1 of 8 ONECHART CHANGES Introduction Effective October 22, 2014, system changes will occur in preparation for a code upgrade on December 6, 2014. The changes will impact the following areas: Medication History Medication Reconciliation Orders Documentation Ambulatory Organizer Medication History Medication History Snapshot Available for Ambulatory Clinic and Inpatient Locations Medication History Snapshot provides an updated version of the medication history each time changes are made to Document Medication by History. The option to select Medication History Snapshot is available from the Orders or Medications navigator column. Any clinician or non-clinician with the ability to view Document Medication by History will be able to utilize the Medication History Snapshot. On October 22, 2014, this view will be blank as previous Medication History Snapshot information will not be available. The Medication History Snapshot information will begin to populate as medication histories are completed. The option to view This Visit, 6 Months, 1 year, and All Visits is available. The default view will be This Visit. When the medication history is begun or completed, and the Medication History Snapshot is selected, a title bar with the date, time, clinician name, and the Meds History status will display. Five columns of information will be available: Order Type, Medication Name with order details, Last Updated, Compliance Status, and Status. NOTE: The Last Updated column will reflect the last date modifications are made to the medication order details. Modifications to the Add/Modify Compliance information will not change the Last Updated date.
2 of 8 Pending Home Medication Available for Ambulatory Clinic and Inpatient Locations In the Ambulatory Clinic locations, certain clinicians are allowed to propose prescription medications to the physician or nurse practitioner. The proposed prescription medication is pending and is only confirmed upon LIP acceptance. In the Ambulatory Clinic view, the proposed prescription medication(s) will be listed in the Medications category (subcategory of Prescription) on the menu options of Orders and Medications. In the Inpatient view, the proposed prescription medication(s) will be listed in the Medications category (sub-category of Prescription) on the menu option of Medications. NOTE: The Pending Proposal icon will display in the Notifications column and the order status will be Proposal. MEDICATION RECONCILIATION Reset Reconciliation Available for Ambulatory Clinic and Inpatient Locations / LIPs The Reset Reconciliation button will clear the Continue After Reconcile, Create New Rx, and Do Not Continue After Reconcile selections on Medication Reconciliation (prior to signature). This returns all medications to an unreconciled status. Show More Details Available for Ambulatory Clinic and Inpatient Locations / LIPs When a medication is highlighted and the Show More Details button is selected, the medication field will display all available information on the Medication Reconciliation window. Prior to October 22, 2014, hovering over the medication was necessary to cause a pop up box that contained the information. This option will hold once the LIP selects it. Non-Compliance Information Available for Ambulatory Clinic and Inpatient Locations / LIPs Medication non-compliance information will display in red lettering on the Orders Prior to Reconciliation column when the information is documented in the Document Medication by History window. The non-compliance icon to precede the medication name on the Orders Prior to Reconciliation column. will continue
3 of 8 Orders Order Search The order search field will search based on the Contains criteria. If the clinician changes the search criteria to Starts With, this option will not hold after the clinician logs out of the system. Parent / Child Orders The symbol that indicates orders on a recurring basis is changing from a plus sign to a delta symbol. Physician Documentation Dynamic Documentation Refresh Options Available for Ambulatory Clinic Locations / LIPs Providers may refresh narrative components, such as the History of Present Illness (HPI), Physical Exam (PE), and Review of Systems (ROS), in Dynamic Documentation. Selecting the Refresh prompts will automatically update the selected narrative components if the component text is modified on the mpages view after the note has been created. To select a narrative refresh option, complete the following: 1. Select Customize from the View Menu option from any Dynamic Doc Template or the New Note Tab. The Customize window will display. 2. Select the User Options tab. Click the drop down for the narrative section refresh behavior. The Refresh options will list for selection. Only one of the options may be selected. Click Apply and then OK.
4 of 8 Combined Author or Contributor Names Available for Ambulatory Clinic, Inpatient and Emergency Department Locations / LIPs The LIP may customize the ambulatory, inpatient, or emergency department PowerNote to reflect a combined author and contributor names on the List view. To create a column on the list view that will list the author and contributor name, complete the following: 1. Select Customize from the View Menu option. The Note List Options window will display. 2. Click the box in front of the option to Show combined author and contributor names. The Author and Contributors will display from the List view in a separate column. List Display Filter Options Available for Ambulatory Clinic, Inpatient and Emergency Department Locations / LIPs A new display of All Physician Notes is available. To change the List view to this option: 1. Select Documentation from the Menu within the patient chart. 2. Select All Physician Notes from the Display.
5 of 8 Custom Display Option Available for Ambulatory Clinic, Inpatient and Emergency Department Locations / LIPs The ability to create a custom list display will be available. This will allow the LIP to narrow the List to only physician notes and to identify the author and/or contributor(s) that should be included on the List view. To create a custom list display, complete the following steps: 1. Select Documentation from the Menu within the patient chart. 2. Select the List tab and click the ellipsis to open the Advanced Filters window. 3. To customize the List by Document author and/or Document contributor, search for and select the appropriate LIP. The option to narrow the List to Physician Notes Only is available under the Restrict the documents displayed by.
6 of 8 4. Click Save As and the Save Filter As window will display. Type the name of the Custom Display option and click Save. 5. The Custom List is available to select from the Display: option. AMBULATORY ORGANIZER Appointment & Appointment History Views Available for Ambulatory Clinic Locations /All Roles with Organizer Access The appointment details may be viewed by clicking on Appointment View or Appointment History View. These options will display when the user clicks the appointment listed in the Appointment Details column. Appointment View Display
7 of 8 Appointment History View Display Organizer Row Checked In Available for Ambulatory Clinic Locations / Clinic Manager, Nurse and MA After the patient is checked in, the entire row on the Organizer will display in a light blue color. Task Options Available for Ambulatory Clinic Locations / All Roles with Organizer Access The format for the menu on the upper right of the Organizer window will display in a different format. There will no longer be boxes prior to the menu options, but a check mark will display in front of the item when selected. The Auto Update Schedule item is a new option. Auto Update Schedule Available for Ambulatory Clinic Locations /All Roles with Organizer Access The Auto Update schedule option is available to select from the menu on the upper right of the Organizer window. Selecting Auto Update Schedule will update the Organizer by adding new appointments and removing canceled appointments.
8 of 8 Patient Appointment Status Available for Ambulatory Clinic Locations Front Office Staff, Ambulatory Nurse and Ambulatory MA. The ability to change the patient appointment status will be available from the Ambulatory Organizer Status column. NOTE: Please do not use this functionality until instructed to do so. The workflow for the ambulatory clinics must be finalized and may be piloted in some of the ambulatory clinics prior to being used by all of the clinics.