The VSR icon now displays in orange to indicate when a corresponding Clinical Summary has not been created for a Visit Summary Report. In many cases, this can be resolved by re-generating the Visit Summary Report. Do so by right-clicking the patient’s name and clicking Print Visit Summary Report.
Practice managers can now set out-of-office reminders for others at their practice.
The From field is now available to be updated for all clinical messages to which a patient is attached (provided you are associated with the same clinic as the patient). Previously, unless a patient was selected as a message recipient, the From field defaulted to the logged on user and could not be changed. Changing the From field is useful in workflows where a member of a shared desk (such as Medications or Referrals) sends a message to another practice or physician, and wishes any other member of that shared desk to see the response to (and possibly act upon) that message.
When you sort by a column on the Patient Requests tab, the LMR retains that sorting for the entire LMR session.
The
icon displays whenever you select a
patient who is enrolled into the same practice as your current
location. Clicking this icon allows you to start a new Patient
Gateway message to the patient.The message count now displays in the lower right corner of the Clinical Messages tab. This includes the total number of messages and the number of messages for the current day.
The acceptable age of eligibility data (displayed in the banner of the Medications screen) has been reduced from 30 days to 72 hours. This will result in an increase in the number of drug formulary searches, and help achieve benchmarks for Meaningful Use measures for eRx.
Note: In some cases, the displayed “As of” date may be out-of-synch with the actual displayed data. Click Refresh, if applicable.
The LMR can automatically remove pharmacies from provider favorites and patient lists if the pharmacy has been removed from the pharmacy database. Previously, pharmacies that were deleted in the pharmacy database were no longer displayed in search results screens, but continued to be listed with provider favorites and patient lists.
The Pharmacy database now includes additional types, such as Long Term Care, Specialty, Compounding, and Other. The list of pharmacies (displayed by clicking the View link in the banner or on Summary 2) now includes a column for Type.
When reconciling medications, you can now click By Drug Class to sort medications by therapeutic class.
The Medication List screen may now include a “Document to Reconcile” link and banner at the top of the screen. It displays if any external documents have been received within the past 180 days and if the Medication List section for at least one of those documents has not been certified as complete. For details, click here.
To meet Meaningful use and certification requirements, alerts for duplicate medication, drug-pregnancy, and drug-disease interactions now include the icon
. Clicking this link
to learn more about the source of the alert being triggered
within the patient's record.The main Medications page includes a link for "Consolidated Med List View." Clicking this link displays a comprehensive view of medications for the selected patient. Its purpose is to gather medication information from multiple sources and organize that data in a way that facilitates medication management by all clinicians. Initially, the application includes medications from source systems, such as Oncall and the LMR. If patient consent has been obtained, data from pharmacies and insurance companies may also be included.
The Allergy List screen may now include a “Document to Reconcile” link and banner at the top of the screen. It displays if any external documents have been received within the past 180 days and if the Allergy List section for at least one of those documents has not been certified as complete. For details, click here.
The Problem List screen may now include a “Document to Reconcile” link and banner at the top of the screen. It displays if any external documents have been received within the past 180 days and if the Problem List section for at least one of those documents has not been certified as complete. For details, click here.
This new option from the Patient Chart menu allows you to display a list of all external documents (such as CCDAs) received for this patient from the past 365 days. A requirement of Meaningful use is that the LMR provide a method of receiving electronic documents from external sources to facilitate the sharing of health information between health care providers.
Using this module, you can view, print, save, or send any document to another provider. You can also click links for the Medications, Problems, and Allergies section to reconcile the associated LMR lists with the content from these lists. For details, click here.
The Notes module now includes a link for "Non-LMR Documents." This link allows you to view letters, notes, and consents created using an application other than the LMR. These documents were previously only available from the Notes Viewer option in the Results Web or CAS Results.
When saving a note, you are now prompted to add “None” to the Medication or Problems List or “NKA” (No Known Allergies) to the Allergies List if the patient does not have any entries for these lists. You are only prompted for the lists that contain no entries. You can choose whether or not to include this information. This prompt only displays if switched “on” in the BICS-ADO Practice Dictionary. Contact your LMR support analyst for details.
To meet Meaningful use and certification requirements, suggested problem list additions (displayed when saving a note) now include the icon
. Click this link to
learn more about the source of the prompt being triggered
within the patient’s record.
To meet Meaningful use and certification requirements, Reminders displaying on the Summary screen or within the Reminders module now include the icon
. Click this link to learn more about
the source of the intervention being triggered within the
patient’s record.The interface between the LMR and the Patient Keeper application has been enhanced. When you click the Patient Keeper link from the Summary screen, information regarding service dates and diagnosis codes entered using the End of Visit module are available in the Patient Keeper application. The Patient Keeper application is used by the MGPO and other practices to manage charge capture workflow.
When validating EOV orders, the LMR can now check that a diagnosis has been marked as the primary diagnosis. A primary diagnosis code is required in order for charges to be processed in the BICS Confirm Out system.
This new report, accessed from the Reports menu, allows you to generate a report showing whether orders written by you, your practice, or selected providers at your practice can be reconciled with completed test results (based on a table of the most commonly ordered tests). A basic requirement of the Patient-Centered Medical Home (PCMH) is to ensure that ordered labs are tracked so that a practice knows which ones have been completed, and which ones still need to be done.
Available sections for this report are:
Outstanding Orders – Orders for the most commonly ordered tests that the LMR could not match with test results. The section also identifies any high risk tests.
Orders for Manual Reconciliation – Orders for tests other than those most commonly ordered. The LMR does not try to automatically match these orders to tests. Use either the Results Manager or Results Viewer application to reconcile these orders.
Auto-Reconciled Orders – Orders for the most commonly ordered tests that the LMR could match with test results.
You can run the report in either summary mode (with total numbers for each category for each patient) or detail mode (with details for each order grouped by patient).
Once you generate a report, you can either print it or export it as a Microsoft® Excel file.
The New Visit screen of the Infusion Flowsheet has been enhanced to include a field for REM (Risk Evaluation Mitigation). In this field, type all medications where a Risk Evaluation Mitigation is needed. This information display in a tool tip for each visit on the Infusion Flowsheet.
You are no longer allowed to create more than one visit for the same date.
The Goal of Treatment/Indication field of the Treatment Plan has been enhanced. The field is now required and includes choices consistent with the Chemo Order Entry application (from the COE Dx/Indication field). Previously, the LMR included the same two choices (“Curative/Adjuvant/Neo-adjuvant” and “Palliative/Non-curative”) regardless of the diagnosis. Additionally, the steps for completing this field have been modified. For details, click here.
The Health Monitoring grid includes additional sections to meet ACO (Accountable Care Organization) screening requirements. These include screening sections for Depression, Falls Risk, and Weight Management.
The following new sections are now included on Visit Summary Reports: Demographics, Reason for Visit, Medications Administered, Smoking Status, Care Plan, and Care Team.
The LMR now sends a Clinical Summary to the patient’s PG account in addition to the Visit Summary Report when you click Send to PG, Print, or Send to PG. Likewise, the LMR now automatically generates Clinical Summaries whenever Visit Summary Reports are generated. Note that neither report is generated for teen patients.
You are now able to indicate if a patient has declined a Visit Summary Report. When a report is declined, the LMR does not create a Clinical Summary CCDA.
Visit Summary Reports are now automatically generated and posted to a patient’s PG account by the day after the visit, if not yet manually created. Previously, the LMR automatically generated Visit Summary Reports after 3 days.
The Visit Summary Report can now be automatically generated for patients with Patient Gateway (PG) accounts, whether or not the practice is an active PG practice. Previously, both the practice and the patient were required to have active PG accounts. Contact your LMR support analyst for details.
You can now suppress the automatic generation of Visit Summary Reports for certain visit types. See Customizing Visit Forms for details.
The Visit Summary Report now includes additional statuses to indicate previous changes made to medications, not related to the most recent visit. For example, the status “No Change (Not Taking)” displays for medications marked as “Not Taking” during reconciliation for a previous visit by another provider. Likewise, the status “No Change (Taking Differently)” displays for medications marked as “Taking Differently.”
Future appointments are now listed in chronological order. Previously, future appointments were listed in reverse chronological order.
A link on the Visit Summary Report History screen now allows you to view the corresponding Clinical Summary. Click the
in the CCD column to view the Clinical Summary.
Note: Patients can view Visit Summary Reports in the LMR using the Visit Summary Report option from the Health Record menu. Patients can view Clinical Summaries in PG using the Health Information Reports option from the Health Record menu.
Deleting a Visit Summary Report now deletes the corresponding Clinical Summary.
You can now suppress the automatic generation of Visit Summary Reports for specific visit types. A
icon displays to allow you to select the applicable visit
types. Previously, the LMR generated Visit Summary Reports
for all visit types, and could not be changed.When setting the parameter configuration for forms, the default for all form types (Forms, Visit Summary, Standardized Forms) is set to include auto-generation for all visit/appointment types. If the header check box is selected, newly added visit/appointment types default as selected. Otherwise, newly added visit/appointment types default as not selected.
The following new sections are now included on Visit Summary Reports: Demographics, Reason for Visit, Medications Administered, Smoking Status, Care Plan, and Care Team. You cannot suppress these sections from Custom Visit Summary Reports.
Interactive visit forms, sent as tasks to the patient via Patient Gateway, now include the exact response selected by the patient at his or her previous visit as well as the date entered. Previously, a “patient friendly” coded response was displayed to the patient, and dates were omitted in some cases (such as when the patient declined the associated health monitoring item). This change also affects forms printed by the provider using the Patient Forms option from the Reports menu.
To meet Meaningful use and certification requirements, Reminders displaying on the Summary screen or within the Reminders module now include the icon
. Click this link
to learn more about the source of the intervention being triggered
within the patient’s record.Reminder reports can now be run on the behalf of providers by authorized staff using the new report, Patient List Query (stage 2) for Practice Managers (via Report Central). Previously, reports could only be run by the provider.
Each report generates two lists: patients with active reminders, and patients without reminders (same report name, but with a suffix of "NoRem"). Practices may choose to send generic reminders to patients without reminders, such as to encourage discarding expired medications. Built-in logic prevents duplicate messages from being sent to patients listed with multiple providers on the Institution or Enterprise Level report.
You can no longer choose to send reminders to patients via e-mail. For details, click here.
If "Email" was previously selected for the patient (on the Summary 2 screen), the LMR updates this option to PG (for PG patients) or mail (if the patient does not have PG but has a mailing address). If the patient does not have PG or a mailing address, the preference is blank.
Note: The option to sort a Reminder list by a preference of "Email" still displays, but patients will no longer include this preference.
The Patient Entered Data module now includes an Archive tab. The LMR automatically archives data 6 months or older. In order to act on data on the Archive tab, you must first unarchive it. Once on the Archive tab, data remains on the tab indefinitely.
LMR support analysts can now add a subject line to be included with Enterprise-level broadcast message templates (for either PG mail or notification email messages). When saving a broadcast message template, the Save box now includes a text box for “Subject.”
The Patient Gateway application has been redesigned with a modern look and feel to improve usability.
Patients are now limited to a maximum of 1,500 characters when writing, replaying to, or forwarding a clinical message. Previously, messages could be written with no character limit. A character counter displays on the Patient Gateway (PG) message screen, and is highlighted in red when the patient reaches 1,350 characters. The PG application also prevents patients from pasting in content exceeding this character limit.
The reconciliation status (such as Taking or Not Taking) is now displayed in the Medications view of the Health Record.
Patients can now set a preference for how they want to receive healthcare reminders. Default is PG (meaning patients receive healthcare reminders via the Patient Gateway application, unless they indicate otherwise).
Patient passwords are now partially hidden in the Search/Details menu option. Only the first two and last two characters are now displayed (other characters are marked with small x’s).
A patient’s PG status (Active or Inactive) now displays as a new column in the Transition of Care report. Access this report from the Tools option from the Admin menu.
PG Admin Superusers can now create PG menus. A new menu option, Customize Menu, is available from the PG menu for authorized users.
The Referral Management module has been enhanced for this release to comply with PCMH (Patient-Centered Medical Home) requirements. The main referral screen now includes additional statuses and a Next Step column to improve your ability to track referrals.
The module uses an automated background process (to find appointments, completed visits, and consult notes), when available, to populate the Next Step field.
The module now includes an AutoFilter option to allow you to sort your In-Progress queue of Referrals. Previously, the module included a Status drop-down list.
Referrals are now flagged as overdue (“Next Step” is highlighted in yellow) if specific targets are not met for the appointment date, visit note, acknowledgement of the specialist note, and communication to the patient. The targets differ depending on the appointment urgency (Emergency, Urgent, or Routine).
The Close button has been removed from the main screen. To close a referral, click the referral to view its details, and select the Close Referral check box in the Referral Actions section.
Clicking the first column (!) allows you to sort your list of active referrals by those flagged as High Priority referrals. Previously, clicking this column allowed you to sort the list by those with informal notes to staff concerning this referral (Intra Office Communications) or by those marked as “Send Immediately.”
A Note column has been added to the main referral screen, displaying with a
icon if a specialist note has been
attached to this referral. (Notes can be attached either automatically
by the LMR or manually.) If the specialist note has been acknowledged
by a provider, it displays as 
.The Comm column has been updated to include additional details regarding successful or failed referral transmissions.