Centricity® Practice Solution - Cpstraining
Transcription
Centricity® Practice Solution - Cpstraining
GE Healthcare IT Centricity® Practice Solution CPS Upgrade Companion Guide Centricity® Services 1 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information CPS Upgrade Companion Guide 1 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Confidentiality and Proprietary Rights and Limitations and Conditions of Use This document is the confidential property of GE Healthcare, a division of General Electric Company (“GE Healthcare”) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non-disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by Photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, Imagination at work, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Copyright 2010 General Electric Company. All rights reserved. Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL 60010 U.S.A. www.gehealthcare.com How to Use this Companion Guide: 2 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS or EMR Computer Based Tutorials (CBT's), CPS or EMR Help Guides (F1), and CPS or EMR New Version Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS or EMR Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version Release Notes. This Companion Guide is a compilation of “best practices” obtained from multiple healthcare practice workflows, which are combined with the functionality of CPS or EMR software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS or EMR product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. Since this Upgrade Companion Guide is a compilation of “Best Practices” related to new features contained in this specific CPS or EMR product release, it is important to acknowledge that each product release contains an assortment of technical enhancements. Since these technical enhancements do not directly impact the average end user, they are not discussed here. Please reference the Release Notes for this specific product version to learn more about all technical improvements, changes and enhancements. Very Important Notice: If you have access the CPS or EMR Upgrade Companion Guides prior to General Release of a specific product release (i.e., You are an Early Adopter Program-EAP Customer, etc.), please note that content within that release's section may be subject to update and may not contain the most recent screen shots and/or product information. Until General Release, the word DRAFT will appear at the top of that section. At the time of General Release, that particular section will be finalized and should be obtained once more from the Customer Education website. For more information on customer education services and tools concerning the CPS or EMR products, please visit the Centricity Customer Portal, http://centricityportal.gen21.com/knav/nav and/or the Customer Education website: www.cpstraining‐gehc.com. 3 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information CPS Upgrading Companion Guide Upgrading PM2004 and EMR2005 to CPS 2006 1 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Table of Contents for Upgrading PM2004 and EMR2005 to CPS 2006 New Features for CPS06 Summary: ........................ 3 Administration ........................................................... 4 User Set-Up ................................................................. 5 Scheduling ................................................................... 6 Registration ................................................................ 7 Billing and Charge Retrieval .................................... 8 Collections ................................................................... 9 Payment Plans .......................................................... 10 Reports....................................................................... 11 Chart .......................................................................... 12 2 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information New Features for CPS06 Summary: Logon & Main Menu Administration: Active Directory and Users are created as a Single Sign On (SSO) to both PM & EMR. Login Page allows an (SSO) to access both the PM & EMR portions of the product. A dropdown allows selecting Location Of Care or setting as default by users. Logout Button allows you to logout to the Login Screen that you can then Exit the system. Main Menu has a fresh new look with new buttons, icons, and additional features. Support screen has changed, the Product update now is a link, and Optional Components have been added. Preferences can be set per user to open directly into the Chart Module bypassing the Main Menu. Administration has changed in structure. The Admin Drop List, also known as the List Editor, is restructured into a component related format with added files. Doctor’s are now Responsible Providers with NPI field added in set up. NPI’s are also added in Company, Facilities, and Referring Providers table. Application window has new items dealing with Payment plan, Guarantor-based collection letters, Warnings, and Charge Import for the EMR. Idle timeout system setting is available in Administration setup. Security Set-up, Preferences, and Privileges for both present in the EMR & Practice Management modules. Collections & Reports: Registration & Scheduling: The previous Patient Information is now Registration with improved functionality. Required Fields selected in Administration show with asterisks (*) in Registration. Patient Search Criteria has been added with Insured ID, External ID, Status, Location, and Bill Code. Payment Plan option is now available for Patients in Registration. Scheduling Module now allows the user ease to open a new view without closing out. The edit menu from the Schedule has new options to select from. Billing Module now has a status of Bad Debt when writing off accounts to collections. Visit Info Tab has changed Doctor to Responsible Provider. Collection now has an option to update multiple visits by guarantor from the Correspondence Notes. Allows selection of All, Some, or No other visits once the functionality is set in Administration. Collection has an option to enter a Next Contact Date. Collection has a new status of Payment Plan Delinquency when using the Payment Plan. Reports Module has added new reports such as Collections Bad Debt Write-off, Payment Plan List, Payment Plan Agreement, and Referral Source Financial Analysis for Appointment. 3 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Administration Scenario: You are asked by the Practice Administrator to set up, verify, and understand the new features and options in your upgraded product. Typical Staff Responsible for this Process: Office Manager, Operations Managers, IT staff, and/or Practice Administrators Considerations: You will need to review new fields in Registration and develop workflows that address the data entry and usage of these new fields. Administrative: Determine who is responsible for setting up and maintaining Active Directory for the staff. Review the Administration>System>Application; Reports>Collection Letters; and Security making necessary changes. Review and update Preferences and Privileges for Responsible Providers, Resources and Pharmacy. These are located under Administration>Edit Menu>Responsible Providers; Resources; and Pharmacy. You will need to review new fields in Registration and develop workflows that address the data entry and usage of these new fields. 4 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information User Set-Up Scenario: You are assigned the responsibility of Setting up Users, Preferences, and Security for the staff. Typical Staff Responsible for this Process: Office Manager, Operations Managers, IT staff, and/or Clinical Specialists Administration>System>User/Location Setup> Users, User Preferences, and Security. Providers and Resources needing Chart Access: Considerations: For more information on Active Directory, Preference, Privileges, and/or Security reference the online Help Guide. Administrative: PM Groups will need to be created for users with like privileges or preferences for the Active Directory. Then set up security and privileges. Users needing Chart access need to be set up as Resources in Administration. 5 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Scheduling Scenario: You are working with clinical staff and schedulers who will need to verify appointments. You must review the schedules, appointment types, and decide if you want to associate appointment types with an encounter form. That will place the document on hold once you check the patient in on the schedule. You may select a default schedule for each user’s Summary Tab of the Chart Module. Typical Staff Responsible for this Process: Office Manager, Operations Managers, IT staff, and/or Clinical Specialists Scheduling appointments in the Centricity Practice Solutions application is based on the functionality that previously existed in the PM application-nothing has changed. But with the integrated scheduling functionality, you no longer need an interface to handle the following scenarios: Cancelling appointments or marking them as No-Shows Arriving a patient and alerting the nurse or medical assistant the patient is ready Associating the documentation with the appointment so that paperwork isn’t lost and appointments are associated with orders Considerations: Will you associate an appointment type to an Encounter type in Administration? Who is responsible for verification of mapping HL7 appointment status to arrived, completed, cancelled, and no-shows? What will be the workflow for arriving a patient to notify clinical staff when patients are ready? Administrative: Appointment types need to match or be created. 6 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Registration Scenario: Because of the additional fields in Registration, you now need to determine who is responsible for collecting and entering the information. *Note: This information is the first step in filling out the claim form and has impact on patient demographics for the Chart module. Typical Staff Responsible for this Process: Office Manager, Front office staff, and/or all staff for practice. Patient Tab-Contact information, demographics (such as race, language, birth date), sensitive chart status, and patient status (active, inactive, deceased and date of death, or obsolete). Guarantor Tab-Contact information and relationship to the patient, as well as employment information for the guarantor. Additional Tab-Referrals, employment, student status, authorizations, notes, and alerts. Insurance Tab-Insured information, insurance policy and eligibility information, along with company contact information. Contacts Tab-Personal and professional contacts, as well as Pharmacies are entered here. Payment Plan Tab-Payment history, current balances, and active/inactive payment plans. Appointment tab-Appointment notes, recall, history. Financial Tab-Billing and statement information and notes. 7 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Decide which fields will be required when registering new patients. Decide what fields, tabs, and insurance information will be collected during scheduling. Decide who is responsible for verification of the patient registration at time of appointment, scanning insurance cards, assigning Sensitive Chart option. Create a workflow for Authorizations and dates, which are required for billing. Create a workflow for obtaining Patient photos. Create policy for Patient Note and Patient alert Note field’s use. These will display on the Summary Tab of the Chart and printing a patient record. Administrative: Select required field in Administration for registering new patients. Billing and Charge Retrieval Scenario: You are now using the combined CPS product and ready to utilize the Orders component area of the chart module. This will directly impact the Charge Entry process and workflow in the Billing module for service charge capture. Typical Staff Responsible for this Process: Office Manager, Billing and/or Check out staff In this release, your orders billing information flows seamlessly through to your financial department without the need for an HL7 interface, minimizing potential lost charges. This application associates a patient chart document with an appointment. The link to a visit only exists if the appointment is linked to a document that is also linked to a visit. When the responsible provider adds and signs orders to that chart document, the application automatically matches up the order information with the associated appointment. 8 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Create workflow for starting the appointment on the EMR Chart side and make certain to associate it to the visit or it will create another ticket. Decide if the responsible provider will sign the orders prior to or at the same time they sign the document. Signing the order triggers the charge transfer. Create a workflow when changes need to be made to the charges. This is only a one-way flow from the EMR Chart to the PM system. Any changes made on the visit in PM will not be reflected on the order or Office visit document. The Authorized Provider on the Order must also be the Responsible Provider on the Visit or another ticket will be produced in the billing screen. It will be important to monitor duplicates that appear in billing. This could be caused by Appending original Chart documents or adding new clinical date that is not a match for service date. Collections Scenario: You are responsible for Collection actions for the practice and need to understand the new collection features. Typical Staff Responsible for this Process: Billing Managers and Billing staff New Collections functionality now allows letters and correspondence notes for multiple-visits to be updated simultaneously for a single guarantor. You can print one collection letter that has the total overdue balance for a guarantor instead of one collection letter per visit. You can also select the specific visits you want to work with. You can easily create and review correspondence notes and update contact dates. Collection status is also updated automatically. When a collection balance reaches zero, the payment plan is automatically inactivated. 9 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: The Collection Status and Next Contact Date can only be updated for those visits in Collections. Correspondence notes can be updated on all visits regardless of status. On the correspondence tab, all other patients associated with a single Guarantor will appear in a box on the upper right. Create a workflow for managing Payment Plans that become delinquent –reversing the Payment Plan Delinquency status. New Billing Status of Bad Debt has been added to be user defined for Collections, as well as use in an Active Report to Write-off balances. A pop-up warning can be selected to warn the user when accessing patients with this status. Administrative: To use the new functionality to update multiple visits, you must select Guarantor Based Collections in Administration>Systems>Application. Payment Plans Scenario: You have patients that are currently making payments on accounts. You are now able to create, monitor, and report on guarantor based Payment Plans within Registration. Typical Staff Responsible for this Process: Billing Managers and Billing staff 10 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Create a workflow to utilize the Payment Plan feature, which is specific to patient not guarantor. You must Checkmark the Agreement Signed box & enter Date Signed to activate. You will need to make a new Payment Plan when there are additional charges for the patient after a plan was initialize. Only one Payment Plan can be active at a time for each patient. Reference the Collections considerations for the use of the Reverse Delinquency button. Create policy on Payment Plans for pre-paid service such as OB, Surgeries, and/or Consultations. Administrative: Customization of the Agreement letter can be done in Reports>Component specific to associate with Payment Plan in Administration>Registration>Bill Code. Reports Scenario: Now that the Migration is complete, you need to check functionality of custom reports you had prior to upgrading. Typical Staff Responsible for this Process: Office Manager, Operations Managers, IT staff, and/or Clinical Specialists For this release, all standard shipped reports have been converted to Crystal Reports V10.0. If you plan to use only the shipped reports without modifying them, you don’t need to convert anything. The application includes all the Crystal Reports files you’ll need to run the shipped reports. However, if you created custom reports with custom SQL, they will not work until you convert them to Crystal Reports v10.0 Financial reports. To upgrade your custom financial reports, use ReportCoverter.exe. See online help for Reports for complete instructions. Clinical reports. If you converted your custom clinical reports when you upgraded to Centricity Physician Office-EMR 2005, they will work in this release. If you recently upgraded and have not converted your reports, see System Requirements for Centricity Practice Solutions. Printing Reports instructions are also in the New Release notes. Please refer to them if you need assistance. There are new reports in this release, which require security access to be assigned. Considerations: You will need to test and update Custom reports from both the PM and EMR modules. You need to run reports and other financials prior to the upgrade and again after the upgrade to compare for accuracy. Identify the need to outsource the custom reports creation, re-build, and/or conversion. Clinical custom reports not completed and ready for immediate use must be considered and workflow in-place. Administrative: New reports need to have security assigned to them in Administration for anyone to use 11 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Chart Scenario: Your clinic has just upgraded to CPS06 and you are responsible for understanding how the Chart module of CPS06 compares to stand-alone, Oracle EMR 2005. Typical Staff Responsible for this Process: Clinical Staff and/or all staff with access to the Chart Considerations: The Chart Module within CPS 2006 is functionally comparable to Oracle EMR 2005. If migrating from Oracle EMR 5.6 to CPS 2006 then please reference the Upgrade Companion Guide and Release Notes for Oracle EMR 2005. Selecting “Reg” in the EMR launches the Registration Module that contains information used in both the PM and EMR side of CPS 2006. PM users with chart access can double-click on the flag icon to go directly to the Chart’s Desktop and view the flag. Administrative: The Go>Setup>Settings/Preferences/Privileges have been incorporated in the Administration Component. Chart Access must be granted for all users that require it in Administration>System>Security>Main Menu>Chart>View Chart. Users that are not Responsible Providers or Resources will need to be added to the Resource table prior to granting them Chart access. Preferences can be set to for a user to open directly into the Chart Module instead of the Main Menu at login. 12 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information NOTES: 13 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information CPS Upgrading Companion Guide The new features in this release primarily impact the clinical side of Centricity Practice Solutions. In addition to meeting the Certification Commission for Healthcare Information Technology’s (CCHIT) 2007 Certified Ambulatory EHR requirements, the features included in Centricity Practice Solution 9.0 focus on: Improving workflow and the user experience Enhancing the overall interoperability infrastructure General system maintenance and improved serviceability 1 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Table of Contents for Migration to CPS9.0: New Features for CPS 9.0 Summary: .............................................................3 Patient Historical Information .......................................................................4 Care Alerts- Individual .....................................................................................5 Care Alerts- Bulk ...............................................................................................6 Pop Up Care Alerts in Chart Module..............................................................7 Patient History Tab in Chart ...........................................................................8 Advanced Directives ........................................................................................9 Orders Completion Assistance .................................................................... 10 Other Enhancements .................................................................................... 11 Online help feedback .................................................................................... 11 Login security ................................................................................................. 11 Crystal Reports............................................................................................... 11 Data Symbols.................................................................................................. 12 Default plan-specific information for order codes.................................. 12 Tamper-resistant prescription reports ..................................................... 12 Support for sliding fee schedules ............................................................... 12 External charge retrieval enhancements ................................................. 13 New cell phone and pager fields................................................................. 13 New audit option for Find Patient query ................................................... 13 New minimum number of characters for patient search ...................... 13 Ability to a open chart from the schedule ................................................ 13 Ability to change the Desktop schedule date........................................... 13 Additional data on the Update Problems window................................... 13 Admin Hold orders can now be completed ............................................... 13 Role-based access to inquiries ................................................................... 14 Expanded advance directives options ....................................................... 14 DoFirst kit updated ........................................................................................ 14 New Print Handout button for medications ............................................. 14 No known medications watermark in Charts .......................................... 14 Advanced Eprescribing ................................................................................. 14 Notes: ............................................................................................................... 15 2 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information New Features for CPS 9.0 Summary: Registration: EMR or Chart Module: Patient Historical Information Tab added to track updates. Changes tracked with Inquiries tab of the Reports in EMR. Care Alerts that signal information without being a permanent part of the EMR. Pop Up Alerts in the Chart Module. History Tab comes in 2 view options shipped with the system. Editing optional. Advanced Directives Reviewed & Medications Reviewed as items to a flowsheet. Orders Completion preferences added to Administration. Advanced ePrescribing Update Other Enhancements: Default Service Providers by Location of Care. HL7 Orders can be designed to send signed orders. All standard reports convert to Crystal Reports 11.5. New Data Symbols added for EMR use. Updated Data Symbols. Online Help Enhancements 3 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Patient Historical Information Scenario: You are now using your new CPS 9.0 system and have a client that is updating their demographic information. In the past, tracking changes made to patient data was not available, but the Historical Tab will now track any demographic changes made to the patient’s account. It also enables you to report on it within the Inquiries Tab in the Chart Module. Typical Staff Responsible and/or impacted with this Process: Office Manager, Billing Department, Collections Department, and/or Clinical Staff Considerations: Create a policy or workflow for reviewing and updating patient demographics. Users need to understand filling in a previously blank field will NOT populate an entry to the Historical Data tab. An Example to using this feature is trying to locate a patient by a maiden or changed last name and/or trying to find previous addresses or phone numbers for patients. Reference online help for more information on creating an inquiry or reporting of this function. Administrative: Security needs to be granted to users allowing them Inquires in the EMR Reports module. 4 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Care Alerts- Individual Scenario: As the Nurse for your clinic you want to create a reminder for patient Walter Caldwell that he needs to have a Flu Shot at his next appointment since he was not able to get one today. You are going to create a Care Alert as a future reminder in his chart. Typical Staff Responsible for this Process: Clinical Manager, Nurses, Medical Assistant, and/or other clinical staff Individual Care Alerts are created in Chart>Alerts/Flags. Considerations: Care Alerts can be hidden on your desktop but are always visible in the patient chart from all modules except Flowsheet and Orders. All Care Alerts will appear in each patient Chart. But like Flags, they are not a legal, permanent part of the Chart unless converted to a document. Administrative: Security needs to be granted to users allowing them access to Inquiries in the EMR Reports module. Care Alerts, as well as Pop ups, can be specific to a Location of Care. Filtering by To Location works in conjunction with a user's settings on the Organize Alerts/Flags window. See Release notes for more information as to new system settings, preferences, and Reports pertaining to Care Alerts with this release. 5 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Care Alerts- Bulk Scenario: As the Nurse for your clinic you were asked by the doctors to monitor all patients that have Hypertension to have a Cholesterol check at least once yearly. You can run an Inquiry to find all patient with diagnosis of HTN and add a Care alert accordingly. Typical Staff Responsible for this Process: Clinical Manager, Nurses, Medical Assistant, and/or other clinical staff Bulk Care Alerts are created in Chart Module>Reports>Inquiries. Considerations: Care Alerts will appear on the Responsible Providers desktop unless hidden. Care Alerts also appear in each patient’s Chart but are not a permanent unless converted to a document. Care Alerts for patients without a Responsible Provider selected in Registration will have the flag set to go to desktop of the creator of the Bulk Care Alerts. Administrative: Security needs to be granted to users allowing them Inquires in the EMR Reports module. For more information on creating, using, and options for Care Alerts please reference online Help. See Release notes for more information regarding new system settings, preferences, and Reports pertaining to Care Alerts with this release. 6 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Pop Up Care Alerts in Chart Module Scenario: As the Nurse for Dr Winston, you are updating patient Jason A. Grant’s EMR record from a Consultation Letter received in your office today from his Cardiologist. You want to add a Pop Up Care Alert concerning his Emergency Heart Stent to make certain that staff is aware of this. Typical Staff Responsible for this Process: Clinical Staff, Nurses, and other Specialists Considerations: Determine a workflow for the use of Pop Up Alerts, as they will create a stop for the user, requiring an action. Pop Up Alerts are created with the same functionality of a Flag and are never a permanent part of a patients chart unless converted to a document. You can view Care Alerts from the Alerts/Flags Tab in the chart, and hover over them to see more information. Administration: Pop Ups, as well as Care Alerts, can be specific to a Location of Care. Filtering by To Location works in conjunction with a user's settings on the Organize Alerts/Flags window. See Release notes for more information as to new system settings, preferences, and Reports pertaining to Care Alerts with this release. 7 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Patient History Tab in Chart Scenario: Walter Caldwell has his annual visit scheduled for today and you want to prepare by reviewing his past history. You may also want to order labs or tests prior to this visit. History views are a particularly useful alternative to flowsheets for displaying narrative text. Typical Staff Responsible for this Process: Nurses, Medical Assistant, and/or other clinical staff. Considerations: The Set Attached View button allows you to attach a preferred view to a particular patient's chart. You can define a preferred view (template) at the user, group, or enterprise level. Administration: To define a preferred view (template) at the user, group, or enterprise level from Administration | System | User/Location Setup > User Preferences > Patient Charts > History view. These views are included in Clinical Kit content and must be imported. See the Set up charts > Set up Charts > Set up patient history views book or search for “history template” in online help for more information. 8 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Advanced Directives Scenario: Your physician has called you from the hospital asking for Chart information on a critical patient he is caring for, specifically Advanced Directives. You can easily access this information within the patient chart to inform your physician. Typical Staff Responsible for this Process: Nurses, Medical Assistant, and/or other clinical staff. Considerations: The user that documents last reviewed is listed on the date/time stamp. Administration: The flowsheet view must include the observation term, named ADV DIR REV. For more information about reviewing directives, see the Using directives book or search for “update directives” in online help. 9 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Orders Completion Assistance Scenario: As the physician, you would like to gain efficiencies by completing your Orders when reviewing and signing the corresponding documents (i.e., Lab results, Consultation Reports, etc) associated with that Order. The Orders Completion Assistant allows for a workflow where reviewing, completing and signing can be completed with one workflow. Typical Staff Responsible for this Process: Physicians, Mid Level Providers, Nurses, Medical Assistant, and/or other clinical staff. Considerations: This is an enhancement to make it easier to find and close matching orders when signing documents. This is designed to assist when labs do not have the ability to return the original order number with results or when the order is not processed electronically. The workflow to complete orders from the Documents tab (from Desktop or from Chart) is simplified with steps outlined in the Release Notes. Centricity Practice Solution identifies the potential matches based on date of service, ordering provider, and location of care. For a document to be considered a potential match it must meet multiple criteria. Administration: Orders Completion is turned on per Provider in their Preferences, per Document Type. For more information about signing and completing orders, see the Placing Orders > Sign and Complete orders book or search for “orders completion” in online help. New orders completion preferences To remind users to review and complete matching orders, your practice can choose to automatically launch the Select Orders to Complete window when a particular document type is signed from the desktop or Charts. Potential matching orders appear here. Matched data is shown in bold text. Since potential matches are automatically selected for you, you can complete the order and sign the document with a single click of the Sign and Complete button. 10 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Other Enhancements Online help feedback This release of Centricity Practice Solution includes a new interactive online help. While using the online help, you can rate each topic’s effectiveness and provide specific feedback to the GE documentation team. The online help also passively transmits data for which topics the users view. Note: All ratings and usage data are anonymous. Each help topic includes a 5-star rating system. One star represents an unhelpful topic, and five stars represent a very helpful topic. You can also submit feedback to the GE documentation team, via online help topics. All submitted feedback is anonymous unless you choose to use your real name. If you would like follow-up from the GE documentation team regarding your feedback, please e-mail the GE documentation team at CentricityDocs@ge.com. If you do not wish to transmit online help usage data, block the https://onlinehelp.gehealthcare.com Web address in your security configuration. Blocking this Web address will not affect the functionality of the online help. Login security Centricity Practice Solution 9.0 includes changes to the login process to prevent disclosure of valid login information. On the Login window, the Location of Care field is disabled until you enter a valid user ID and password. Once you enter a valid user ID and password, Press Tab to move to the Location of Care field, select the desired authorized location of care, and then press Enter or click OK OR Press Enter (or click OK) immediately after entering a valid user ID and password to log into your previously logged into location of care Crystal Reports For this release, all standard reports have been converted to Crystal Reports® v11.5. If you plan to use only the standard reports without modifying them, you will not need to convert anything. The application includes all the Crystal Reports files you will need to run the 11 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information standard reports. If you plan to modify the standard reports, you must use Crystal Report v11.5 Professional edition. If you created custom Chart (EMR) reports with custom SQL, they may not work until you convert them to Crystal Reports v11.5. While Crystal Reports v11.5 has backward compatibility for reports created with v10, older reports may not actually work without conversion. GE strongly encourages you to convert your custom Chart reports to v11.5. Steps for doing so are provided below. IMPORTANT: Reports created with a version newer than Crystal v11.5 may not work. See instructions on converting your Crystal Reports in the Release notes. Data Symbols There are numerous new and updated data symbols in this release, which are listed in the Release Notes. See online help for detailed descriptions of these data symbols. Default plan-specific information for order codes With Centricity Practice Solution 9.0 you can now specify default plan-specific information at the order code level. Previously, you could only specify this information at the order category level. When an order is entered, the system will look for the plan and location of care match. If the match is not found, the plans specified as the default for the order code will be entered. Note: For more information about setting up order codes, see the Set up orders > Set up order defaults book in Administration online help. Tamper-resistant prescription reports As of October 1, 2008, all non-electronic (paper-based) Medicaid outpatient prescriptions that are reimbursable by the federal government must contain at least three tamper-resistant features. This requirement was included in section 7002(b) of the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007. The requirements were outlined in guidance issued by the Centers for Medicare & Medicaid Services (CMS) on August 17, 2007 in a letter to State Medicaid Directors. To provide a solution for this requirement, GE Healthcare is updating all prescription reports for Centricity Practice Solution 2006 concurrently with the development of Centricity Practice Solution 9.0. These changes will allow you to continue using prescription forms from the application in specific states without needing to either customize the forms, or purchase tamperproof paper. To download the prescription forms and release notes, go to: http://centricitypractice.gehealthcare.com/rx/index.htm. Support for sliding fee schedules Centricity Practice Solution 9.0 introduces fully integrated poverty discounts for qualified patients using sliding fee schedules. A sliding fee schedule is a percentage discount, usually recorded as an adjustment to the original fee for a service rendered by a provider. Discounts are based on the patient's income subsidy level, as defined by the Federal Poverty Guidelines. Previously, poverty discounts were only available via a separately-licensed plug-in or through VAR applications. Note: For more information, search for "Process map: Setting up sliding fee schedules" in the online help. 12 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information External charge retrieval enhancements In Centricity Practice Solution 9.0, for visits with a status of Filed or greater, you have the option of retrieving external charges to an existing visit or retrieving the charges to a split visit. For example, if you have patient orders transferring to a visit that complete after you have filed the associated claim, you can now choose whether or not to import those charges into the existing visit or to split the charges off into a new visit all with one keystroke/click. Additionally, new settings in the Administration module allow you to manage bulk charge retrieval for visits with a status of Filed or greater and assign a specific visit status and visit owner for affected visits. Note: For more information on these settings search for “charge import options” in Administration online help. New cell phone and pager fields Additional fields have been added to Registration, Contacts, and Banner to capture cell phone and pager numbers. Linklogic support is under evaluation for inclusion in a future release. New audit option for Find Patient query A new system setting option for auditing is available from Administration >System > Auditing (Clinical). When selected, the Audit find patient queries option records an audit event whenever a user runs the Find Patient query. Enabling this option is not recommended unless needed, as it will significantly increase your database storage requirements. New minimum number of characters for patient search A new enterprise-wide setting has been added to Centricity Practice Solution 9.0 to specify the minimum number of characters you must enter in the Search For field of the Find Patient window. The required character count displays below the field. To specify a value for this setting, go to Administration > Charts | Chart > Find Patient. Ability to a open chart from the schedule Centricity Practice Solution 9.0 includes the ability to right-click on an appointment in the Schedule component and quickly opens the corresponding patient’s chart. This time-saver eliminates the extra steps associated with navigating to the Charts component and searching for the patient before viewing the chart. Ability to change the Desktop schedule date In Centricity Practice Solution 9.0, from the Desktop Summary tab in the Chart component, you can now select a date to view appointments for. Previously, you could only view the schedule for the current date from this tab. Additional data on the Update Problems window The Update Problems window shows the name of the person who entered the problem and the responsible provider who signed the document in which that problem was added to the chart. Admin Hold orders can now be completed You can now complete orders from the “Admin Hold” state. Previously, only orders in an “In Process” state could be completed. 13 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Role-based access to inquiries Role-based access to saved inquires has been implemented. This functionality allows users such as front office staff to have limited access to historical and other demographic data, without allowing them to have access to chart data. Expanded advance directives options The drop-down list on the New Directive window now includes the following new options: Living Will on File Power of Attorney Narcotics Agreement HIPAA Disclosure Privacy Notice Acknowledged To view appointments for a different date, click the down-arrow to choose a date from a calendar. DoFirst kit updated The Basic Practice DoFirst kit has been simplified to include the minimum set of clinical content required for Centricity Practice Solution to function after installation. Your clinic will likely add additional clinical content from the content provided with the install, from the KnowledgeBank, or other sources. New Print Handout button for medications A Print Handout button has been added to the Find Medication window. When clicked, the handout automatically prints to d default printer. If no handout exists for this medication, a message appears, stating No handouts available for medication: <medication>. No known medications watermark in Charts When the “This patient takes no known medication” (NKMED) check box is selected on the Update Medications window, a watermark message now appears on the Medications tab and Summary tab. Advanced Eprescribing Information pertaining to Eprescribing found in Release Notes. Eprescribing review and training completed outside this document. Contact GE Support or VAR to set up this training. Since this Upgrade Companion Guide is a compilation of “Best Practices” related to new features contained in this specific CPS or EMR product release, it is important to acknowledge that each product release contains an assortment of technical enhancements. Since these technical enhancements do not directly impact the average end user, they are not discussed here. Please reference the Release Notes for this specific product version to learn more about all technical improvements, changes and enhancements. 14 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Notes: 15 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information CPS Upgrade Companion Guide The new features in this release primarily impact the clinical side of Centricity Practice Solutions and fulfill Certification Commission for Healthcare Information Technology’s (CCHIT) 2008-2011 Certified Ambulatory EHR requirements and ARRA Meaningful Use reporting requirements. 1 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Table of Contents: New Feature Summary ............................................. 3 Registration New Features ...................................... 4 Sensitive Charts ......................................................... 5 Continuity of Care Document .................................. 5 Allergy or Adverse Reaction: ................................... 6 Drug Interaction Checking ....................................... 7 Associating Medications with a Problem .............. 9 Advanced eRx Medication History Checking ...... 10 System Folder-Auditing Enhancements .............. 11 Customized Log in Message .................................. 12 Data Symbols............................................................ 13 Advanced Eprescribing ........................................... 13 NOTES:........................................................................ 14 2 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information New Feature Summary EMR or Chart Module: Maintaining the Patient’s Current Problem & Medication Lists. Advanced eRx features. Allergies/Sensitivities Enhancements. Drug Interaction checking. EMR Auditing Enhancements. Continuity of Care Document (CCD). Enhanced Clinical Content. Registration: New Contact By field. New Birthtime field. New Ethnicity field. Sensitive Charts enhanced feature enables by user. Other Enhancements: Customized Message on Login Screen. Securing user passwords. Crystal Reports Upgrade. 3 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Registration New Features Scenario: You are using your new CPS 9.5 system, which has added features and fields for recording patient demographics. You are registering new patient Ben Gibbons and can record his birthtime and Ethnicity to meet reporting requirements and assist with clinical measures. You can enter a Contact By preference that also provides reporting options. Typical Staff Responsible and/or impacted with this Process: Office Manager, Billing Department, Collections Department, and/or Clinical Staff Considerations: Contact By allows you to report on the % of reminders for preventive and follow up care sent to patients. You can search for a method and send a pre-built letter for a specific method. Birthtime can be useful for Pediatric practices management of care. Determine how you will document for the patients not wanting to provide Ethnicity information. Ethnicity is now a reporting requirement. A workflow for capturing each of these fields should be created. Administration: Determine what Contact by methods you need and create them in Administration. Determine if they are going to be required fields. Privileges must be set for running the inquiries on Contact by method. 4 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Sensitive Charts Scenario: While registering Ben Gibbons his mother mentions that she does not want your receptionist, Jennifer Brown, to have access to Ben’s Chart due to personal reasons. The new Sensitive chart feature allows you to disable a specific user from seeing chart information as an added security layer. Typical Staff Responsible for this Process: Office Manager, Clinical Manager, Nurses, Medical Assistant, and/or other clinical staff Considerations: Determine a policy for individual users to be restricted from accessing specific charts and who will restrict those individuals. This option allows an extra layer of security to the chart. Administration: Selecting “Sensitive Chart” checkbox and restricting user access must be a privilege that is set up in Administration. Continuity of Care Document Scenario: Patient Walter Caldwell was seen in your office today and referred out to a Cardiologist. Walter requests a copy of his records to take with him to this appointment and a copy for him to keep. He is supplying an encrypted dump drive for this request. Typical Staff Responsible for this Process: Office Manager, Clinical Manager, Nurses, Medical Assistant, and/or other clinical staff 5 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information CCD’s will display the Allergies, Directives, Problems, Medications, Immunizations, Diagnostic Results, and Vital Signs (with the option to include Diagnostic results and Vital Signs, unsigned or pending final signature). Considerations: You can print this document, send via email, or download to approved hardware. CCD’s are required to be provided in encrypted format or sent via secure email. CCD’s can also be brought into your practice via the patient. Determine a workflow for who/how the CCD will be provided within your clinic. The “reason for exporting”, allowing “Vital Signs” or “Lab results”, and “include observations that are unsigned or pending final signature” are all options when creating a CCD. Patients can make a request through secure Patient Portal if you have this interface. You can report on CCD’s provided from your clinic. Administration: Organizations that use the auto-sign on their lab interfaces will need to determine if they will disable this function for abnormal labs. This will not allow them to be added to the CCD prior to physician review and final signature. It is important not to rename Flowsheets related to the CCD items. See Release notes for more information. Allergy or Adverse Reaction: Scenario: As the Medical Assistant you are updating Walter Caldwell’s Allergies and Alerts in your newly updated CPS 9.5. You need to review previously entered allergies with the understanding that there are now 4 reaction types instead of 3. Typical Staff Responsible for this Process: Nurses, Medical Assistants, Clinical Staff, Medical providers 6 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information 4 Reaction Types: Critical, Severe, Moderate, and Mild. Considerations: Determine a workflow to review and confirm previously documented allergies. Allergies and alerts listed as non-critical prior to the upgrade will now display as Moderate after the upgrade. Allergy reactions previously documented as Critical will still display as Critical after the upgrade. Drug Interaction Checking Scenario: Walter Caldwell is being seen today by your Provider and is being prescribed some new medications. While adding these medications, new functionality of drug dosing and interaction checking will appear. You need to understand these features and set preferences, per provider, in the new CPS 9.5 system. Typical Staff Responsible for this Process: Office Manager, Clinical Managers, Physicians and Mid Level Providers, Other Clinical Staff. 7 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information 8 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: You can set up quick text for commonly used dosing instructions. When dosing by a patient’s weight, it will show you the last weight recorded, even if it is today’s entry, where clinical list changes have not been signed yet. Requiring a reason for overriding an interaction can be set in security, as well as the option to “Always Apply Prior Override Reason” to same medications used on & off during a patient’s treatment. (i.e. morphine for a chemo patient) All override reasons will show in the lower right hand box on the mediation tab, including user and date stamp. Once you have overridden an interaction, a check mark in a green circle will display on the new/change medication window. Administration: You will need to determine if “Ignore Uncoded Medications” will be enabled. Determine what reasons will be allowed for overriding drug interactions. Determine which users or roles will have the ability to override drug interactions and grant them security to do so. Associating Medications with a Problem Scenario: During your office visit with Walter Caldwell, you now can use the option that allows Associating Medications with Problems. This will allow Walter to better understand which medication is treating which problem and he can review this with his family. Walter is very excited since he has frequently wondered about this in the past and has trouble remembering. When patients fill their prescriptions, this information will be added to the medication label for Walter. Typical Staff Responsible for this Process: All medical staff refilling and prescribing medications for patients. 9 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Determine if your staff will update prior medications and associate with specific problems. You will not see the Print Dx box on the New Medication form unless you have selected a Prescribing Method that includes printing. You will be able to see the Medication with Associated problem on the Charts Medication Tab. You can select more than one Problem to associate to a medication by using the Ctrl key during selection. When using Advanced eRx, this feature will print on the medication labels through faxing/electronically sending the prescriptions when set up in Administration as the default. Reference the Release Notes for more information on this feature or the online Help. Advanced eRx Medication History Checking Scenario: You are the nurse, updating the patient’s chart, and a Medication history Reconciliation has been returned from SureScripts for one of your patients. You will need to spend a few moments to update the medication list, but you will have a true value of what medication each patient is taking. Typical Staff Responsible for this Process: Any staff that will be monitoring eRx and/or adding medication refills. 10 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Written Consent must be obtained from the patients for Medication History Checking. You will need to allow 2-3 minutes to populate this information to populate into the chart. A workflow for reconciling the medication brought into the chart must be designed, as each one will require the step to add as a new medication. Create a workflow for who will initiate the checking; will they also be responsible for reviewing and reconciling?; and will this be performed prior to each visit? Medications reconciled will display an abbreviation/icon in the far left column of the Medication Hx form prescribing network grid with: E: Exact (coded) match. I: Inexact match based on the GP8 Code. ?C: Uncoded med (no code from SureScripts) **Note-If you try to add an uncoded med, it will launch the search med screen. System Folder-Auditing Enhancements Scenario: As the Practice Administrator and because your clinic is required to report on specific events, you can turn on a more granular auditing option in Administration. These audits can be selected by 3 different Categories: 1. Do Not Log 2. Log Audit Events 3. Log and Send Audit Events **NOTE: Only items that do not have an Asterisk (*) can be added to this category. Typical Staff Responsible for this Process: Practice Administrator, Office Manager, Operations Managers, IT staff, and/or Clinical Specialists 11 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Determine who will manage this operation for your clinic. Determine which auditing events will be logged vs. not logged vs. logged and sent. Select which audit reports you would like to utilize or make required in your clinic. Administrative: Security must be given to the user responsible for auditing. Reference the Release Notes for more information on this feature or the online Help. Customized Log in Message Scenario: As the Practice Administrator, you want to add an extra layer of security to your EMR by adding a warning message to the login screen that states, “Access to this software is allowed to Authorized Users ONLY”. This message can be update with proper privileges. Typical Staff Responsible for this Process: Practice Administrator, Office Manager, IT Staff/ Providers. Considerations: Determine which Users/Roles will have privileges to set this message. Determine what the Message will state and the reason it could be changed. Administrative: The message is set up under Administration>System>Login> Log in Message Box This message displays at the bottom on the homepage once you have logged into CPS. Reference the Release Notes for more information on this feature or the online Help. 12 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Data Symbols There are numerous new and updated data symbols in this release, which are listed in the Release Notes. See online help for detailed descriptions of these data symbols. Advanced Eprescribing Information pertaining to Eprescribing found in Release Notes. Eprescribing review and training completed outside this document. Contact GE Support or VAR to set up this training. Since this Upgrade Companion Guide is a compilation of “Best Practices” related to new features contained in this specific CPS or EMR product release, it is important to acknowledge that each product release contains an assortment of technical enhancements. Since these technical enhancements do not directly impact the average end user, they are not discussed here. Please reference the Release Notes for this specific product version to learn more about all technical improvements, changes and enhancements. 13 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information NOTES: 14 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information CPS Upgrade Companion Guide The new clinical features in this release fulfill Certification Commission for Healthcare Information Technology’s (CCHIT) 2008-2011 Certified Ambulatory EHR requirements and ARRA Meaningful Use reporting requirements. The new practice management features in this release include support for the American National Standards Institute (ANSI) Accredited Standards Committee x12 Version 5010 requirements for claims transactions. Additional features in this release include: Enhanced user model and security workflows. LDAP vs. Application Authentication set up New PM Reports and updates to existing reports Financial Dashboard module 1 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Table of Contents: New Feature Summary ............................................. 3 Security Enhancement .............................................. 4 Password Management Enhancement.................. 5 Customized Log in Message .................................... 5 Advanced Embedded Help ....................................... 6 New Management for Users, Referring Providers, Responsible Providers Administrative Set up ...... 7 Practice Management Reports ............................. 10 Financial Dashboard Module................................. 12 ANSI 5010 Compliance ............................................ 13 Advanced eRx Medication History Checking ...... 14 System Folder-Auditing Enhancements .............. 15 New Physician Experience ..................................... 16 Data Symbols............................................................ 17 Advanced Eprescribing ........................................... 17 Clinical Content Enhancements ............................ 17 Meaningful Use Requirements .............................. 17 NOTES:........................................................................ 18 2 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information New Feature Summary EMR or Chart Module: New Physician Experience Advanced ePrescribing Features Practice Management: New Financial Dashboard New User, Referring Provider, Responsible Provider windows 6 New and Multiple Enhanced PM Reports Enhanced CCC Clinical Auditing Features EDI Claims Submission using 5010 ANSI format Other Enhancements: User Management and Security Enhanced Meaningful Use Requirements with Additional Reports CCHIT 2008-2011 and ARRA 2001 Phase 1 certification Advanced Embedded Help 3 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Security Enhancement Scenario: As the Practice Administrator using your new CPS 10.0 system, you want to ensure you are meeting new requirements with the added security features. This offers your patients peace of mind that their EMR is protected. Typical Staff Responsible and/or impacted with this Process: Practice Administrator, Office Manager, IT Staff and all other staff. 4 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Clinics can determine levels of security and permissions by user, by security group, by permission, or directly from a user’s profile. Security at the group level is now inclusive, meaning that a permission granted to a user in one group is extended to that user even if the user is in another group that excludes permission. Administration: New Superuser Account allows users to immediately log into the application and set up security groups and administrative users. *See additional information on Superuser. Reference the Release Notes for more information and details on this feature. Password Management Enhancement Scenario: As the Practice Administrator, you want to add Password requirements for an added layer of application authentication. Typical Staff Responsible for this Process: Practice Administrator, Office Manager, IT Staff/ Providers. Options: Maximum Number of Login Attempts Time Between Login Attempts (in Seconds) Expiration (in days) Number Retained Password Composition Requirements Minimum Size Force Password Change for Security Groups Considerations: Determine which settings will improve protection without causing frustration for users. Determine who will manage these options and have a back up person. Administrative: Passwords now are encrypted with Advanced Encryption Standard (AES) encryption with a SHA@/SHA-256 hash algorithm. Existing passwords stored with previous MD5 encryption will be verified and updated when users login for the first time after the upgrade. Reference the Release Notes for more information on this feature or the online Help. Customized Log in Message Scenario: As the Practice Administrator, you want to add an extra layer of security to your EMR. You can do this simply by adding a warning message to the login screen that states, “Access to this software is allowed to Authorized Users ONLY”. This message can be updated with proper privileges. Typical Staff Responsible for this Process: Practice Administrator, Office Manager, IT Staff/ Providers. 5 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Determine which Users/Roles will have privileges to set this message. Determine what the Message will state and the reasons for changing. This message displays at the bottom on the homepage once you have logged into CPS. Administrative: The message is set up under Administration>System>Login> Log in Message Box. Reference the Release Notes for more information on this feature or the online Help. Advanced Embedded Help Scenario: As the Office Manager, you are working with the new features on CPS 10 and need some help on how to set up your Financial Dashboard. F1 Help has additional information about specific tasks and now offers brief videos that highlight key workflows. Typical Staff Responsible for this Process: All staff using the new system and learning new features and functionality. Considerations: F1 Help has been available in all releases. Per customer feedback, enhances continue to be made with CPS 10 F1 help containing workflow videos. Encourage the use of F1 Help among staff to save time and increase knowledge base. F1 Help is available from anywhere within the product to all users. Administration: Make certain that the workstations have needed software to run the videos. 6 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information New Management for Users, Referring Providers, Responsible Providers Administrative Set up Scenario: As the Practice Administrator, you are evaluating and tweaking Administration settings for your Users, Referring Providers, and Responsible Providers. Understanding the changes in these areas are very important. Billing accuracy and reporting depends on their setup. Typical Staff Responsible for this Process: Practice Administrator, Office manager, Clinical Manager, and Billing Managers. Users: 7 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Referring Providers: 8 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Responsible Providers: Considerations: Determine who will review/update the Users, Referring Providers, and Responsible Providers in Administration. Determine if any Resources need reviewed, updated, or inactivate. Administration: A single NEW button has replaced the New Providers and New Resources buttons. Determine that all areas are completed to meet billing and reporting requirements. Reference the Release notes for more information on these administrative tables as they are visually and functionally changed. 9 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Practice Management Reports Scenario: As the Practice Administrator, you are ready to run reports in CPS 10. Past reports are enhanced and there are 6 new reports added which you will need to understand prior to running. You should reference the Release notes for more information. Typical Staff Responsible for this Process: Practice Administrator, Office manager, Clinical Manager, Billing Managers, and other staff that run reports. Report Changes: Accounts Receivable: All accounts receivable reports now include multi-select criteria for provider, facility and company, where applicable. Provider, facility, and company group by options were also added to the reports, as necessary. In addition to the multi-select criteria changes, the Aging by Guarantor and Procedure Date Aging by Guarantor reports also include new criteria for Bill Code. You can choose to filter the report by one or more bill codes, which pull from the list of bill codes in Administration | Registration > Bill Code. Administrative: All administrative reports include multi-select criteria for provider, facility, company, insurance group, and insurance carrier, where applicable. Correspondence Audit: The Correspondence Audit report includes more detailed criteria that allow you to view correspondence notes by searching for either the patient or the guarantor. Additionally, the report supports a multi-select list of users who have entered correspondence notes in the application. You can group the report output by patient, guarantor, or user, and sort the notes by note created date or visit date. Provider Fee Schedule: The Provider Fee Schedule report (formerly Doctor Fee Schedule) includes new multi-select criteria for company, facility, insurance group, insurance carrier, and fee schedule. The report allows you to limit the output by active schedules only, and to specify a date range for the effective or expiration date of the fee schedule. Insurance Carrier Maintenance: The new Insurance Carrier Maintenance report helps you identify insurance carriers with missing information. The report identifies insurance carriers without an associated insurance group, carrier type, policy type, financial class, or transaction column set, as well as carriers with a default filing method of Paper. The report can also include inactive insurance carriers. Financial: All financial reports include multi-select criteria for provider, facility, company, insurance group, and insurance carrier, where applicable. Net Charges by Insurance: The new Net Charges by Insurance report helps you review charges and adjustments per insurance group. The report includes criteria for provider, facility, company, insurance carrier, insurance group, and the charge date of entry or date of service range. Patient: All patient reports include multi-select criteria for provider, facility, company, resource, insurance group, and insurance carrier, where applicable. Duplicate Patients: The new Duplicate Patients report helps you identify duplicate patients in your database. You can choose to display duplicate patient matches by social security number (SSN), SSN and date of birth, and SSN and last name. 10 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Patient Balance with No Statement Bill Code: The new Patient Balance with No Statement Bill Code report identifies patients with outstanding balances who do not receive statements due to guarantor settings in Registration. You can run the report by bill codes that do not trigger statements (set in Administration | Registration > Bill Code when Print Statement = N), and include or exclude both inactive and deceased patients in your report. The report output by default lists patients by the highest balance. Patients Missing Standard Claim Data: The new Patients Missing Standard Claim Data report lists patients and the types of data their registration records lack. The report output groups patients inherently by status (active, inactive, deceased, obsolete) and displays the patient ID, name, responsible provider, authorization source, patient information release designation, privacy policy designation, benefit assignment, signature on file designation, birthdate, and gender. Schedule: All schedule reports include multi-select criteria for provider, facility, company, and resource, where applicable. Appointments reports: To help you identify patients who are in Collections, the appointments reports now include a designation on the report outputs, using a double asterisk (**), for patients who have at least one visit in Collections. Appointments reports include: Appointments Appointments (Single-Line) Appointments by Facility Appointments by Resource Appointments with Eligibility Blocked Appointments: The new Blocked Appointments report lists blocked appointments, the user who blocked them, and the date the appointment was blocked. Considerations: Determine what reports your clinic used in the past and what changed with this release. Determine if you have any custom reports created and what changes may be required following the upgrade. To improve consistency with labels between modules, the term ‘Doctor’ has been replaced with the term “Provider’ throughout the reports module. Administration: All reports have been updates to accept the required character lengths meeting 5010 ANSI Standards. Reference the Release notes for more information on the new and enhanced reports. 11 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Financial Dashboard Module Scenario: As the Practice Administrator, you are asked by the Executive Committee to give them a Financial Overview of the Practice. With the new Financial Dashboard Module, you have a display of high-level financial metrics for key performance indicators in accounts receivable and revenue/visits at your fingertips. Typical Staff Responsible for this Process: Practice Administrator, Office manager, Clinical Manager, Billing Managers, and Providers. Financial Dashboard Metrics: Account Receivable Metrics: Charges, Payments, Adjustments Aggregate Days in Accounts Receivable Days in Accounts Receivable by Insurance Group Days in Accounts Receivable by Financial Class Revenue/Visits Metrics: Net Charges by Provider Number of Visits Percentage Billing Status Percentage Billing Status by Balance 12 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Determine which staff needs access for the Financial Dashboard. Apply global filters to metrics to see financial information comparing ‘apples to apples’. Administrative: Make certain to save preferred metric layouts. Layouts can be saved per user so you can customize the view and track like information over periods of time. Set up access from the Main Menu and Module toolbar in Administration> System> Permission>Dashboard> View dashboard for each user. Defaults are also set up under Administration>System>Permission>Dashboard> Edit dashboard default settings. 13 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information ANSI 5010 Compliance Scenario: As a biller for your clinic you are concerned with workflow changes that may be required after January 1, 2012. 5010 ANSI standards are inherent in the CPS 10 product; therefore the charge posting and billing process will not change. Typical Staff Responsible for this Process: Practice Administrator, Office manager, Clinical Manager, Billing Managers Considerations: Determine what staff training will be required for understanding the 5010 ANSI standards. Determine charge entry workflow changes that are needed with 5010 ANSI standards. With the 5010 ANSI standards, 12 diagnosis codes are allowed per claim. Administration: Over 850 modifications were done for 5010. Reference the Release Notes for Key changes included in the 5010 ANSI standards. Advanced eRx Medication History Checking Scenario: As the nurse, when updating the patients chart, a Medication history reconciliation has been returned from SureScripts for one of your patients. You will need to spend a few moments to update the medication list, but you will have a true value of what medication each patient is taking. Typical Staff Responsible for this Process: Any staff that will be monitoring eRx and/or adding medication refills. 14 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Written Consent must be obtained from the patients for Medication History Checking. You will need to allow 2-3 minutes for this information to populate into the chart. A workflow for reconciling the medication brought into the chart must be designed, as each one will require the step to add as a new medication. Create a workflow for who will initiate the checking; will they also be responsible for reviewing and reconciling; and will this be performed prior to each visit. Medications reconciled will display an abbreviation/icon in the far left column of the Medication Hx form prescribing network grid with: E: Exact (coded) match. I: Inexact match based on the GP8 Code. ?C: Uncoded med (no code from SureScripts) **Note-If you try to add an uncoded med, it will launch the search med screen. System Folder-Auditing Enhancements Scenario: As the Practice Administrator and because your clinic is required to report on specific events, you can turn on a more granular auditing option in Administration. These audits can be selected by 3 different Categories: 1. Do Not Log 2. Log Audit Events 3. Log and Send Audit Events **NOTE: Only items that do not have an Asterisk (*) can be added to this category. Typical Staff Responsible for this Process: Practice Administrator, Office Manager, Operations Managers, IT staff, and/or Clinical Specialists 15 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Considerations: Determine who will manage this operation for your clinic. Determine which auditing events will be logged vs. not logged vs. logged and sent. Select which audit reports you would like to utilize or required in your clinic. Administrative: Security must be given to the user responsible for auditing. Reference the Release Notes for more information on this feature or the online Help. New Physician Experience Scenario: Upgrading to CPS 10, you will notice a new look and functionality to the Chart. There have been many enhancements to allow for a better overall workflow and ease to access patient information. Typical Staff Responsible for this Process: Clinical Staff, Providers, all staff with Chart Access. Considerations: Refer to the Release Notes, Online Help, and CBT’s to learn about and understand all the changes that come with this upgrade. Icons have changed. No longer use Update button but instead New Document is used to start an update. Visual alert of new flags or documents now on top of screen instead of the bottom. There are no tabs, but left hand listing of Chart Component to open that selection. Quality and Reporting button on bottom left to access MQIC reports once loaded. Enhanced with Physician input for easier viewing and access of data. 16 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information Data Symbols There are numerous new and updated data symbols in this release, which are listed in the Release Notes. See online help for detailed descriptions of these data symbols. Advanced Eprescribing Information pertaining to Eprescribing found in Release Notes. Eprescribing review and training is completed outside this document. Contact GE Support or VAR to set up this training. Clinical Content Enhancements There are numerous new features and updated enhancements with the Clinical content in this release, which are listed in the Release Notes. Please reference the Release Notes and use the CCC training tools to understand these changes. Meaningful Use Requirements With this release there is support to meet the Meaningful Use requirements. Reference the Release Notes for further information on this topic. Since this Upgrade Companion Guide is a compilation of “Best Practices” related to new features contained in this specific CPS or EMR product release, it is important to acknowledge that each product release contains an assortment of technical enhancements. Since these technical enhancements do not directly impact the average end user, they are not discussed here. Please reference the Release Notes for this specific product version to learn more about all technical improvements, changes and enhancements. 17 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information NOTES: 18 Copyright 2011 General Electric Company. All rights reserved. Confidential and Proprietary Information