Please schedule an appointment at one of our daily webinars to learn more about these new features

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1 Welcome to the MediTouch New Feature Blog called You Spoke We Listened. We are very proud of our MediTouch EHR, but as is the case for all software, it can always be improved. We know of no better way to improve our software then to listen to the physicians who use it every day. Our team is listening and incorporating many of your suggestions into the MediTouch EHR system. One way we are different than other software companies is that we are able to create enhancements quickly. Our software is updated at least every 3 months (and usually more frequently) and each update incorporates many of the creative ideas suggested by our users. Each time we release a major update we will update this blog, who knows, maybe we will be blogging about one of your suggestions! Remember with MediTouch EHR, as the Beatles said, It s Getting Better All the Time. Release Date July 17th & August 4 th 2011 Please Check this Blog Again After August 4th for Screen Capture Documentation of All Features related to the July MediTouch EHR Release Please schedule an appointment at one of our daily webinars to learn more about these new features This July release proves that MediTouch is really a leader in EHR innovation, especially with regard to using the latest web browser technologies to make the physician experience special. The deployment is set for two days, July 17 th and August 4th. We have done what some thought impossible our technical team has added drawing on anatomical diagrams or patient pictures on the ipad a reality. Our team has created a great new way to manage letters and document creation. Now it is simple to send a letter to a referring doctor or a reminder letter to a patient. With our letters and document templates you can insert a physician or patient signature into any form created with this new feature.* In our continuing quest to make documentation of the Chief Complaint (CC) and History of Present Illness (HPI) faster our team has added a new way to use your patient s already existing problem list to document the HPI using the chronic complaint method a real time saver for those patients that visit your office frequently for maintenance of several chronic illnesses. This method is a very fast way to meet the 1997 Medicare E/M coding guidelines for documenting HPI for chronic diseases. Another improvement to the CC/HPI module is a way to use some general HPI descriptors provided by MediTouch to free-form HPI documentation for any new complaint. Our medical team continues to add more default Complaint Forms. Default Complaint Forms sometimes contain many questions we have added a feature that allows the user to hide questions that they would not usually ask. We have added specialty specific Review of Systems (ROS) capability. For certain specialties we have already added a set of ROS system findings that are specific to a specialty, for other specialties our medical team is still creating those specialty specific findings. If your practice would like to suggest a set of findings for a specialty type please contact our implementation team at implementation@healthfusion.com and our team will evaluate your request. In addition On the ROS module it is now possible to clear an individual Yes/No answer to the neutral state by clicking on the Yes or No button making recording findings more efficient. Our team has made several upgrades to MediTouch specifically for the Podiatric Medicine profession. Our program is simply the best EHR for foot and ankle specialists. Our hard work was recently recognized by the APMA (American Podiatric Medical Association) The Podiatric Seals Committee has recommended to the APMA Board of Trustees that the Seal of Acceptance be awarded to HealthFusion s MediTouch. Our Podiatric Medical Team has created podiatry specific Chief Complaints and HPI, Review of Systems, Physical Exam, Diagnosis and Procedure Code sets.

2 In addition the team has added several anatomical diagrams suitable of drawing and incorporating into an encounter note. For Immunizations there are two new workflows that are real time savers. First our team has introduced a new concept for organizing the administration of immunizations vaccine inventory management. With Vaccine Inventory Management your staff can manage each immunization vial or pre-filled syringe. They can record the number of dosages available. In addition they can associate each inventory item with an NDC code. Now when an immunization is administered the inventory will automatically be managed and the CPT code and NDC code will be simultaneously sent to the procedure coding page immunization management and coding all in one new feature. Another new workflow now allows the exporting of your entire practice s immunization history in a single HL7 file great for communication with third parties. Encounter creation was enhanced - last release we introduced MediTouch Grand Central a new way to re-use previous encounter data to create a new encounter. Some providers wanted to start with their set of normals already loaded into the encounter at the time that each ne encounter is created. Now providers can set a default Blueprint that loads automatically each time a new encounter is created no need to start from scratch anymore for routine visits just modify your normal. Also now documents linked to an encounter show as a link in the encounter preview. Printing Encounters has been enhanced. Now with Customized Encounter Printing - prior to printing, choose what part of the encounter you need to print and print only that portion of the encounter complete with the patient name and page number on each page. For Diagnosis and Procedure coding the system allows now allows for a quick reordering of codes so that the code order is optimized for your claim. Physical Exam Documentation has been upgraded with improved (diagrammatic) navigation of the musculoskeletal system, the ability to import physical exams created with custom forms and color coding to signal phrase specific notes. In addition users draw on anatomical diagrams or patient photos When Follow Up documentation is created in the Plan section of the SOAP note, now the Follow Up directions are conveyed to the Check Out screen in the Practice Management Module. Now our front office will automatically know when to re-schedule the patient s next appointment. Our team has created a new type of flow sheet. Today our flow sheets allow for the recording of a single value for a specific date. The New Multi-Value Flow Sheet allows the user to compare several findings for a specific date easily in a table view. This new functionality works well to compare a set of findings over time; example a set of fetal ultrasound results. Custom forms now work very much like chief complaint forms, now the user controls the output, instead of showing a question and answer our new custom forms can display a specific output determined by the form creator including headers separate content and make your output easy to read. This new method improves the encounter output display and can be applied to all types of custom forms in addition users can import a legacy custom form and modify it for this new output format! Also new with custom forms is the ability to set a custom form as the default tab (landing page) for a module. Now there are new ways to leverage the data aggregated by our Health Maintenance module. The system with now generates patient lists that assist in corresponding with patients that have not been evaluated for a specific measure. The system also generates patient lists that help your practice choose the 30 patients that meet the PQRS program measures for the measure

3 group you have chosen to report on. Soon our team will be contacting all providers that have indicated interest in the PQRS incentive program to assist them in file creation and management of their relationship with the AOA registry it is that registry that will transmit your file to CMS. There are times when a third party wants proof that a provider has reviewed a document. For a scanned.pdf a provider can add the text in the left margin of any.pdf that they have electronically signed a document when they mark the document as reviewed. With regard to documents, users now the ability to assign any user, not just a provider to review a document. In addition with our new letter and document creation module a document can be created that allows for the addition of signing area that can be signed with a stylus or finger on an ipad.* Labs and Orders have been enhanced now users can Copy as New a previous order for a patient. If you check the same lab tests repetitively for a patient, this new feature is a real time saver. In addition on the orders page consults now display the consult specialty instead of the diagnosis code, users can add notes to orders from the Orders Dashboard, and when entering results the comment section is no longer mandatory to save; just mark a test as abnormal and save. In addition quick results recorded when resulting an office test also now show up on the encounter preview. OB docs can now print the complete pre-natal record in the standard format. In addition for OBs documenting the Cervix Exam STA is now a separate field in the observation table, with the options of "-5 to 5. Dashboard Enhancements include the ability to see a quick list of recent patients and a 2-hour schedule for all providers. The multi-provider 2-hour schedule view assists staff in managing multiple provider office patient flow. When managing encounters on the dashboard, if the user changes the date of service to work on several encounters for a specific prior date the dashboard will hold the page (date) they were previously on and not default back to today s date. This makes it easier to catch up on prior date s encounters that require completion. In the Task and Messaging Module last release we introduced the concept of a quick Chart Note. Now Chart Notes print as part of the print wizard they can also be edited and deleted.* With our vital signs module now users can repeat more than one set of respiratory vitals (helpful for practices that repeat a peak flow measurement during the same encounter) also it is easier now to document the number of ounces in the weight section.

4 Table of Contents of Screen Capture Documentation Chief Complaint (CC) and History of Present Illness (HPI) Review of Systems (ROS) Immunizations Encounter Creation Diagnosis and Procedure Coding Physical Exam Follow Up Flow Sheet Custom Forms Health Maintenance Reporting Document Management Labs and Orders OB/GYN Dashboard Task and Messaging Chart Notes Vital Signs Document Library

5 Chief Complaint (CC) and History of Present Illness (HPI) Two new methods of creating CC/HPI were introduced in this release; the first is a method that permits the user to free-form any complaint based on a set of common descriptors. After navigating to EHR>S(Subjective)>Chief Complaint>Chief Complaint Forms 1. Select Enter a Complaint 2. Then Quick HPI After selecting Quick HPI the user can add descriptors for each of the 8 HPI elements, below is an example of the set of descriptors for duration. Simply use as many elements and descriptors that are appropriate for the complaint. Remember for maximum credit per the E/M coding guidelines use at least 4 HPI elements. The second new method of entering CC/HPI was suggested by one of our users that specializes in the care of chronically ill patients she suggested that we use a version of the patient s problem s list to meet the E/M coding guidelines for the Chronic Complaint method of documenting CC/HPI. To obtain maximum credit 3 chronic complaints must be reviewed. The problems that are listed in your patient s Chronic Conditions List are displayed in a similar manner as the standard problem list. They include all problems listed in the patient problem list even ones that are not marked chronic. (Release date 7/31) 1 After navigating to the CC/HPI module select Chronic Conditions 2 Mark the current status (the choices for current status are displayed in the screen capture below) The system will track how many complaints were reviewed and adjust our E/M coding calculator to reflect the amount reviewed by selecting a finding in the Currently column.

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7 Review of Systems (ROS) After navigating to EHR>S(Subjective)>Review of Systems 1. Select Specialty to use a specialty specific ROS. Not all specialties have been prepopulated yet. If your practice would like to suggest a set of findings for your specialty type please contact our implementation team at implementation@healthfusion.com and our team will evaluate your request. 2. Toggle Yes or No for a ROS finding to return the finding to the neutral state (a finding that the user does not want documented as either reported or denied.

8 Immunizations For organizing the administration of immunizations use vaccine inventory management. Start by selecting Vaccine Inventory on the Immunization Module landing page Add a Vaccine to Inventory 1. Add a Vaccine Type 2. Choose the Brand Name 3. Our system will automatically find the manufacturer 4. Enter the Lot# 5. Enter the NDC# 6. Enter the vaccine and VIS expiration dates 7. The system will auto-fill the most common dosage 8. Enter how many doses are remaining in this case 6 doses was entered

9 Next use your vaccine inventory to choose the appropriate vaccine for your patient The user is asked to confirm the vaccine details and enter any additional information, note the CPT, Lot# and NDC code automatically fill. The user is prompted as to whether they want to add the vaccine CPT and NDC codes to the bill on the procedure code page (coming soon). The vaccine is added to the Immunization List for that patient

10 The vaccine inventory is decreased by 1 now there are 5 doses remaining since one dose was used.

11 Encounter Creation Providers can set a default Blueprint that loads automatically each time a new encounter is created after creating your normal default blueprint check the appropriate box (arrow) prior to saving the blueprint. A document linked to an encounter now shows as a link in the encounter preview making it easy to view that document when reviewing the encounter preview. The document links show below the Problem List at the bottom portion of the encounter preview. Click on the button (in this case EKG ) to view the document directly from the encounter preview

12 Printing Encounters has been enhanced. Use the Patient Copy button. The Patient Copy button can be found at the top of any encounter preview On in the Encounter Module OR After selecting the Patient Copy button the user has the option of selecting what part of the Encounter Preview to print. Uncheck any portion of the encounter that you would prefer NOT to print. Also note - the page number of each page and the patient s name and date of birth will now print on each page.

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14 Diagnosis and Procedure Coding Quickly re-order codes so that the code order is optimized for your claim. Below is an example of Diagnosis Coding. Highlight a row and then use the Move Up and Move Down buttons to reset the order of your codes. Works the same way for Procedure Coding (in our July 31 st release). Note: with procedure coding, pointing to codes is not longer required.

15 Physical Exam Navigating the Musculoskeletal Physical Exam has been simplified with the use of diagrammatic navigation When a note is added to a phrase now the phrase is color-coded (yellow) to signify where a custom note was added. Also not shown is a new ability to import physical exams created with custom forms. Now when documenting the physical exam a provider can draw on an anatomical image or a patient image (patient image drawing requires premium document management ). Drawing can be performed on an ipad with a stylus or fingertip or any standard computer with a mouse. Navigate to the SOAP > Physical Exam Module and Select the Image Icon on the left side toolbar Choose whether you would like to draw on an anatomical image or a patient image (picture) Search for an anatomical image that applies to your physical exam findings A list of keyword search terms is available for review Based on the body part of the physical exam that is in context the most appropriate images are displayed

16 Your most recent patient images stored in your premium document image inbox are also displayed Choose the target image and add it to the Physical Exam Click on the thumbnail version of the image that you have associated with your exam to open the Drawing Window Pick a color and brush size Add a comment to the drawing Save when the drawing is complete Experiment with a sample at www. For Foot and Ankle specialists a Podiatric Medicine specific set of physical exam findings were added based on templates created by our Podiatric Medical Director s guidance.

17 Follow Up Follow Up documentation is created in the Plan section of the SOAP note. Follow Up directions are conveyed to the Check Out screen in the Practice Management Module. Now your front office will automatically know when to re-schedule the patient s next appointment.

18 Flow Sheet Multi-Value Currently flow sheets allow for the recording of a single value for a specific date. The New Multi- Value Flow Sheet allows the user to compare several findings for a specific date easily in a table view. This new functionality works well to compare a set of findings over time. Select Start a New Flow Sheet Begin to create and customize your Multi-Value Flow Sheet 1 Choose Multi-Value 2 Name the Flow Sheet 3 The first column is always a date the date associated with the rest of the values in the row 4 Choose additional column headings (as if you were creating an Excel document) 5 Next choose the value type

19 This is an example of sample Multi-Value Flow Sheet enter values and Save compare dates in the easy to read table view

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21 Custom Forms Custom forms now allow the user controls to control the output, instead of showing a question and answer learning how to use the new features related to custom forms require a basic knowledge of the use of custom forms. The traditional version of custom forms are called tabular forms the new version is called narrative forms. Narrative forms allow the user to display output in a paragraph type format complete with headers to separate content. Users can convert a traditional tabular form to a narrative form Users can author content that is triggered to display when an answer or choice is selected and a default answer can be selected. Headers separate content and make your output easy to read. 1. Select the location that you want the header to be placed ABOVE 2. Click New Header 3. Add the Header Name 4. Select Add Header to save These new methods improve the encounter output display and can be applied to all types of custom forms. To become an expert in creating custom forms please attend one of our daily webinars!

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23 Health Maintenance Reporting Now there are new ways to leverage the data aggregated by our Health Maintenance module. Generate a patient list that can be used to correspond with patients that have not been evaluated for a key preventive care measure. Navigate to Documents > My Reports > Health Maintenance. Choose a measure and a status (Passed, Failed or All) The system will generate a patient list for that measure overnight. The patient list will be placed at Documents > My Reports

24 The system also generates patient lists that help your practice choose the 30 patients that meet the PQRS program measures for the measure group you have chosen to report on. Navigate to Documents > My Reports > PQRS report. First pick the provider that is participating in PQRS.

25 The system will find Medicare patients that meet the denominator criteria for the measure group that the provider is enrolled in. Soon our team will be contacting providers that have indicated interest in the PQRS incentive program to assist them in file creation and management of their relationship with the AOA registry it is the AOA registry that will transmit your file to CMS.

26 Document Management For a scanned.pdf add the text in the left margin that the provider has electronically signed the document by selecting the document and then using the review and stamp button. When printing make sure your printer setting is set at Fit to Page so the margin is included in the printing. Open a patient chart and navigate to the Administration module 1. Select a row (hint do not click on the document button that will open the document_ 2. Select Review & Stamp An electronic stamp documenting when and who reviewed the.pdf is placed in the left margin.

27 Labs and Orders Copy as New a previous order for a patient. Works for any order type: Lab, Radiology, Consult or Office. Example; if you check the same lab tests repetitively for a patient, this new feature is a real time saver. It will repeat the order exactly same lab destination, same test(s), same diagnosis, but with today s order date. Consult listing on the orders page now display the consult specialty and not the diagnosis code In addition users can add notes to orders from the Orders Dashboard, and when entering results the comment section is no longer mandatory to save, just mark a test as abnormal and save. Also quick results recorded when resulting an office test now show up on the encounter. (not documented in this blog with screen captures)

28 OB/GYN Print the complete pregnancy history in the generally accepted format. Navigate to the OB History Module and find the active pregnancy. Select print. The formatted pregnancy history will be compiled and sent to the document section. The Cervix exam STA can now be recorded as part of the standard pre-natal observations

29 Dashboard Now on the dashboard there are 2 new tabs one to see a quick list of recent patients and another to see the 2-hour schedule for multiple providers at one time. The multi-provider 2-hour schedule view assists staff in managing multiple provider office patient flow. Simply scroll horizontally through all provider schedules on a single screen. View the last 10 patients that you worked on to get easy access to your recent work and click on a chart number to review the chart

30 When managing encounters on the dashboard, if the user changes the date of service to work on several encounters for a specific prior date the dashboard will hold the page (date) they were working on and not default back to today s date. This makes it easier to catch up on prior date s encounters that require completion.

31 Task and Messages Chart Notes Quick Chart Notes are added via the Task and Messaging module. Now they can be edited and deleted.

32 Vital Signs Users can now repeat more than one set of respiratory vitals. It is now easier to document the number of ounces in the weight section.

33 Document Editor The MediTouch Document Editor facilitates Provider-to-Patient communication: example, a letter mailed to all patients over the age of 55 reminding them to make an appointment for their annual flu shot. In addition it promotes easy Provider-to-Provider correspondence: example, a Referral Report to communicate encounter data back to the provider who referred the patient to the practice. Facilitating this process from within MediTouch is the ability for users to create and merge document templates with patient data or generate a custom documents on-the-fly. Content Blocks To get started users my want to create re-usable Content Blocks: the basic building block of any document. Like a Lego or piece of a puzzle, by itself, the content block serves no purpose. Combined with other elements, it is used to build Document Templates. An example of a standard content block would be the Patient_Demographics block shown below: <Last Name>, <First Name> <Address 1> <Address 2> <City>, <State>, <Zip> Templates Templates are created using any combination of user-defined text and/or content blocks. An example of a letter template, Flu Shot Reminder might include the Patient_Demographics content block along with practice-related data elements, and a user-defined text message: <Location_Name> <Location_Address> <Location_Phone> <Patient_Demographics> Dear <First_Name>, Your healthcare provider would like to remind you that flu season is upon us once again. To schedule an appointment for your annual influenza vaccination please call us at <Location_Phone>. Sincerely, The Friendly Staff of Happy Valley Wellness To get started navigate to Documents > Document Library Select New Document to get started

34 A sample of creating a simple template that can be saved to the document library 1. Choose whether you are creating a Template or a Content Block 2. Choose the Document Type 3. Name and Describe the document 4. When appropriate add a Patient 5. When appropriate add a Rendering Provider 6. Drag the appropriate content blocks into the editor 7. Add a custom message 8. Save the document

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