TABLE OF CONTENTS PREFACE ICD-10 ENHANCEMENTS KEY USABILITY ENHANCEMENTS. MicroMD EMR Update Guide Version 10.0

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1 U P D A T E G U I D E

2 TABLE OF CONTENTS PREFACE Welcome to MicroMD EMR... i How This Guide is Organized... i Understanding Typographical Conventions... i Cross-References... i Text You Type Using the Keyboard... i Keys You Press and Buttons You Click... i Dialog Box, Application Window Titles, and Field Names...ii Notes, Warnings, and Tips...ii ICD-10 ENHANCEMENTS ICD-10 is here!... 3 EMR Manager Enhancements... 3 ICD-10 Modifications... 7 Patient Groups... 7 The Rule Builder... 8 Assessments in the Common List Builder... 9 Histories Problem List Women s Health Prescriptions Orders Templates Reports The Descriptor Manager Window Diagnosis Reference Pointers on the Bill Builder are now Alpha Mail Merges Clinical Quality Measures Form Encounters and the Administrative Form Builder Drug-to-ICD Warnings ICD-10 and Code Scrubbing in the Bill Builder Miscellaneous ICD-10 Enhancements CCR, CCD and CDA Templates Enhanced ICD Searching Edit Diagnosis ICD-10 Code Mapping Report KEY USABILITY ENHANCEMENTS Parentheses Have Replaced Brackets in Text Encounters Instructional Video Clips Added to the EMR Patient Information Added to the Encounter Window Header Enhancements to the Common List builder MicroMD EMR Update Guide Version 10.0 TOC.1

3 Table of Contents Encounter Levels in the Bill Builder Updating Screening and Prevention Within an Encounter Signing Multiple Completed Encounters Minimizing Encounters into a Hold Status Repeating Family History Information with the Apply/New Button Automatically Opening Encounter SOAP Panes in Expanded View Grouping of Result Reports Ordered at One Time Splitting Lab Orders Selecting Other Labs on the Custom Labs Tab Future Lab Orders on the Desktop Creating Orders in Backdated Encounters Enhanced Patient Care Plan Variable Text Formatting Encounter Copy Details Window Enhancements Hover Text in the Medical Information Review Window Reporting Year Drop-Down for Administrative Clinical Quality Measures TOC.2 MicroMD EMR Update Guide Version 10.0

4 PREFACE WELCOME TO MICROMD EMR From all of us here at Henry Schein Medical Systems, Inc., thank you for selecting MicroMD EMR, the definitive Electronic Medical Records (EMR) solution. This manual is a quick reference to all of the newest features of MicroMD EMR. This manual does not cover hardware setup, networking, or installation of the program. HOW THIS GUIDE IS ORGANIZED We have organized this guide according to the modules within MicroMD EMR. The discussion consists mainly of the new features within the modules. You can find in-depth information about the entire module in the MicroMD EMR User s Reference Manual located in the Help menu of MicroMD EMR. UNDERSTANDING TYPOGRAPHICAL CONVENTIONS Before using this manual, it is important to understand the typographical conventions used to identify and describe information. Cross-References Cross-references to chapters, sections, page numbers, headings, etc. are shown in an italic typeface. e.g., Refer to Edit Diagnosis on page 147. Text You Type Using the Keyboard Text that you type using the keyboard is shown in a Courier typeface. e.g., Type Anthony Smith in the Name field. Keys You Press and Buttons You Click Keys that you press on the keyboard and buttons/icons that you click with the mouse are shown in a bold sans-serif typeface. e.g., Press Enter. e.g., Click OK to continue. MicroMD EMR Update Guide Version 10.0 i

5 Chapter 1. ICD-10 Enhancements Understanding Typographical Conventions Dialog Box, Application Window Titles, and Field Names The titles of dialog boxes and application windows are shown in italics. Field names and selections made from dropdown menus, etc. are also shown in italics. e.g., The Print Preview dialog box appears. e.g., Select Commercial Insurance from the drop-down list. Notes, Warnings, and Tips Notes, tips and warnings are provided throughout the manual. These provide additional information that is important for you to know about the topic. NOTE A note is an important piece of information. STOP You should definitely read the information in a warning. It could help you prevent a disaster. TIP A tip table helps you with some interesting information about different ways to use the program. ii MicroMD EMR Update Guide Version 10.0

6 ICD-10 ENHANCEMENTS CHAPTER 1 ICD-10 IS HERE! On October 1, 2015, the ICD-9 code sets used for medical diagnosis and procedures will be replaced with the ICD- 10 code set. ICD-10 is a more robust code set, and many new codes for more specific diagnoses have been added. These are big changes for any medical practice, and MicroMD wants to make this transition as seamless as possible for you and your practice. Our new releases, MicroMD Version 10 EMR and PM (please see our PM Update Guide for Version 10), have been enhanced and coded specifically for ICD-10 to assist our clients with the transition from ICD-9 to ICD-10. We have completely updated our software and databases for the new code set, including an option for a practice to continue to use ICD-9 in some circumstances. This Update Guide will explain all of the recent changes to our software, and how we have developed this new version with the medical practice in mind. EMR MANAGER ENHANCEMENTS An option has been added to the Interface Setup in Step 4 of the System Integration Wizard to export billing files containing either ICD-9 or ICD-10 as shown below. Figure 1.1 Selecting ICD-9 or ICD-10 for exporting billing file data MicroMD EMR Update Guide Version

7 This option is also available when configuring a Lab Interface to send the appropriate set of codes in a lab file as shown below. Figure 1.2 Selecting ICD-9 or ICD-10 for lab interface data In the System Practice Settings under the General tab, a checkbox has been added to control the display and printing of ICD-9 codes within the application as shown below. 4 MicroMD EMR Update Guide Version 10.0

8 Figure 1.3 ICD-9 display and print option in the System Settings Manager We have included another new setting in the User Preferences of the EMR that will override the optional setting in the EMR manager covered earlier. A screenshot of this drop-down is below. You can override the setting and either hide or display the codes (depending on the setting you made in the EMR Manager), or you can choose to use the Practice Default. MicroMD EMR Update Guide Version

9 Figure 1.4 ICD-9 Override option in the EMR User Preferences The Edit Diagnosis and Enter New Diagnosis windows of the EMR Manager (accessed from within the Diagnosis Reference List viewer) have been modified to allow users to enter/edit ICD-10 codes as well as ICD-9 codes. Figure 1.5 ICD-10 Code option on the Edit Diagnosis window 6 MicroMD EMR Update Guide Version 10.0

10 Figure 1.6 ICD-10 Code option on the Enter New Diagnosis window Other interfaces that are configured from within the EMR Manager now have an option to export ICD-9 or ICD-10 as well. These interfaces include Registries. ICD-10 MODIFICATIONS We have made many modifications in the EMR to incorporate the ICD-10 code set. The following items explain these modifications in greater detail. Patient Groups To configure a patient group to use ICD-10 codes: Procedure 1. From the Desktop Navigator, select Administration, then select Manage Patient Group from the sub-menu, then click the Patient Groups Manager button, located near the upper right corner of the window. Details The Patient Groups Manager window will open. Alternatively, you can select Administration from the Desktop Navigator, then select Patient Groups Manager from the Administrative panel under Miscellaneous Tasks. 2. Click the Add button. The Patient Groupings window opens. MicroMD EMR Update Guide Version

11 3. Give your new Patient Group a name, and select automatic in the Population Method drop-down menu. 4. Click the Conditions... button. This will open the Patient Group Conditions window. 5. Under the Field Name column, select either Problem List (ICD) or Encounter Assessment (ICD). 6. Select a condition from the drop-down, then click the small button located inside the fields of each row of the Value column. This will open the Condition Data window. 7. Click the All button. A list of ICD-9 and ICD-10 codes will populate the window. 8. Select one for the rule you are creating and click the Add button. Click the OK button and close the two windows. The Rule Builder To configure a rule to use ICD-10 codes: Procedure 1. From the main menu, select Tools > Rule Manager. Details This will open the Rule Manager. 2. Click the New button. The Rule Wizard window will open. 3. Select a rule trigger from the Available Rule Triggers column, then click the Add button in the middle to move the condition to the Selected Rule Trigger column. Click Next. 4. Under Conditions for Activation, in the Field Name column, select Problem List ICD. 5. Select a condition from the drop-down, then click the small button located inside the fields of each row of the Value column. This will open the Condition Data window. 8 MicroMD EMR Update Guide Version 10.0

12 6. Click the All button. A list of ICD-9 and ICD-10 codes will populate the window. 7. Select one for the rule you are creating and click the Add button. Click the OK button and close the two windows. Assessments in the Common List Builder On the right side of the Common List Builder window, ICD codes are now displayed to the left of all Assessments, Assessments (for Risk) and Assessment (for surgery) if ICD codes exist. The ICD-10 code will be listed first in brackets, followed by the ICD-9 code in brackets. If there is no code, an [X] will be a placeholder. Figure 1.7 ICD-9 and ICD-10 Codes in the Common List Builder for Assessments MicroMD EMR Update Guide Version

13 Histories All histories, including Medical History, Surgical History, Family History, Hospitalization History, and Surgical Procedures, have been modified to show and/or print ICD-9 and ICD-10 codes. Figure 1.8 ICD-9 and ICD-10 codes in Medical History Figure 1.9 ICD-9 and ICD-10 codes in Surgical History 10 MicroMD EMR Update Guide Version 10.0

14 Figure 1.10 ICD-9 and ICD-10 codes in Family History Figure 1.11 ICD-9 and ICD-10 codes in Hospitalization History MicroMD EMR Update Guide Version

15 Figure 1.12 ICD-9 and ICD-10 codes in Surgical Procedures 12 MicroMD EMR Update Guide Version 10.0

16 Problem List ICD-10 Enhancements ICD-10 codes have been integrated into MicroMD to work with the problem list. Below, a patient s chart is open and we are viewing the problem list showing both ICD-9 and ICD-10 codes. MicroMD EMR Update Guide Version

17 Women s Health The Women s Health OB module has been modified for ICD-10 as well. Gynecology History, Menstruation History, Pregnancy History and OB Medical History will now display ICD-10 codes where appropriate. Figure 1.13 ICD-9 and ICD-10 codes in Gynecology History Figure 1.14 ICD-9 and ICD-10 codes in Pregnancy History 14 MicroMD EMR Update Guide Version 10.0

18 Figure 1.15 ICD-9 and ICD-10 codes in the OB Medical History Figure 1.16 ICD-9 and ICD-10 in the Menstruation History MicroMD EMR Update Guide Version

19 Prescriptions Modifications have been made to the Prescription Pad, Prescription Request and Prescription Processor windows and templates to show/print both ICD-9 and ICD-10 codes. The new format is [ICD-10][ICD-9] Description [SNOMED code]. Figure 1.17 ICD-9 and ICD-10 codes in the Prescription Pad 16 MicroMD EMR Update Guide Version 10.0

20 Figure 1.18 ICD-10 codes in the Prescription Processor window Figure 1.19 ICD-9 and ICD-10 Codes in a Template-Based Prescription MicroMD EMR Update Guide Version

21 Orders Lab Orders, Procedure Orders and Referral Orders have also been updated to accept both ICD-9 and ICD-10 codes. Figure 1.20 ICD-9 and ICD-10 codes on the Lab Orders window 18 MicroMD EMR Update Guide Version 10.0

22 Figure 1.21 ICD-9 and ICD-10 Codes on the Referral Orders Window MicroMD EMR Update Guide Version

23 Figure 1.22 ICD-9 and ICD-10 Codes on the Procedure Orders Window 20 MicroMD EMR Update Guide Version 10.0

24 Templates ICD-10 Enhancements CliniGuides, Standard Form, Text Encounter Templates and History Templates have been modified to display/print ICD-10 codes. Figure 1.23 ICD-9 and ICD-10 Codes in the Cliniguide MicroMD EMR Update Guide Version

25 Figure 1.24 ICD-10 Codes on a Standard Form Template 22 MicroMD EMR Update Guide Version 10.0

26 Picklists Figure 1.25 ICD-9 and ICD-10 Codes on a Text Encounter Template ICD-9 and ICD-10 codes can now be viewed in picklists of text encounters along with the description. In the Text Encounter Recorder, when viewing a picklist, the format is [ICD-10][ICD-9]Assessment[SNOMED}, as shown below. Figure 1.26 ICD-9, ICD-10 and SNOMED Codes in a Picklist of a Text Encounter MicroMD EMR Update Guide Version

27 ICD-9 and ICD-10 codes will also appear when editing a picklist. Figure 1.27 ICD-9 and ICD-10 codes while editing a picklist 24 MicroMD EMR Update Guide Version 10.0

28 Reports Figure 1.28 ICD-9 and ICD-10 Codes on a History Template 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. MicroMD EMR Update Guide Version

29 Figure 1.29 ICD-9 and ICD-10 codes in the Medical Information Report in the Chart Reports Patient Care Plan The Patient Care Plan has been modified to show both ICD-9 and ICD-10 codes. 26 MicroMD EMR Update Guide Version 10.0

30 MicroMD EMR Update Guide Version

31 Encounter Reports Encounter reports have been modified to display both ICD-9 and ICD-10 codes. Figure 1.30 ICD-9 and ICD-10 Codes on the Encounter Report 28 MicroMD EMR Update Guide Version 10.0

32 The Descriptor Manager Window ICD-9 and ICD-10 codes will now display in the Descriptor Manager. Figure 1.31 ICD-9 and ICD-10 Codes in the Descriptor Manager MicroMD EMR Update Guide Version

33 Diagnosis Reference Pointers on the Bill Builder are now Alpha The diagnosis reference pointers on the Bill Builder have been changed from numeric to alpha to match the PM. Figure 1.32 Diagnosis Reference Pointers on the Bill Builder are now Alpha 30 MicroMD EMR Update Guide Version 10.0

34 Mail Merges ICD-10 codes now appear in Letters, Referral Letters and Encounter Reports. Figure 1.33 ICD-9 and ICD-10 Codes on the Encounter Report MicroMD EMR Update Guide Version

35 Clinical Quality Measures 43 Clinical Quality Measures have been updated for Stage 2 to include ICD-10 codes as well as ICD-9 codes. These updates are done behind the scenes in the reference database. Form Encounters and the Administrative Form Builder Users can create forms using the Form Encounter or the Administrative Form Builder to create forms containing ICD- 10 codes. The codes will work with checkboxes, options buttons, pick lists and when inserting medical information or assessments with ICD view/print. Drug-to-ICD Warnings Figure 1.34 ICD-9 and ICD-10 codes in the Form Builder MicroMD has incorporated First DataBank s Medical Lexicon Module, which integrates all existing ICD-10 codes into the EMR, and drug-to-icd warnings are current with the new code set. 32 MicroMD EMR Update Guide Version 10.0

36 ICD-10 and Code Scrubbing in the Bill Builder The Bill Builder has been modified to accept ICD-10 codes as well. Figure 1.35 ICD-10 Codes in the Bill Builder 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. MicroMD EMR Update Guide Version

37 MISCELLANEOUS ICD-10 ENHANCEMENTS CCR, CCD and CDA Templates The CCR, CCD and CDA xsl templates have been updated for ICD-10 codes and indicators. Enhanced ICD Searching Search windows, like the Reference List Viewer, now allow for the search arguments and and or. This is available in multiple areas of the EMR to narrow ICD-9 and ICD-10 list searches. Areas that include this enhancement are Encounters (Assessment), Problem List, Medical History, Surgical History, Family History, Hospitalization History, Surgical Procedures, Lab Orders, Procedure Orders, Referral Orders, CliniGuide Builder, Prescription Pad, Reports, Patient Recalls and Common Lists. Using the and argument will bring up a list of diagnosis codes containing both A and B. For example, a search for diabetes and kidney (shown below) results in two diagnoses that contain both the word diabetes and the word kidney. Figure 1.36 Using the "and" search argument 34 MicroMD EMR Update Guide Version 10.0

38 Using the or search argument will bring up a list of diagnosis codes containing either A or B. For example, a search for diabetes or kidney (shown below) results in a long list of diagnoses containing either the word diabetes or the word kidney. Edit Diagnosis Figure 1.37 Using the "or" search argument The Edit Diagnosis window (shown below) has been enhanced with a new lookup functionality and the ability to display both ICD-9 and ICD-10 codes for each diagnosis. Figure 1.38 ICD-9 and ICD-10 codes in the Edit Diagnosis window MicroMD EMR Update Guide Version

39 ICD-10 Code Mapping Report In the Administration Section of the Desktop under Advanced Reporting, you will find a new ICD-10 Code Mapping Report. This report identifies those ICD-9 codes that do not have direct one-to-one mappings with ICD-10 codes or are lacking a SNOMED code. Figure 1.39 The ICD-10 Code Mapping window Table 1-1 Using the ICD-10 Code Mapping Report Procedure 1. From the Desktop Navigator, select Administration. Details This opens the Administration section of the EMR. 36 MicroMD EMR Update Guide Version 10.0

40 2. From the Advanced Reporting Options section, choose the ICD-10 Code Mapping report as shown above. 3. First, select a field name from the Field Name drop-down menu. 4. Next, select the operator (=, >, <, etc.) from the Condition drop-down menu. This opens the ICD-10 Code Mapping Report. Choose from Appointment On, Patient Name, Patient, and Provider. = Is equal to (what follows in the Value field) <> Is not equal to (what follows in the Value field) < Is less than (what follows in the Value field) > Is greater than (what follows in the Value field) <= Is less than or equal to (what follows in the Value field) >= Is greater than or equal to (what follows in the Value field) 5. Select a value for the Value field. If Patient or Patient Name has been selected for the field name, you will be provided a patient look-up window. 6. Other conditions can be added to the query to streamline the report. For example, you can add another condition by using the Add Row button. If Appointment On has been chosen as the field name, you will be provided a drop-down calendar and menu to look-up the correct date and time. If Provider has been selected for the field name, you will be provided a look-up window for the provider. 7. You can also use logical operators to further define your report. If you add another row to the query, use the drop-down under Logical to define how the rows work with each other. For example, using the AND operator will return results only if both conditions are true. Using the OR operator will return results if either one of the conditions is true. 8. When you are satisfied with the conditions for the report, click the Run button. 9. You now have the options to print or export (save) the report. Click the Print button and select your printer to print the report. Click the Export button to name and save the report in the format of your choice. MicroMD EMR Update Guide Version

41 Figure 1.40 Results of the ICD-10 Code Mapping Report In the result above, a diagnosis (Edema) has been highlighted. In the lower section, we can see that there are multiple ICD-10 mappings for this particular ICD-9 code. 38 MicroMD EMR Update Guide Version 10.0

42 KEY USABILITY ENHANCEMENTS CHAPTER 2 The following enhancements of the MicroMD EMR are designed to increase productivity and improve usability. Parentheses Have Replaced Brackets in Text Encounters In text encounters, brackets have been replaced by parentheses. When using Dragon for dictation, it will stop when it comes to brackets because it believes the brackets contain a variable. The brackets are now parentheses, and Dragon continues as expected. MicroMD EMR Update Guide Version

43 Key Usability Enhancements Instructional Video Clips Added to the EMR Over 40 new instructional video clips have been added to the EMR. These clips are located in parts of the application that sometimes require a bit more explanation. Whenever you see the video icon, you can click it to watch a short instructional video that will present more information about the area of the EMR you are in. Figure 2.1 Instructional Video Clips under Administration Patient Information Added to the Encounter Window Header At the top of each page of an encounter in the encounter window header, the patient s full name, sex, years of age and date of birth will appear. This will ensure that the proper patient s encounter is being edited. Figure 2.2 Patient Information in the Encounter Window Header 40 MicroMD EMR Update Guide Version 10.0

44 Enhancements to the Common List builder Key Usability Enhancements The fields and scrollbars have been expanded so the full description and associated codes can be seen for each selection, even those with longer descriptions. Also, entries in the Occupations and Religions Common List now reflect the Practice-wide Common Lists in the EMR Manager. Figure 2.3 Horizontal Scrollbar in the Common List Builder MicroMD EMR Update Guide Version

45 Key Usability Enhancements Encounter Levels in the Bill Builder When adding an Encounter level in the Bill Builder, the new encounter level will be the first in the list instead of the last. Figure 2.4 Before Setting the Encounter Level 42 MicroMD EMR Update Guide Version 10.0

46 Key Usability Enhancements Figure 2.5 After Setting the Encounter Level Updating Screening and Prevention Within an Encounter When in an encounter, if Plan items like Labs or Nursing Care are performed, and these items have a corresponding item in Screening and Prevention, the user will be prompted to update Screening and Prevention. Now the Provider will no longer need to check or remember what Screening and Prevention items the patient has enabled in their chart. This also saves time on data entry in both the Encounter and in Screening and Prevention. MicroMD EMR Update Guide Version

47 Key Usability Enhancements Signing Multiple Completed Encounters When signing or co-signing an encounter from the desktop, you are now taken directly to the Bill Builder screen. The preview window has been removed to reduce the number of clicks it takes to sign an encounter. The encounter list has been modified to make signing multiple encounters an easy task. A Sign column has been added with a checkbox placed next to each encounter. Simply place a checkmark in the box next to each encounter that you wish to sign, as shown below. Figure 2.6 Selecting Encounters to Sign on the Desktop Notice that the second encounter cannot be signed because it contains prescriptions that have not been processed. This warning appears after attempting to place a checkmark in the box next to an encounter that cannot be signed. After multiple encounters have been checked, the Sign Encounter button becomes a Sign Multiple button. When the Sign multiple button is clicked, the Encounter Sign window will pop up and prompt you for a password. Figure 2.7 Signing Multiple Encounters with a Single Password Enter the password and click the Sign button to sign all of the checked encounters simultaneously. 44 MicroMD EMR Update Guide Version 10.0

48 Key Usability Enhancements In the Bill Builder, you can set a signature to use for signing the next ten encounters. Figure 2.8 Signing Multiple Encounters from the Bill Builder Minimizing Encounters into a Hold Status Encounters can now be minimized while being created or edited so the desktop and other areas of the EMR can be utilized without the need to close the current encounter. This will save time and allow or a more flexible workflow. Figure 2.9 The Minimize Button on an Encounter Near the top of each encounter window, just under the X is a minimize button. It includes a hover text label of Minimize (save encounter to holding area). Click this button to place the encounter in a hold status whenever you would like to leave the encounter but not close it. When there are encounters in the holding area, a new icon on the Desktop and in patient s charts will be visible (it will be grayed-out when there are no encounters in the holding area). Figure 2.10 Holding Area Icon on the Desktop If there are multiple encounters in the holding area, the holding area icon becomes a drop-down so you can select the specific encounter you would like to return to, and the system will open that encounter at the place where you were prior to minimizing. Select an encounter to open from the drop-down list of encounters in the Holding Area. MicroMD EMR Update Guide Version

49 Key Usability Enhancements Figure 2.11 Multiple Encounters in the Holding Area In the Practice Settings of the EMR manager, there is a new setting that sets the maximum number of encounters that can be in the hold area at one time. You can choose to have anywhere from 1 to 9 encounters in the holding area at one time. The default setting is 3. Figure 2.12 Max Number of Held Encounters Setting in the EMR Manager Practice Settings 46 MicroMD EMR Update Guide Version 10.0

50 Repeating Family History Information with the Apply/New Button Key Usability Enhancements In version 10.0, the Apply/New button works a little differently. After entering family history information in the Add Family History window, when the Apply/New button is selected, all information is applied to the selected family member and retained in a new window. NOTE After the Apply/New button is clicked, it will appear as nothing has happened, when in fact, the Add Family History window in which you entered the patient s information has actually become a new window that has retained all of the previously entered data. This way, you can change either the diagnosis OR the patient information while retaining the rest of the information already entered. When you click the OK button, all new family history information that has been entered will be visible in the list above. Procedure Details 1. From the Charts tab, select Family History from the Chart Navigator. 2. Click the Add button to add a family history. This opens the Add Family History window. 3. Select a family member s name from the drop-down menu. 4. Enter any relevant data including birth year, age, diagnosis, start date, etc. The family member s relationship to the patient will automatically populate the Relationship: field. If you are finished entering the data, and plan on changing/adding family history for only one family member, click the OK button to see your additions and/or changes applied. If you plan on adding family history for multiple family members or multiple diagnosis codes for one family member, click the Apply/New button instead. This will turn the Add Family History window that you ve been working in into a new window (although this change will not be evident), retaining all of the information previously entered. 5. Make any changes or additions in this new window. Repeat this process as many times as necessary. When you have completed your changes and additions, click the OK button. All new additions and changes will now be visible, and the Add Family History window will close. MicroMD EMR Update Guide Version

51 Key Usability Enhancements Figure 2.13 Duplicating Family History In the figure above, a family member has been selected and a diagnosis has been entered. When the Apply/New button is clicked, the window changes to a new Add Family History window and much of the information is retained. Notice that the diagnosing provider and date fields have been cleared, as well as the Terminated By: fields near the bottom. From here we can change the family member and keep the diagnosis the same if it is appropriate, or we can continue with the same family member and add more diagnoses as needed. Automatically Opening Encounter SOAP Panes in Expanded View A new setting in User Preferences will allow you to set the default list and details view to an Expanded view. This will be the view used when an encounter SOAP pane is opened. Figure 2.14 Expanded View Options in User Preferences 48 MicroMD EMR Update Guide Version 10.0

52 Key Usability Enhancements For both Expanded List View and Expanded List Details, check the Yes radio button to default the lists to an expanded view. Check No for the non-expanded view. Grouping of Result Reports Ordered at One Time 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. Figure 2.15 The View Grouped Button in Test Results Table 2-1 Grouping Lab Orders and Test Results Procedure Details 1. On the Desktop, select Imported Labs or Test Results from the Desktop Navigator. 2. Select a lab or test result for the patient who s results you would like to see grouped. 3. Click the View Grouped button. This will open the View Results Grouped window (shown below). MicroMD EMR Update Guide Version

53 Key Usability Enhancements 4. In the View Grouped Results window, you can manipulate the date range to see more or less results in your report. Figure 2.16 The View Results Grouped Window 50 MicroMD EMR Update Guide Version 10.0

54 Splitting Lab Orders Key Usability Enhancements Lab orders now allow for the splitting of orders based on the samples storage temperature, anatomic pathology (cytology and histology)and grouping or splitting based on the user assigned to the order. For example, if frozen, refrigerated, and cytology tests are each ordered for one patient simultaneously, the order needs to be split into three orders. Line items no longer need to be deleted before manually recreating another order. Figure 2.17 Selecting the Lab Order Type from the Custom Laboratory Panel Manager During an order being entered outside of an encounter, the split will occur when printing or saving. At Print or Print Preview, an alert will open to inform the user that another order is being created. The user will need to review and print the other order separately. Procedure Details 1. Open the EMR Manager and select the In- House Settings. 2. Select the In-house Labs or Custom Labs tab. 3. Select a panel and click the Edit button. This will open the Custom Laboratory Panel Manager window. MicroMD EMR Update Guide Version

55 Key Usability Enhancements 4. In the Type drop-down, select the panel type to split the order if necessary. Selecting Other Labs on the Custom Labs Tab In the In-House Settings of the EMR Manager, a new Laboratory: drop-down menu has been added. From this menu, you can select a category of custom lab panels that can be edited or deleted. You can also select Other from the drop-down. This will allow you to create or edit other labs as you can with panels and tests. Figure 2.18 Selecting "Other" in the Laboratory Drop-down 52 MicroMD EMR Update Guide Version 10.0

56 Key Usability Enhancements It is also possible to change the order of the tests in the list on the Custom Laboratory Panel Manager. By selecting an item in the list and dragging/dropping to the desired location, the list can be ordered to suit the needs of your practice. When you move the selected item, it will be highlighted in blue. A gray double-line marks the new location of the item. Figure 2.19 Changing the Test Order MicroMD EMR Update Guide Version

57 Key Usability Enhancements Future Lab Orders on the Desktop When in Orders on the Desktop, a new option has been added to the Date Range filter called Future. When Future is selected, the date range is changed to today s date to two months into the future. Also in the Filters section, Status will be set to Requested and Requested By will be set to All. Figure 2.20 The "Future" Option in the Filters for Orders If the resulting list is very large, you can place the cursor in the Patient field to narrow the search by patient. When an In-House lab or procedure has been ordered during an encounter for a future date and the order has not been billed within that related encounter, the system will now display a dialog box asking the user if they would like to create a bill for that order. If the user selects Yes, then the Bill Builder will open, allowing the user to send a bill to the MicroMD PM system s Pending Charges. There will also be an entry added to the billing preparation area allowing the user to see what orders have been sent over to the PM, but no editing will be allowed from this area. Creating Orders in Backdated Encounters The system now allows for an order to be created for plan items in an unsigned encounter from a past date. When the user clicks the Create Order checkbox (when encounter is saved), an order will be created after the encounter has been saved. Until now, the system allowed the plan item to be added but nothing was added. Figure 2.21 The Create Order Checkbox in the Plan Section of the Encounter Enhanced Patient Care Plan 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. 54 MicroMD EMR Update Guide Version 10.0

58 Variable Text Formatting Key Usability Enhancements A new field has been added to the Practice Settings of the EMR Manager called Default text formatting. The setting will default to Tahoma 10 pt. but will give the practice the ability to change the default font to their liking. Figure 2.22 Default Text Formatting in the EMR Manager MicroMD EMR Update Guide Version

59 Key Usability Enhancements Encounter Copy Details Window Enhancements The Encounter Copy window is now called the Encounter Copy Details window. A button has been added near the bottom of the window labeled Set All>>. When clicking this button, the user will be given four choices: 1. Include All The copied encounter will include everything in the original encounter 2. Exclude All The copied encounter will not include any data from the original encounter 3. Normal / Absent (All Normal) Sets the value of the descriptors as Normal. Normal / Absent (All Absent) Sets the value of the descriptors as Absent. 4. Present / Absent (All Present) Sets the value of the descriptors as Present. Present / Absent (All Absent) Sets the value of the descriptors as Absent The choices the user makes here will be reflected in every category, saving the steps of going through each category of the encounter. Figure 2.23 The Set All Options on the Encounter Copy Details Window 56 MicroMD EMR Update Guide Version 10.0

60 Hover Text in the Medical Information Review Window Key Usability Enhancements In the Medical Information Review Screen, users can now hover over a medication to see the description, dosage, duration and refills. Figure 2.24 Hover Text for Medications in the Medical Information Review Window Reporting Year Drop-Down for Administrative Clinical Quality Measures The radio button for selecting the reporting year for Clinical Quality Measures (under Administrative reporting) has been changed to a drop-down menu to accommodate more reporting year options in the future. MicroMD EMR Update Guide Version

61 Key Usability Enhancements Figure 2.25 Reporting Year Drop-Down Menu 58 MicroMD EMR Update Guide Version 10.0

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