Blog Archive: Uncategorized

ChartMaker® 2016 Software Release 6.2.3

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

Where can I find it?

Clinical: Chart > Audit > Audit Trail

Practice Manager: Administration > Utilities > Audit > Audit Trail

What do I need to know?

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

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

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

How do I use it?

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

Faxing: Open Text Fax Appliance Updates

Where can I find it?

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

What do I need to know?

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

How do I use it?

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

 

Mobile App: Charge Capture Update

Where can I find it?

Mobile App: Charge Capture

What do I need to know?

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

          

How do I use it?

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

Scan Manager Updates

Where can I find it?

Clinical: Chart > Scan Documents or Notes > Scan Documents

What do I need to know?

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

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

How do I use it?

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

Ransomware Campaign

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

You may send additional questions to cip@hhs.gov

HHS/ASPR Critical Infrastructure Protection Program

If you are the victim of a ransomware attack

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

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

Mitigating against this threat

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

US-CERT Resources

Multiple Petya Ransomware Infections Reported

06/27/2017 12:56 PM EDT

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

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

Sector ISAO and ISAC resources

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

HITRUST has shared the following Threat Bulletin for distribution.

ONC and OCR resources

ChartMaker® 2016 Software Release 6.2.2

Here are some of the main highlights in ChartMaker® Medical Suite 2016 (file version 6.2.2). To read a full list of enhancements, view the Release Notes.
New Implantable Device Widget

Where can I find it?

Clinical: Chart Notes

What do I need to know?

The system has been updated to allow you to add information for implantable devices with the additional ability to retrieve device information from the FDA based on the Device UID for those templates that have the new Implantable Device widget.

When the Implantable Device widget is clicked, the Implantable Devices dialog will appear allowing you to add, edit, and delete implantable device information for the patient.

In the Device List section of the dialog, any implantable devices that have been entered for the patient will appear. If the information for the device was received from the FDA, a bullet mark will appear in the FDA column, and the Name column will contain the FDA Device Name. If the information for the device was manually entered, the FDA column will be blank for the device, and the Name field will contain the User-defined Device Name.

When adding a new implantable device, in the Device Details section, you can enter a User-defined Device Name, enter or paste the Device UDI into the corresponding fields, and then click the Verify UDI with FDA button to retrieve device information from the FDA.

If a Device UDI is entered and validated, the system will populate the Device Information section, along with the FDA Device Name, Device Identifier, Serial #, Batch/Lot #, Manufacturer Date, Expiration Date, and Distinct Identification Code fields in the Details Device section with information pertaining to the device you are adding. You are not allowed to modify this information. However, you can click the Refresh FDA Data button to query the FDA database to see if any information has been added or changed.

If a Device UDI is not available, or is not valid, you can manually enter information into the aforementioned fields, except the FDA Device Name, as needed.

Once the FDA data is retrieved, or manually entered if no UDI is available, you can enter an Implanted Date, and then configure the Device Status and Device Removed information and any corresponding dates, as needed.

You can also check the Display in list format option that allows you to determine whether you want the implanted device information to appear in list format, or paragraph format, in the chart note. If the Display in list format option is checked, the configured implant information will appear in list format in the note, if this option is not checked, it will appear in paragraph format.

When the OK button if clicked, the information will be displayed in the chart note, and the information will be tracked in the Audit Trail, as well as the History tab for the patient.

Also, the Facesheet has been updated with an Implantable Devices section that will list any implantable devices that were added for the patient via the new Implantable Device widget. If you click the asterisk (*) button next to the device, the context menu will display the information configured for that device. You can also add a new Implantable Device button to a note by clicking the heading of this section, and then dragging and dropping to the location in the note where you want the button to appear.

How do I use it?

Upon upgrade, an Implantable Device option will be available in the Template Editor to add the Implantable Device widget to applicable chart note templates. Once the widget has been added to a template, simply click the Implantable Device button from inside a chart note to access the Implantable Devices dialog.  Then select the applicable options and click the OK button once finished.

 

New MIPS Dashboard

Where can I find it?

Clinical: Reports > MIPS Dashboard

What do I need to know?

The system has been updated with a MIPS Dashboard that will allow MIPS Eligible Clinicians (ECs) to report their MIPS quality measures with ease. ECs can track their progress throughout their MIPS performance period and make any necessary corrections before submitting their data.

When you access the MIPS Dashboard, you can select, add, edit, and delete various Configurations where you set the eligible clinicians and the various parameters for each of the four categories for of the MIPS program: Quality, Advancing Care Information, Improvement Activities, and Cost. Do note that the Cost category is not available for 2017.

After a Configuration is set up and selected, you will have access to each of the categories to select various parameters for those categories, as well as calculate scores based on the parameters set and your data entered to date. Each of the categories will have a last calculated/modified date so you will easily know if you need to run these again. Likewise, you can also view MIPS Requirements and the system will calculate an Estimated MIPS total composite score.

Prior to configuring and running any data in the MIPS Dashboard you must select a Configuration in the corresponding field. Configurations can be added by clicking the Add button to the right of this field. Likewise, you can edit and delete a configuration by selecting the desired Configuration, and then clicking the Edit or Delete button to the right.

In the MIPS Dashboard Configuration dialog, you can enter a Configuration name, select the Performance period (which needs to be 90 days or more), select the Eligible clinicians (NPI) (which needs to be a single clinician, or all clinicians in the practice), and then select the parameters for the Quality Reporting, Advancing Care Information Exemption, and Improvement Activity Adjustments. Do note, that by default, Quality Reporting is weighted as 60%, Advancing Care Information (ACI) as 25%, and Improvement Activity (IA) is 15%. If a user is configured to be exempt from reporting for ACI, the Quality category will be weighted as 85% and ACI will be 0% and disabled.

Once a configuration is selected in the MIPS Dashboard, you can access the Quality Measures dialog to select the quality measures for your performance period, calculate your estimated score, run a reconciliation report, and generate a file for submission by clicking the Quality button.

In the Quality Measures dialog, in the left pane, the existing 29 quality measures will be listed, like the Meaningful Use Dashboard, but here are re-categorized as Outcome Measures, High Priority Measures, or Other Measures. You can select as many measures as desired, however, at least one outcome or high priority measure must be selected. The selected measures will appear in the right pane as a single row for each selected measure. Once the applicable measures are selected, you can calculate your estimated score by clicking the Calculate button, and after the system is done collecting and running data for the performance period, a Total score will appear at the bottom. After the total score has been calculated you can run a Reconciliation Report and Generate Files for Submission via the corresponding buttons at the bottom of the dialog. Clicking the OK button will save the selected quality measures and maintain any scores.

When calculating quality measure scores, the standard Numerator and Denominator information will be displayed along with a percentage result and a final score. The score starts as a base 3 points for all measures. If the measure has 20 or more in the denominator and at least 1 patient is marked as having Medicare as an insurance during an encounter, the measure is eligible for additional benchmark points. Benchmark points are determined by information provided by CMS, however, not all quality measures have a benchmark. Double clicking a row within the grid will display the benchmark breakdown and bonus points if they exist.

Only the top 6 best performing measures will be counted in the score, if more than 6 measures are calculated. Measures that are not included in the score will be marked with a gray background and reordered to the bottom of the grid. The top 6 measures are then eligible for 1 additional bonus point each for submitting through an EHR (for a maximum of 6 points). One outcome or high priority measure is required, however for each additional outcome 2 bonus points are awarded and 1 for each additional high priority measure (for a maximum of 6 points). Double clicking a row within a grid will also show the bonus points awarded.

When generating files for submission, as QRDA file will be generated that will include all measures that are selected, not just the 6 top performing measures.

If the total score is greater than 60, a warning text will appear indicating that the final score is capped. Clicking the OK button will automatically update the main dashboard view with the final capped score and the weighted score and update the total MIPS score.

If you chose to use the Reporting through the STI Quality Reporting Registry option in the MIPS Dashboard Configuration dialog (see figure 10 above), when you click the Quality button in the MIPS Dashboard, a Quality Score dialog will appear allowing you to manually enter the Quality score from the registry.

With a configuration is selected in the MIPS Dashboard, you can access the Advancing Care Information dialog to select the Advancing Care Information (ACI) options for your performance period, calculate your estimated Base Score, Performance Score, and Bonus Points, run a reconciliation report for your Performance Score, and Print your Performance Score information by clicking the Advancing Care Information button.

The Advancing Care Information dialog is broken up into three areas for Base Score, Performance Score, and Bonus Points. The Base Score must be completed before any other section of the ACI will count. Performance and Bonus sections will automatically be in a disabled state (although measures can be calculated but will show as gray rows and their score will not be added to the total) if Base Score credit is not awarded, and warning text will appear at the bottom to indicate that base credit was not met.

In the Base Score section, you must first check the Performed a security risk analysis option, followed by getting a 1 in the numerator after calculating the 3 base performance measures. You also have the option to select Include controlled substances in the E-Prescribing measure. As an exemption, a user with less than 100 in the denominator for E-Prescribing will count even if they do not have at least 1 in the numerator. To run the base performance measures, click the corresponding Calculate button. Once these conditions are met, the rest of the dialog will be enabled.

The Performance Score section contains a Submitted data for immunization registry reporting option that allows you to indicate immunization registry use for 10 points. In addition, 6 measures can be calculated for an additional 0 to 10 points each, two of which are worth double points, where scoring is based on the performance percentage per CMS requirements and guidelines. Once the applicable options are selected, you can calculate your estimated score by clicking the Calculate button, and after the system is done collecting and running data for the performance period, the results and applicable scores will appear in the corresponding columns in the grid. After the scores have been calculated, you can run a Reconciliation Report and Print the results via the corresponding buttons.

The Bonus Points section has a Submitted data to one or more public health or clinical data registries option that is worth 5 points. Likewise, you may also receive 10 points by making any selection in the ACI Bonus tab of the Improvement Activities dialog which will be described further below.

The final score (points) is listed at the bottom as a breakdown of Base Score plus the Performance Score plus any Bonus Points.

Clicking the OK button will save any calculated scores and selections, and will automatically update the MIPS Dashboard view and the Estimated MIPS total composite score.

With a configuration is selected in the MIPS Dashboard, you can access the Improvement Activities dialog to select an improvement activities that you qualify for during your performance period, by clicking the Improvement Activities button.

The Improvement Activities dialog is broken into three tabs: ACI Bonus, High Weighted, and Medium Weighted activities. Each tab will display the applicable list of activities with a link for More Information and a Yes/No selection drop-down box. High Priority activities are worth 20 points and medium weight are worth 10 points.

If you chose the Small practice, rural area, or non-patient facing clinician option in the Improvement Activity Adjustments section of the MIPS Dashboard Configuration dialog, you will receive double points for each selection. If you selected the Patient Centered Medical Home or equivalent option, you will receive full credit automatically (40 points), but can still make other choices. If you selected the Other approved Alternative Payment Model, you will receive half credit (20 points) automatically.

If you make any selection from the ACI Bonus section, 10 points will be given to the ACI total.

The Total score (capped at 40 points) is listed at the bottom. Clicking the OK button will save any selections and scores, and will automatically update the MIPS Dashboard view and the Estimated MIPS total composite score.

How do I use it?

Upon upgrading the ChartMaker Medical Suite, the MIPS Dashboard will be accessible by clicking Reports > MIPS Dashboard. In the MIPS Dashboard you can then create Configurations as needed, and then select and calculate the applicable options for Quality Measures, Advancing Care Information, and Improvement Activities as outlined above.

Patient Health Information

Where can I find it?

Clinical: Chart > Patient Health Information, The Note Tab, The Organizer, & Scan Management

What do I need to know?

The Clinical system has been updated with a variety means to capture Patient Health Information for patients from both within the Clinical application and from external sources. You can now maintain external links, import external files to a patient's chart, tag chart notes, and scan items for a patient as Patient Health Information.

The system has been updated with a Patient Health Information dialog that allows you to add and maintain external links to a patient’s health information, as needed. In addition, the Patient Health Information dialog will include a listing of all chart notes that have been tagged as Patient Health Information in the Clinical applicable, allowing you to select and open those notes.

To access the Patient Health Information dialog for a patient, open the patient’s chart, and then click Chart > Patient Health Information. You can then Add, Edit, and Delete external links for patient health information using the corresponding buttons, or access any chart notes that were marked as patient health information.

The Note tab context menu has been updated with an Add Patient Health Information option that allows you to add external files to the patient’s chart that will be marked as a patient health information record. When adding files the functionality is similar to using the Add Existing File option.

The Organizer has been updated with a Patient Health Info column that will display Yes when a chart item has been tagged as Patient Health Information. Likewise, the right-click context menu has been updated with a Mark as Patient Health Information option that allows you to tag any non-form chart notes as Patient Health Information.

The Scan Management dialog has been updated with a Scan as Patient Health Information option that allows you to tag scanned documents for a patient as Patient Health Information.

How do I use it?

Upon upgrade, the various methods of maintaining Patient Health Information described above will be available. You can maintain links, import external files, mark chart notes and scan as Patient Health Information as outlined.

Meaningful Use Dashboard Updates: MU 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 the following Clinical Quality Measures (CQMs):

  • NQF0101 Screening for Future Fall Risk
  • NQFTBD Dementia: Cognitive Assessment.

The NQF0101 Screening for Future Fall Risk CQM will measure the percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period. The LOINC and SNOMED codes used in the Falls Risk Assessment Form screening will count toward the numerator and exceptions.

The NQFTBD Dementia: Cognitive Assessment CQM will measure the percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period. The LOINC and SNOMED codes used in the Blessed Orientation Memory Concentration Test (Cognitive Assessment) screening will count toward the numerator and exceptions.

See Screening Widget Updated entry in the ChartMaker® 2016 Software Release 6.2.2 highlights for further details on these new screenings.

How do I use it?

These changes do not require intervention on the user's part in order for them to be displayed.

Allergy Widget Updated

Where can I find it?

Clinical: Chart Notes

What do I need to know?

The Active Allergies dialog has been redesigned so that the Reaction SNOMED field precedes the Reaction Whenever SNOMED codes are added in the Reaction SNOMED field for an allergy, the descriptions for the selected SNOMED codes will automatically be added, or appended if there is existing information, to the Reaction field. You can then modify the text in Reaction field as needed.

Also, the Active Allergies dialog has been updated with a Display in list format option that allows you to determine whether you want the allergy information to appear in list format, or paragraph format, in the chart note. If the Display in list format option is checked, the configured allergy information will appear in list format in the note, if this option is not checked, it will appear in paragraph format

In addition, the system has been updated so that the allergic reaction configured for an allergy will be outputted in the chart note.

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.

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 a Falls Risk Assessment Form questionnaire, and a Blessed Orientation Memory Concentration Test (Cognitive Assessment) questionnaire.

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

The Falls Risk Assessment Form 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. Do note if the answer to the second question (Is the patient ambulatory?), is anything other than Yes or blank (unanswered), the assessment questionnaire sections below will be grayed out and not score will be given. Likewise, if the answer to the third question (Screening not done for medical reason), is Yes, the assessment questionnaire sections below will be grayed out and not score will be given.

If you click the Balance link you are provided with additional information on how to access the patient for the questions in that section.

The Medication link provides access to a list of medication to consider while answering the questions in that section of the questionnaire. While the Predisposing Conditions or Diseases link provides access to a list of conditions and diseases to considered when answering the question for that section.

The various assessment questions have a measured Total Score based on the answered questions allowing you to quickly determine if the patient is “at risk” for future falls and thereby offer further testing or treatment as needed. If you click the Total Score link, additional information is provided, displaying how the scoring is conducted and providing further information.

The Blessed Orientation Memory Concentration Test (Cognitive Assessment) 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. Do note if the answer to the first question (Screening not done for medical reason), is Yes, the assessment questionnaire sections below will be grayed out and not score will be given. Likewise, if the answer to the second question (Screening not done for patient reason), is anything other than Yes or blank (unanswered), the assessment questionnaire sections below will be grayed out and not score will be given.

The Repeat the memory phrase… link provides access to detailed information on how to score this aspect of the questionnaire.

The various assessment questions have a measured Total Score based on the answered questions allowing you to quickly determine if the patient assessment is consistent with dementia and thereby offer further testing or treatment as needed. If you click the Total Score link, additional information is provided, displaying how the scoring is conducted and providing further information.

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 and/or SNOMED codes will be attached to the options selected and will be used to access any applicable Meaningful Use quality measures. Likewise, 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.

Mobile App: Charge Capture Updates

Where can I find it?

Mobile App: Charge Capture

What do I need to know?

The Enter diagnosis and Enter procedure functionality has been redesigned and enhanced to allow you easily select and search for diagnosis and procedure codes when capturing a charge for the patient. Also, to assist you in easily and efficiently selecting procedures during Charge Capture, the Settings area has been updated with a Procedure Lists option that allows you to create practice-level procedure lists.

The Enter diagnosis functionality in the Charge Capture screen has been enhanced to allow you to easily select and search for diagnoses for the patient. You can now select from recently used diagnoses (Recent Dx), select from the active, inactive, and pre-existing diagnoses from the patient’s facesheet (Facesheet Dx), and search for any diagnosis in the system (Dx Search), to configure current diagnoses for the charge you are capturing. Any of these methods can be used in conjunction when entering diagnoses, and the selected diagnoses (up to five) will be queued in Dx Review area where you can confirm your diagnostic selections.

After you have accessed the Charge Capture area, you can tap the Enter diagnosis link, and you will default to the Recent Dx screen. You can then toggle between the Recent Dx (the compass icon), Facesheet Dx (the stethoscope icon), Dx Search (the magnifying glass icon), and Dx Review (the paper airplane icon) by tapping the applicable icon below.

                    

To select a diagnosis in the Recent Dx and Facesheet Dx screens, tap the diagnosis you wish to add, and a check will appear next to the diagnosis, and the Dx Review icon will keep a tally of the number of diagnoses you have selected.

                   

When you click Dx Search icon you will enter the Dx Search screen where you can search diagnostic codes by ICD10 Description, or by ICD10 Code. You can toggle between these options by tapping the Search By button to the left of the Search field.

You can then enter a description or code in the Search field, or you can tap through the diagnostic tree below to find the applicable diagnosis.

When entering a description or code in the Search field, the system will narrow the diagnostic tree based on your search criteria. You can then tap through the various diagnostic categories until you locate the billable diagnosis code you want to select. As when selecting diagnoses in the Recent Dx and Facesheet Dx screens, when you select a diagnosis in the Dx Search screen a check will appear next to the diagnosis, and the Dx Review icon will keep a tally of the number of diagnoses you have selected.

                   

                   

After all the applicable diagnoses have been selected in the Recent Dx, Facesheet Dx, and/or Dx Search screens, you can click the Dx Review icon to go to the Dx Review screen to review and finalize your diagnostic selections. In the Dx Review screen you can remove any diagnoses that you do not want to include with the charge by tapping the Trash button next to diagnosis. Once all diagnoses have been reviewed, click the OK button to add the selected diagnoses to the charge capture. Those diagnoses will then appear in the Diagnosis area of the Charge Capture screen.

                   

The Enter procedure functionality in the Charge Capture screen has been enhanced to allow you to easily select and search for procedures for the patient. You can now select from a practice-level Procedure List, or search for any procedure in the system (Procedure Search), to configure a procedure for the charge you are capturing. Practice-level procedure lists are maintained via Settings > Procedure List. You can create a single list, or multiple lists, per your office’s needs.

After you have accessed the Charge Capture area, you can tap the Enter procedure link, and the Procedure List screen will default. You can then select a procedure in the Procedure List (star icon) screen, or search for a procedure in the Procedure Search (the magnifying glass icon) screen by tapping the applicable icon below.

In the Procedure List screen, you can toggle the various procedure lists open and closed by tapping the corresponding arrow button to the right of each of the lists. Once the applicable procedure is located, simply tap it to select it.

                   

When you click Procedure Search icon you will enter the Procedure Search screen where you can search procedure codes by Description, or by CPT Code. You can toggle between these options by tapping the Search By button to the left of the Search field.

When entering a description or code in the Search field, the system will display any procedures that contain any of the description or code based on your search criteria. You can then scroll through the list, and once the applicable procedure is located, tap that procedure to select it.

After the procedure has been selected it will appear in the Procedure section of the Charge Capture screen.

                   

                                  

To assist you in easily and efficiently selecting procedures for charge capture, the system has been updated with the ability to create practice-level Procedure Lists via the Settings sub-menu.

Once the Procedure Lists area has been accessed, you can create and maintain procedure lists. In the Procedure Lists screen, you will see any practices that have procedure lists configured. To maintain an existing procedure list, select the applicable list under the practice name. To create a new procedure list, select the Create List option.

                   

When creating a new procedure list, you can select which practices you want the list to be available for, and then tap the Create button. In the Edit Procedure List screen, you can then enter or modify a List Name, and then add procedures by selecting the Add Procedure option. When the Add Procedure option is selected, you can search for and select the applicable procedures to add to the list in the Procedure Search screen.

When the procedures are selected, they will be added to the Procedures list in the Edit Procedure List screen. In the Edit Procedure List screen, you can add additional procedures by clicking the Add Procedure option. You can remove any added procedures that you do not want to include in the list by tapping the Trash button next to procedure. Once all procedures have been selected for the list, you can tap the Save List option. To remove the list, you can tap the Delete List option.

When procedure lists have been created, they will appear in the Procedure List screen when entering a procedure for charge capture for the applicable practices.

                    

                    

How do I use it?

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

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.