iknowmed Software Release

Transcription

1 iknowmed Software Release Version December 2013 Copyright 2014 McKesson Specialty Health. All rights reserved.

2 iknowmed Software Release Version December 2013 Release at a Glance (Table of Contents) 1. Overview ICD-10 and the Problem List Tool Mark Problem Reviewed ICD10 Codes in the Problem List Tool Edit ICD10 Codes Search by ICD10 Code or Description ICD10 Codes in the Flowsheet ICD10 Codes in Progress Notes ICD10 Codes on the Charge Capture Report Other Charge Capture Changes ARRA Meaningful Use Stage 2 Preparation Demographics: Multi-select Race Treatment View: Searchable Encounter Notes Viewed Attachments Cleared from Temporary File Cache Attachment Review: Sign All Items Behavior Corrected Attachments: Attending Required to Attach, Web Site Printing Not Supported Copyright 2014 McKesson Specialty Health. All rights reserved.

3 6. Medications Prescriptions: Added Patient Address, erx Disabled for Controlled Drugs Regimens: Better Explanation When Adding Cycles, Cycle Day Admin Fix Added Gehan & George BSA Formula Results: Renamed Lab Report, Added Next Appt to Result Review, and more Encounter Note: Added Bone Health Agent, Fixed Assisted By Nurse Display Improved Flowsheet View, Interface Monitor, Saving Dictations, OET Display and Timeout Behavior Patch Release Addendums Version b64 (December 13, 2013) Version b84 (January 7, 2014) Version b91 (January 15, 2014) Version b98 (January 24, 2014) Version b99 (February 5, 2014) Copyright 2014 McKesson Specialty Health. All rights reserved.

4 1. Overview iknowmed version prepares iknowmed for the transition to the ICD10 billing code system and increases iknowmed s compliance to Meaningful Use Stage 2 regulations. Important changes include adding/editing ICD10 codes in the Problem List Tool, allowing multiple selections for a patient s race, providing a way to search an encounter note, improving the removal of PHI from the workstation, fixing Attachment Review problems, adding the patient s address to the Prescription editor, adding the Gehan & George BSA formula, renaming Lab Report to Result Report, and making the Log In page appear after a timeout. 2. ICD-10 and the Problem List Tool The entire ICD10 code set is loaded into iknowmed. Billing of ICD10 codes begins on 10/01/2014, however we encourage providers to select ICD10 codes well before 10/01/2014 to minimize billing disruptions after that date. Before then, both ICD9 and ICD10 codes are captured, but ICD10 codes will not display on the Charge Capture Report until 10/01/2014. iknowmed s ICD10 code lists are being refined, and will improve over the coming months. 2.1 Mark Problem Reviewed With this release, we hope many users will transition from using the Progress Notes Problems row to using the Problem List Tool for charting problems. To facilitate that transition, problems can be marked as reviewed in the current visit by checking the new checkbox next to the problem. Right-click a problem s name to see the available options for: adding detail, inactivating a problem and removing a problem. As with the existing behavior, changes that will be charted display in blue. In the example above, the ICD10 code D70.1 was matched with the existing Neutropenia problem, so only the ICD10 code will saved to the chart, so only the code is blue. 4 Copyright 2014 McKesson Specialty Health. All rights reserved.

5 2.2 ICD10 Codes in the Problem List Tool ICD10 codes display in a new column in the Problem List Tool. ICD9 codes do not display in the Problem List Tool. Multiple ICD10 codes may be associated with a problem. A green checkmark next to the ICD10 column indicates a specific code is selected, and no further code editing is necessary. In some cases, the default code is specific enough for billing purposes that the green checkmark appears. In other cases, the default code is not specific, other more appropriate codes are available, and the green checkmark does not appear. Sometimes, no default code is associated with a problem, in which case Select code appears. If no code is linked with a problem No available code appears. ICD10 codes that are not associated with any problem display on their own row. Clicking the checkbox next to a loose ICD10 concept (which has No problem selected ) shows as Capture code in the flowsheet. Hover on the ICD10 code to see the ICD10 description. Right-click a row in the ICD10 column to see the available options for adding, editing and removing codes. Editing an ICD10 code does not mark a problem as reviewed. ICD10 codes do not appear in the Inactive Problems area. 2.3 Edit ICD10 Codes Progress Notes derive the specific ICD10 code for a small subset of primary diagnoses, so this tool will primarily be used to assign specific ICD codes to the remaining primary diagnoses and general problems. To add, edit, or remove an ICD10 code, left-click the ICD10 cell associated with the problem. A window appears listing the codes associated with the problem. Check and uncheck codes as desired. Codes are only pre-checked if they were manually checked in the current editing session. If you click Save (to save changes to the Problem List) or click Cancel (to forego making a change to the Problem List), any selection will not be selected the next time you open the Problem List. 5 Copyright 2014 McKesson Specialty Health. All rights reserved.

6 2.4 Search by ICD10 Code or Description The search area allows for searching on problems, ICD10 codes and ICD10 descriptions. Searching by ICD9 codes in the Problem List Tool is not supported. Choose the Billing codes search option below the Problem / Code Search field to search for ICD10 codes and descriptions. 2.5 ICD10 Codes in the Flowsheet The ICD10 codes display as rows in the flowsheet within the category ICD10, as shown below. Flowsheet Views can be customized to hide these services or even the new ICD10 Code Category from view. (Contact the iknowmed Help Desk for help modifying Flowsheet Views) The value Capture code indicates that the code will display on the Charge Capture Report. If the code should no longer be captured, the value N/A displays. Additionally, the specific ICD10 code displays when hovering on a problem, as shown below. The ICD9 code will continue to display until some period after 10/1/ Copyright 2014 McKesson Specialty Health. All rights reserved.

7 2.6 ICD10 Codes in Progress Notes Progress Notes automatically capture the specific ICD10 code for a small subset of diagnoses. If not enough information is available to capture a specific code, an alert displays in the knowmed. ICD10 codes for primary diagnoses captured in Progress Notes generate the same services in the flowsheet as the Problem List Tool. By placing the Problem List toolbar button to the right of the toolbar, the Problem List Tool can be accessed with the Progress Note knowmed open. 2.7 ICD10 Codes on the Charge Capture Report ICD10 codes will display on the Charge Capture Report and will be transmitted via the charge interface beginning10/01/2014. Charges prior to 10/01/2014 will report ICD9 codes. The Charge Capture Report no longer displays the text Missing code for problems without codes. Instead, No code selected or No code defined display. In the example below, no code was selected for Essential hypertension, and no code was available for Fear of medical personnel. 2.8 Other Charge Capture Changes The Capture Charges section of the Charge Capture Report displays dose amount exactly as the Medication Administration section displays it. This corrects a problem in which the doses were displayed with different precision (decimal places). The Charge Capture Interface now sends the first Attending found at any practice when there is no provider at the practice under which billable services were charted. 7 Copyright 2014 McKesson Specialty Health. All rights reserved.

8 3. ARRA Meaningful Use Stage 2 Preparation 3.1 Demographics: Multi-select Race iknowmed fully meets Meaningful Use requirements for the Demographics (a)(3) objective. The objective requires the Race to support multiple values, and requires any value not equal to one of the five OMB defined values (i.e., American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander and White) to be aggregated into one of the five. By keeping races already charted, and aggregating them to the OMB values, most practices will be in a good place for meeting this measure s 80% Stage 2 threshold. Race, in the Patient Demographics window, is completely redesigned. The previous drop-down list is replaced with a No Race specified link. Click the link to update the patient s Race. The new Modify Patient s Race dialog appears. The five OMB defined races are represented as Categories. Other races available in iknowmed display under Races. Selecting a Race also selects the Race s Category, but selecting a Category does not select a Race. Clicking Declined or Unknown deselects all other selections, and selecting a race or category deselects Declined and Unknown. Click Declined or Unknown to clear all other selections. The OK button is only enabled after making changes. Races received by interface are handled just like manual updates. Races not represented in the dialog can be mapped to an existing value, or the new value can be requested from the iknowmed Help Desk. 8 Copyright 2014 McKesson Specialty Health. All rights reserved.

9 3.2 Treatment View: Searchable Encounter Notes To meet Meaningful Use requirements for the Electronic Notes (a)(9) objective, you can now search for text in an encounter note by way of the Treatment View. To view encounter notes via Treatment View, click the View menu s Treatment View option, and click an icon on the same row as the diagnosis. Use the Find feature at the bottom of the window to search for a word or phrase in the currently selected note. 3.3 Viewed Attachments Cleared from Temporary File Cache To better meet HIPAA regulations and the Meaningful Use End-user Device Encryption (d)(7) objective, viewed attachments are cleared from the Temporary File Cache when navigating to a different page of iknowmed. To take advantage of this functionality, be sure your local IT has installed the latest ActiveX controls. 4. Attachment Review: Sign All Items Behavior Corrected When signing an entire page of attachments in Attachment Review, prior to the release, subsequent pages of attachments did not function properly. This release changes the behavior so that when the user signs all of the items on page one the following occurs: 1) the item count does not change, 2) The page of items are signed, the list is advanced to the next page and the first item is selected. 3) The first page of attachments can still be accessed. In the initial release there are two problems that will be corrected in a later patch release: When there are no items in the queue three flashing squares display on the left side, implying something is loading, but nothing ever loads. Hover on the To Do List button to determine if items should appear in the queue, or Customize the list for a different queue. When signing all items in the queue, the items may remain in the queue after clicking Refresh. In this case, click the To Do List button s Attachment Review option to refresh the page. 9 Copyright 2014 McKesson Specialty Health. All rights reserved.

10 5. Attachments: Attending Required to Attach, Web Site Printing Not Supported Each chart must have an attending physician selected in the demographics for any charting to occur, and now, this includes attachments. When attaching, if a chart is not assigned an attending and no provider is selected in the Signature Required field, then an error appears and the document cannot be attached. When attempting to print a web site linked to a chart in Attachment Review, a message appears indicating that this type of document is not supported in iknowmed. To print this kind of attachment, display and print it using the associated application, which, in nearly all cases, will be using Internet Explorer's Print capability. 6. Medications 6.1 Prescriptions: Added Patient Address, erx Disabled for Controlled Drugs The patient's address now appears on the Add/Edit Order window. This was done to make it easy to provide pharmacies with the patient's address when creating/editing Prescriptions, but it also appears for Admixtures and other orders. For controlled drugs, the disabled e-prescribe option is more easily seen as disabled. 6.2 Regimens: Better Explanation When Adding Cycles, Cycle Day Admin Fix When changing number of cycles in a regimen, the dialog now explains, "New cycles are copied from the last cycle. Held and Discontinued orders in the last cycle are not copied to new cycles. After adding new cycles, you can add and modify the orders." Prior to this change, it was not clear that held and discontinued orders in the last cycle would not be propagated to new cycles. When loading the Cycle Day Administration window, a "Loading" message appears, preventing clicks from occurring in the window and thereby preventing other, downstream errors. 6.3 Added Gehan & George BSA Formula The Gehan & George BSA formula is added to iknowmed. It can be chosen in the Regimen Order Editor or by editing the Body Surface area (BSA) service directly. 7. Results: Renamed Lab Report, Added Next Appt to Result Review, and more The Lab Report is now named Result Report because results displayed on the report are not always labs. The patient's next appointment (at any location at the customer) displays when reviewing results in the Result Review Queue. In the printed Lab Trend Report, text results are truncated at 25 characters to correct a problem that caused other results to be hidden. A result's requeue option is disabled if the practice does not use the Result Review Queue. 10 Copyright 2014 McKesson Specialty Health. All rights reserved.

11 8. Encounter Note: Added Bone Health Agent, Fixed Assisted By Nurse Display On the encounter notes, "Bone health agent" appears in Completed Treatment Details. When more than one person is selected in the "Bone Marrow biopsy/aspiration procedure note" > "Assisted by Nurse" the encounter note now shows the names of those selected rather than a string of numbers. 9. Improved Flowsheet View, Interface Monitor, Saving Dictations, OET Display and Timeout Behavior This release corrects a problem that prevented Flowsheet View hide/zip preferences from affecting child services. Error messages in the Interface Monitor are more simply worded for easier troubleshooting. This release improves saving dictations in progress notes. This release improves the display of the Order Entry Tool (OET) so that the OK and Cancel buttons are not partially or fully hidden. When a session times out, instead of closing the window, the login page appears with a message indicating the timeout occurred. 10. Patch Release Addendums 10.1 Version b64 (December 13, 2013) In the initial release, a problem was introduced causing the attachment list to be populated with many repeating attachments after signing the entire first page of attachments. This patch release corrects that behavior. In fixing the behavior mentioned above, a problem is introduced. If you select one or more attachments and move to another page of attachments, then the previous selections are lost. Until this problem can be addressed in an upcoming release, we recommend signing or transferring selected attachments on the current page before viewing another page. An occasional problem preventing the creation of new patients received by interface is fixed Version b84 (January 7, 2014) This patch release corrects behavior introduced in the previous patch (see bullet #2 in section 10.1). If you select one or more attachments and move to another page of attachments, then the previous selections are now retained. This patch release also corrects a problem that showed new regimen orders as if they were part of the original regimen order. A configuration issue no longer generates errors when attempting to Save Chart to File. 11 Copyright 2014 McKesson Specialty Health. All rights reserved.

12 10.3 Version b91 (January 15, 2014) Hour glassing in Attachment Review is fixed. The Race Filipino was incorrectly categorized as Native Hawaiian or Other Pacific Islander. It is now correctly categorized as Asian. A problem which prevented a new cycle from being added to a regimen is fixed. Searching an encounter note for a phrase, through the Treatment View, now finds the whole phrase instead of finding each word in the phrase separately. Accessing the Home page no longer clears the cache a feature introduced in as a back-up precaution to protect patient health information (PHI). Removing the cache clearing from the Home page cuts the Home page load time by half. PHI is still protected by clearing the cache after viewing attachments. Interface message errors, in the Interface Monitor, are clearer and use less jargon, making troubleshooting interface messages easier Version b98 (January 24, 2014) Attachments: Fixed a problem that caused the Duplicate Check feature not to recognize already attached documents as duplicates. Problem List: Fixed a problem in which reviewed problems did not always save properly in the chart Version b99 (February 5, 2014) Interface Monitor: The message error [Test identifier] received more than once in panel now shows in the Interface Monitor. 12 Copyright 2014 McKesson Specialty Health. All rights reserved.