MicroMD EMR version 7.5. update GUIDE

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1 MicroMD EMR version 7.5 update GUIDE

2 THIS PAGE INTENTIONALLY LEFT BLANK

3 MICROMD EMR UPDATE GUIDE VERSION 7.5

4 TRADEMARKS Because of the nature of the material, numerous hardware and software products are mentioned by their trade names in this publication. All product names referenced herein are trademarks of their respective companies. The MICROMD design mark is a registered trademark of Henry Schein Medical Systems, Inc., and HENRY SCHEIN and the Henry Schein logo mark are registered trademarks of HS TM, Inc. COPYRIGHT This document is covered by the terms and conditions of the license agreement and/or the non-disclosure agreement, and may not be reproduced according to the terms of that agreement, or without the written consent of Henry Schein Medical Systems, Inc. 24, Henry Schein Medical Systems, Inc. All rights reserved. Printed in the United States. Please forward all corrections, comments or suggestions to: editor@micromd.com.

5 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 GENERAL CHANGES DESKTOP Rule Activation Window Patient Recalls Running Patient Recalls Drug Warning Level Audit Log Options Confidential Reminders View Lab Results From Desktop CHART CHANGES Viewing Vital Signs Records Request Viewing Records Requests Creating New Records Requests Transition of Care Viewing Transition of Care Requests Creating a Transition of Care Request Transition of Care Rule Smoking Status Changes Patient Monitor Shortcut Key Add Multiple Allergic Reactions Allergy Smart Button Add Allergy Emergency Access Setup Emergency Access Using Emergency Access Hearing Screening Hospitalization and Surgical History Comments MicroMD EMR Update Guide Version 7.5 TOC.1

6 Table of Contents ENCOUNTER Vital Signs Measurement Problem List History Status of Problem List Items View Inactive Problems Option Problem List in Rule Manager Growth Chart Options View Document In Patient Education Encounter Common Lists Default Diagnosis for CliniGuide Labs Encounter Comments REPORT CHANGES Quality and Objective Measures Setting Up Measures for Users Quality Measures Button Measures Sub-Tab Running Reports for Clinical Quality Measure and Objective Measures Patient Lists Reports Patient Query PRESCRIPTIONS Formulary Display RxHub History FILE TRANSFER Immunization Registries Public Health Surveillance Establish Health Surveillance Settings Using Surveillance Monitoring CCR and CCD Chart Tools Expanded CCR/CCD Encrypt/ Decrypt Files Setting up Encryption/ Decryption in MicroMD EMR Using Encryption and Decryption in MicroMD EMR Hash a File for FTPS Transfer Setting Up Hashing in MicroMD EMR Using Hashing in MicroMD EMR MICROMD PATIENT PORTAL Setup Your Practice in MicroMD Patient Portal Add MicroMD EMR Users to Patient Portal Add Patient Users to MicroMD Patient Portal Using the MicroMD Patient Portal Portal Updates in MicroMD EMR TOC.2 MicroMD EMR Update Guide Version 7.5

7 Table of Contents Publish to the MicroMD Patient Portal Publish CCR/CCD Records to MicroMD Patient Portal MicroMD EMR Update Guide Version 7.5 TOC.3

8 Table of Contents TOC.4 MicroMD EMR Update Guide Version 7.5

9 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 Understanding Typographical Conventions on page i. 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 7.5 i

10 Preface 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 7.5

11 GENERAL CHANGES CHAPTER 1 RULE ACTIVATION WINDOW The buttons on the Rule Activation dialog box were renamed to Apply and Don t Apply to avoid confusion when the user has the option to enact a rule in the system. Figure 1.1 Buttons on the Rule Activation Dialog Box PATIENT RECALLS MicroMD EMR allows you to search for patients by a number of criteria and generate patient recalls in a mail merge format or print a list of selected patients. Click the Patient Recalls button in the Advanced Reporting section of the Administrative Panel (Figure 1.2) to access this new function. MicroMD EMR Update Guide Version

12 Chapter 1. General Changes Patient Recalls Figure 1.2 Patient Recalls in the Administration Panel Running Patient Recalls You can base your recall query on a variety of conditions in the Selections triggers at the top of the window, such as age, gender, allergies, immunizations, etc. To create a patient recall: Procedure 1. Click on the Administrative Panel section in the Desktop Navigator (Figure 1.2) 2. Click the Patient Recalls button. 3. Enter the appropriate query conditions in the Selections section. Details NOTE Only users with the Administrator or Practice Manage role associated with their account have access to the Administrative Panel. The Patient Recall Monitor window opens. Click the Delete Row or Add Row buttons to remove or add additional conditions to the query. 4. Click the Run button to create the recall list. The patient list appears in the Title portion of the window. 5. Select or remove patients in the recall list using the appropriate checkboxes next to their names. 6. Click the Print button to print the list of selected patients in the recall. You can also utilize the Select All or De-Select All options on the Select button drop-down to quickly add or remove patients from the list. The recall prints with the list of patient names and contact information. 1.2 MicroMD EMR Update Guide Version 7.5

13 Drug Warning Level Chapter 1. General Changes Procedure Details 7. Click the Mail Merge button to open the Mail Merge window and choose the appropriate letter template or labels. 8. Click the Close button to exit from the window. Figure 1.3 Patient Recall Monitor DRUG WARNING LEVEL You now have the option to set a default drug warning level for the practice. In the new Default Drug Interaction Warning level drop-down (on the Prescriptions tab of the EMR Manager), select the appropriate interaction level for your practice. MicroMD EMR Update Guide Version

14 Chapter 1. General Changes Audit Log Options Figure 1.4 Default Drug Interaction Warning Level Drop-Down AUDIT LOG OPTIONS When creating an Audit Log report from the Administration section of the Desktop Navigator, you have the additional option to create a query based on Action Time. In the Value section of the Report Wizard (Figure 1.5), you can enter a specific time to base the query from or be prompted to enter it when you run the report. 1.4 MicroMD EMR Update Guide Version 7.5

15 Audit Log Options Chapter 1. General Changes Figure 1.5 New Action Time Query Option MicroMD EMR Update Guide Version

16 Chapter 1. General Changes Audit Log Options 1.6 MicroMD EMR Update Guide Version 7.5

17 DESKTOP CHAPTER 2 CONFIDENTIAL REMINDERS When you place a check mark in the Confidential field on the Reminders/ Patient Follow-up window and save it, the system displays Confidential in red text on the note section of the Desktop (Figure 2.1). This will display for users saved in the From and To fields of the reminder. Figure 2.1 Confidential Reminder Warning VIEW LAB RESULTS FROM DESKTOP To save time when viewing lab orders, you can now right-click on a completed order on the Desktop and select View Result for Order (Figure 2.2) to open the Lab Results window. MicroMD EMR Update Guide Version

18 Chapter 2. Desktop View Lab Results From Desktop Figure 2.2 View Lab Orders from Desktop 2.2 MicroMD EMR Update Guide Version 7.5

19 CHART CHANGES CHAPTER 3 NEW CLINICAL CATEGORIES A number of clinical categories added in MicroMD EMR Version 7.1 are now information categories for Clinical Dashboards (Figure 3.1) in version 7.5. Figure 3.1 New Clinical Dashboard Categories To create or edit Clinical Dashboards, select Tools > Clinical Dashboard Templates from the main menu. The new Clinical Dashboard categories in Version 7.5 include: Surgical Procedures Surgical History Nursing Care Birth History MicroMD EMR Update Guide Version

20 Chapter 3. Chart Changes Viewing Vital Signs Hospitalization History Vision Screening Eye Tests Hearing Screening Hearing Labor and Delivery Allergy Testing Geriatric Lab Orders Procedure Orders Referral Orders Immunization Orders Nursing Orders Attachments Letters Patient Directives Confidential Information Forms VIEWING VITAL SIGNS While in a chart, the system displays a complete list of patient vital signs even if you place a check mark in the Default Medical Information items to display only current items checkbox (located on the Medical Information Common List Manager window or in your User Preferences in the Medical Information category). If this preference is set, the system will not automatically place a check mark in the Current checkbox in the Vital Signs filter (Figure 3.2). 3.2 MicroMD EMR Update Guide Version 7.5

21 Records Request Chapter 3. Chart Changes Figure 3.2 Vital Signs Filter RECORDS REQUEST MicroMD EMR 7.5 includes a new feature to request and send patient records. When a patient or provider contacts your practice to ask for records, you have the option to print paper records, send them electronically or make them available on the Patient Portal. See page 8.5 for more information on sending items in the MicroMD Patient Portal. Viewing Records Requests Click the Records Request section in the Navigator to display requests in your Desktop (Figure 3.3). You can filter the list of record requests using the Filters area at the top of the list. Table 3.1 explains the filters in more detail. MicroMD EMR Update Guide Version

22 Chapter 3. Chart Changes Records Request Figure 3.3 Records Request Desktop There are a number of buttons in the Records Request Desktop (Figure 3.3): Click the New button to create a records request and send it to yourself or another user in your practice so they can complete the request. The request then appears in the Desktop Navigator. As with other Desktop Navigator tasks, the system displays the number of unaddressed requests. See page 3.5 for more details on creating a records request. Click the Open button to view the request in the Patient Record Request window. Once the request is completed, click the Mark as Done button to remove the request from your Desktop. See page 8.5 for more information on sending patient records. NOTE When a user sends a record request to multiple recipients and one of those recipients marks the request as Done, the system marks it as Done for everyone and removes the request from the Desktop of all recipients in the request. Click the Print Request button to print just the highlighted request. Click the Print List button to print the entire list of records requests displayed on the Desktop. To view the chart of the patient the record request was made for, simply click the Open Chart button. 3.4 MicroMD EMR Update Guide Version 7.5

23 Records Request Chapter 3. Chart Changes Table 3.1 Field Request Date Status Type Patient Received From Filters Available for Records Requests Description To display a list of requests for a specific time period, you can make a selection from the Request Date drop-down or set the range using the From and To fields. Once you mark the records requests as done, the system removes them from your active list. If you would like to see those messages again, simply select Completed from this drop-down list. From the Type drop-down you can requests completed or to be completed via paper, electronic copies or send to the MicroMD Patient Portal. See page 8.5 for more information on using the Patient Portal. You can filter the list to display only those requests pertaining to a specific patient. Type the patient s name in the field. If the system finds a match, it enters the patient. If not, the Search window opens so you can find and insert the appropriate patient s name. To filter the list to include only those requests you have received from a specific user in the system, select that user from this drop-down. Creating New Records Requests Once you receive a request for patient records, you can open the New Record Request window (Figure 3.4) from the Workflow Communicator (Chart > Workflow Communication) or Desktop Navigator. The system can print paper records, send them electronically or make them available on the Patient Portal (see page 8.5 for more information on using the MicroMD Patient Portal). Users can also print a chart report or send a CCR or CCD health record from this window (see page 7.5 for more information on sending CCR and CCD health records). MicroMD EMR Update Guide Version

24 Chapter 3. Chart Changes Transition of Care Figure 3.4 New Record Request Window TRANSITION OF CARE The new Transition of Care utility creates a workflow task item for either importing or exporting a CCR or CCD file to or from a patient chart. You can access the Transition of Care (In) or Transition of Care (Out) windows from the Workflow Communicator section of a patient chart or the main menu. Viewing Transition of Care Requests Click the Transition of Care section in the Navigator to display requests in your Desktop (Figure 3.5). You can filter the list of record requests using the Filters area at the top of the list. Table 3.1 explains the filters in more detail. 3.6 MicroMD EMR Update Guide Version 7.5

25 Transition of Care Chapter 3. Chart Changes Figure 3.5 Transition of Care Desktop There are a number of buttons in the Transition of Care Desktop (Figure 3.5): Click the New button to create a transition of care request. You have the option to select Transition In or Transition Out. Make the appropriate selection to open the Transition of Care (In) or Transition of Care (Out ) window. Once the request is saved, it then appears in the Desktop Navigator. As with other Desktop Navigator tasks, the system displays the number of unaddressed requests. See page 3.8 for more details on creating a transition of care request. Click the Open button to view the request in the Transition of Care (In) or Transition of Care (Out ) window. Once the request is completed, click the Mark as Done button to remove the request from your Desktop. See page 8.5 for more information on sending patient records electronically through the MicroMD Patient Portal. Completed requests can still be viewed by selecting Completed in the Status field of the filter. Click the Print button to print just the highlighted request. Click the Print List button to print the entire list of transition of care requests displayed on the Desktop. To view the chart of the patient the transition of care request was made for, simply click the Open Chart button. MicroMD EMR Update Guide Version

26 Chapter 3. Chart Changes Transition of Care Table 3.2 Field Date Range Direction Status Filters Available for Transition of Care Requests Description To display a list of transition of care requests for a specific time period, you can make a selection from the Request Date drop-down or set the range using the From and To fields. From this drop-down, you have the option to show all transition of care requests, requests that have come into the office (In) or requests to send patient records to another office (Out). Once you mark the records requests as done, the system removes them from your active list. If you would like to see those messages again, simply select Completed from this drop-down list. From the Type drop-down you can requests completed or to be completed via paper, electronic copies or send to the MicroMD Patient Portal. See page 8.5 for more information on using the Patient Portal. Patient Provider You can filter the list to display only those requests pertaining to a specific patient. Type the patient s name in the field. If the system finds a match, it enters the patient. If not, the Search window opens so you can find and insert the appropriate patient s name. To filter the list by the user who made request, select the appropriative name in the dropdown. Creating a Transition of Care Request When you receive a transition of care request to export client records to another practice, you can open the Transition of Care (Out) window (Figure 3.6) from the Workflow Communicator (Chart > Workflow Communication) or Desktop Navigator. From this window, the system can print paper records or export them in CCR and CCD formats. See page 8.8 for more information on exporting CCR or CCD records to the MicroMD Patient Portal. To import a patient into your practice, select Transition In, in the New drop-down. Enter the appropriate information in the Transition of Care (In) window. You have the option to import the CCR or CCD file right from this window. 3.8 MicroMD EMR Update Guide Version 7.5

27 Smoking Status Changes Chapter 3. Chart Changes Figure 3.6 Transition of Care (Out) Transition of Care Rule You can add a condition in the Rule Manager (Tools > Rule Manager) to have the system check for transition of care task items and display the Rule Activation window as a reminder every time you open a chart or encounter. SMOKING STATUS CHANGES The patient habit list was modified to accommodate monitoring the smoking status of patients. This is to ensure proper coding and recording in MicroMD EMR. Changes include updated smoking status options in the Patient Monitor, Medical History Recorder and Rule Manager. When adding smoking as a habit in the Add Habit or Edit Habit windows, the option in the Category drop-down was changed from Smoker to Smoking Status. The No History of checkbox is removed when adding a smoking status. This ensures proper codes are entered in the Status drop-down. Smoking status is displayed on the Chart Board and Patient Monitor sections of the patient s chart. You now have the ability to include smoking status as a value when creating rules in the Rule Manager. PATIENT MONITOR SHORTCUT KEY You can quickly display the Patient Monitor window by pressing the F3 key on your keyboard whenever you see the question mark icon ( ) in the top right corner of the Title Bar, such as in the Add Immunization window. MicroMD EMR Update Guide Version

28 Chapter 3. Chart Changes Add Multiple Allergic Reactions ADD MULTIPLE ALLERGIC REACTIONS To save steps, users can now include multiple reactions at once when documenting an allergy in a patient s chart. Click the Lookup button ( ) next to the Reaction field (Figure 3.7) to open the Add Adverse Reactions window and enter all the appropriate reactions. The system separates multiple reactions by semicolon in the Reaction text box. Figure 3.7 Add Multiple Reactions to an Allergy ALLERGY SMART BUTTON When a user looks up an allergy, the Smart button on the Reference List Viewer window displays the patient s current and past medications. ADD ALLERGY While in the Medications section of a chart (Figure 3.8), you now have the ability to quickly add a prescription to the patient s allergy list when you right-click the entry and select Add to Allergies MicroMD EMR Update Guide Version 7.5

29 Emergency Access Chapter 3. Chart Changes Figure 3.8 Add to Allergies Option In Medications Section When you select Add to Allergies, the system opens the Add Allergy window. EMERGENCY ACCESS Version 7.5 of MicroMD EMR allows users to access a patient s chart in an emergency situation. This feature is to be used as a temporary solution when an authorized user cannot be in the office and a normally unauthorized user must access a patient chart. Setup Emergency Access It is important to establish these settings before you have an emergency situation. You should select a user to be granted emergency access. You can then modify their user profile: Procedure Details 1. In the MicroMD EMR Manager, click the Users & Facilities button and make sure you have the Users tab highlighted. 2. Highlight the appropriate user in the left side of the window and click the Roles tab. The system displays all roles and functions for the user. MicroMD EMR Update Guide Version

30 Chapter 3. Chart Changes Hearing Screening Procedure Details 3. Click the Edit button. The User Roles and Functions window opens. 4. Place a check mark in the Emergency Access checkbox. 5. Click OK. Using Emergency Access When the user with emergency access attempts to open the chart, the system displays a dialogue box (Figure 3.9) asking them to enter a reason why the chart needs to be accessed. Figure 3.9 Emergency Access Dialogue Box The system keeps records of emergency access in the Audit Log reports. HEARING SCREENING The Hearing Screening (Figure 3.10) now includes additional values for 25 and 40 db HL levels to accommodate the use of testing devices MicroMD EMR Update Guide Version 7.5

31 Hospitalization and Surgical History Comments Chapter 3. Chart Changes Figure 3.10 Additional Values for Hearing Screening HOSPITALIZATION AND SURGICAL HISTORY COMMENTS Any Hospitalization and Surgical History comments entered in the Medical Information tab of a chart now appear in Encounter Reports and Medical Information Reports for the patient. VITAL SIGNS MEASUREMENT You can now default MicroMD EMR to use either imperial or metric units when measuring patient vital signs. Procedure Details 1. While in the MicroMD EMR Manager, click the System Settings button and verify you have the Demographics tab selected. 2. Click Edit. The Demographic Defaults window opens (Figure 3.11). 3. In the Vital Sign Units drop-down, select the default unit of measure you want to use in the practice. 4. Click OK. MicroMD EMR Update Guide Version

32 Chapter 3. Chart Changes Problem List History Figure 3.11 Default Vital Sign Units PROBLEM LIST HISTORY You can now view an audit history for each problem in a patient s chart. Simply click the Activity button on the Edit Problem window (Figure 3.12). The Problem Activity History window opens and provides you with a history of each change to that patient s Problem List item. Figure 3.12 Activity Button on the Edit Problem Window 3.14 MicroMD EMR Update Guide Version 7.5

33 Status of Problem List Items Chapter 3. Chart Changes STATUS OF PROBLEM LIST ITEMS To allow proper reporting, users now have the ability to classify the status of problems as Current, Inactive or Resolved. Current: The problem is ongoing and is currently being treated, such as diabetes. Inactive: The problem is not currently active but can become present again, such as eczema. Resolved: The problem was successfully treated, such as a singular case of bronchitis. VIEW INACTIVE PROBLEMS OPTION Users can now decide to show inactive problems when viewing a patient s current problem list. In the Medical Information section of the User Preferences window (Figure 3.13), place a check mark in the Include Inactive Problems with Curren to enable this user preference. Figure 3.13 Display Current Items Option in User Preferences Window PROBLEM LIST IN RULE MANAGER The Problem List condition in the Rule Manager (Tools > Rule Manager) was updated in version 7.5 to include only current patient problems when it triggers an action. MicroMD EMR Update Guide Version

34 Chapter 3. Chart Changes Growth Chart Options GROWTH CHART OPTIONS You now have added functionality when viewing the Pediatric Growth Charts window. You can maximize or print any of the four displayed growth charts when you click the corresponding button at the top of each graph. Figure 3.14 Maximize or Print Buttons for Graphs VIEW DOCUMENT IN PATIENT EDUCATION In the Patient Education section of the Medical Information tab (Figure 3.15), you can now open the highlighted document simply by clicking the View button. The system opens the document in the appropriate program MicroMD EMR Update Guide Version 7.5

35 View Document In Patient Education Chapter 3. Chart Changes Figure 3.15 New View Button in Patient Education MicroMD EMR Update Guide Version

36 Chapter 3. Chart Changes 34BView Document In Patient Education 3.18 MicroMD EMR Update Guide Version 7.5

37 ENCOUNTER CHAPTER 4 ENCOUNTER COMMON LISTS Users who create pre-encounters now have the option to view their own common lists while in the encounter or use the common lists of the selected provider. To use the common lists of the provider, place a check mark in the new Nurse to use providers common list checkbox located on the User Preferences window (Figure 4.1). Figure 4.1 Nurse to Use Providers Common List DEFAULT DIAGNOSIS FOR CLINIGUIDE LABS When creating or editing a CliniGuide, you now have the ability to add default diagnoses for lab orders. MicroMD EMR Update Guide Version

38 Chapter 4. Encounter Encounter Comments Figure 4.2 Default Diagnosis for Labs in CliniGuides In the CliniGuide Builder window (Figure 4.2), click the Lookup button ( add default diagnoses to the selected lab order. ENCOUNTER COMMENTS ) next to the Associated Diagnosis field to A scroll bar was added to the Comment area of signed encounters (Figure 4.3) so users can view long comments added before the encounter was signed and locked by the provider. Figure 4.3 Comment Scrollbar in Signed Encounters 4.2 MicroMD EMR Update Guide Version 7.5

39 REPORT CHANGES CHAPTER 5 QUALITY AND OBJECTIVE MEASURES Version 7.5 introduces clinical quality and objective measures in MicroMD EMR. These are measures of actions done in the system that refer to patient care, treatment and communication. MicroMD EMR Version 7.5 includes the tools to meet these objectives, calculate them and report them to appropriate agencies if needed. NOTE These measures are used primarily for practices planning to participate in government incentive programs. Contact Henry Schein Medical Systems or visit the HSMS website ( for more information on Meaningful Use criteria and the Health Information Technology for Economic and Clinical Health (HITECH) Act. NOTE Refer to the MicroMD EMR Version 7.5 Reference Manual for in-depth documentation on how these measures are calculated. Once you have established which measures you want your practice to meet, you can easily see if you are achieving compliance for the quality and objective measures. In the Advanced Reporting section of the Desktop, you can view stated goals for each measure and how close your practice is to reaching them. See page 5.4 for more information on running reports. For example, your practice is trying to stay compliant with the objective measure of keeping an up-to-date problem list for each patient. In the HITECH Measure Calculations Report (Figure 5.1) you can quickly see that the goal for this measure is that more than 80% of patients your practice sees this year have an up-to-date problem list. However, after running the report, you see that only 44% percent of patients have an up-to date problem list. You can then instruct staff that they must check patient problem lists and ensure that they are marked as reviewed in MicroMD EMR. MicroMD EMR Update Guide Version

40 Chapter 5. Report Changes Quality and Objective Measures Figure 5.1 Objective Measures in the HITECH Measure Calculations Report Window MicroMD EMR also includes a new button on the Encounter Ribbon Bar that displays which measures should be met during a patient visit. See page 5.3 for more information on the Quality Measures button. Setting Up Measures for Users If you plan on calculating and reporting quality and objective measures, you need to set user preferences so they can be calculated while in the encounter: Procedure Details 1. Open the User Preferences window (under Tools > User Preferences) 2. Select Quality Measures in the Preference Category section of the window. 3. Move all applicable items from the Available Quality Measures section to the Provider Quality Measures section of the window. The system displays the Quality Measures section. Either drag-and-drop the Quality Measures or use the arrows to move them between the sections. 4. Click Close. 5.2 MicroMD EMR Update Guide Version 7.5

41 Quality and Objective Measures Chapter 5. Report Changes Quality Measures Button The Quality Measures button (Figure 5.2) in the Administration section of the Encounter Ribbon Bar indicates if the patient chart or encounter does not meet the requirements of the selected quality or objective measures. The button is red if you have not met all the measures. Figure 5.2 Quality Measures Button When you click the Quality Measures button, the system displays the Patient Quality Measures window (Figure 5.3). This window displays all measures being calculated during the encounter. The system indicates with a green check mark ( ) which measures have been met. The measures that have not yet been met are marked with a red X ( ). NOTE You can click the Quality Measures button at any time while in an encounter to view the measures that are being calculated. Figure 5.3 Patient Quality Measures Window NOTE While on the Patient Quality Measures window, you can open the Patient Monitor simply by clicking the question mark icon ( ) or by pressing the F3 key on your keyboard. From the Patient Monitor, you can fulfill many of the Quality Measures such as monitoring a patient s smoking status while you still have the encounter open. MicroMD EMR Update Guide Version

42 Chapter 5. Report Changes Quality and Objective Measures Measures Sub-Tab To fulfill some clinical quality measures, users are required to complete certain actions and add them while recording encounters. While on the Plan tab of the Encounter Builder, click the Measures sub-tab (Figure 5.4) to view the actions and codes specific to clinical quality measures. NOTE Refer to the MicroMD EMR Version 7.5 Reference Manual for more information on specific clinical quality measures and what codes must be added while recoding encounters. Figure 5.4 Measures in the Plan Tab NOTE MicroMD EMR includes a Print Measures option when you create a standard encounter report. When enabled, the system includes the codes and descriptions of the actions added to the Measures sub-tab in the Encounter Builder. Running Reports for Clinical Quality Measure and Objective Measures Users with the Administrator or Practice Manage role associated with their account have access to the Administrative Panel and can run reports for objective measures and clinical quality measures. In the Advanced Reporting section (Figure 5.5), there are two options for these reports: HITECH Measure Calculations: This is where users run reports for objective measures Clinical Quality Measures: This is where users run reports for clinical quality measures 5.4 MicroMD EMR Update Guide Version 7.5

43 Quality and Objective Measures Chapter 5. Report Changes Figure 5.5 To run reports for objective measures or clinical quality measures: Advanced Reporting Section of Administration Panel Procedure Details 1. Verify that you have the Desktop displayed. 2. In the Desktop Navigator section, click Administration and choose Administrative Panel from the options available. 3. Click the HITECH Measure Calculations or the Clinical Quality Measures button under the Advances Reporting section. The HITECH Measure Calculations Report or Clinical Quality Measures Report window (Figure 5.6) opens. 4. If you are running multiple reports, place a check mark next to each one. 5. Click the Retrieve button. The system displays the results in the Numerator, Denominator and Reached / Percentage columns on the same line as the report title. MicroMD EMR Update Guide Version

44 Chapter 5. Report Changes Quality and Objective Measures Procedure 6. Highlight each report to view results and descriptions in the dialogue pane on the bottom of the window. Details NOTE Double-click a report to open it in a detailed window. 7. Click Print to print a summary of the report results. 8. Click Export to save the report summary. Objective measures in the HITECH Measure Calculations Report are saved in PDF format and clinical quality measures are saved in XML format. 9. Click Close Report to exit the window. Figure 5.6 HITECH Measure Calculations Report and Clinical Quality Measures Report Windows There are a number of options in the Filters section of the HITECH Measure Calculations Report and Clinical Quality Measures Report windows. These reports are usually calculated on a yearly basis, but you can run them for previous years or by a selected date range. 5.6 MicroMD EMR Update Guide Version 7.5

45 Patient Lists Reports Chapter 5. Report Changes Table 5.3 Field Date Range Provider Show All Filter Options for Measure Reports Description In this drop-down, select Current Year (January 1 st to December 31 st of this year), Last Year (January 1 st to December 31 st of last year), 2 Years Ago (January 1 st to December 31 st of two years ago) or <Custom Range> (select the range in the From and To fields). The system defaults this drop-down to Last Year. In this drop-down, select the user who ran the report or click the Lookup icon ( ) and select the user. Place a check mark in this field to show all measure reports. PATIENT LISTS REPORTS In MicroMD EMR 7.5, there is now an area to store reports based on patient lists, such as a report that displays patients seen by each provider. To add, edit or run these reports, open the Reports area (under the Administration button of the Desktop Navigator) and select Patient Lists. Figure 5.7 Patient Lists Area of Reports MicroMD EMR Update Guide Version

46 Chapter 5. Report Changes Patient Query PATIENT QUERY The Problems with Medication report template was renamed to Patient Query (Figure 5.8). Figure 5.8 New Clinical Dashboard 5.8 MicroMD EMR Update Guide Version 7.5

47 PRESCRIPTIONS CHAPTER 6 FORMULARY DISPLAY MicroMD EMR displays formulary information only for users enrolled with Surescripts. RXHUB HISTORY With version 7.5, the RxHub Medications History window was enhanced and made easier to read. The Last Filled column displays dates for each prescription in the expanded view. Also, the LTM and Other buttons in the Add to Chart column only display if the medication is not current or not present in the patient's chart. MicroMD EMR Update Guide Version

48 Chapter 6. PRESCRIPTIONS RxHub History 6.2 MicroMD EMR Update Guide Version 7.5

49 FILE TRANSFER CHAPTER 7 IMMUNIZATION REGISTRIES MicroMD EMR has the ability to send patient immunization records to immunization registries in a standard HL7 format. The system includes a standard immunization file in the System Integration Wizard. Once you establish a path in the MicroMD EMR Manager, you can export a HL7 file with patient immunization information. Open the Immunization Upload Monitor from the in the Administrative Panel section of the Desktop Navigator (Figure 7.1). Figure 7.1 Immunization Monitoring Button The Immunization Upload Monitor (Figure 7.2) replaces the Immunization Upload window from previous versions of MicroMD EMR. It retains the same functionality but includes an updated filter at the top of the window. MicroMD EMR Update Guide Version

50 Chapter 7. File Transfer Public Health Surveillance Figure 7.2 Immunization Upload Monitor PUBLIC HEALTH SURVEILLANCE The system now includes options to send files to agencies that monitor public health trends. Establish Health Surveillance Settings Procedure 1. In the MicroMD EMR Manager, click the Communication button. Details The Communication Setup Manager opens. 2. Click the Surveillance option under the System column. 3. Click the Add button The System Integration Wizard window opens. 7.2 MicroMD EMR Update Guide Version 7.5

51 Public Health Surveillance Chapter 7. File Transfer Procedure 4. In the Product Name drop-down, select Health Surveillance. Details The Vendor field is automatically populated. 5. In the Exchange Mechanism drop-down, select the method of delivery for the files. 6. In the Exchange Mode drop-down, verify if the files will be sent continuously or in a batch file. 7. Enter a name for this particular surveillance in the Surveillance Name field. 8. Click Next. The Task add System Schedule window opens. 9. Place a check mark in the Active check box to activate the sending of files to the surveillance organization. 10. In the Computer Name field, type the name of the computer on which the EMR stores/sends the data files. 11. In the Path field, enter the location on that computer where the EMR stores/sends the data exchange files. 12. Click Next. The Communication Parameters window opens. 13. Click Next. 14. In the System Specific Data window, enter the criteria you want to use to gather information for the surveillance organization. You have the option to gather information by age gender, encounter assessment codes or encounter date. 15. Click Finish when you have completed your surveillance query. Using Surveillance Monitoring To use the Surveillance Monitor, click the Surveillance Monitoring button in the Administrative Panel section of the Desktop Navigator (Figure 7.3). MicroMD EMR Update Guide Version

52 Chapter 7. File Transfer Public Health Surveillance Figure 7.3 Surveillance Monitoring Button From the Surveillance Monitor (Figure 7.4), you can send monitoring reports, new mail messages, view reports that have been sent or print a list of reports. 7.4 MicroMD EMR Update Guide Version 7.5

53 CCR and CCD Chart Tools Chapter 7. File Transfer Figure 7.4 Surveillance Monitor CCR AND CCD CHART TOOLS The menu for importing or exporting CCR or CCD files (Chart > Export/Import Chart (CCR/CCD) has been simplified. The system also exports both the CCR and CCD medical records in separate data files and in human-readable form (four separate files are created). MicroMD EMR Update Guide Version

54 Chapter 7. File Transfer CCR and CCD Chart Tools Figure 7.5 Export/Import CCR/CCD Menu Options Additionally, there is a new View CCR or CCD option in the Chart Tools section of the application (Figure 7.6). Click the button to open the View CCR/CCD File window. 7.6 MicroMD EMR Update Guide Version 7.5

55 Expanded CCR/CCD Chapter 7. File Transfer Figure 7.6 View CCR or CCD Option in Chart Tools EXPANDED CCR/CCD The CCR and CCD health records now include additional information from the following areas of a patient chart: Problem List Vital Signs Social History Family History Lab Results Insurance ENCRYPT/ DECRYPT FILES You now have the option to create encrypted patient health records that are not human-readable and decrypt files to make them human readable. This is an added security measure when sending electronic health records. Setting up Encryption/ Decryption in MicroMD EMR To setup encryption in MicroMD EMR, open the Security Settings window (Figure 7.7) in the MicroMD EMR Manager (from the Security tab of the System Setting section). In the Encryption Passphrase field enter a practice-wide code or password. MicroMD EMR Update Guide Version

56 Chapter 7. File Transfer Encrypt/ Decrypt Files Figure 7.7 Encryption Passphrase on the Security Settings Window STOP It is important to write down the passphrase used for encryption and keep it in a safe place. Once it is entered in the Security Settings window, it can no longer be read. Using Encryption and Decryption in MicroMD EMR Select Chart > Encrypt File to open the Open File for Encryption window and select the file to encrypt. Once this is complete, the file is not longer human-readable. Select Chart > Decrypt File to open the Open File for Decryption window and browse to the file you want to decrypt. The system opens the CCR / CCD Viewer window and displays the file when you successfully decrypt a CCR or CCD health record. 7.8 MicroMD EMR Update Guide Version 7.5

57 Hash a File for FTPS Transfer Chapter 7. File Transfer HASH A FILE FOR FTPS TRANSFER In version 7.5, you have the ability to hash a file with the SHA-1 algorithm and send it to a third-party through a FTPS transfer. Setting Up Hashing in MicroMD EMR Procedure 1. In the MicroMD EMR Manager, click the Communication button. Details The Communication Setup Manager opens. 2. Click the Report Exporting option under the System column. 3. Click the Add button The System Integration Wizard window opens. 4. In the Product Name drop-down, select the name of the practice or organization where the hashed file will be sent. The Vendor field is automatically populated. 5. In the Exchange Mechanism drop-down, select FTP. 6. In the Exchange Mode drop-down, select Continuous. 7. Click Next. The Task add System Schedule window opens. 8. Place a check mark in the Active check box to activate the sending of files. 9. In the Computer Name field, type the name of the computer on which the EMR stores/sends the data files. 10. In the Path field, enter the location on that computer where the EMR stores/sends the data exchange files. 11. Click Next. The Communication Parameters window opens. 12. In the Upload FTP Path field, enter the upload path on the FTPS machine. 13. In the Download FTP Path field, enter the download path on the FTPS machine. For example, ftp:// :990/in For example, ftp:// :990/out 14. Enter the proper login name and password in the appropriate fields. MicroMD EMR Update Guide Version

58 Chapter 7. File Transfer Hash a File for FTPS Transfer Procedure Details 15. Place a check mark in the Enable SSL check box. 16. In the Manual Copy Path field, enter a path that can be shared with another machine. 17. Click Next. 18. Enter the receiving and sending facility names if appropriate. 19. Click Finish. Using Hashing in MicroMD EMR To hash a file, select Chart > Hash File and browse to its location. When you click the Open button on the Open File for Hashing window, the file is changed to a HAS (.has) format and renamed with an additional date/time stamp. Once the FTPS transfer settings are established in the MicroMD EMR Manager, you can select Chart > Manual Copy for FTP to send the file and/or hash MicroMD EMR Update Guide Version 7.5

59 MICROMD PATIENT PORTAL CHAPTER 8 The MicroMD Patient Portal provides patients and office staff a web site containing a number of easy-to-use features that will save time for both patients and office staff, including: A customizable landing page to view office hours or directions to the practice where patients can log in A messaging system to stay in contact with the practice or view medical records A secure area to view medical records in CCR and CCD format A number of online and secure forms that can save time and paper An area within MicroMD EMR for staff to quickly send medical information to the patient NOTE For purchasing and registration information, please contact Henry Schein Medical Systems. Use of the MicroMD Patient Portal within a practice involves the coordination of the MicroMD EMR software with a web-based workspace area for MicroMD EMR users and a web-based area for web-enabled patients. The MicroMD EMR software sends medical information and receives reminders in the Portal Updates section of the Desktop. See page 8.5 for more details. The web-based administration area serves as a workspace for the practice. This is where the practice users customize the patient area, create users, create user forms and view a log of all web-based communication. The web-based area for patients includes modules for messaging, viewing records and completing forms. NOTE Refer to the Help (F1) menu of the administrative workspace for more instructions on using the web-based portions of the MicroMD Patient Portal. SETUP YOUR PRACTICE IN MICROMD PATIENT PORTAL Before using the MicroMD Patient Portal, you must configure MicroMD EMR, MicroMD EMR Manager and webbased areas of the Patient Portal. To set system settings for the MicroMD Patient Portal: Procedure Details 1. In the MicroMD EMR Manager, click the Communication button 2. In the System column, click the Patient Portal button. The MicroMD PM Patient Portal configuration details display in the right pane of the MicroMD EMR Manager. MicroMD EMR Update Guide Version

60 Chapter 8. MicroMD Patient Portal Setup Your Practice in MicroMD Patient Portal Procedure Details 3. Click the Edit button. The Patient Portal Settings window (Figure 8.1) opens. 4. In the Web Address field, enter the address provided to you by your MicroMD Support Team. 5. In the CCD / CCR Message text box, enter a standard message explaining to patients how their CCR and CCD files will be displayed and added to the MicroMD Patient Portal. 6. In the Department drop-down, select which department in the practice will be handling the communication through the MicroMD Patient Portal. You may be prompted for a key code. This is the address of the web-based administration workspace for MicroMD EMR users. Patient users view this message in their My Records section of the MicroMD Patient Portal. NOTE Leave the Patient Portal Settings window open if you are planning to add MicroMD EMR users to the Patient Portal. Figure 8.1 Patient Portal Settings Window 8.2 MicroMD EMR Update Guide Version 7.5

61 Add MicroMD EMR Users to Patient Portal Chapter 8. MicroMD Patient Portal ADD MICROMD EMR USERS TO PATIENT PORTAL Once the system settings have been established for the MicroMD Patient Portal, you can add MicroMD EMR users authorized to contact patients and send information via the Patient Portal. Procedure Details 1. Log in to the web-based administrative application and add a new user(s) (under Admin > Manage Users). 2. In the Registered users section of the Patient Portal Settings window (Figure 8.1), click the Add button. The Portal User window opens: 3. Enter the user name and password that were established in the web-based administration workspace for the MicroMD EMR user. 4. Click OK. The username appears in Users Name section of the Patient Portal Settings window. 5. Click on the Users & Facilities button on the left side of the MicroMD EMR Manager and verify the Users tab is displayed. 6. Highlight the appropriate user in the left side of the window and click the Access tab. The system displays the user s current details in the right side of the window. 7. Click the Map to External System button. The External System Mapping window opens. 8. Click the Lookup icon ( ). The Edit Mapping window opens. 9. From the System drop-down list, select MicroMD Patient Portal. 10. In the External Id drop-down, select the correct username established in the web-based administration application of the MicroMD Patient Portal. MicroMD EMR Update Guide Version

62 Chapter 8. MicroMD Patient Portal Add Patient Users to MicroMD Patient Portal ADD PATIENT USERS TO MICROMD PATIENT PORTAL Once MicroMD EMR users are added to the MicroMD Patient Portal, you can then make patients web-enabled. This is done from the patient s chart in MicroMD EMR. You can then the patient their log in information for the web-based portion of the Patient Portal. To make a patient web-enabled for the MicroMD Patient Portal: Procedure Details 1. In MicroMD EMR, open the chart of the patient you want to make web-enabled. 2. Open the Health Information Access portion of his or her chart. 3. Click the Portal button. The Patient Portal Setup window (Figure 8.2) opens. 4. In the Commen text box, enter any pertinent information. NOTE It is recommended that you enter the patient s address here so it is easier to it in the web-portion of the MicroMD Patient Portal. 5. Click the CREATE button. The system displays a dialogue box explaining that the account was successfully created. The system automatically generates fields for Portal Patient Id, Portal User Name and Portal Password. NOTE The patient can change his or her login and password in the My Profile section of the web-based Patient Portal. 6. The system sends a secure message to the administrative workspace of the MicroMD Patient Portal. NOTE You can click on this secure message in the web-based administration workspace of the Patient Portal to the patient their username, password and verification code (which is their date of birth). NOTE To remove the web-functionality for a patient, remove the check mark from the Active checkbox on the Patient Portal Setup window. The system then displays a message stating that the patient has been deactivated from the MicroMD Patient Portal. 8.4 MicroMD EMR Update Guide Version 7.5

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