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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.

    CECity Invoices for 2016

    We are receiving inquiries about the recent invoices that were sent to your office regarding CECity enrollment years 2016 and 2017. Some offices received 2 invoices- this is not in error. Providers that enrolled later in the year for 2016 (October or later) received 2 invoices. The invoice for 2016, payment is expected UPON RECEIPT before your data feed can be started. Payment for 2017 enrollment year invoices for ALL recipients is expected by 12/15/2016. Read More →

    Meaningful Use Attestation Period Update

    Since our November newsletter, CMS has changed the reporting period for new and returning participants to be any 90 day period during 2016. Again, you must attest by the deadline of February 28, 2017. By successfully attesting and satisfying all other program requirements, you will avoid the payment adjustment in 2018. For more information on Meaningful Use, please visit the CMS website.

    ChartMaker® 2016 Software Release 6.1.8

    Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.1.8). To read a full list of enhancements, view the Release Notes.
    Referral Widget Updated

    Where can I find it?

    Clinical: Chart Note and the Referrals section of the Facesheet

    What do I need to know?

    Two changes have been made to the Referral widget accessed within a chart note, with the first being the ability to add additional SNOMED codes when the referral pertains to weight assessment or to an eye exam.

    new_referral

    Additional SNOMED codes are added for the referral by accessing the Search List dialog via the the Search button. Codes will default by the Category you have selected: Referral for Weight Assessment, or Referral for Eye Exam. You have the ability to add multiple codes for the referral as needed.

    referral_snomed_search

    This addition will aid in entering data for the Clinical Quality Measure (CQM) for Preventative Screening: Body Mass Index (BMI) Screening and Follow-Up (NQF 0421)  or Diabetes: Eye Exam (NQF 0055).

    When a SNOMED code is saved for weight assessment, if the patient’s BMI (at the time of entry) and age combination falls into the underweight or overweight category as defined by the CQM for Preventative Screening: Body Mass Index (BMI) Screening and Follow-Up (NQF 0421), then the appropriate underweight (248342006) or overweight (238131007) SNOMED will also be attached to the event, and used when calculating the numerator for this CQM.

    When a SNOMED code is saved for eye exam, that configured code will be used in conjunction with the SNOMED code generated by a referral response with a negative finding, when calculating the numerator for the CQM for Diabetes: Eye Exam (NQF 0055).

    Next, the Referrals dialog has been updated with the addition of a Response Details column that contains a Details button.

    referrals_dialog

    The Details button allows you to access the Referral Response Details dialog where you can configure specific details for the referral response that was received for the patient. In this dialog you can add a Response, a Finding Status, and a Response Comment for the referral response.

    referral_response_details

    When the Response received option is selected, the system will attach a SNOMED code (371530004) to the event (similar to checking the Response Received option in the Referrals dialog proper). Likewise, if a Negative finding is selected for the response in the Finding Status section, an additional SNOMED code (442225006) will be attached to the event, and that code will be used in conjunction with the SNOMED code previously attached to the referral, when calculating the numerator for the CQM Diabetes: Eye Exam (NQF 0055).

    You can also access the Referral Response Details dialog via the Referrals section of the patient’s facesheet by clicking the * (asterisk) button next to the applicable referring provider, and selecting the Response Details option in the context menu. When Response Details are configured via the facesheet, the system will automatically populate the corresponding information in the Referral widget in the chart note, and vice versa. When information is configured in one area, it will automatically populate in the other area.

    facesheet_referrals

    How do I use it?

    Upon upgrade, the user will see the new options available in the Referral widget, as well as in the context menu in the Referrals section of the facessheet. To receive credit for quality reporting purposes, be sure to enter all applicable information through these new options.

    Estimated Start Date for Pre-Existing Medication

    Where can I find it?

    Clinical: Prescribe Medication Dialog

    What do I need to know?

    The Prescribe Medication dialog has been updated so that whenever you uncheck the Started date to enter a preexisting medication for the patient, the Earliest Fill Date field will change to an Est. Start Date field, allowing you to enter the estimated start date for the preexisting medication. When an estimated start date is entered fop a preexisting medication, the system will use that date for any exclusion cases when calculating applicable CQMs for Meaningful Use.

    prescribe_medication_est_start_date

    The Confirm Prescription dialog will also contain an Est. Start Date field that will display the estimated start date whenever an estimated start date is configured for a preexisting medication for a patient in the Prescribe Medication dialog

     

    How do I use it?

    When adding a preexisting medication for a patient, once the Started field has been unchecked, check the Est. Start Date and enter the applicable estimated start date for the medication.

    Dashboard Updates: CQMs

    Where can I find it?

    Clinical: Reports > Meaningful Use… > Dashboard

    What do I need to know?

    Three of the CQMs have been updated to accommodate for changes in the July 2015 version which is applicable to attestation year 2016.  The measures that had changes are below:

  • NQF0033 - Chlamydia Screening for Women
  • NQF0055 - Diabetes Eye Exam
  • NQF0421 Preventative Screening: Body Mass Index (BMI) Screening and Follow-Up
  •  

    How do I use it?

    Neither of these changes require intervention on the user's part in order for them to be displayed.

    New Screening Widget

    Where can I find it?

    Clinical: Chart Notes

    What do I need to know?

    A new Screening widget is available to add to chart note templates, via the Template Editor, that allows you to configure screening questionnaires, surveys and forms (at this time only the Social, Psychological and Behavioral questionnaire is available).

    screening_button

    When the Screening widget is accessed, a Screenings dialog will appear and you will see the corresponding questionnaire (at this time only the Social, Psychological and Behavioral questionnaire is available). Here you can configure the answers for questions regarding Financial Resource Strain, Education, Stress, Depression, Physical Activity, Alcohol Use, and Violence that are based on the 2015 Edition Health IT Certification Criteria published by the Office of the National Coordinator for Health IT.

    The Depression, Alcohol Use, and Violence options have a measured Total Score based on the answered questions within the respective section 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 in each section additional information is provided that displays how the scoring is conducted and providing further information.

    In addition, you also 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 be used for any applicable Meaningful Use objectives and measures.

    screening_dialog

    How do I use it?

    Upon getting the upgrade, a Screening option will be available in the Template Editor to add the Screening widget 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 the applicable options and click the OK button once finished.

    Match Patients in PM Data Import Module

    Where can I find it?

    Practice Manager Data Import Module

    What do I need to know?

    A new Match Patients button has been added to the Practice Manager Data Import dialog that allows you to associate an unmatched patient in an imported file with a current patient in Practice Manager. When the system does not import all of the records in the imported file, you will see a number of possible matches in the # Possible Matches column in the Patient Records with Counts section.

    pmdi_dialog

    Upon accessing the Patient Matching dialog you will see the patients with possible matches displayed on the left-side of the screen. When you highlight a patient on the left, the system will display any possible matches. You also have the ability to modify the search criteria to locate the applicable patient. Once a the correct patient is located you can link that patient to the existing patient by clicking the Link to existing patient button, or you can click the Create new patient button if there is not a matching patient. And if you mistakenly match an unmatched patient to an existing patient, you can highlight that patient and then click the Remove account number button.

    pmdi_patient_mathcing

     

    How do I use it?

    Access the Practice Manager Date Import module and import a file. If that file contains patients that did not get matched, click Match Patients button, associate the unmatched patient with an existing patient, and then click the Link to existing patient button. When the patients have been matched, click the OK button.

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