer available for reporting:

  • NQF 0036 – Use of Appropriate Medications for Asthma
  • NQF 0060 – Hemoglobin A1c Test for Pediatric Patients
  • NQF 0064 – Diabetes: Low Density Lipoprotein (LDL) Management
  • NQF 0075 Ischemic Vascular Disease (IVD): Complete Limpid Panel & LDL Control
  • NQF 0403 – HIV/AIDS: Medical Visit
  •  

    How do I use it?

    These changes do not require intervention on the user's part in order for them to be displayed. Do note that, for Stage 2 2017, this year (and every year) CMS has made changes to the requirements for some of the CQMs. Please be sure to check the CQMs you are reporting to determine if changes were made that may affect your reporting and make adjustments accordingly.

    Smoking History Widget Updated

    Where can I find it?

    Clinical: Chart Notes

    What do I need to know?

    The Smoking/Tobacco Use dialog has been updated to display the Tobacco use screening not performed due to limited life expectancy option if the date of the chart note is before 01/01/2017. This allows you to easily capture all of the smoking/tobacco use data needed to satisfy the 2015 version of the Clinical Quality Measure NQF 0028 for Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention. However, if the date of the chart note is 01/01/2017 or later, the Tobacco use screening not performed due to limited life expectancy option will not be displayed, as it is no longer applies to the 2016 version of the Clinical Quality Measure NQF 0028 for Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention.

    Smoking/Tobacco Use (Chart Note Date Prior to 01/01/2017)

    smoking_history_prior

    Smoking/Tobacco Use (Chart Note Date of 01/01/2017, or after)

    smoking_history_after

    How do I use it?

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

    Vitals Widget Updated

    Where can I find it?

    Clinical: Chart Notes

    What do I need to know?

    Due to changes between the 2015 version and the 2016 version of the Clinical Quality Measure NQF 0421 for Preventative Care and Screening: BMI Screening and Followup, the BMI section of the Vital Signs Entry dialog has been updated to calculate the BMI correctly based on the chart note date. If the date of the charge note is before 01/01/2017, the system will calculate overweight/underweight based on the 2015 version’s ranges. If the date of the chart note is 01/01/2017 or later, the system will calculate overweight/underweight based on the 2016 version’s ranges

    In addition, the Status section options in the Options dialog, accessed via the Options button, has also been updated to adhere to the differences between the 2015 version and the 2016 version of the Clinical Quality Measure NQF 0421 for Preventative Care and Screening: BMI Screening and Followup.

    If the date of the chart note is before 01/01/2017, and the BMI was calculated in the Vitals dialog for the patient, the active option will be Follow up plan documented.

    vitals_options_priora

    Likewise, if the date of the chart note is before 01/01/2017, and the BMI was not calculated in the Vitals dialog, the active options will be BMI not done for medical or other reason and BMI refused by patient.

    vitals_options_priorb

    However, if the date of the chart note is 01/01/2017 or later, and the BMI was calculated in the Vitals dialog, the active options will be Follow up plan documented, Follow up plan not done for medical or other reason, and Referral not done for medical or other reason.

    vitals_options_aftera

    Likewise, if the date of the chart note is 01/01/2017 or later, and the BMI was not calculated in the Vitals dialog, the active option will be BMI refused by patient.

    vitals_options_afterb

    When the options in Options dialog are selected the system will link the selected options to the applicable SNOMED and LOINC codes and will be used to calculate any applicable Meaningful Use Clinical Quality Measure NQF 0421 for Preventative Care and Screening: BMI Screening and Followup. Likewise, the information configured will be tracked in the History tab and Audit Trail.

    How do I use it?

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

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