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.

    Comments are closed.