Blog Archive: Release Highlights

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.

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.

    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.

    ChartMaker® 2016 Software Release 6.1.7

    Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.1.7). To read a full list of enhancements, view the Release Notes
    EPS File Confirmation

    Where can I find it?

    To Do List (Practice Manager and Clinical)

    What do I need to know?

    The new To Do List notification will serve as a confirmation that Electronic Patient Statements (EPS) were sent successfully.  A notification is also generated if the batch was not successfully created. 

    EPS_ToDoList

    How do I use it?

    These notifications will happen automatically and will be displayed on the To Do List of the user that created the batch.

    Zip Code on the Meaningful Use Facesheet

    Where can I find it?

    Practice Manager > Documents tab > Face Sheet > Face Sheet – Meaningful Use

    What do I need to know?

    The Meaningful Use Facesheet will now properly print the patient’s zip code in the Patient Demographic section whereas in previous versions it was not.

    MUFacesheet_Preview

    How do I use it?

    The zip code will automatically be displayed.  No user intervention is needed to see this change.

    Fun Facts on the Login Screen

    Where can I find it?

    Login Dialog (Practice Manager and Clinical)

    What do I need to know?

    Each time the login screen appears we will display text that describes a feature available in the ChartMaker® Medical Suite.  These messages may relate to new product features, industry news or tips and tricks when using the product.  We will update them on a regular basis.

    Login_PRM2

    How do I use it?

    These messages will appear automatically.  No user intervention is necessary (beyond reading them!).  😉

    Patient Sexual Orientation and Gender Identity (SO/GI)

    Where can I find it?

    Practice Manager > Patient tab > More Patient

    Clinical> ID tab > Additional Info

    What do I need to know?

    We have added the option to document a patient’s sexual orientation.  You will only be allowed to select one option for sexual orientation and the applicable SNOMED code will be documented once you do.

    Your options for sexual orientation include:

  • Lesbian, gay, homosexual (38628009)
  • Straight or heterosexual (20430005)
  • Bisexual (42035005)
  • Other
  • Don’t know
  • Declined to specify
  • We have also expanded the Gender field to include more options, which can be multi-selected.  Gender is meant to be the gender in which the patient currently identifies with, whereas Birth Sex (located on the Patient tab in Practice Manager and the ID tab in Clinical) is meant to be the gender in which they were born.  The applicable SNOMED code(s) will be documented once a selection is made.

    Your options for gender identity include:

  • Male (446151000124109)
  • Female (446141000124107)
  • Transgender Male/Trans Man/Female-to-Male (407377005)
  • Transgender Female/Trans Woman/Male-to-Female (407376001)
  • Genderqueer, neither exclusively male nor female (446131000124102)
  • Other
  • Declined to specify
  • SOGI_CM

    How do I use it?

    You may want to consider updating your office forms to include this information.  Upon upgrade, you will be able to document this information within ChartMaker® Medical Suite.

    In this release you will only see the data entry fields for sexual orientation and gender.  Reports (CCDA, etc) and Template Editor (Lookup Fields) have not been updated at this time.

    Ability to Capture Patient’s Full Middle Name

    Where can I find it?

    Practice Manager: Patient tab

    Clinical: ID tab

    What do I need to know?

    The “Middle" field will now allow you to capture the patient's full middle name instead of just an initial.  In Practice Manager the field will be labeled "Middle" and in Clinical it will be named “Middle Name”, however a full middle name can be entered in either.  

    No changes were made to printable documents (except the CCDA).  The Template Editor “Lookup Field” was re-labeled to Middle Name however due to spacing limitation it will still only print the initial.

    MiddleName_CM

    How do I use it?

    There is no user intervention in order to see this change. Upon upgrade, the middle initial will be saved and you will have the option to add to the field if you prefer to do so.

    Update ICD-10 Database

    Where can I find it?

    Diagnosis Search in Practice Manager and Clinical

    What do I need to know?

    We updated the ICD-10 database with the latest 2017 codes available from the CDC.  Also to note, there is now a “Code Set” dropdown in the Diagnosis Search dialog which will allow you to select the date of the file.  Your options will be the Code Set from Oct 1st 2014 through Sept 30 2016 OR the Code Set from Oct 1 2016 through Sept 30 2017 (new data) OR all.

     

    We added the ability to search by Code Set in case you are editing a charge with a DOS prior to 10/1/16, you will be able to find the correct code.  Or, if you want to update your templates ahead of time with codes that aren’t effective until 10/1/16 you can.

     

    ICD10_CodeSet

    How do I use it?

    No user intervention is needed to see this change. 

    If you are searching for a diagnosis through the Charges dialog, the dialog will automatically narrow your results based on the service start date that was entered.  If you are searching for a diagnosis through a Clinical Note, the dialog will narrow your results based on the Note Date selected.  All other ICD-10 search dialogs will use the current date or today’s date.

     

    PDFs in Direct Messages

    Where can I find it?

    Patient's Chart

    What do I need to know?

    When importing a Direct Message with an embedded/attached PDF, we will now pull out the embedded PDF, and treat it as an additional attachment for import.

    Essentially there will be two files saved to the patient’s chart now – the CCDA, which will have a message at the bottom indicating that this file contained an embedded PDF, and a separate PDF, which is treated as an external file.

     

    CCDA Chart Note:

    DM-PDF_ChartNote2

    Attached PDF Chart Note:

    DM-PDF_PDF2

    How do I use it?

    After selecting "Import into chart" from the Direct Message dialog, you will be presented with a dialog allowing you to select the patient as well as the PDF for attachment.  If PDF was selected to be saved as an attachment, the CCDA chart note as well as the PDF chart note will automatically be created in the patient's chart.

     

    Specimen Label Printing

    Where can I find it?

    Clinical: Order Procedure dialog and the Chart menu

    What do I need to know?

    We now have the option to print labels that can be placed on specimen bottles for things such as blood samples or other lab specimens.  The option will be available in the Order Procedure dialog, or through the Chart Menu within the chart (see below).

    The option will only be available for procedures configured as “Labs” or “Tests” through the Order Procedure dialog.

    The option accessible through the Chart menu will be available at all times – no matter whether a procedure has been selected through a note or not.  Labels are not connected to a specific order.

    Specimen labels can only be printed using a DYMO printer.  The label will print the Collected Date and Time, the patient's First and Last Name as well as their Date of Birth.

     

    Order Procedure Dialog:

    LabLabels_withPrintDialog2

     

    Chart Menu:

    LabLabels_Chartmenu

     

    How do I use it?

    Configure the DYMO printer on each workstation you would like to print labels.  From within the Order Procedure dialog (or the Chart menu), click "Print Specimen Labels".  Select the applicable DYMO printer from the dropdown as well as the desired number of labels (max 9).  Click "Print" to complete the process.

    SNOMEDs Available in the Facesheet

    Where can I find it?

    Clinical: Facesheet (right-click a diagnosis)

    What do I need to know?

    We now have the ability to view the SNOMEDs that are attached to a diagnosis directly from the Facesheet, by right-clicking on the diagnosis.  If there are multiple SNOMEDs attached, they will all be displayed.  This feature was incorporated so you no longer need to access a chart note and the diagnosis widget to see this information.

     

    SNOMED_FS

    How do I use it?

    Right-click on the diagnosis from the Clinical Facesheet.  The attached SNOMED or list of SNOMEDs will be displayed below the diagnosis code.

    To modify the SNOMED, open a chart note and edit the diagnosis through a Diagnosis Checklist.

    Smoking History Widget Updated

    Where can I find it?

    Clinical: Chart Note

    What do I need to know?

    In order to meet the 2015 version of NQF-0028 - Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention, we needed to update the Smoking Widget dialog.

    Beyond adding additional questions, we have also started saving additional LOINC codes to some of the existing questions.

    Questions added or moved:

  • Have you used tobacco in the last 30 days?
  • Have you used smokeless tobacco products in the last 30 days
  • Tobacco use screening not performed for medical reason
  • Tobacco use screening not performed due to limited life expectancy
  •  
    The last two checkboxes for Tobacco Use Screening Not Performed will fulfill exclusion requirements that are part of the measure.

    SmokingWidget_arrows

    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.

    Dashboard Updates: Secure Messaging and CQMs

    Where can I find it?

    Clinical: Reports > Meaningful Use… > Dashboard

    What do I need to know?

    The first change was to the Secure Messaging measure.  For Stage 1 and 2 for 2016, the measure has been updated and our dashboard will now reflect this change.

    The measure states:

    For an EHR reporting period in 2016, at least 1 patient (or patient representative) seen by the EP during the EHR reporting period, was sent a secure message using the electronic messaging function of the CEHRT during the EHR reporting period.

    Keep in mind that the measure previously stated that the patient had to send a message, and now it requires the provider to send the message.  This includes messages originating from the provider – either new OR in response to a patient message.

    The other change to this measure is the threshold or goal.  The new “Goal” is 1 patient, which is highlighted in the screenshot below.

    The measure will still show Numerator and Denominator counts but it in order to meet the measure you are only required to have a count of 1 in the Numerator.  The Result column will show the same count as the Numerator and be green if the value is 1 or more (indicating you have met the goal).

    SecureMessaging

    We have also updated 9 of the CQMs to accommodate for changes in the July 2015 version which is applicable to attestation year 2016.  Not all of these measures have differences from the last release however since we were parsing a new file, they were updated on the dashboard.

    The measures that had changes are marked with an asterisk and are bolded:

  • CMS 0065 - Hypertension BP Improvement *
  • NQF 0081 - Heart Failure ACE or ARB Therapy for LVSD
  • NQF 0108 - ADHD follow up
  • NQF 0028 - Preventive Care and Screening: Tobacco Use *
  • NQF 0083 - Heart Failure: Beta-Blocker Therapy for LVSD
  • NQF 0002 – Pharyngitis
  • CMS 0163 - Diabetes LDL Management
  • NQF 0052 - Use of Imaging Studies for Low Back Pain *
  • NQF 0088 - Diabetic Retinopathy: Documentation
  • CMS 0182 - Complete Lipid Panel and LDL Control
  •  

    How do I use it?

    Neither of these changes require intervention on the user's part in order for them to be displayed, however be aware of the measure requirement changes for the Secure Messaging objective.

    Vitals Widget Updated

    Where can I find it?

    Clinical: Chart Note

    What do I need to know?

    We have made several changes to the Vitals widget accessed within a chart note, with the first being the addition of the change in last Height or Length.

    This is similar functionality to what we already display for Weight.  The system will now look for any previous notes that include data entered on Height or Length and calculate the loss or gain since the most recent visit. It will then display that information, including note date, in the Vitals dialog as well as the chart note. The text will output in the chart note by default and you cannot modify this setting.

    Vitals Widget:

    Vitals_Height_crop

    Chart Note:

    Vitals_Height_note

     

    Next, we have added a second Pulse field to allow a user to collect multiple Pulse values in one note.  This addition will aid in entering data for exclusionary purposes for the Clinical Quality Measure (CQM) for Heart Failure: Beta-Blocker Therapy for LVSD (NQF 0083 or CMS 0144).

    Vitals_Pulse2_crop

     

    Also in relation to a CQM requirement, we have removed the option to edit the Position for Blood Pressure and have limited the options to Sitting, Standing and Lying.  The Position dropdown will default to "Sitting" and a SNOMED code will only be documented when the Position of Sitting is selected.  This was implemented because the CQM (Hypertension: Improvement in Blood Pressure [CMS 0065]) states the Blood Pressure should only count for numerator fulfillment if it was in a Sitting position.

    If a user selected a custom Position in a previous note, it will still display when viewing that old note, however going forward you will only be able to select from the 3 options mentioned above.

    For Blood Pressures taken prior to this change that didn't have a Position documented, we will set it to Sitting so you can receive credit for legacy data.

     

    Vitals_Position_Crop

     

    Lastly, several changes were made to the BMI section.  First, we have removed the “Follow up plan documented” option from the main dialog and have added an "Options" button in this area instead.

    Vitals_BMIOptionsButton

    Within the Options dialog, you will see the “Follow up plan documented” checkbox.  This checkbox will only be available for selection if you have entered Height/Length and Weight in this chart note.  When selected, the applicable SNOMED code will automatically be documented in the chart as well.

    Vitals_BMIOptions_HTWTEntered2

    If Height/Length and Weight have not been entered, you will now have two additional options that can be documented as to why this data was not collected - BMI not done for medical or other reason or BMI refused by patient.  

    These options will fulfill the exclusion or exception cases for the CQM related to BMI Screening and Follow Up (NQF 0421 or CMS 0069) and the applicable SNOMED and LOINC codes will be documented when they are selected.

    Vitals_BMIOptions2

    Finally, options to account for the CQM related to Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (NQF 0024 or CMS 0155) were added to allow the user to document the information without having to manually add procedure codes or text to their note.

    The new options are Provided counseling for nutrition and Provided counseling for physical activity.  When either option is selected the applicable SNOMED and LOINC codes will automatically be documented in the chart.

    Vitals_BMIOptions_Counseling

    How do I use it?

    Upon upgrade, the user will see the new options available in the Vitals widget.  To receive credit for quality reporting purposes, be sure to enter all applicable information through these new options. 

    Disable PDR Printing When Patient Not Present

    Where can I find it?

    Clinical: Prescribe Medication and Preferences

    What do I need to know?

    Since there are times when patients are not present when prescribing a medication or times when you are just entering pre-existing medications and we really don’t want patient savings materials printing out, we added a checkbox preference to the Prescribe Medication dialog and the Confirm Prescription dialog to allow you to turn off printing.

    The "Print patient prescription savings materials" checkbox will be checked by default for all medications, even if you have disabled it in a previous prescription.

    PDR_Prescribe_crop

    If you unselect the Started field (indicating this is a pre-existing medication), the checkbox for “Print patient prescription savings materials” will automatically be unselected as well.

     

    We also added an option to the Preferences dialog to accommodate cases where medications are prescribed or renewed through the Facesheet.  Since many times renewals without the patient present are done through the Facesheet, we are giving you the option to default the print feature as turned off when the process is initiated in this manner.

    When "Print prescription savings material when prescribing from the Facesheet" is unchecked, the checkbox for "Print patient prescription savings materials" on the Prescribe Medication (and Confirm Prescription) dialog will automatically be unselected.

    PDR_Preference

     

    This preference will be checked by default and the user will have to uncheck it if they do not want to print patient savings materials when going through the Facesheet.

     

    How do I use it?

    To disable the option to print patient savings materials when prescribing from the Facesheet, go to Edit > Preferences and click the Prescription tab.  Uncheck the option for "Print prescription savings material when prescribing from the Facesheet".  Then click "Set" and "OK" to save your changes.

    To disable printing patient savings materials when prescribing a medication through a chart note, uncheck "Print patient prescription savings materials" from the Prescribe Medication or the Confirm Prescription dialog.

    Easier Signing Process for Groups of Results

    Where can I find it?

    Clinical: Results Note and Preferences

    What do I need to know?

    In order to allow for signing of multiple Results (labs, images, etc.) more easily, we have added logic that will group them together so the signing process can be done in less clicks.

    The results must come from the same vendor and have the same collected date in order for this process to work.

    In order to take advantage of this addition, you must turn on the Preference in the Signing tab to “Allow Group Signing of Results”.  This preference will be turned on by default upon upgrade.

    ResultGrouping_Preference

    Then whenever a group of results comes in, matching on vendor and collected date, they will be grouped.

    In the chart note, you will see new buttons at the top, which allow you to scroll through the grouped results by clicking “Previous” or “Next Result”.  It will also display which number result you are viewing and how many are in the group.

    ResultGrouping_ChartNote_crop

     

    When you click “Sign” on any one of the grouped results, it will take you to a dialog with all the viewed results checked off, ready to sign.

    Keep in mind that if a result has not been viewed, you will not be able to sign it.  Unviewed labs will be marked with an asterisk.

    ResultGrouping_Sign_NotAllAvailable

    Once you click “Sign” on this dialog, it will sign all the results that were checked off and remove the reminders from your To Do List.

    The process of unsigning a result is still done on an individual basis.

     

    How do I use it?

    To enable the option to allow group signing of results, go to Edit > Preferences and click the Signing tab.  Check the option for "Allow Group Signing of Results".  Then click "Set" and "OK" to save your changes.

    To sign multiple results at a time, first make sure you view all the results.  Then click the "Sign" icon or go to the Note menu and select "Sign".  Check the box next to the results you want to sign and click "Sign" once again.

    EPA Process Changes

    Where can I find it?

    Clinical: Prescribe Medication Dialog and To Do List

    What do I need to know?

    Several changes were made to the ePA process to make the workflow more user friendly.  First, we have removed the ePA required status if you are prescribing a pre-existing medication (Started field is unchecked).  Since the medication is not intended to be prescribed, the ePA approval process is not necessary.

    EPA_PreExisting_crop

    Next, we added the ability to override the ePA process if the Formulary tells us that ePA is required.  Previously, the Override button was only present if ePA was NOT required.  This will be helpful in situations where the selected medication is displaying as ePA required, however you are sure that ePA is not required for this particular medication/patient.

    EPA_Override_crop

    Lastly, we have addressed the issue of too many ePA messages cluttering a user’s To Do List.

    Messages that require intervention were generally fine, however when the ePA is completed, the To-Do List messages remained for everyone else that received the message, causing confusion as to whether the ePA actually still needed to be addressed or not.

    We decided to programmatically removing some of the messages after a new status arrives for that ePA message.

    Now, when an ePA request changes to a pending or final status, we will delete all previous To-Do List items associated with that ePA item from all user's To-Do Lists.

    When an ePA medication is prescribed, it will delete all previous To-Do List items associated with that ePA medication unless the ePA denied status is because the medication was "ePA is not required".

     

     

    How do I use it?

    In order to override a medication that is showing as "ePA is required", click the "Override?" button.  This will remove the ePA designation and allow you to proceed without ePA being checked.  The other changes mentioned above do not require user intervention in order to utilize the functionality.