Copyright. Last updated: August 9, 2016 MicroMD EMR Update Guide Henry Schein Medical Systems, Inc. All rights reserved.

Transcription

1 Update Guide

2 Trademarks Because of the nature of the material, numerous hardware and software products are mentioned by their trade names in this publication. All product names referenced herein are trademarks of their respective companies. The marks MICROMD, HENRY SCHEIN, and the HENRY SCHEIN LOGO are registered trademarks of HS TM, LLC, a subsidiary of Henry Schein, Inc. Copyright This document is covered by the terms and conditions of the license agreement and/or the non-discloser agreement and may only be reproduced if allowed by the terms of that agreement or with written consent of Henry Schein, Inc. Last updated: August 9, 2016 MicroMD EMR Update Guide 2016 Henry Schein Medical Systems, Inc. All rights reserved.

3 TABLE OF CONTENTS GENERAL ENHANCEMENTS Enhanced Patient Recalls and Reminders View... 3 Spell Checker Added to Comment Areas... 6 Stock Management Publically Supplied Vaccines... 6 PATIENT MODULE ENHANCEMENTS Patient Gender Identity and Sexual Orientation... 8 DESKTOP ENHANCEMENTS Enhanced Hover Text Information Care Plan Printed Indicator Enhancements to Phone Messages New Reply To All Option in Mail Quick Text Access Added to Mail New Ability to Search for Direct Mail Users by Zip Code Enhanced Mail Functionality MEDICAL INFORMATION ENHANCEMENTS BMI Percentile Added to Vital Views Vaccine Database Updated to Handling Compound and Replacement Vaccines ORDERS ENHANCEMENTS New Bill Type Added to Lab Orders Additional Options for Sending CIN Direct Messages Suppress an Unidentified Provider on Lab Results Carbon Copy Diagnostic Test Results and Hospital Reports ENCOUNTER ENHANCEMENTS Group Encounter Charting New Face x Face Time Tracking Tool for Encounters PRESCRIPTION MODULE ENHANCEMENTS New eservice Prescription Prior Authorization (epa) Label Change for Prescriptions and Medications Alerts for Obsolete Medications Descriptions on Medications PATIENT PORTAL ENHANCEMENTS Importing Patient-Generated Health Data Notification of a Submitted Form Data Reconciliation Table of Contents 1

4 General Enhancements Bi-Directional Secure Messaging Appointment Request and Patient Scheduling Options Practice Setup Locations and Providers for Online Scheduling Locations Providers Practice Setup Appointment Templates Scheduling Setup on the Portal Side What the Patient Sees on the Portal Appointment Request Appointment Scheduled Issuing CDA from the Portal Updates Screen New Portal Account Flag for Scheduled Visits Viewing Patient Messages From the Publish Log Quick Text Access Added to Patient Message Windows Link to Online Payment on Patient estatements What the Patient Sees Adding the Payment Link MICROMD DMS ENHANCEMENTS New Forwarding Option for DMS Documents Enhanced Patient Recalls and Reminders View 2

5 GENERAL ENHANCEMENTS Enhanced Patient Recalls and Reminders View We have enhanced the patient recalls and reminders area to allow the practice to build a list of recalls and manage them from the desktop. Patient Recalls under Desktop Administration has been changed to Recall/Reminder Builder. Figure 1 Recall/Reminder Builder in Desktop Administration When this option is selected, the Recall/Reminder Builder window will open. Figure 2 New Recall/Reminder Build Window Enhanced Patient Recalls and Reminders View 3

6 General Enhancements Recall/Reminder Selections Practice Name. Allows you to choose the appropriate practice that the user wants to query since the EMR can have multiples practices associated with their own independent set of recalls. New Reason. Allows you to add a new recall reason. This will bring up a new window that allows you to name the recall, set the defaults days in which the recall should take place and associate an appointment class. Once the reason is built than the query fields can be established to generate recalls for that new reason. Figure 3 Adding a New Recall Reason Query. This allows the practice to designate what the specific criteria that they would like to use to generate the recall list. The practice must set at least one field name, condition and value. Recalls last generated. This will show the last date and user that generated a set of recalls for the highlighted reason. Days. This will show the days that the highlighted recall is setup to be recalled Appointment Class. This will show the appointment class that is setup for the highlighted recall Sort. The system allows the practice to sort the recall list by patient name, age, demographics last updated and gender in both ascending and descending order Delete Row/Add Row. Allows the practice to add and remove query lines for the highlighted recall reason Save Reason. This will save the current query settings that were just entered for the reason highlighted. In the action buttons there is now a To Worklist button. This will move/add the selected patients to a work list on the new Desktop Recall/Reminder Worklist. This will allow users to manage the recalls that have been generated from one main area. The patient list will be cleared once they have been moved to the Worklist. Desktop Area. Recall Worklist A new Desktop option, Recall Worklist, will open the Recall/Reminder Worklist and populate it with patients moved from the Recall/Reminder Builder. The following roles will have access to the Recall/Reminder Worklist: Physician, Non-Physician Care Giver, Nurse, Receptionist, Physician Assistant, Practice Manager, Nurse Practitioner and Administrator. The recall is created when the patient is moved to the Worklist. The Worklist allows users to manage recalls and to take action on them, such as a phone call, , etc. Enhanced Patient Recalls and Reminders View 4

7 General Enhancements Figure 4 Options on the Recall/Reminder Worklist Recall Worklist on the Desktop Button Select All / De-Select All Mark Recalled Declined Publish Function Selects or de-selects all entries. User can select this button to indicate that the selected patients were recalled by other means. The ability to choose selected patients who have declined the recall in order for the system to remove it from the list for all future recalls for the specified reason. Ability to post to the Patient Portal if available. The system will publish a generic message stating the need for the patient to contact the office due to recall reason. For example, A friendly reminder please contact (provider name s inserted here) office to address (recall reason inserted here). If select all is chosen and a patient in the selected list does not have portal access then the system will skip over publishing for those patients. Enhanced Patient Recalls and Reminders View 5

8 General Enhancements Mail Merge Open Chart Utilities Ability to use mail merge capability to print a letter. Similar to mail merge in Admin reports, this is the same as the current function is in the recall window. Selection of the Mail Merge will open the Mail Merge window where the user can select the letter template, create labels and print the letter. The system will open the chart of the highlighted patient. Allows the practice to view patient s vital signs and clinical dashboard information and add administrative forms and letters. Spell Checker Added to Comment Areas A spell checker has been added to comments areas within the phone messages, encounter comment boxes and most medical information and desktop categories Figure 5 Spell Checker on the Ribbon Bar of Phones Messages Figure 6 Spell Checker Within the Comment Box Stock Management Publically Supplied Vaccines To account for enhanced pricing options for vaccines in particular, there are now two new fields in Stock Management: Publically Supplied Price per unit on the Stock Item Details window and Publically Supplied on the Administer Immunization and Stock Usage windows. Figure 7 Stock Item Details Window Spell Checker Added to Comment Areas 6

9 General Enhancements When you select Yes from the Publically Supplied drop-down on the Administer Immunization window, the Stock Usage window automatically marks the Publically Supplied checkbox on the Stock Usage window and displays the Publically Supplied Price per unit in the Price per unit field. Figure 8 Administer Immunization Window Figure 9 Stock Usage Window Stock Management Publically Supplied Vaccines 7

10 PATIENT MODULE ENHANCEMENTS Patient Gender Identity and Sexual Orientation To meet requirements for UDS reporting and for Meaningful Use, there are two new fields on the Patient Information window: Gender Identity and Sexual Orientation. There are several options in each drop-down. Table 1 Field Figure 10 Gender Identity and Sexual Orientation Fields New Fields on the Patient Information Window MicroMD Location Gender Identity Sexual Orientation From the Gender Identity drop-down, select the gender with which the patient most closely identifies himself or herself. This can be the same or different from their sex assigned at birth. The recommended best practice is to ask the patient, "What is your current gender identity?" You have the following options: Male Female Trans Man (FTM) Trans Woman (MTF) Genderqueer Other (specify): When you select Other, MicroMD PM displays the Note icon ( ). Click this icon to type in a description that doesn t appear in the list. Not Disclosed From the Sexual Orientation drop-down, select the patient s inherent or immutable and enduring emotional, romantic or sexual attraction to other people. The recommended best practice is to ask the patient, "Do you think of yourself as...?" You have the following options in the drop-down: Straight Patient Gender Identity and Sexual Orientation 8

11 Patient Module Enhancements Field MicroMD Location Gay or Lesbian Bisexual Other (specify): When you select Other, MicroMD PM displays the Note icon ( ). Click this icon to type in a description that doesn t appear in the list. Unknown Not Disclosed Patient Gender Identity and Sexual Orientation 9

12 DESKTOP ENHANCEMENTS Enhanced Hover Text Information We have added enhanced hover text to display more patient information. This was added to scheduled visits, order windows, test result windows, phones messages, mail and prescriptions received. A hover text will now appear when highlighted over the name that contains name, gender, age, DOB, chart no, MRN no, primary and secondary phone numbers, insurance and co pay amount. Figure 11 Enhanced Patient Information on Hover Care Plan Printed Indicator There is now a new field in the Schedule Visits sticky note for a patient that allows the user to know whether a care plan has been printed for that particular encounter. If the patient care plan has been printed then the system will show a checkmark in the Care Plan Printed field. Figure 12 New Patient Care Plan Indicator in Scheduled Visits Enhancements to Phone Messages The send button has been reduced in size, and a new area for the patient picture is now available. These items will remain for all mail functions including New, Reply and Forward. Within the Phone Messages Read/Open window, the comment field has been increased to unlimited characters. After a phone message has been saved, previous comments are no longer editable. A date/time/user stamp can be appended to the beginning of a comment. Enhanced Hover Text Information 10

13 Desktop Enhancements Figure 13 New Phone Message Window A new window called the Comment Editor will open. The Quick Text button will also be present for quick entry of common text. When the OK button is clicked, the information is stored in the Existing Comments section. These comments are stored newest to oldest with a date/time stamp and cannot be overwritten. Figure 14 Phone Comment Editor Window Enhancements to Phone Messages 11

14 Desktop Enhancements New Reply To All Option in Mail The system now allows the ability to reply all to a mail message that was sent to a group of users. The window will now show the reply going to the individual that sent the message along with the group or multiple individuals that were included. Figure 15 Reply All Message View Quick Text Access Added to Mail The Quick Text option (QT) has now been added to the Mail window. Figure 16 Quick Text Access on the Ribbon Bar of the Window New Reply To All Option in Mail 12

15 Desktop Enhancements New Ability to Search for Direct Mail Users by Zip Code Users now have the ability to search by zip code in the direct user list on the Direct Mail users tab. The display has also been enhanced to be able to view additional information including the name, address, fax number, phone number and direct address. Figure 17 Searching for Direct Users by Zip Code Enhanced Mail Functionality When sending or replying to multiple groups, if a user is in more than one group, that user will receive only one instead of one for each group. In addition, when sending messages, only the last action (reply or forward) will be shown in the subject line. Figure 18 Only the Most Recent Action is Displayed in the Subject Line New Ability to Search for Direct Mail Users by Zip Code 13

16 MEDICAL INFORMATION ENHANCEMENTS BMI Percentile Added to Vital Views The BMI percentile for patients is now stored and displayed on windows showing vital signs. These include the Medical Information windows on the chart (Vital Signs), vitals entry/edit screens, encounter header, patient care Desktop, encounter medical information viewer, patient monitor medical information viewer, care plan, encounter preview, clinical dashboard, medical information report, medical information summary report and reports where the vitals option is used. The percentiles are designated by colors. Figure 19 BMI Percentiles in the Patient Chart Vaccine Database Updated to 2016 The vaccine tables in the Reference Database were updated with the CDC IIS code set updates as of April BMI Percentile Added to Vital Views 14

17 Medical Information Enhancements Handling Compound and Replacement Vaccines In the Medical Information Immunizations window, users now have the ability to view the immunizations grid in an alternate view: Default view This is the previous view of the grid Series view This view shows the immunizations individually which will break out the combo immunization into individual rows in alphabetical order. Group view This option will show the immunizations individually but grouped by the vaccine group separated in alphabetical order by the group name. If the individual immunization is in multiple groups it will show up within that group. Setting up Compound Vaccines. The system allows you to specify the vaccines included in a compound vaccine. This will then allow a link to be created between individual vaccines and compound vaccines. When administering the vaccine, the system will be able to document in the appropriate fields. To add a new compound vaccine in the EMR Manager, Reference Lists, Customizable List, Compound Vaccines and click the Add button. This will bring up the compound vaccine window and allow the user to select the proper compound vaccine to be defined. Click the reference icon, choose the vaccine that is designated as the compound vaccine, and insert. Figure 20 Specify Compound Vaccine Window Choose the vaccines included in the compound by choosing the reference icon and selecting each and insert. Handling Compound and Replacement Vaccines 15

18 Medical Information Enhancements Figure 21 Adding a Compound Vaccine When administering a compound vaccine the system will replace the individual vaccines with the word replaced. The record will now reflect the fact that a compound was given on a particular date in place of individual vaccines. The system will also reflect the fact that individual vaccines were given in place of a compound vaccine. Note: This will apply to those immunizations that are already present in the grid Figure 22 Grid View for Compound Vaccines Figure 23 Series View Compound Vaccines Handling Compound and Replacement Vaccines 16

19 Medical Information Enhancements Figure 24 Group View for Compound Vaccines Setting up Replacement Vaccines. The system allows you to designate replacement vaccines. This will allow the practice to link a new vaccine code to an obsolete one. To add a new replacement vaccine in the EMR Manager, Reference Lists, Customizable List, Replacement Vaccines and click the Add button. This will bring up the replacement codes window and allow the user to designate the vaccine to be replaced. Figure 25 Specify Replacement Vaccine Window Choose the vaccines to be replaced by choosing the reference icon and selecting each and insert. Figure 26 Adding a Replacement Vaccine Handling Compound and Replacement Vaccines 17

20 Medical Information Enhancements The system will pop up a message based on the information entered into the replacement area of the EMR manager. This message will let the user know that a replacement exists and allow them to determine whether it should be used. Figure 27 Adding Vaccine from Within an Encounter Handling Compound and Replacement Vaccines 18

21 Medical Information Enhancements Figure 28 Ordering Vaccine from the Desktop Figure 29 Adding a Vaccine to the Patient Chart Handling Compound and Replacement Vaccines 19

22 ORDERS ENHANCEMENTS New Bill Type Added to Lab Orders A new type called Indigent was added to the Bill Type drop-down for a Lab Order when sending a lab to LabCorp. For LabCorp, the requisition prints Third Party next to Bill Code. Figure 30 New Bill Type Additional Options for Sending CIN Direct Messages We have added the direct mail option within the print options window for a referral order. Figure 31 Mail Capability Added to Referral Order Print Options Window We added the direct mail option within the transition of care out window. New Bill Type Added to Lab Orders 20

23 Orders Enhancements Figure 32 Mail Capability Added to the TOC Out Window Suppress an Unidentified Provider on Lab Results In lab results where the ordering or attending provider is suppressed (and there is a cc d practice or provider in the results) due to the use of a third party for labs, we have changed the presentation of this data. Now, the unidentified provider is suppressed, and the provider who was the recipient of the forwarded lab results will now appear as a provider who was carbon-copied results that were ordered by an outside provider. Carbon Copy Diagnostic Test Results and Hospital Reports You now have the ability to CC other users on any diagnostic test results or hospital reports, in addition the lab results you could already copy to another user. Under User Preferences > Reroute Items, you now have the ability to CC results automatically for diagnostic results and hospital reports has been added. These new categories function the same as the lab results. Suppress an Unidentified Provider on Lab Results 21

24 Orders Enhancements Figure 33 Diagnostic Results and Hospital Reports Can Now Be CC d to Other Users Carbon Copy Diagnostic Test Results and Hospital Reports 22

25 ENCOUNTER ENHANCEMENTS Group Encounter Charting MicroMD EMR now has the ability to do group charting. It is now possible to create encounters for group sessions using patient groups. On the EMR Desktop (within Patient Care), there is a new window called Group Encounter, accessible from the navigation pane on the left. This area is used to view a list of group encounters and to create new group encounters. By default within the window the system will display all group encounters that are In progress (a group encounter that has at least one individual patient encounter that has not been signed off on) and those encounters that are Completed (group encounters are considered completed when all individual encounters within the group are signed off on) for the current day. Figure 34 Group Encounters on the Desktop Group Encounter Filters. In the Filter areas, you can filter results based on Date Range, Provider, Status, Department or Group Name, as shown below (Figure 35). Group Encounter Charting 23

26 Encounter Enhancements Figure 35 Filters in the Group Encounter Window Group Encounter Action Buttons. The system allows the user to add a new group encounter, edit a new group encounter and access other areas of the chart such as dashboard, goal monitoring, screening & prevention, etc. under the health maintenance section. There is also access to the utilities such as mail merge, administrative form, letters, etc. Adding a new Group Encounter. A user can start a new group encounter by clicking the New Group Enc button. This will open the add group encounter window and allow the user to populate the below fields. When the Create Patient Encounters button has been selected, a new encounter will be created for each patient in the patient group list on the Group Encounter window. If individual patient encounters started using a group encounter and exist for that day, the encounter for that patient will be available and appended. Group Name. Users can choose from a group name that has already been created or add a new group by choosing the reference icon. The drop down list will contain the common list of group names. If choosing an existing group that has been populated with patients then the system will automatically populate the patients from that group in the patient group list once selected. If adding a new group then the user can populate the patients using the Patient Group reference icon. Note: Group names can also be added through the EMR manager. Please refer to the MicroMD EMR User s Reference Manual for details on user-defined additions to reference lists. Encounter Header Information. This information (Encounter For, Encounter Level Category, etc.) will be populated from the user preferences for the user logged in. The note timing will default to the current date and time as it does for an individual encounter. Patient Group List. The patient group encounter window will allow the user to choose which patients they would like to be part of this group encounter. Users have the ability to add or delete patients from a group. See more information below on how to populate this list. Group Note. The note added here will be added to new encounters or appended to current encounters for all patients that are part of this group encounter. Group Encounter Charting 24

27 Encounter Enhancements Patient Encounters. Listing of all the current group patient encounters. This list will comprise of any encounters created during this group encounter and those encounters that are already open under other group encounters for the same patient. By choosing the create/append button the system will append now group note information to current encounters that are listed or create a new encounter for each patient listed in the patient group list box. The plus sign next to each patient s name allows you to put a patient specific note into the encounter. Within the group encounter in the Patient Encounters area, individual patient encounters can be accessed by double-clicking the row. The Right-click options available are; Sign encounter, Open encounter and open Patient Monitor Note: Group encounters can only be recorded using the Text encounter type. Figure 36 Recording a New Group Encounter Group Encounter Charting 25

28 Encounter Enhancements Populating patient group list. Once the patient group list reference icon is clicked the patient group encounter window opens. This window allows you to add patients from several different patient groups either individually or the whole group for the group encounter. Figure 37 Patient Group Encounter Window Editing a group encounter. By choosing the Edit Group Enc button the system will bring up the edit group encounter window and the user to edit information related to the selected group encounter such as encounter header information, add additional group notes, etc. Figure 38 Edit Group Encounter Window Group Encounter Charting 26

29 Encounter Enhancements Adding a patient note. By selecting the + to the left of a patient s name an individual patient encounter note window will open with the ability to add from text, copy previous individual patient group note, quick text and spell check. Users can add data to this note field, and then select OK to insert an individual patient note to the existing encounter. Figure 39 Adding a Patient Note Chart Summary Tab. The system will now display a group encounter icon on the summary tab within the chart to indicate if a particular encounter was generated as a group encounter. The hover text will list the group name and the date and time of the group encounter. Note: The system will list all group encounters if there are more than one for that same encounter. Figure 40 Group Encounter Indicator Icon on the Chart Summary Group Encounter Charting 27

30 Encounter Enhancements Encounter Groups within the EMR Manager. You can also setup new group names in the EMR Manager with the new Encounter Groups in the Reference List as shown below. New groups can be added, old groups can be deleted or made obsolete, and any group name can be edited. Figure 41 New Encounter Groups in the EMR Manager New Face x Face Time Tracking Tool for Encounters For encounters, we have added a new Face x Face Time Tracking window to gather user, start time, end time and the calculated duration in minutes. The time will be entered into the comment area of the bill builder and then passed to MicroMD PM pending charges and be retained as a sequence note. Figure 42 Accessing Face x Face Time Tracking on the Encounter Ribbon Bar Clicking the Face x Face button on the ribbon bar will open the Encounter Face Time window New Face x Face Time Tracking Tool for Encounters 28

31 Encounter Enhancements Figure 43 Encounter Face Time Window The Encounter Face Time window will remain open to allow the start or end times to be edited, as well as the Encounter or the Bill Builder. New Row Button. This will add a new row to the time tracking. Start Button. This will add the current time in the start time field of the active row. Stop Button. When selected, this will add the current time in the stop time field of the active row. Submit Button. This will only be active when the Bill Builder screen is open. When selected, the data from the Face x Face Time will be added to the Encounter Information Comment field. For example: Dr. Smith: 10:00 A.M.-10:05 A.M. Dur: :05 Dr. Jones: 10:07 A.M.-10:23 A.M. Dur: :16 Dr. Berry: 10:41 A.M.-11:04 A.M. Dur: :23 Total: 44 min. Close Button. This will close the Face x Face Time window and save any added or edited data. Right-click. This will bring up an option to delete the selected row. New Face x Face Time Tracking Tool for Encounters 29

32 PRESCRIPTION MODULE ENHANCEMENTS New eservice Prescription Prior Authorization (epa) Prescription Prior Authorization (epa), adds the ability to complete prior authorizations for medications electronically within the EMR. Streamlining workflow with electronic prior authorizations saves practices time on a costly element of the healthcare system. In order to utilize epa, a prescriber must be using the eprescribing functionality within the EMR. At the time of prescribing, when a medication is selected and the patient has coverage data returned for formulary within their record, the system checks to see if prior authorization is necessary using the formulary prior authorization flag. If one is required the system will automatically send over the initiation request and will put an indicator within the formulary window. Figure 44 Prior Authorization Notification in the Formulary Details In the above example, Prior Authorization is required in order to prescribe this medication. Click the Authorize Prescription button. This will open the Prescription Processor window. New eservice Prescription Prior Authorization (epa) 30

33 Prescription Module Enhancements An icon in the Prescription Processor window will turn green as a notification that an electronic prior authorization request has been sent. The system will also show the status as it does with all other prescriptions. For epa, it will display Sent for epa. Note: If the system knows based on the formulary data that a prior authorization is required for a medication then an electronic prior authorization request will automatically be sent and the indicator will already be visible. The user can always initiate an epa request even if it is not showing as required by clicking the epa button. Figure 45 Prior Authorization Indicator in the Prescription Processor Processing epa from the prescription processor window. From the Rx Prior Authorization icon within this window, there are two choices: Complete Selecting this option will open an epa Process Detail window and allow the user to complete the appropriate questions required to process the prescription or acknowledge the prior authorization if there is no action to be taken. Note The Pharmacy Benefit Manager (PBM) may send over more than one set of questions. Forward to staff Selecting this option will forward the processing of the epa to staff to complete the process. epa Staff assignments are configured in User Preferences under Prescriptions (see Figure 52 on page 35). New eservice Prescription Prior Authorization (epa) 31

34 Prescription Module Enhancements When the complete option is chosen the epa Process Detail window will open It will automatically bring the user to the workflow processes for this patient s current prior authorization. From this point the user will be able to identify what the next steps are to complete the epa. The epa starts with an initiation request that is sent to the PBM. The PBM will then respond to the request and send that response back to be displayed in the epa Process Detail Window within the EMR Figure 46 epa (Prior Authorization) Initiation on the Workflow Processes Tab If there are questions to be answered, the user can click on Complete PA Form under the action-required section within the Workflow Processes window. New eservice Prescription Prior Authorization (epa) 32

35 Prescription Module Enhancements Figure 47 Completing the epa Form on the Workflow Processes Tab The questions are presented on the worklist screen allowing the user to complete the questions by clicking the start button and answer the appropriate questions to respond back to the PBM. Figure 48 Worklist Window to Start epa Questions New eservice Prescription Prior Authorization (epa) 33

36 Prescription Module Enhancements Figure 49 epa Questions When Prior Authorization has been approved the user can Acknowledge Approved PA button to complete the epa process from within the Worklist tab of the epa Process Detail window (see below). Note: The epa must be acknowledged by a user in order to complete, even if the PA has been denied. In which case, it will say Acknowledge Denied PA, or if there is no need for a PA. Figure 50 Acknowledgement Screen New eservice Prescription Prior Authorization (epa) 34

37 Prescription Module Enhancements The worklist tab allows a user to see all epa instances for all patients including those that are still in process and those that are complete. A user can click on a particular one to review a specific epa. Figure 51 Worklist Window to View and Manage All epa Requests User Configuration for epa. Within the Prescriptions area of user preferences there is a new option added called Rx Prior Authorization staff. By clicking the reference icon, a user can set whom in the practice they would like to access and handle their epa requests. This can be given to more than one person in the practice. Figure 52 User Configuration for Rx Prior Authorization staff New eservice Prescription Prior Authorization (epa) 35

38 Prescription Module Enhancements Desktop Prescriptions area. There is a new action button in the Prescriptions. If the prescriber chooses not to address the need of a prior authorization at the moment of prescribing then the system will automatically create an action that will be added to the prescribers and designation staff s Desktop Prescriptions. From this area then both the prescriber as well as designated staff can take action on the epa by highlighting the desired prescription and choosing Process epa from the action buttons. This will bring up the epa Process Window as it does when using it from the prescription processor window. Figure 53 Desktop Prescriptions to Process epa Desktop Tool. A new Desktop tool, Rx Prior Authorization, is now available to prescribers and staff who have been set up in the prescriber s user preferences. This will allow the user to open up the worklist within the epa Process Window. Figure 54 Rx Prior Authorization Button in Desktop Tools A Prescription History of the Rx Prior Authorization is kept for any necessary review of workflow or processing. New eservice Prescription Prior Authorization (epa) 36

39 Prescription Module Enhancements When epa is denied, a mail message is sent to the prescriber so the user is notified that the epa has been denied and further action will need to be taken. When a cancel status is found, the epa initiate button will become available so a user can re-initiate if necessary. epa status is shown in the sticky note of the prescription. Below are the status that may be shown and a brief meaning. Status Meaning 1: Draft Msg is being formed to be sent. 2: Pending Msg waiting for sending. 3: Assigned Msg epa is assigned to a user to complete the next task (on the PBM side). 4: Distributed The listed item was sent to the listed recipient. 5: Accepted The listed item was accepted by the listed recipient. The user took action or began to take action on the task. 6: Released The listed item/task was locked, and the lock was released by the user who accepted it. It was not completed. Complete PA Form tasks will lock upon being accepted when the user selects the Start button. 7: Complete The epa message case has been completed and requires no further action on the part of the prescriber or the PBM/payer. This may have been the result of an approved/denied epa message or closed status returned by the PBM/payer. 8: Cancelled An approved Cancelled response was received from the PBM/payer. The epa message was cancelled. 9: Errored An error condition was met that resulted in the epa message case erroring out. The message must be restarted by the initiator. 10: In Progress The electronic prior authorization case is currently in progress and is awaiting action from either the prescriber or the PBM/payer. The case may be completed and responded to by the PBM/payer, but the task is in progress until it is acknowledged by a user in the epa Process window to complete the message workflow. Each status will have a : Textual name representing the status and/or a case note and the authorization number New eservice Prescription Prior Authorization (epa) 37

40 Prescription Module Enhancements Label Change for Prescriptions and Medications On the Prescription Pad and on medications in the encounter, the label Other Instructions was changed to Additional Dosage Instructions to better define the purpose of the field and reduce conflicts with other comments on the medication. Figure 55 Additional Dosage Instructions Alerts for Obsolete Medications With the new version, when a medication is obsolete or in other ways inactive, a message pops up when someone attempts to prescribe it to alert them about the medication s status. In addition, when a prescription request comes from a pharmacy, there is now an indicator that the medication is obsolete. Figure 56 Obsolete Medications Descriptions on Medications Medication descriptions in the EMR now use the First DataBank MedID description to ensure more robust Surescripts messaging. Label Change for Prescriptions and Medications 38

41 PATIENT PORTAL ENHANCEMENTS Importing Patient-Generated Health Data The Patient Portal now provides practices with a built-in Patient Health Information form that allows patients to submit updates to their health data. The patient can submit as little or as much information as needed. When they click Submit Form, the system sends the form to the practice s inbox in the EMR, ready for practice users to import and reconcile the data. STOP If your practice uses the Patient Portal but does not want to use this form, you must turn the form off. On the administrative side of the portal, remove the check mark from the Active checkbox from the form under Menu > Admin > Forms. Figure 57 Built-in Patient Portal Health Information Form The built-in form allows the patient to submit data for the following areas of their chart: Problem List Allergies Medications Immunizations Vital Signs Family History Social History Procedures/Surgeries TIP Patients can click the Save Data button to save the form and submit it later. Importing Patient-Generated Health Data 39

42 Patient Portal Enhancements Notification of a Submitted Form When patients submit new medical history, a MicroMD EMR user must reconcile those changes and accept them into the patient s chart. The system sends a Mail message to the practice with an XML file attached (Figure 59). The system also enables several alerts throughout the system to indicate that there is new health data that you need to add to the patient s chart (Figure 58). Figure 58 PHD Alerts in MicroMD EMR Data Reconciliation When you open Mail message or click a PHD icon, the system displays the message with the data file attached. To begin your reconciliation, simply right-click the attachment and select Import from the pop-up menu (Figure 59). Figure 59 File Import Importing Patient-Generated Health Data 40

43 Patient Portal Enhancements On the initial Data Reconciliation window, the file should already appear in the drop-down so all you have to do is click the Load button. The system loads the data that the patient submitted and adjusts the Data Reconciliation window (Figure 60). Figure 60 Data Reconciliation Window The system populates the Current MedInfo pane with the current medical information from the patient s chart. In the New Info pane is the information the patient submitted from the Patient Portal health information form. Any new information or information that differs from what is currently in the chart appears with a red bar. NOTE If you do not want to import an entry into the patient s chart, simply remove the check mark from the entry under the New Info pane. Double-click each entry you want to reconcile (for example, the Pancreatic Cancer entry in Figure 60) to open the appropriate Add window for the medical information (for example, Figure 61). Importing Patient-Generated Health Data 41

44 Patient Portal Enhancements Figure 61 Example Medical Information Window For any discrete data fields such as Diagnosis, Medication, Habit, Social History, etc. click the Lookup icon ( ) and select the appropriate entry from your database. If the entry does not exist in your database, click the New button to add it. STOP If you do not save this information as discrete data, you will not be able to report on it or select the same entry for other patients in the future. NOTE You must have the Add Reference Data function associated with your user account to add an entry to your database. Once you click OK on the Add window, the system adds the data to the patient s chart and clears the red bar and the check mark from that item in the New Info pane. You can also see the word ADDED next to any item you have imported into the patient s chart. Close the windows when your reconcile is complete. Figure 62 Medical Information Added Importing Patient-Generated Health Data 42

45 Patient Portal Enhancements Bi-Directional Secure Messaging With the new version, we have integrated bi-directional secure messaging between MicroMD EMR and the Patient Portal. Now, when a patient sends a message to the practice from the portal or replies to a message sent from the practice, that message now also comes back into the EMR automatically. It also means that when a patient sends a message through the portal, that message appears in the individual user s Mail or within the practice s mailbox (as well as the patient s chart). NOTE All message threads appear in the patient s chart under the Mail in the patient s Workflow Communicator. NOTE Mail messages sync between the Patient Portal and MicroMD EMR every 15 minutes. Appointment Request and Patient Scheduling Options For practices with MicroMD PM + EMR, you can now provide your patients with scheduling options in the Patient Portal. The information comes from the Patient Portal into MicroMD every 15 minutes and includes new, cancelled and rescheduled appointments. You can allow the patient to: send an appointment request Once they send their request, it appears in the Appointment Request list in the Appointments window and in the Check-in/Check-out window. Staff can then confirm the appointment and add it to the practice s schedule. schedule the appointment from available open time slots Practices can establish the available time slots for Patient Portal users. Once the patient chooses an appointment time slot and clicks Request, the appointment is made and the appointment added to their list. Practice Setup Locations and Providers for Online Scheduling To let the Patient Portal know which practice locations and practice providers you want to make available for online scheduling, there is a simple action to take. There is an OS checkbox on both the practice locations and the practice providers. TIP OS stands for Online Scheduling. Locations To include a practice location in online scheduling for the Patient Portal, place a check mark in the OS checkbox for that location under Maint > Practice > Location (Figure 63). Bi-Directional Secure Messaging 43

46 Patient Portal Enhancements Figure 63 OS Checkbox for a Location Providers To make a practice providers available to the Patient Portal, place a check mark in the OS checkbox for that provider under Maint > Practice > Provider (Figure 64). Figure 64 OS Checkbox for a Provider Practice Setup Appointment Templates In MicroMD PM, there is also a new option on the Appointment Day Setup template (Figure 65) and on the Customize Day feature that allows you to restrict the appointment time slot available to patients on the portal for automatic online scheduling. The P column in both of these windows allows you to click the column one time to display a lock icon and protect the time slot. This now prevents staff members AND patients from scheduling appointments in those slots. If you click the P column a second time, MicroMD PM displays an R in the column and restricts this time slot. This restriction prevents scheduling from the Patient Portal but allows staff members to schedule in the time slot as normal. Appointment Request and Patient Scheduling Options 44

47 Patient Portal Enhancements Figure 65 Appointment Day Setup For example, Betty at Summervale Medical Center has opened up the time slots between 8:00 am and 9:45 am to allow their patients to schedule appointments automatically from the Patient Portal. For those time slots, she has neither a lock icon nor an R in the P column. For all other time slots on the day, she has the R, which allows her staff to schedule appointments but prevents the patients from scheduling on the portal during the rest of the time slots. Scheduling Setup on the Portal Side Once you have the PM set up appropriately, you can activate the appointment scheduling from within the administrative side of the Patient Portal. As a user with the Admin privilege, log in to the portal and select Menu > Admin > Scheduling. The Scheduling Admin window opens (Figure 66). Appointment Request and Patient Scheduling Options 45

48 Patient Portal Enhancements Figure 66 Scheduling Options for the Practice on the Portal Make sure there is a check mark next to Patients can schedule appointments. Then select how far into the future they can schedule appointments and whether you want the portal to schedule the appointments automatically or if the portal should only create an appointment request in the PM. TIP The Appt. Types, Templates and Calendars tabs do not need to be edited. In addition, the reminder options on the Rules tab are not currently in use. Appointment Request and Patient Scheduling Options 46

49 Patient Portal Enhancements What the Patient Sees on the Portal When the patient logs into the Patient Portal and wants to schedule an appointment, they can click the Appointments tab (Figure 67). This displays the patient s current upcoming appointments, along with the ability to request (or schedule) the appointment. Figure 67 Appointments on the Patient Portal The patient can select the provider, practice location, the type of appointment, and the time frame. Once the patient clicks Refresh, the system displays all of the available time slots from MicroMD PM. The slots that appear in the list are those time slots where there is no lock and no R in the P column of the appointment s setup, as well as no other appointment scheduled. Figure 68 List of Available Time Slots When the patient clicks a time slot to choose that appointment, the system displays the Request Appointment window (Figure 69). The patient can verify the information, add a note to the practice and click the Request button. Appointment Request and Patient Scheduling Options 47

50 Patient Portal Enhancements Figure 69 Appointment Request on the Patient Portal Appointment Request If the practice has elected to allow patients only to send appointment requests from the Patient Portal, when the patient clicks Request, the portal sends the request to the PM and the request appears in the Appointment Request window (Figure 70). Figure 70 Appointment Request List On the red corner flag of the request, the system displays the date and time the patient submitted the request, as well as the date and time slot they requested. When the practice schedules the appointment, the portal adds the new appointment to the patient s appointments list on the portal. Appointment Scheduled If the practice has elected to allow patients to schedule the actual appointment, when the patient clicks the Request button, the portal adds the appointment to the patient s list automatically and automatically adds it to the appointment schedule back in the PM (Figure 71). Figure 71 Appointment Schedule Appointment Request and Patient Scheduling Options 48

51 Patient Portal Enhancements Issuing CDA from the Portal Updates Screen The Portal Updates area has been enhanced to allow a user to publish multiple CDAs to the Patient Portal. Patients will only appear in this area if they have an active Portal account and pertinent changes were made to their chart. The system is looking at the following areas to populate the appropriate patients: Demographics, Family History, Immunizations, Laboratory Results, Laboratory Tests, Medication Allergies, Medications, Problems, Procedures, Race, Smoking Status, Social History, Vital Signs Figure 72 Portal Updates Screen Column S Checkbox. Select the CDA(s) that are to be queued for publish. Column E Checkbox. Edit the CDA(s) before publishing. When the E checkbox is selected, it will automatically check the S checkbox for publishing. The Data Category column has been removed. The Recorded On, Patient and Last Published columns can be sorted in ascending or descending order Select Button; Select All and De-Select All. Select All will check all the boxes in the S column and De-Select All will uncheck all the boxes in the S column. Figure 73 New Select Button Edit Button; Select All and De-Select All. Select All will check all the boxes for both columns, S and E. De- Select All will only uncheck the E column, the S column will remained checked. Issuing CDA from the Portal Updates Screen 49

52 Patient Portal Enhancements Figure 74 A right-click menu has been added with the following options: Open Chart Will open the chart of the patient New Edit Button Print List Prints the list from the Portal Updates window Queue CDA Places the CDA in a queue for batch publishing at day s end Do Not Publish Will not publish the CDA if checked Show Publish Log Shows a log of all published CDAs through the Portal Change History (This Entry) changes that cause the patient to be in this list are listed under Change History, similar to the Change History functions in other areas of the EMR. Queue CDA Button. This will schedule the selected (S column) CDAs for a nightly job to automatically Export CDAs (requires no action other than queuing CDAs). If you selected the E column for any of the patients, the CDA Data Edit window will appear before publishing. The window allows for the selection of desired sections to edit before publishing. Figure 75 Button to Queue Patient CDA Issuing CDA from the Portal Updates Screen 50

53 Patient Portal Enhancements Figure 76 Individual CDA Edit Window Do Not Publish. Will not send the CDA for the patient that is highlighted. Show Publish Log Button. Opens the Patient Portal Publish Log for the patient who is currently highlighted. New Areas Added to the Publish Log: Demographics, Family History, Immunizations, Laboratory Results, Laboratory Tests, Medication Allergies, Medications, Problems, Procedures, Race, Smoking Status, Social History, Vital Signs. Figure 77 Additional Fields on Patient Portal Publish Log Window Issuing CDA from the Portal Updates Screen 51

54 Patient Portal Enhancements Status Filter. Filter the window according to CDA Status. There are five new filters: 1. To Be Processed (Default) Contains entries that need the CDA to be published. 2. Delivery Failed Contains a list of entries where the delivery failed. 3. Sent Contains a list of entries sent. 4. Queued Contains a list of entries queued to be sent via the nightly job. 5. Do Not Publish Contains a list of entries that are not to be published. Right Click Options: Open Chart Will open the chart of the patient Print List Prints the list from the Portal Updates window Queue CDA Schedule CDAs that are selected for export via the nightly job Do Not Publish Will not publish the selected (S column) CDAs Show Publish Log Shows a log of all published CDAs through the Portal Change History (This Entry) changes that cause the patient to be in this list are listed under Change History, similar to the Change History functions in other areas of the EMR. New Portal Account Flag for Scheduled Visits In the Scheduled Visits area of the Desktop, all patients with an active Portal account are now denoted with a Portal icon as shown below. Figure 78 Active Portal Account in Scheduled Visits Scheduled Visits Portal Registration. The ability to register a patient for the portal if there are not already signed up has been added to a right click menu right from scheduled visits. By choosing the Patient Portal setup icon it will open the registration window and allow the user to register the patient for the portal. The option will be greyed when a patient is already signed up for the portal. New Portal Account Flag for Scheduled Visits 52

55 Patient Portal Enhancements Figure 79 Right-Click Menu for Patient Portal Setup Viewing Patient Messages From the Publish Log We have added the ability to view messages from the Publish Log if a message has been sent along with a document when publishing to the portal. These messages can be found under the medical information category that the message was attached to when publishing. Messages can now also be seen when being sent as a message only. These messages can be found under the Sent Message without Medical Information section. Hovering over the message will display the text of the message. If the message was sent prior to upgrading to Version 12.0, the hover text will read, No message available for display. Viewing Patient Messages From the Publish Log 53

56 Patient Portal Enhancements Figure 80 Viewing Sent Messages in the Published Log Quick Text Access Added to Patient Message Windows The Quick Text option (QT) has now been added to the Patient Message windows. Figure 81 Quick Text Access in Patient Messages and Memos Link to Online Payment on Patient estatements For clients with estatements (along with epayments), there is now an option to add a link on the patient estatement and on the Patient Portal that allows the patient to pay by credit card through the Patient Portal. What the Patient Sees The estatement will display Pay Statement Online, and the Patient Portal pages will also display a Pay Statement Online link throughout the patient s experience on the site (Figure 82). Quick Text Access Added to Patient Message Windows 54

57 Patient Portal Enhancements Figure 82 Payment Link on the Patient Portal When the patient clicks the link, the system prompts them to let them know they are leaving the Henry Schein Secure Chart Patient Portal and going to the payment site. Adding the Payment Link When you log in to the Patient Portal as an administrative user, you can enter the web address to your payment site under Menu > Admin > MicroMD Patient Payment URL (Figure 83). This activates the link on your estatements and on the Patient Portal. (Be sure to click the Save button at the bottom.) Figure 83 Pay Statement Online Option Link to Online Payment on Patient estatements 55

58 MICROMD DMS ENHANCEMENTS New Forwarding Option for DMS Documents A Forward option has been added to DMS. This will allow users to forward an attachment, similar to the same function from the Desktop. This is for EMR users only. If the user is not accessing DMS from the EMR, this Forward button will be disabled. Figure 84 New Forward Button in DMS New Forwarding Option for DMS Documents 56

59 MicroMD DMS Enhancements Once the forward button is clicked the system will open up the forward attachment window where the user can associate an order, change the folder and attach it to the user that they would like to send it to. Figure 85 Forward Attachment Window New Forwarding Option for DMS Documents 57

60 Henry Schein MicroMD 760 Boardman-Canfield Road Boardman, OH