NDoc Version Number: 16.05.01 Important Installation Considerations: Users logged in while installing an update will lose access and any unsaved work. Installation Steps (does not apply to Hosted customers*): 1. Download the update a. Browse to http://www.myndoc.com and login with your MyNDoc credentials. b. Navigate to Welcome > NDoc Updates c. Click on the 16.05 exe to download the update executable. 2. On the NDoc server, execute the 16.05 update executable downloaded in step 1c. 3. Select Ok at the prompt to proceed with the update installation. Selecting Cancel will exit the update installation. Important: Do not attempt to execute an update on a NDoc shadow server. Shadow servers are updated automatically during installation on the primary NDoc server. 4. Once the update has completed, the update status page will redirect to the main Sign-In page. Summary: This update contains the following enhancements and corrections (applies to all customers): IMPORTANT Pre-Install Reminder Related to Billing (Non-Hosted Agencies): NDoc Billing/HBS Customers: Prior to installing this update, you need to have NDoc Billing/HBS update 1.2.8.33 installed and be running version 1.2.1.50 of the HBS Service to ensure level of care and hospice facility/location data continues to import properly. If the specified billing update is not installed, the level of care and hospice/facility location data will stop importing into billing until the billing update is applied. To confirm the HBS Service version, access the billing server and go to either C:\Program Files (x86)\has\homecare Billing Solutions\ (x64 server) or C:\Program Files\HAS\HomeCare Billing Solutions\ (x86 server). Next, highlight the HBSService.exe file, right click, and select Properties. On the Details tab, note the File Version details. To check the NDoc Billing/HBS Update version, open the billing module and go to Help>About. FGA Billing: Prior to installing this update, you must verify with FGA that you are running the latest version of their software that imports level of care and hospice facility/location changes data exports (released in the NDoc 16.04 update), to ensure level of care and hospice facility/location data continues to import properly. If the specified billing update is not installed, the level of care and hospice/facility location data will stop importing into billing until the appropriate FGA billing update is applied. SIGNIFICANT NEW FEATURES/ENHANCEMENTS/REGULATORY CHANGES - Supervisory Visit Documentation and Tracking: In an effort to expand NDoc s current supervisory visit tracking logic and provide agencies greater flexibility in documenting and tracking supervisory visits, several new features have been introduced along with enhancements of existing functionality. Specifically, this update includes: new agency settings to control the disciplines that require supervision and customize those requirements based on parameters, including insurance, company, etc., updated visit charting screens to provide greater clarity to the supervision activities, updated warnings and reminders for compliance, and new reporting tools to track supervisory visits completed, due, or coming due. For additional details, please refer to the NDoc Reference for Supervisory Visit Tracking. To accommodate these updates and enhancements, the following actions were taken with the existing functionality: Visit Charting>Patient Profile Removed Options: Within Patient Profile, the Sup/MD Visit screen has been renamed MD Visit and all fields related to supervisory visits have been removed, so the charting and logic can be tracked within the visits directly. Reporting: Old Reports Removed (under Reports>Tracking>Patient): The HHA/PCA Supervisory Due and HHA/PCA Without Supervisory Visits Reports have been removed with these reporting features to be covered by new reports. Hospice Volunteer Management: To help hospice agencies capture and track volunteer activities, this update includes several changes to quantify the volunteer efforts and calculate the annual 5% volunteer cost savings achieved through these volunteer hours. The changes include: 2001-2017 Thornberry Ltd. Page 1 of 6
Administrative Settings Changes: Updates to the Employee Table, the addition of new Volunteer Activities Tables, and changes to field options in existing agency tables. Migration of Existing Settings: Data previously contained in the Volunteer Type tables will be migrated to the new Volunteer Activity Tables. New Volunteer Management functionality (Operations>Volunteer Management): A new category within Operations gives users two new options (Volunteer Activity and Volunteer Cost Savings) to document volunteer activities and to calculate the volunteer cost savings. Additional guidance on this functionality is available within the NDoc Reference for the Volunteer Management Functionality. Please note that to accommodate the volunteer changes described above, the following existing items were altered or removed in NDoc: Operations>Contact Management> o Contact Activity Volunteer Activity Fields: These fields have been removed with this charting now captured in the Volunteer Activity function. o Contact Profile Volunteer Fields: These fields have been disabled are will be captured within the Employee Access Tables. Reports>Contacts>Volunteer Log This report has been moved to Reports>Other>Volunteer Log in order to provide access to pre-16.05 data. Contact Management Changes: In addition to the removal of volunteer related charting in Contact Activity, the following changes related to Contact Management were included in this update. Table Change - Contact Event Table (Administration>System>Agency Table (A-I)) New Field: A new field labeled Create Visit has been added to this table. When checked, a patient visits is created automatically when choosing the specific event in Contact Activity using the Other option. Contact Activity Options (Operations>Contact Management>Contact Activity): Based on the table settings described above, this update added the ability to select an event and have a visit created automatically upon saving the activity. The event must be marked using the new Create Visit field in the Contact Event table. When selecting an event with this designation, the patient and clinician fields will become required. Reporting Options (Reports>Contact) New Reports: Two new reports have been added for viewing data charted in Contact Activity - Meetings and Other. Each will show data charted with the respective option in Contact Activity. CARE PILOT: Visit Charting (OASIS, HIS, Today s Care, Patient Profile [also in Operations and Administration]) Vital Signs New A1C Diabetes Field: This update includes a new field for the documentation of A1C level percentages within the Vital Signs screen next to the Cap Glucose field. Pain Management>Pain Scale Used Issue with Observation Output: Although the option observation is correct in the charting screens. The selection included a typo when displayed within the Patient Summary and Visit Reports. This has been corrected. Visit Charting>OASIS Assessments and Operations>Data Entry>Assessments (back-office) Telephone Visit Options: An RFA 7 is now allowed for Service Provided Codes with Telephone Visit? set to YES.) Hospice Charting Visit Charting (HIS, Today s Care, Patient Profile [also in Operations and Administration]) - Field Labels for Clergy and Spiritual Caregiver: These fields under the Spiritual and Pronouncement categories have shared data, but have been labeled separately. For consistency, these fields have been updated and are both now labeled Spiritual Caregiver (non-hospice) and can be used to document a spiritual caregiver not associated with the hospice s spiritual team. HIS Record (Care Pilot>Visit Charting and Operations>Data Entry>HIS Records (back-office data entry) Date Initial Nursing Assessment Initiated (A0245) Charting: Users are now able to record no initial assessment was initiated. Patient/Disc Status (also in Operations and Administration) Discipline Discharge: Users may now modify the Discipline Discharge Reason after the patient has been discharged. Document Library Trigger: This update includes a correction for a bug that prevented the proper setup of documents in Document Library for non-admitted hospice patients if the user entered an Agency SOC Date after clicking "Modify. Using 2001-2017 Thornberry Ltd. Page 2 of 6
"Admit to Hospice" in this scenario worked correctly. Admit to Hospice under Level of Care: Level of Care is now required if none exists after the user has entered an Agency SOC Date. MEDICATIONS: Medication and Allergy Database: The First Databank medications and allergy database included in this update is dated 02/23/2017. PLAN OF CARE: Create Plan of Care Selecting the Cert Period: This update corrects a bug preventing users from being able to select a valid cert period for the plan of care when it is more than 15 days from the current date, despite an alert being present on the Employee Dashboard indicating you should be able to create the plan of care. ICD Transition Export - This functionality to aid users during the transition between ICD-9 and ICD-10 has been removed. ADMINISTRATION: Patient>HIS Records Maintenance Correction Number: Users are no longer allowed to enter 00 for the Correction Number field in the HIS Record Maintenance routine. The valid entry is 0 for the correction when necessary. Employee>Employee Table>Access Team Designation: The Team designation section includes an option to designate the Primary Team of the employee. System> Agency Tables (J-Q)>Physician NPI Validation: An issue was corrected that resulted in inconsistencies in the validation of NPI, which would have allowed an invalid NPI to be entered. Agency Settings>Visits>Service Provided Field Requirements Field Update: The Adverse Reaction fields that are no longer present within the Visit Charting screens has been removed from the selection options. OPERATIONS: Intake>Patient Registration Register/Refer Access: Users without access to Patient Referral will no longer be able to access the Register and Refer action. Prior to this release, the action would cause the session to lock up, though the action was ultimately prevented when the user did not have access to Patient Referral. Document Management>Document Library Auto-Add Documents Feature: Issues were found related to synchronizations that would sometimes prevent a document from being added automatically, despite being setup that way in Document Library settings. This has been corrected. Patient Management> Flow Sheet View Column Header Issue: This update corrects a bug causing the label of the 11 th Column Header to display incorrectly, resulting in users misinterpreting the date within the 11 th Column. Billing Management Ready to Bill Report Results: In certain instances, an issue was found that caused POC documents to display as missing for deceased patients. This has been corrected. REPORTS: Bereavement>Print Bereavement Letters Inactive Letters: A bug has been corrected that allowed letters marked as inactive in the bereavement plan to still be setup in the print queue for the next print run executed. Select Contacts Issue: In some cases, contacts were prevented from displaying in the Select Contact(s) field within the Print Bereavement Letters functionality, if the contact did not have a patient (DE#104543) in their profile. The same problem was identified with printing letters using the Reprint Bereavement Letters functionality. This has been resolved. Bereavement Printing via CSV Export within Reprint Bereavement Letters Option - To aid users in printing labels for bereavement letters, a CSV Export action has been added which will generate a list of contact information (name, address, etc.) based on the contacts selected for a specified print run. If no contacts are selected, all will be displayed on the CSV export. 2001-2017 Thornberry Ltd. Page 3 of 6
Patient Physician Summary Narrative Summary Issue: In certain cases, an issue was discovered that could cause the wrong narrative summary to display when printing Physician Summaries by transfer date or recert date. This has been resolved. Now, the value of the narrative summary (DE#101167) from the last RFA charted during the time period selected will be used. Patient Record Reports: A bug has been corrected that caused OASIS fields to not display OASIS values (i.e., number or letter associated with the response), only the OASIS text. This applied to fields that were charted as Late Charting and/or Amendment Charting. This problem does not affect the OASIS diagnoses fields that are normally amended in Data Entry since these diagnoses fields do not have OASIS values, only the diagnosis codes. Discipline Abbreviation Correction The following reports have been corrected to address an issue that prevented the reports from running correctly for disciplines with abbreviations that have changed since the initial NDoc Implementation. Frequency Exceptions (Reports>Orders) Visit Exceptions (Reports>Visits) Therapy Census List (subset of the Patient Care Conference Report under Reports>Tracking>Patient) INTERFACES: NDoc Billing/HBS Facility Table Issue: A correction for a bug tied to the Facility Table (Administration>System>Outside Tables>Facility) has been released that caused a duplicate facility/institute to be created in NDoc Billing/HBS when adding/editing a facility in NDoc that already exists in NDoc Billing/HBS. NDoc Mobile (AirClic): Updated Diagnosis Label: The View Patient Info option has been updated to change the diagnosis label from ICD9 to Dx. New Fields: The Care Plan Information screen now has the Case Manager listed. The Patient Information screen now displays the Emergency Contact, Emergency Contact Phone, DNR, and Case Manager. TABLE CHANGES/ADDITIONS FOR ODBC REPORT USERS: Data Access Changes: The following properties have been made available via SQL: Tables.Company o RequireOasis o RequireOasisAns Tables.Location o AgencyName o Require485 o Require485Ans o RequireOasis o RequireOasisAns Tables.Program o Require485 o Require485Ans o RequireOasis o RequireOasisAns Table Changes: User.DemoII - The following properties relating to patient supervisory visit tracking have been removed and replaced by new tables for better tracking: o AideLastSupervisoryVisitDate o AideLastSupervisoryVisitDateHx o PCALastSupervisoryVisitDateHx o AideNextSupervisoryDue o PCANextSupervisoryDue o AideSupervisorVisitReason o LastSupervisoryVisitDate o o User.HospiceContactActivity The property VoluntMeetYTDTimeHrs has been removed. Table Additions: The following tables have been added to track patient supervisory visits: o Patient_Visit.Supervisory o Patient_Visit.SupervisorySchedule The following tables have been added to track volunteer activities and their history as entered in the new Volunteer Activity feature: o Volunteer.Activity o Volunteer_Activity.HistoryHeader o Volunteer_Activity.HistoryItem o Tables.VolunteerActivity o Tables.VolunteerActivityType o 2001-2017 Thornberry Ltd. Page 4 of 6
Table Property Correction: A bug has been corrected to force properties OasisRequiredBilling, Required485Billing and F2FRequiredBilling to always have a value of 0 (No) or 1 (Yes). DOCUMENTATION: The changes to documentation with this update include, but are not limited to the following: NEW References: NDoc Reference for Supervisory Visit Tracking NDoc Reference for the Volunteer Management Functionality The following items are included in the 16.05.02 Sub-Release: 16.05 SUB-RELEASE - 16.05.02 Supervisory Visit Settings based on Insurance (Administration>System>Agency Settings>Supervisory Visit Settings): A bug has been corrected that would produce invalid results in reporting when using the option to track patient supervisory visits by insurance. Contact Activity Process of Creating Visits (Operations>Contact Management>Contact Activity): A bug has been corrected that caused visit data created through the new feature for contact activity, via events designated as such, to be lost in some cases after the Process Patient Now was used or daily processing had completed. The following item is included in the 16.05.03 Sub-Release: 16.05 SUB-RELEASE - 16.05.03 Hospice Item Set (HIS) Version 2.0 Default: An issue was found with HIS Admissions and Discharges started after April 1. Specifically, the records were not defaulting correctly at the HIS sign-in screen (either in Care Pilot>Visit Charting>HIS or Operations>Data Entry>HIS Records (Back-Office Date Entry)) to the 2.0 Version of the HIS specifications effective April 1. This has been resolved and new records started after this sub-release is installed on the server and updated on the clients will default to the 2.0 Version automatically. The following item is included in the 16.05.04 Sub-Release: 16.05 SUB-RELEASE - 16.05.04 Visit Charting>HIS Record and Operations>Data Entry>HIS Records (back-office data entry) J0900D Field Requirement: An issue was found regarding the required field logic for J0900D (Type of Standardized Tool) that was not being triggered as required correctly when J0900C (Patient s Pain Severity) was charted as 0=None. This has been resolved. Hospice Volunteer Management Changes The following changes were applied to the Volunteer Management Functionality released with 16.05.01. Please refer to the Volunteer Management Functionality Reference for additional details. Employee Name Displayed in Non-Volunteer Activities: In certain cases, the employee associated with a non-volunteer activity was not displaying. This has been resolved. Service Provided Code Table (Administration>System>Agency Tables (R-Z)>Service Provided Code) New Field for Volunteer Management Calculation: There are certain activities that should not be counted toward the paid staff time calculation (denominator) of the volunteer cost savings value. In order to differentiate these activities, a new field is available in the Service Provided Code table with the label Include in Volunteer Cost Savings? - Y/N. If this field is checked as Yes, the activities are included in the Volunteer Cost Savings calculation for paid staff (non-volunteer activities) involving direct patient care. If the field is checked as No, the activities are not considered direct contact with patients and are not included in the paid staff time calculation. Note: The field defaults to Yes and when installed all of the Service Provided Codes will be set to Yes automatically. Patient Activity Calculations (Administration>System>Agency Tables (J-Q)>Pt Activity To/From) New Field for Volunteer Management Calculation: As with the change to the Service Provided Code described above, certain Patient Activity entries should not be included in the calculation for direct patient contact of paid staff. To ensure data is captured correctly, a new field has been added to this table labeled Applicable to Volunteer Cost Savings? Y/N. In this case, if the entity is set to Yes, the Call/On-Call activities between the entity and an employee with a non-volunteer team selected are included in the Volunteer Cost Savings calculation for paid staff (non-volunteer activities) involving direct patient care. If set to No, the 2001-2017 Thornberry Ltd. Page 5 of 6
activities are not considered direct contact with patients and are not included in the paid staff time calculation. Note: The field defaults to No and when installed Patient, Caregiver, and Family are set to Yes by default. Calculating Bereavement Activities: The Volunteer Cost Savings calculation needs to include all direct time with patients, families, or hospice survivor. In that case, calls or meetings with bereaved contacts involving paid staff also need to be included in the denominator (non-volunteer activities). These are activities that are also completed by volunteers and may need to be considered as part of the numerator. The following changes are included in this sub-release: o Volunteer Activity Type Table (Administration>System>Agency Table (R-Z)>Volunteer Activity Type) New Option: A new option has been added labeled Contact Bereavement. o Volunteer Activity Table ((Administration>System>Agency Table (R-Z)>Volunteer Activity) Link to the Activity Type: The two options of Bereavement Call and Bereavement Meeting should be linked to the Contact Bereavement type described above. o Contact Activity Charting (Operations>Contact Management>Contact Activity): When adding a call or meeting with Bereavement selected as the Event Type enables new options to chart the corresponding Clinician, Team, and Time fields. If the Contact Activity is associated with a clinician linked to a non-volunteer team, the activity is added to the Volunteer Cost Savings Report under the Non-Volunteer Activities calculation (denominator). If the Contact Activity is associated with a clinician linked to a volunteer team, the activity is added to the Volunteer Cost Savings Report under the Volunteer Activities calculation (numerator). Note: even though a Contact Activity entry might be linked to volunteer time it will not display in the Volunteer Activity function (Operations>Volunteer Management>Volunteer Activity). * For Hosted Customers only, all NDoc monthly updates are installed by the Thornberry support team per the terms of the Memorandum of Understanding: Server Maintenance and Updates. **These Release Notes detail significant changes in user side functionality. Coding changes for program maintenance are not reflected. 2001-2017 Thornberry Ltd. Page 6 of 6