Paragon. Physician Modules What s New Guide (Release 13.0) DRAFT

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1 Paragon Physician Modules What s New Guide (Release 13.0) PWSP700HX1301 Release 13.0 February 24, 2015

2 2 Paragon Physician Modules What s New Guide (Release 13.0) Publication Information Copyright 2015 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved. Use of this documentation and related software is governed by a license agreement. This documentation and related software contain confidential, proprietary and trade secret information of McKesson Corporation and/or one of its subsidiaries and are protected under United States and international copyright and other intellectual property laws. Use, disclosure, reproduction, modification, distribution, or storage in a retrieval system in any form or by any means is prohibited without the prior express written permission of McKesson Corporation and/or one of its subsidiaries. This documentation and related software are subject to change without notice. Publication date February 24, 2015 Release Paragon Physician Modules, Release 13.0 Trademarks All other product and company names may be trademarks or registered trademarks of their respective companies. Disclaimer The names used in this publication are not the names of real individuals. Any similarity or likeness of the names used in this publication with the names of actual persons is purely coincidental and not intentional. February 24, 2015 Release 13.0 McKesson Corporation

3 Paragon Physician Modules What s New Guide (Release 13.0) 3 Contents Publication Information... 2 About this guide... 5 Computerized Physician Order Entry (CPOE) : Fully Processed Orders (FPO) enhancement : Full order text sort enhancement Prerequisites : Ability to default CPOE orders to a frequency of Once Prerequisites : Zynx Ability to preview an active order set Prerequisites : Zynx Authorspace order sets enhancement : Zynx Item to dispense mapped to a pending order Prerequisites Added system parameter Prerequisites Zynx Additional data attributes Prerequisites Medication Reconciliation Formulary substitution enhancement Prerequisites Direct Messaging : Processing Indicator Physician Documentation : Ability to send documents in pdf format : Plan of Care gallery can be added to any template type McKesson Corporation Release 13.0 February 24, 2015

4 4 Paragon Physician Modules What s New Guide (Release 13.0) Prescription Writer Transaction column Added transaction field : Quantity Printed prescription : Enhancements to the Specification sub-tab February 24, 2015 Release 13.0 McKesson Corporation

5 Paragon Physician Modules What s New Guide (Release 13.0) 5 About this guide Where applicable, this What s New guide provides information about the enhancements and changes in the following Paragon Physician Modules, Release 13.0 including: Computerized Physician Order Entry (CPOE) and Zynx Medication Reconciliation Direct Messaging Physician Documentation Prescription Writer McKesson Corporation Release 13.0 February 24, 2015

6 6 Paragon Physician Modules What s New Guide (Release 13.0) Computerized Physician Order Entry (CPOE) : Fully Processed Orders (FPO) enhancement If Fully Processed Orders (FPO) is turned on, when you order a code status for a patient that already has an active code status, a new message appears that specifies the old code that will be discontinued and the new code that will be added. If you proceed, the old code status is discontinued automatically and the new code status is added. Prior to this enhancement, you had to manually discontinue an existing code before you could add another. When FPO is turned off, the system functions as it did previously and you must manually discontinue the existing code before you can add another. 1. Verify that the system parameter COE_FPO_OMS_FG in Paragon Reference Masters is set to Y. 2. Log on to Paragon Clinician Hub and select an active visit. 3. Click Ordering and click Search. 4. Search for a code and then click the to display the Order Detail. 5. Complete all required fields (if necessary) and click submit. 6. Click the Order Queue and verify the code is in an Active status. 7. Click Search, search for a different code, and then click the to display the Order Detail. 8. Verify the following message appears: A Code Status order already exists for this patient. Would you like to save the code status Status> and discontinue the current status of <Previous Code Status>? 9. Click Yes. 10. Verify the Order Detail for the new code status is displayed. 11. Complete all required fields (if necessary), and click submit. 12. Click the Order Queue, and verify the new code status is in the queue and the old code status has been discontinued. 13. Return to Paragon Reference Masters and set the COE_FPO_OMS_FG system parameter to N. 14. Log off Paragon Clinician Hub, log back on, and select the patient used above. 15. Click Ordering and click Search. 16. Search for a code, and click the to display the Order Detail. 17. Verify that the following message appears: A Code Status order already exists for this patient. February 24, 2015 Release 13.0 McKesson Corporation

7 Paragon Physician Modules What s New Guide (Release 13.0) : Full order text sort enhancement The full order text sort has been modified to better group similar items together. The system previously sorted by ascending descriptions and now sorts by ascending description, ascending dose amount, and then ascending not to exceed dose. Note: Search results for orders originating from the Emergency Department (ED) are not affected by this work item. They are displayed in once-frequency indicator, order description sequence when ED_ORD_DEF_FG is set to Y per "Work Item ID (12.1.1/13.0.0)". Prerequisites In Paragon Reference Masters, select Common > System Parameters and verify ED_ORD_DEF_FG is set to N. In CPOE Reference Masters, on the General tab, verify that no sorting is specified under Full Order Text Sort (the right panel is blank). 1. Log on to Paragon Clinician Hub as a non-ed caregiver and select a patient. 2. Click Ordering, then click Search. 3. Enter acetaminophen in the Search text box and click go. 4. Select Acetaminophen Oral, deselect Common orders only, and select Ignore age specific dosing options to maximize the results that are displayed. 5. Verify that orders are sorted by order description, then dose amount, and then not to exceed dose, so that orders with the same dose amount are grouped together. McKesson Corporation Release 13.0 February 24, 2015

8 8 Paragon Physician Modules What s New Guide (Release 13.0) : Ability to default CPOE orders to a frequency of Once This enhancement provides the ability to default CPOE orders to a Frequency of Once for all single (non-order set) orders if the user is designated as an emergency physician/mid-level provider. For CPOE Verbal Orders, the system uses the caregiver selected as the Ordering Physician for the telephone/verbal/protocol order. The system defaults the Frequency of Once based on whether the selected Ordering Physician is an Emergency Department (ED) physician. When a Frequency of Once defaults, it can be changed to another valid choice on the Order Detail window prior to submitting the order. A new system parameter labeled ED_ORD_DEF_FG controls whether the order detail defaults are enabled for Emergency Department orders. in this enhancement. Additionally, if CPOE is accessed via the Patient Care Workspace window in the Emergency Department Information System application, the Frequency defaults to Once, regardless of whether the caregiver is designated as an emergency physician/provider. Note: Diet orders and Code Status orders do not default to a Frequency of Once. They are not included February 24, 2015 Release 13.0 McKesson Corporation

9 Paragon Physician Modules What s New Guide (Release 13.0) 9 Prerequisites Turn on/off ED Order Defaults 1. Log on to Paragon Reference Masters, click the Common icon, and select System Parameters in the pop-up menu. 2. Under the CPOE category, double-click the ED_ORD_DEF_FG system parameter and set the Default Value to Y (Yes, Enable ED Order Detail Defaults) or N (No, do not enable). 3. Click OK on the Maintenance window and then close the System Parameters window. Make a physician an emergency department caregiver: A. Caregiver Master - Service Instructions: 1. Log on to Paragon Reference Masters, click the Common icon, and select Caregiver in the pop-up menu. 2. On the Caregiver Maintenance window, find the physician you want to use to create orders, and double-click the physician. 3. On the Caregiver tab of the Caregiver Maintenance window, change the Service to Emergency Service and click OK. B. Caregiver Master - Functions Instructions: 1. Log on to Paragon Reference Masters, click the Common icon, and select Caregiver in the pop-up menu. 2. On the Caregiver Maintenance window, find the physician you want to use to create orders and double-click the physician. 3. Click the Functions tab. 4. If the Emergency option displays in the Available Masters list, move it to the Selected Masters list. If the Emergency option does not display in the Available Masters list, add it and then move it to the Selected Masters list. 5. Click OK directly under the Selected Masters list next to the Copy button and click OK at the bottom of the Caregiver Maintenance window. C. ED Caregiver in Department Maintenance for Emergency Department Management: 1. Log on to Emergency Department Management. 2. From the List menu, select Department Maintenance. 3. Click the Caregiver tab. 4. If the caregiver selected in Reference Masters is not in the list, scroll down to the empty row at the bottom of the window, and then click the Search button for the row. 5. Find the caregiver and add him/her to the list. 6. Click Save on the Department Maintenance window. Test 1 The order sentences are sorted by the "Once" order first when ED Order Defaults are disabled and the caregiver is an ED caregiver. 1. In Paragon Reference Masters, set the ED_ORD_DEF_FG system parameter to N (see "Turn on/off Order Defaults" in the Prerequisites). 2. Make your caregiver an ED caregiver (see "Make a physician an emergency department caregiver " A, B or C, or any combination in the Prerequisites). 3. (For Release ) Log on to WebStation for Physicians, select a patient visit in the worklist, click the CPOE tab, and then click the Search sub-tab. McKesson Corporation Release 13.0 February 24, 2015

10 10 Paragon Physician Modules What s New Guide (Release 13.0) 4. (For Release ) Log on to Clinician Hub, search for a patient, put the patient in focus, click the Ordering tab, and then click the Search sub-tab. 5. Search for an OrderView drug. 6. Click the description hyperlink in the results to view the full order sentences list. 7. Verify that if Once order options are present, they are sorted at the top of the results. 8. Change the sort order of the items by clicking a field header. 9. Select or deselect the Common orders option or one of the other filters and verify that your sort selection remains intact. Test 2 The ED Order Defaults are enabled and the caregiver is an ED caregiver. 1. In Paragon Reference Masters, set the ED_ORD_DEF_FG system parameter to Y (see "Turn on/off Order Defaults" in the Prerequisites). 2. (For Release ) Log off of WebStation for Physicians, if the application is open. (For Release ) Log off of Clinician Hub, if the application is open. 3. Make the caregiver an ED caregiver (see "Make a physician an emergency department caregiver" A in the Prerequisites). 4. (For Release ) Log on to WebStation for Physicians, select a patient visit in the worklist, click the CPOE tab, and then click the Search sub-tab. (For Release ) Log on to Clinician Hub, search for a patient, put the patient in focus, click the Ordering tab, and then click the Search sub-tab. 5. Search for a Rx order that normally defaults to a blank Frequency or a value other than Once. 6. Select the order description hyperlink to open the Order Details window and verify that the Frequency defaults to Once. 7. Cancel the order. 8. Search for and select an OrderView order. 9. In the full order sentences selection list, verify the Frequency filter defaults to once, if the option is available. 10. Cancel the search or select an item and then cancel the order. 11. On the Search sub-tab, search for a non-rx, non-orderview order that normally defaults to a blank Frequency or a value other than Once. 12. Select the order to open the Order Details window and verify that the Frequency defaults to once. 13. Click the Favorite Orders tab, click a Rx, non-rx, and OrderView order, and confirm that they work in the same manner as they do when selecting from the Search list. 14. Undo the Caregiver ED setup (step 2), returning the caregiver to a non-ed state. 15. Repeat steps 4-13 with the ED caregiver setup B and then C. 16. Repeat steps 4-13 with the ED caregiver setup for A, B and C all at once. February 24, 2015 Release 13.0 McKesson Corporation

11 Paragon Physician Modules What s New Guide (Release 13.0) 11 Test 4 The ED Order Defaults are enabled and WebStation for Physicians/Clinician Hub is accessed via the CPOE Verbal Order function from either Order Management or Emergency Department Management. 1. In Paragon Reference Masters, set the ED_ORD_DEF_FG system parameter to Y (see "Turn on/off Order Defaults" in the Prerequisites). 2. Log on to Emergency Department Management or Order Management, select a patient visit, and click the CPOE Verbal Order toolbar button. 3. When the Select Ordering Physician dialog box opens, select a physician who is set up as an ED caregiver (A,B, or C in the Prerequisites) in the Ordering Physician field. Click the Select Physician button, click the Confirm Physician button, select the desired Ordering Source option, and then click the Enter New Order button. 4. Repeat steps 5-13 in Test 2. Test 5 The ED Order Defaults are disabled/off and a Non ED Physician is used. 1. In Paragon Reference Masters, set the ED_ORD_DEF_FG system parameter to N (see "Turn on/off Order Defaults" in the Prerequisites). 2. Remove the ED caregiver setup for the caregiver you want to use for testing (see "Make a physician an emergency department caregiver" in the Prerequisites). 3. (For Release ) Log on to WebStation for Physicians, select a patient visit in the worklist, click the CPOE tab, and click the Search sub-tab. (For Release ) Log on to Clinician Hub, search for a patient, put the patient in focus, click the Ordering tab, and then click the Search sub-tab. 4. Search for and select one of the previously selected Rx orders that does not default to Once and verify that the Frequency field does not default to Once on the Order Detail window. 5. Repeat step 4 for all non-rx order types. 6. Search for and select an OrderView order. 7. Verify that when the full order sentences are displayed, the system does not default the Frequency filter to Once, and that the sentences are sorted alphabetically : Zynx Ability to preview an active order set The CPOE Reference Masters application now provides the ability to preview an active order set so that content builders can see how the order set will function in CPOE. It is modeled after the CPOE order entry tree view. The preview option pertains to active order sets only rather than inactive, obsolete, or retired order sets. This enhancement is applicable to order sets built in CPOE Reference Masters and to order sets that are imported from AuthorSpace. Prerequisites 1. Log on to Reference Masters, click the Common icon and select Interface Connection Maintenance in the pop-up menu. 2. Open the new CPOE Ref Mstrs OrderSet Preview entry on the Interface Connection Maintenance window. McKesson Corporation Release 13.0 February 24, 2015

12 12 Paragon Physician Modules What s New Guide (Release 13.0) 3. Enter the name of the server that houses the Paragon database in the Server Name field and enter the name of the Paragon database in the Database field. 4. In the Hypertext Type field, select either http or https. Check with your System Administrator to see if your system uses Secure Socket Layer (SSL) IE https. If you do not enter a value, this field defaults to http. 5. Enter the name of the web server in the Host Name field, enter WSP in the Folder Name field, click OK, and then close Reference Masters. The Connection String field is auto-populated after the data is saved. 6. Log on to CPOE Reference Masters and click the OrderSets tab. 7. Create a new order set with the steps listed below or use an existing order set that meets this criteria. a. Add a group with the Action Type set to Choose Any. This group will be referenced as Group A in the following steps. b. Add two standing orders, each with at least three orderables, to Group A. c. Add a group with the Action Type set to Choose One. This group will be referenced as Group B in the following steps. d. Add two standing orders, each with at least three orderables, to Group B. e. Add a group with the Action Type set to Choose All. This group will be referenced as Group C in the following steps. f. Add two standing orders, each with at least three orderables, to Group C. g. Add a group with the Action Type set to Choose Any and the State set to Required. This group will be referenced as Group D in the following steps. h. Add three standing orders, each with at least three orderables, to Group D. For the first standing order, set the State to Required. For the first orderable in the first standing order, set the State to Required. For the second orderable in the first standing order, set the State to Recommended. For the third orderable in the first standing order, set the State to Recommended with Reason and select an NPR Group. Set the State of the second standing order to Recommended. Set the State of the third standing order to Recommended with Reason and select an NPR Group. 8. Save the order set and then activate it. 1. Log on to CPOE Reference Masters, click the OrderSets tab and select the order set created in the Prerequisites steps above. 2. Click the Preview OrderSet menu option. The Preview OrderSet window shows the CPOE ordering window as it appears in Clinician Hub when placing an order for an order set. 3. On the left side of the window, verify that there are check boxes beside each standing order in Group A since Group A has an Action Type of Choose Any. Select the check box beside Group A and verify the check boxes beside the two standing orders are enabled. Select the check box beside both standing orders and verify the check boxes beside the orderables are enabled. Then, select at least one orderable within each standing order and verify that the orderable moves to the right side of the window. Deselect each orderable and verify that the orderable moves back to the left side of the window. 4. On the left side of the window, verify there is a button beside each standing order in Group B since Group B has an Action Type of Choose One. Select the check box beside Group B and verify the buttons beside the two standing orders are enabled. Select the button beside the first standing order. Then, select one orderable within the first standing order and verify that the orderable moves to the right side of the window. Select the button beside the second standing order and verify the orderable from the first standing order that was on the right side of the window has moved back to the left side February 24, 2015 Release 13.0 McKesson Corporation

13 Paragon Physician Modules What s New Guide (Release 13.0) 13 of the window. Select an orderable within the second standing order and verify that the orderable moves to the right side of the window. 5. On the left side of the window, verify that there are no check boxes at the standing orders level under Group C but there are check boxes at the orderable level within each standing order. Select the check box beside Group C and verify the check boxes beside the orderables within each standing order are enabled. Then select the check box beside one orderable within each standing order and verify that the orderables move to the right side of the window. Deselect each orderable within the standing orders and verify the orderables move back to the left side of the window. 6. On the left side of the window, verify the following for Group D: Group D is checked when the Preview OrderSet window opens and is disabled so that you cannot deselect it (this is due to Group D having a State of Required). The first standing order is checked and disabled, preventing you from deselecting it (this is due to the first standing order having a State of Required). The first orderable in the first standing order is checked and disabled, preventing you from deselecting it (this is due to the first orderable having a State of Required). The second orderable in the first standing order is checked and enabled allowing you to deselect it (this is due to the second orderable having a State of Recommended). The third orderable in the first standing order is checked and enabled allowing you to deselect it (this is due to the third orderable having a State of Recommended with Reason). The second standing order is checked and enabled allowing you to deselect it (this is due to the second standing order having a State of Recommended). The third standing order is checked and enabled allowing you to deselect it (this is due to the third standing order having a State of Recommended with Reason). Deselect the third standing order, make a selection, click the accept button and verify that any orders previously selected are moved back to the left pane. 7. When the Preview OrderSet window opens, verify that the first three orderables in the first standing order in Group D are listed in the Selected Orders grid on the right side of the window. 8. In Group D on the left side of the window, deselect the second orderable in the first standing order and verify that the orderable is removed from the Selected Orders grid on the right side of the window. This orderable has a State of Recommended. 9. In Group D on the left side of the window, deselect the third orderable in the first standing order. Verify that the Reason for deselecting window opens from which you must select a Not Prescribed Reason (NPR) from the list of NPRs in the NPR group assigned to that orderable in the orderset. Select an NPR, click the accept button and verify that orderable is removed from the Selected Orders grid on the right side of the window. This orderable has a State of Recommended with Reason : Zynx Authorspace order sets enhancement When downloading and importing Authorspace order sets, validation is now performed if a PRN Rx frequency is selected but the PRN flag is not manually selected in the order detail. 1. Log on to Zynx Authorspace. Click Control Panel under the Menu on the left side of the window and select the environment. 2. Select Content Explorer under the Menu on the left side of the window. 3. When the Content Explorer window opens, click the + New Folder button and create a new folder. 4. Click the new folder and click the + New Content button. McKesson Corporation Release 13.0 February 24, 2015

14 14 Paragon Physician Modules What s New Guide (Release 13.0) 5. Add a Content Title, select Order Set as the Type, verify that the Open in editor after creating check box is selected, and then click the Create button. 6. When the Content Editor window opens, click the + Add Top Level Item link. 7. Select the Section option and click the Browse link for the Catalog field. 8. Select Med Section Group in the Term Type field. Enter two spaces in the Term Name field and click the Search button. 9. Select a section and click OK. 10. Click the Save button on the order set Content Editor window. 11. Click the drop-down arrow for the newly created item and select Insert in the pop-up menu. 12. Select the Med Order option and click the Browse link for the Catalog field. 13. Enter the first few characters of a medication name in the Term Name field (or enter two spaces to search for all medications) and click the Search button. 14. Select an item and click OK. 15. Click the Save button on the order set Content Editor window. 16. Click the drop-down arrow for the newly created therapy and select Insert in the pop-up menu. 17. Select the Medication Detail option. 18. In the Frequency field, select a PRN frequency (set as PRN in Pharmacy Management). 19. Verify that the PRN check box is not selected. 20. Select a Therapy Type. 21. Add a Dose, Dose Unit, and Route as needed to create the order. 22. Ensure that Export Validation is active. 23. Check in and then stage the order set. 24. Log on to CPOE Reference Masters. 25. Click the OrderSets tab. 26. Click the Authorspace menu and select Download & Import Authorspace Order Sets. The message that the Order Set Import is in progress displays until the process completes. 27. When the download completes, verify that a message indicates that there are validation errors. 28. Open the Validation Failure window and verify that the error message indicates a failure due to the PRN flag. 29. Repeat steps 16 through 25 except in step 19, select the PRN check box. (A non-prn frequency is used and the PRN check box is selected.) 30. From the Authorspace menu, select Download & Import Authorspace Order Sets. 31. When the download completes, a message indicates that the import was successful (no validation errors). 32. On the Validation Successful window, verify that the PRN order is included in the successful order sets. 33. Select and import the order set. Verify that the order set imports successfully. 34. Open the order set and click the Information icon for the medication. Verify that the PRN Flag field displays Yes on the View Detail window. 35. Repeat steps 16 through 25 except in step 18, select a non-prn frequency and in step 19, select the PRN check box. (A non-prn frequency is used and the PRN check box is selected.) 36. From the Authorspace menu, select Download & Import Authorspace Order Sets. The message that the Order Set Import is in progress displays until the process is complete. 37. When the download completes, verify that a message indicates that the import was successful (no validation errors). 38. On the Validation successful window, verify that the PRN order is included in the successful order sets. February 24, 2015 Release 13.0 McKesson Corporation

15 Paragon Physician Modules What s New Guide (Release 13.0) Select and import the order set. Verify that the order set imports successfully. 40. Open the order set and click the Information icon for the medication. Verify that the PRN Flag field displays Yes on the View Detail window : Zynx Item to dispense mapped to a pending order Previously, an item to dispense was not mapped to a pending order (from an imported AuthorSpace order set) that was prescribed on the Medication Reconciliation Discharge draft. This issue has been corrected. Prerequisites 1. Identify an order set with medication orders that has been imported into CPOE Reference Masters and that has been activated. 2. Identify an inpatient who does not have a completed Medication Reconciliation Discharge draft. 1. Log on to Clinician Hub and search for the inpatient who does not have a completed Medication Reconciliation Discharge draft. 2. Put the patient in focus and click the Ordering tab. 3. Click the Search sub-tab, search for the imported order set with the medication orders, and then click the description hyperlink. 4. Select one medication order in the order set and submit it. (Do not process the order in Pharmacy Management.) 5. Click the Medication Reconciliation sub-tab and start the Discharge draft. 6. Click the Prsb button for the pending medication order that was submitted in step When the Med Recon - Rx Writer detail window opens, verify that the Dispense As field is populated Added system parameter This enhancement adds a new WSP_DFT_RSN_COD_FG (Save default reason for Radiology orders) system parameter to Paragon Reference Masters. When this parameter is set to Y for a facility, the entries made in the Reason/Indication and/or Reason/Indication Text fields for the first radiology order default into these fields on all other radiology orders added for the same patient during the same ordering session. Users can change the default information when necessary. Prerequisites 1. Log on to Paragon Reference Masters and verify the system parameter WSP_DFT_RSN_COD_FG is set to Y. 2. Build an order set in Computerized Physician Order Entry (CPOE) Reference Masters that contains multiple orders. radiology McKesson Corporation Release 13.0 February 24, 2015

16 16 Paragon Physician Modules What s New Guide (Release 13.0) 1. Log on to WebStation for Physicians (12.1.2) or Paragon Clinician Hub (13.0.0) and select the test patient. 2. Click CPOE (12.1.2) or Ordering (13.0.0) and then click Search. 3. Search for and select a radiology order to display the Order Detail. 4. Select a Reason/Indication and enter Reason/Indication Text, complete all required fields, and then click Save. 5. Search for and select another radiology order to display the Order Detail. 6. Verify the Reason/Indication and Reason/Indication Text fields are populated with the information entered in step 4, complete all required fields, and then click Save. 7. Search for and select an order set that contains a radiology order. 8. Select a radiology order from the order set and display the Order Detail. 9. Verify the Reason/Indication and Reason/Indication Text fields are already populated with the information entered in step 4, complete all required fields, and then click Save Zynx Additional data attributes This enhancement adds data attributes for Order Management orderables and the Choose Either option for the Action field for sections and sub-sections. Prerequisites None 1. Log on to Paragon CPOE Reference Masters and click the OrderSets tab. 2. Click Authorspace, select Full Catalog Sync and verify that the Full Catalog Sync completes successfully. 3. Log on to Zynx Authorspace and select the same environment in which the Full Catalog Sync was performed. 4. Click Content Explorer and select an existing order set (or create an order set) that contains the ten order areas and the Choose Either option for the Action field. 5. For the following order areas, verify that the associated data attributes have been added to the order detail level and that an entry can be made in each field. For the group type Action field, select the Choose Either option in each Authorspace section and sub-section. Radiology, Other, and Cardiology - # of Days - Total Qty - Instructions - Transport Laboratory and Microbiology - # of Days - Total Qty - Instructions February 24, 2015 Release 13.0 McKesson Corporation

17 Paragon Physician Modules What s New Guide (Release 13.0) 17 Nursing, Isolation, and Code Status - # of Days - Instructions Dietary - Diet Note (different from the Instructions field) Consult - Reason for Consult (different from the Instructions field) 6. After the order set has been modified (or built), click Check-In, and then click Stage to ensure the order set is ready for export. 7. In Paragon CPOE Reference Masters, select Download & Import Authorspace Ordersets from the Authorspace menu, import the specified order set, and then activate it. 8. Verify that all the data attributes and the Choose Either options for the Action fields are displayed correctly. 9. Log on to Paragon Clinician Hub, search for a patient, put the patient in focus and then click the Ordering tab. 10. Click the Search sub-tab, search for the order set imported from Authorspace and click the description hyperlink to open the order set window. 11. Verify the Choose Either option for the Action field is displayed correctly (one or both of the two sections or sub-sections can be selected). Note: Additional prompts are displayed if the State field is set to Required, Recommended, or Recommended with Reason. 12. Verify that all data attributes are displayed at the order detail level for all order areas. Notes: The Number of Days field and Total Qty field are not enabled (gray) for ONCE Frequency orders. If values are entered in these fields, Paragon CPOE Reference Masters generates a validation import error. The Total Qty field values are not displayed in Paragon CPOE Reference Masters > View Mode > View Detail. This applies to both Paragon and imported Authorspace order sets. McKesson Corporation Release 13.0 February 24, 2015

18 18 Paragon Physician Modules What s New Guide (Release 13.0) Medication Reconciliation Formulary substitution enhancement The list of formulary substitutions that is presented when a caregiver continues a non-formulary home medication has been enhanced to provide more precise suggestions. The formulary substitutions are now derived from the same Enhanced Therapeutic Classification (ETC) child class as the non-formulary medication (when available). Note: If there are no medications in the same child class, the list is blank with the options to cancel or to search outside the class. Prerequisites 1. Identify an OrderView medication that is not in the Pharmacy inventory and add it as a home medication to the test patient. 2. Validate the ETC class to which the medication belongs and identify a medication in the same class that is in the Pharmacy inventory. 3. Log on to CPOE Reference Masters, select the Disable "Patient's Own" Option on the General tab, and then click Save. 1. Log on to Paragon Clinician Hub and select the test patient. 2. Click Ordering and then click Medication Reconciliation. 3. Start the Admission draft and click Cont on the medication from step 1 of the Prerequisites. 4. Click yes on the message: Would you like to substitute the medication with a formulary item? 5. Verify that the list of substitutions is from the same ETC class. February 24, 2015 Release 13.0 McKesson Corporation

19 Paragon Physician Modules What s New Guide (Release 13.0) 19 Direct Messaging : Processing Indicator A processing indicator has been added to the Direct Message window during Clinical Document Architecture (CDA) generation, as it can take seconds to minutes to generate the CDA. 1. Log on to an application that provides the ability to send an outbound direct message (such as Clinical CareStation), select a patient, and launch the Direct Message function. 2. On the Direct Message browser page, click the Attach CDA option, click the Yes button when prompted to confirm the patient, and verify that a dotted, spinning circle appears while the CDA is being generated. Note: If the CDA is small, the processing indicator may only appear momentarily. McKesson Corporation Release 13.0 February 24, 2015

20 20 Paragon Physician Modules What s New Guide (Release 13.0) Physician Documentation : Ability to send documents in pdf format Users should be able to send documents from Physician Documentation to McKesson Patient Folder in PDF format. Before you begin In the ParagonImageUpload configuration file on NTier, verify PIUtoPDF is set to TRUE <addkey=piutopdf" value="true" />. You must have an Admin account to make this change. 1. Log on to Paragon Clinician Hub. 2. Search and select a patient whose records should be sent to McKesson Patient Folder. 3. Click the Documentation button. 4. Select the Search Note Template tab, and select a template to use. 5. Note If the document does not open, click the Create Addendum icon to the right of Save. 6. Enter data if desired, scroll down to the very bottom of the template note and check box, and select the Sign Here link below the Signature section. 7. Navigate to the Documents tab, and verify that the document was signed/finalized. (Note the time, type of note, etc.) 8. On the upper right, click the drop-down labeled MORE, and select Medical Record. This opens the MPF/HPF view. If pop-up does not open, then select the View Documents button. 9. Select the All Documents tab in the left side panel. 10. Identify the matching document type and expand the hierarchy tree to the page folders. 11. Select the page folder for each page, and verify that the documents are appearing as they would in the Documentation module, images are not missing, and the form was generated correctly without error. February 24, 2015 Release 13.0 McKesson Corporation

21 Paragon Physician Modules What s New Guide (Release 13.0) : Plan of Care gallery can be added to any template type The Plan of Care gallery item can now be added to any template type instead of only the Discharge Summary. The Content Document Architecture (CDA) document is now populated with the Plan of Care gallery item information from the Discharge Summary Note type (code DSN) or the Emergency MD Note type (code EMD). Paragon updates the Plan of Care information in the CDA based on the latest populated Plan of Care gallery item for the current visit. The Plan of Care information in the CDA is not overwritten if a new template is signed and the Plan of Care gallery item is not completed. 1. Log on to WebStation for Physicians or Paragon Clinician Hub (for Release 13.0) as an attending physician and select a patient for which problems have been entered. 2. Click the Documentation tab and then click Search Note Templates. 3. Open a note published as an Emergency MD Note that contains a Plan of Care section. 4. Click in the Plan of Care section and verify that the Current List of problems/procedures is displayed in a grid on the right side of the window. 5. Verify that you can add to or edit the Current List. 6. Highlight the problems and procedures you want to include in the documentation and click Continue to Plan of Care. 7. In the Plan of Care grid, click the Pencil icon, add information in the Plan and Instructions sections, and then click Save for each problem/procedure to be included. 8. Click Close and verify that the new or modified data populates the Plan of Care section of the Emergency MD Note. 9. Complete and sign the Emergency MD Note. 10. Access Direct Messaging. 11. In the To field, enter the address for Direct Messaging provided by RelayHealth. Note: Paragon cannot provide this address. If you are unsure of what address to use, contact RelayHealth or refer to the setup documentation provided at implementation. 12. After the To field is populated, select the Attach CDA option and click OK on the confirmation prompt. 13. After the CDA is generated, click the Preview hyperlink. 14. Scroll to the Plan of Care portion of the CDA document and verify the plan and instructions for the included. patient are McKesson Corporation Release 13.0 February 24, 2015

22 22 Paragon Physician Modules What s New Guide (Release 13.0) Prescription Writer Transaction column This enhancement adds a Transaction column to the Audit Log search results in WebStation for Security. Previously, users could not distinguish an eligibility request from a medication history request without opening each audit log message. The new column provides a quick way to differentiate between the two message types. 1. Log on to Paragon Clinician Hub and perform both eligibility and medication history requests using Prescription Writer. 2. Log on to WebStation for Security, click the E-Prescribing Admin tab, and then click the Audit Log tab. 3. In the Service field, select Med History & Eligibility. 4. In the Transaction field, select All and then select All in the Event field. 5. Enter a Start Date and an End Date that includes the requests from step 1 and then click Search. 6. Verify that the Transaction column indicates whether a message is for Eligibility Inquiry or Medication History Request Added transaction field A Transaction field has been added as an additional filter for the Audit Log tab under the E-Prescribing Admin tab in WebStation for Security. When a service is selected and the service has associated transaction types, the Transaction field allows selection of a single transaction type. This additional filtering allows users to find messages of interest quickly. 1. Log on to WebStation for Security, click the E-Prescribing Admin tab, and then click the Audit Log tab. 2. Verify the Transaction field has been added between the Service and Event fields. 3. Select All in the Service field and verify the Transaction field defaults to All. 4. Enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned. 5. Select Out Web Service - Prescription Routing in the Service field and verify the following selections are available in the Transaction field: All NewRX RefillRenewalResponse Status Error February 24, 2015 Release 13.0 McKesson Corporation

23 Paragon Physician Modules What s New Guide (Release 13.0) Select one of the options from the Transaction field, enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned Repeat step 6 until all Transaction options have been tested Select ERx Pharmacy Directory Download Service in the Service field and verify the Transaction field defaults to All Enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned Select Med History & Eligibility in the Service field and verify the following selections are available in the Transaction field: All RxHistoryRequest EligibilityInquiry 11. Select one of the options from the step above in the Transaction field, enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned. 12. Repeat step 11 until all Transaction options have been tested. 13. Select ERx Administration Services in the Service field and verify the Transaction field defaults to All. 14. Enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned. 15. Select In Web Service - Prescription Routing in the Service field and verify the following selections are available in the Transaction field: All RefillRenewalRequest Status Error Verify 16. Select one of the options from the step above in the Transaction field, enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned. 17. Repeat step 16 until all Transaction options have been tested. 18. Select ERx Admin - Formulary Data in the Service field and verify the Transaction field defaults to All. 19. Enter dates in the Start Date and End Date fields, click Search, and verify the correct results are returned : Quantity Printed prescription Printed prescriptions should display the Quantity in both numerals and words, for example **30** (thirty) tablets. For Releases and Log on to WebStation for Physicians and select a patient. 2. Click the CPOE tab and click Rx Writer. The patient's Pending tab is displayed. 3. Click Add New. The Search/Home Meds window is displayed. McKesson Corporation Release 13.0 February 24, 2015

24 24 Paragon Physician Modules What s New Guide (Release 13.0) 4. Search for and select an Order View drug and dose sentence. The Rx Detail window is displayed. 5. Complete all required fields, being sure to enter a number in the Quantity field. 6. Click Save. You are returned to the patient's Pending tab. 7. Click Submit. The Submit Prescriptions window is displayed. 8. If necessary, select a Printer and a Document, and click the Print action button. 9. Click Submit. 10. Retrieve the prescription and verify the Quantity is displayed in both numerals and words, for example **30** (thirty) tablets. For Release Log on to Paragon Clinician Hub and select an active patient. 2. Click the Ordering tab and click Rx Writer. The patient's Pending tab is displayed. 3. Click Add New. The Search/Home Meds window is displayed. 4. Search for and select an Order View drug and dose sentence. The Rx Detail window is displayed. 5. Complete all required fields, being sure to enter a number in the Quantity field. 6. Click Save. You are returned to the patient's Pending tab. 7. Click Continue. The Submit Prescriptions window is displayed. 8. If necessary, select a Printer and a Document, and click the Print action button. 9. Click Submit. 10. Retrieve the prescription and verify the Quantity is displayed in both numerals and words, for example **30** (thirty) tablets : Enhancements to the Specification sub-tab The following fields on the Specification sub-tab of the E-Prescribing Admin tab in WebStation for Security have been enhanced to display eight dots to indicate that a password has been entered: Relay Health Routing Service Password field in Prescription Routing section Password field in Prescriber Directory Messaging section Password field in Vendor (Unsolicited) Messaging section Password field in Eligibility Credentials section Prior to this enhancement, the fields appeared as blank even when the password was entered, encrypted, and stored to the database. Important: Test this work item only if your facility uses the eprescribing functionality of Prescription Writer. 1. Log on to WebStation for Security. 2. Click the E-Prescribing Admin tab and then click the Specification sub-tab. 3. Enter the appropriate password in each of the following fields and click Update: Relay Health Routing Service Password field in Prescription Routing section Password field in Prescriber Directory Messaging section Password field in Vendor (Unsolicited) Messaging section Password field in Eligibility Credentials section February 24, 2015 Release 13.0 McKesson Corporation

25 Paragon Physician Modules What s New Guide (Release 13.0) Verify that each field displays eight dots to indicate a password is entered as in the example below: McKesson Corporation Release 13.0 February 24, 2015