MICROMD EMR RELEASE NOTES VERSION 10.0, DECEMBER 2014
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1 MICROMD EMR RELEASE NOTES VERSION 10.0, DECEMBER 2014 Welcome to the new MicroMD EMR! We have been busy with modifications and enhancements to the program that will help overall usability. This list briefly outlines the changes to MicroMD EMR. Please review the MicroMD EMR Version 10.0 Update Guide for a more detailed explanation of all changes to the program. ENHANCEMENTS The MicroMD Development Team has completed a number of behind the scenes coding enhancements to optimize database queries in the EMR. We have improved speed and performance in the following areas: Opening the Bill Builder, ordering medications, calculating desktop counts, displaying phone messages, and changing history in the Chart Navigator. We have also launched the following enhancements to boost usability: Parentheses have replaced brackets in text encounters to accommodate Dragon (17615, 20818): When an allergy field(s) is in a text encounter, parentheses are now used instead of brackets. This allows Dragon to be used for text encounters since brackets would stop Dragon from functioning properly. Enhancements to the Common List Builder (18719, 18798, 19938): The items in the Common List Builder now mirror the items in My Common List. Also, items in the Common List for Risk Assessments will now populate items in My Common List. Also, entries in the Occupations & Religions Common List now reflect the Practice-Wide Common Lists in the EMR Manager. The fields and scrollbar have been expanded so the full description and associated codes can be seen for each selection, even those with longer descriptions. Diagnosis reference pointers are now alpha (20297): Diagnosis reference pointers are now alpha (instead of numeric). This is identical to the PM. New instructional video help clips have been added to the EMR (20471): A series of short instructional video clips have been added to the EMR for users who need assistance. Areas with available videos are clearly marked with a green play icon. Encounter levels in the Bill Builder (21096): When adding an encounter level in the Bill Builder, the new encounter level will be the first in the list instead of the last. Full name, sex, yrs and DOB have been added to the encounter window (10666): In the header of each page of an encounter, the patient s full name, sex, years (yrs.) of age and DOB are fully visible to assist user in verification of the patient. Sign multiple completed encounters (11242): When signing or co-signing a completed encounter from the desktop, the user is taken right to the Bill builder screen and the preview window no longer opens. A Sign Next Encounter button has been added to make it easier to sign multiple encounters quickly. Multiple encounters can also be selected simultaneously from the Encounter list on the Desktop. Minimizing encounters into a hold status (11535): A minimize icon has been added to encounter windows (below the X ). When used, the encounter will minimize and be identified as being held. In the EMR Manager under Practice Settings, a new drop-down has been added called Max no. of minimized encounters, which allows the practice to set the maximum number of encounters that can be 1
2 simultaneously minimized. This allows users to access other areas of the EMR while continuing to work on encounters. Updating Screening and Prevention within an encounter (11940): When in an encounter, if corresponding Plan items like labs and nursing care are performed, the user will be prompted to update Screening and Prevention. Grouping of results reports ordered at one time (12630): In the in-house settings manager, the Custom Labs section within the EMR Manager, a new Laboratory drop-down menu has been added. This will allow users to filter based on a particular lab and now allows access to edit other lab panels. Outstanding orders will also be displayed for the patient. Enhanced Lab Order creation to split orders (13745): Lab orders now allow for the splitting of orders according to the samples storage temperature, anatomic pathology (cytology and histology) and grouping or splitting based on the user assigned to the order. Creating orders in back-dated encounters (13872): Users can now edit unsigned encounters from a past date, with the ability to add plan items and create orders. Selecting Other labs on the Custom Labs tab (14248): In the EMR Manager, the Custom Labs tab under In-House Settings now has a Laboratory drop-down menu. This menu includes a selection of Other, which can be selected to add/edit other labs as is possible with other lab panels and tests. Future lab orders on the Desktop (17984): In Desktop orders, in the Date Ordered filter, a new option for the selection of Future Date for lab orders has been added. This allows the documenting of future lab orders that have not yet been performed. Repeating Family History information with the Apply/New button (13773): The Apply/New button has been changed to function a little differently in the Add Family History window. Now, when family history is entered and the Apply/New button is clicked, another Add Family History window will open and much of the data entered in the first window will be carried over to the new one to reduce data entry. This includes family member name, relationship, birth year, current age and age at death. Automatically opening encounter SOAP panes in expanded view (15524): The encounter panes of Subjective, Review, Objective and Assessment will expand/collapse whenever the encounter is opened per the user settings. If the user clicks the Expand/Collapse button, it will override the default preference. Enhanced Patient Care Plan (16070): The Patient Care Plan has been enhanced to show when a requested lab order is to be completed. If two of the same lab orders are in an encounter, and one is marked with a future date, both orders and dates will now show on the Patient Care Plan. Variable text formatting (16816): Under Practice Settings in the EMR Manager, users can now select a default font and point size using the Default Text Formatting drop-downs. Set All selection in the Encounter Copy window (18156): The Encounter Copy window is now called the Encounter Copy Details window, and features a new Set All button. When clicked, the user will have four options: Include All, Exclude All, Normal/Absent and Present/Absent. Hover text in the encounter window (19113): The encounter window s descriptor, assessment, visit test and plan comment areas now feature hover text on mouse-over. When a user mouses over the comment area, the entire message will pop-up to be reviewed. This eliminates the need to click on the comment and scroll to read. Hover text in the Medical Information Review window (20725): Within the encounter s Medical Information Review screen, users can now hover over a medication to see the description and dosage. 2
3 Drop-down menus in Administrative CQM Reporting (20973): The radio buttons for selecting the year in which to report meaningful use measures have been changed to drop-down menus to accommodate more options in the future. ICD-10 FUNCTIONALITY Most of the enhancements and improvements in Version 10 are due to the adoption of the new ICD-10 code sets. This section documents the visible changes we have made in MicroMD to adopt the new codes. ICD Codes to appear with descriptions when using the Problem List [ICD] rules field (17743): When using the rules field Problem List [ICD] in Screening and Prevention, the ICD code now displays beside the description in the list. Add option to charges Export Interface Setup in EMR Manager to send either ICD-9 or ICD-10 data in billing file (18640): In Step 4 of the System Integration Wizard (in the EMR Manager), a new option has been added when defining system-specific data that will allow the user to select either ICD-9 or ICD-10 as the format for exporting data files. Add option to Lab Interface Setup in EMR Manager to send either ICD-9 or ICD-10 data in file (18641): In Step 4 of the System Integration Wizard (in the EMR Manager) when configuring a new lab interface, a new option has been added when defining system-specific data that will allow the user to select either ICD-9 or ICD-10 as the format for sending or printing data files. Clinigration will also need to be restarted in order for changes to take effect. Modify Patients Groups to work with ICD-9 and ICD-10 (18650, 18651): The patient Group Conditions have been modified when using Problem List [ICD] to use both ICD-9 and ICD-10 code values. Also, the Rule Builder has been modified in the Data for selected condition area in the Rule Wizard to show both ICD-9 and ICD-10. Modify user-defined additions in the EMR Manager to make available a field for a user to add ICD-10 codes within the entry/edit (18654): When incorporating user-defined additions for diagnosis codes in the EMR Manager, a new field has been added that will receive ICD-10 codes within the entry. Modify Histories to handle ICD-10 codes (18655): The following histories have been modified to handle ICD-10 codes: Medical, Surgical, Family, Hospitalization, and Surgical Procedures. Modify Medications to handle ICD-10 codes (18656): Modify the Prescription Pad, Prescription Request, Prescription Processor windows and templates to show/print both ICD-10 and ICD-9 codes, description, SNOMED code as default. Also, User Preference Override options in the Practice Settings now provide an option to show/print (or not to show) ICD-9 codes. Modify Orders to handle ICD-10 codes (18657): Modify all orders to show/print both ICD-10 and ICD- 9 codes, description, SNOMED code as default where diagnosis, assessments, medical history are supplied. Also, User Preference Override options in the Practice Settings now provide an option to show/print (or not to show) ICD-9 codes. Modify Templates to handle ICD-10 codes (18658, 19334): ICD-10 codes now work with Text Encounters and Wizards using Text Encounter templates. 3
4 Modify Chart Reports to handle ICD-10 codes (18659): Modify Chart Reports to show/print both ICD- 10 and ICD-9 codes, description, SNOMED code as default where diagnosis, assessments, and medical history are supplied. Modify Patient Care Plan to handle ICD-10 codes (18660): Modify Patient Care Plan to show/print both ICD-10 and ICD-9 codes, description, SNOMED code as default. Modify Histories Reports to handle ICD-10 codes (18661): Modify Histories Reports to show/print both ICD-10 and ICD-9 codes, description, SNOMED code as default where diagnosis, assessments, and medical history are supplied. Modify Encounter Report to handle ICD-10 codes (18662): Modify Encounter Report to show/print both ICD-10 and ICD-9 codes, description, SNOMED code as default where diagnosis, assessments, medical history are supplied. Modify Referral Letter Mail Merges for ICD-10 codes (18663): Modify Referral Letter Mail Merges for ICD-10, as well as Referral Letters. Modify Form Encounter and Administrative Forms to handle ICD-10 codes (18664): Modify Form Encounters and Administrative Forms to show/print both ICD-10 and ICD-9 codes, description, SNOMED code as default. Interface Setup changes for ICD-9/ICD-10 (18667): A new option has been added to the Interfaces setup in the EMR Manager to send/include either ICD-9 or ICD-10 data. The interfaces include the Registries section. Modify Reports to handle ICD-10 codes (18669): Chart Reports (Medical Information reports), Patient Care Plans and Encounter Reports (Standard Encounter Reports, Template-based Reports and Quick Print) now include both ICD-9 and ICD-10 codes. ICD-10 codes will be visible when you print Patient Care Plans and Medical History Reports. Reports affected by this are: All Medications for a diagnosis, Count of Patients given a Medication, Disease Management by diagnosis, Gynecological History, Habits for a Diagnosis, Immunizations for a Diagnosis, Medical Ingredients for a Diagnosis, Medications for a Diagnosis, Menstrual History, Patient Diagnosis by Encounter, Patient Hospitalization by Diagnosis, Patient Query, Patient s Problems. Patients with a Diagnosis, Patients with a Given Diagnosis, Plans for a specified Diagnosis, Prescription for diagnosis, Top 10 Diagnoses, Top 10 Diagnoses by Description, Top 10 Diagnoses by ICD Code, Top Diagnoses, and Vital Signs for a Diagnosis. Update the Clinical Quality Measures for Stage 1 and Stage 2 to handle ICD-10 codes (18670): Update the Clinical Quality Measures for Stage 1 and Stage 2 to handle ICD-10 codes. Add an option in the System Settings Manager of the EMR Manager under the Practice tab to control if ICD-9 will display or print within application (18694): An option has been added to the Practice tab of the System Settings Manager in the EMR Manager to control the printing of ICD-9 data within the application. Add an option in User Preferences which will override the optional setting in the System Settings Manager of the EMR Manager to control if ICD-9 will display or print within application (18695): In the General section of the User Preferences, an option has been added to override the option setting in the EMR Manager in the System Settings Manager to control if ICD-9 will display or print within application. Modify Problem List Selection list display and sticky note for ICD-10 (19485): Modify Problem List selection list display and sticky note for ICD-10. 4
5 Modify Women s Health Med Info sections, list display and sticky note for ICD-10 (19486): Modify Gynecology History, Menstruation History, Pregnancy History and OB Medical History. Update CCR, CCD, and CDA templates for ICD-10 codes and indicators (19495): Problems, Family History, and Encounter Assessments are now coded for ICD-10 in CCR, CCD and CDA documents. Enhanced ICD searching (18637): Enhanced search window allows for And and Or search options in multiple EMR areas to narrow down ICD-9 and ICD-10 list search: Encounter, Problem List, Medical History, Surgical History, Family History, Hospitalization History, Surgical Procedures, Lab Orders, Procedure Orders, Referral Orders, Radiology Orders, CliniGuide Builder, Prescription Pad, Reports, Patient Recalls, and Common List. Added ICD-10 Code Mapping report to assist users with identifying one-to-many ICD-9 to ICD-10 mappings (19767): A report has been added to the Administration section of the EMR that identifies the ICD-10 codes that need to be mapped to the EMR and in what areas. The report identifies those ICD-9 codes that do not have direct one-to-one mappings or are lacking a SNOMED code. Added an option in the Common List Builder to view the diagnosis code as well as the description (19786): An option has been added to the common list builder under the areas of assessments and assessments for surgery to view the actual diagnosis code along with the definition. This assists users in determining the appropriate ICD-10 codes from a list of many. Bill Builder able to display ICD-10 codes (19809): When the Communication preference for Practice Management is set to send ICD-10 codes, the Bill Builder will now display ICD-10 codes. When there are no ICD-10 codes that match the chosen code, the diagnosis in the Bill builder will be blank and highlighted yellow to draw attention to the missing data. ICD-10 and Code Scrubbing in the Bill Builder (19974): The Bill Builder has been modified to accept ICD-10 codes as well. If the billing system interface is set to expect ICD-10 codes, an assessment code is checked to make sure an ICD-10 code is mapped. Viewing ICD-10 codes within a History Template (20063): Added the ability to view the ICD-9/ICD- 10 codes within a History Template. Added functionality to the Descriptor Window for ICD-10 transition (20070): Added the functionality to be able to display both ICD-9 and ICD-10 codes in the descriptor manager window for assessments. Also added the functionality to be able to copy descriptors from one assessment to another. Added the ability to view ICD-9/ICD-10 codes when editing text encounter assessment pick lists (20074): Added the ability to be able to view the ICD-9/ICD-10 codes when editing an assessment pick list for a text encounter. FIXES Fixed Inactivated employees in the common lists (21365): Inactivated employees will no longer show up in the common lists. Fixed Non-alphabetized folders in the patient record within DMS (21434): Opening DMS directly in a patient s record to add documents will display any existing subfolders in alphabetical order. Fixed Editing impressions in signed encounters (21576): In an encounter containing an impression, the impression will not be editable after the encounter has been signed. 5
6 Fixed - Screening & Prevention (19184): Screening and Prevention items will no longer be added to a patient that does not meet the requirements set by a rule. Fixed Cervical Cancer Screening Report (19932): This report has no selection criteria, but an error was occurring when running the query. This has been corrected, and no error will occur when running the query. 6
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