The Previsit Form option has been renamed "Forms," reflecting that custom forms can be created for any purpose, not just to update information prior to a visit.
When sent to Patient Gateway users, forms display as interactive forms, making it easy for your patients to provide information to you. Additionally, when sent back to you, information is available in the Patient Entered Data module (Patient Chart menu), making it easy for you to incorporate into the patient's chart.
Forms can now include Conditions (Problems), Procedures, and Health Monitoring sections, and can no longer include a Care Reminders section. The section "Today's Visit" has been renamed "Upcoming Visit."
Previsit Forms created prior to November 2012 are no longer available for editing and should be recreated, if applicable, using the enhanced module.
Existing Previsit Forms will continue to be sent out if scheduled using the Customize for PG option. To discontinue sending old forms to Patient Gateway users, delete the form. You cannot make any additional changes to the distribution options for existing Previsit Forms.
Forms are sent to Patient Gateway users according to enhanced criteria you set using the Configure option (by clicking the
icon).Enhanced criteria for sending forms apply not only to forms built using this module, but to Standardized Forms as well (such as the Asthma Control Test, NICHQ Vanderbilt Assessment, and the Pediatric Symptom Checklist).
When a form is sent to a patient, the LMR also sends an email and clinical message notification.
The Delete option has been replaced by the
icon (for consistency).You can now add instructions to the top of each section. You also have a wider variety of options for adding questions to any section.
You no longer need to select a default form (option has been removed).
You can search for a new problem to add directly from the main Problem List screen. A search box has been added, consistent with the Medications screen. Entering problems in this way will save time and key strokes.
The Additional Details column has been broken out into four columns: Additional Details, Onset Date, Resolution Date, and Comments. Previously, all information was grouped under Additional Details.
When inactivating problems, you can now specify a reason of "Duplicate."
The main Problems list view now includes the most recent entries first. Previously, problems were listed with newest entries last.
Onset and Resolution Date fields now accept approximate dates. If you are not sure of the exact date, click the Approx. check box, and type an approximate date (you can use YY, YYYY, MM/YY, MM/YYYY, MM/DD/YY, or MM/DD/YYYY format). Otherwise, type an exact date in MM/DD/YYYY format. Previously, the LMR required you always to specify a date in MM/DD/YYYY format.
On the main Problems list view, problems that include comments carried over from previous notes now include the note date (to provide a time frame for the associated comment).
You can now use Custom Paragraphs when completing the Comments field for problems.
You can search for a new procedure to add directly from the main Problem List screen. A search box has been added, consistent with the Medications screen. Entering procedures in this way will save time and key strokes.
When inactivating procedures, you can now specify a reason of "Duplicate." Additionally, check boxes have been added to the left of procedure names, allowing you to discontinue more than one procedure at a time.
The list of procedures has been changed to the chronological order based on procedure date. Procedures without procedure dates are listed in alphabetical order after procedures that do include procedure dates.
You can now change the order of procedures (displayed here and on the Summary screen). For details, click here.
The Procedure Date field now accepts an approximate date. If you are not sure of the exact date, click the Approx. check box, and type an approximate date (you can use YY, YYYY, MM/YY, MM/YYYY, MM/DD/YY, or MM/DD/YYYY format). Otherwise, type an exact date in MM/DD/YYYY format. Previously, the LMR required you always to specify a date in MM/DD/YYYY format.
The button "None" displays as an option for patients who do not have any recorded procedures.
You can now use Custom Paragraphs when completing the Comments field for procedures.
Problem and procedure lists now include tool tips to allow you to view full details for each entry by moving your mouse pointer over the entry name. If the entry includes more text than can fit within the tool tip, the text "Click on the link to view all text" displays at the bottom of the tool tip.
The list of problems now lists the most recent entries first. Previously, problems were listed with newest entries last.
The LMR now displays alert messages (for allergy checking, duplicate medications, and so on) when medications are reactivated from the inactive medication list. Previously, alerts displayed only for new medications.
The LMR now uses enhanced logic for checking for duplicate medication therapy. Previously, checking was only done for instances of the same medication on the patient's medication list. Now, the LMR checks for instances of duplication within specific therapeutic classes. As with other alerts, you have the option to cancel the new medication, discontinue the existing medication and add the new one, or continue with both medications, providing an override reason. At this time, the implementation of Duplicate Therapy Checking will only monitor for currently approved Partners enterprise duplicate therapy classes. The LMR will not alert providers to all medications that might be potential duplicate therapies. When you add medications, be vigilant for potential for duplicate therapy.
For pilot users only, the LMR now displays a reminder for a chemotherapy consent form when you are adding, renewing, or activating chemo medications. For details, click here.
The BTS Flowsheet module allows the MGH Blood Transfusion Service (BTS) care team to electronically document procedures that would otherwise be available only via handwritten paper records. Although all LMR users can view flowsheet information, only specifically authorized providers can add or enter information.
Growth charts available from the Flowsheet module have been updated according to the latest World Health Organization (WHO) standards. For applicable pediatric patients, the buttons at the top of the flowsheet are replaced by a single Growth Charts button. Clicking this button provides access to the specific growth charts available to this patient based on the age of the patient.
The Advance Care Planning module now allows you to add and update information on Values and Goals. For additional information, click here.
The EOV module now includes a Cancel button to allow you to undo all updates you’ve made to that encounter since accessing it. Clicking the Cancel button also returns to the previous screen (exiting the shopping cart for that encounter).
Note: Clicking Cancel will not delete a newly created encounter.
The LMR now uses an expanded data base when you search for a diagnosis. Additionally, if you select a diagnosis that is not on the patient's active list of problems, EOV displays a new screen to allow you to add the entry. Contact your LMR support analyst for details on enabling this feature.
The Past Pt. Data tab now allows you to perform a more accurate search for a diagnosis based on an entry from the patient's active problem list. Previously, clicking a problem name displayed diagnoses based on the problem name. Now, clicking a problem name displays diagnoses based on the actual diagnosis codes. You can also click the Past Pt. Data heading to display all diagnoses based on the diagnosis codes of all problems.
The Template Builder function has been enhanced to allow you to reuse order sets from any other template, even those from other practices. When building a template, the “Add sub item from” drop-down list now includes the option, Order Set Search. Clicking this option allows you to search all other templates for any other unique order set (defined in the LMR as groupings previously entered as sub-items). For details, click here.
Authorized users can now run a report showing all EOV orders that have not been cosigned within 48 hours after the order's execution date (EOV Co-sign 48-hour Non-Compliance Report from the HIS Reports module). The report lists orders by the providers for whom they were entered. (Cosigning orders within 48 hours of execution is a requirement for DFCI providers.) Orders with no calculated execution date (at next visit, before next appointment, and so on) will not be included on this report.
The CPT Add Map Tool has been enhanced to allow you to update multiple tests for the same CPT code in batch. Previously, you could only update a single test per CPT code. For details, click here.
The integration between EOV and the Notes module has been enhanced. You now have access to the full EOV module from any note, including the ability to run medical necessity checking and other order validation.
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Individual sections on the Pt. Data tab have been consolidated
into a single section (EOV), which allows you to import or add
items for any individual section. The EOV section also includes
a new section, EOV Additional Information, for importing other
EOV concepts (such as copay information) from custom templates.
(Previously, this information could not be imported into a Note.)
Click the 
at the EOV section to
import only EOV information for the same practice and same date
as the service date of the note. Click the section name (EOV)
to access the EOV Summary screen, with access to all individual
sections as well as access to the full EOV module (by clicking
Add New).
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For structured notes, the list of available sections now
includes "EOV Additional Information." Click the 
for
any section to access the EOV Summary screen, with access to all
individual sections as well as access to the full EOV module (by
clicking Add New).
The Patient Assessment section of the Infusion Flowsheet has been updated to assess the patient's risk for a fall while under care. A new Risk for Falls section has been added to the Patient Assessment with four required questions. If a risk is identified, a series of interventions is also displayed to allow you to document additional information.
Oncology data is now being sent to the QDM for Staging/Treatment Plans.
A disclaimer now displays at the bottom of the note created when a treatment plan is saved as Final. This disclaimer alerts other providers to the limitations of the treatment plan. Wording for this disclaimer is based on disclaimers from the American Society of Clinical Oncology (ASCO).
The LMR Oral Chemo Meds section of the treatment plan now more clearly indicates the drug and dose when the treatment plan was started.
Treatment plans now include start and stop dates for the plan. A new field has been added (First Administration/Start Date) to the Regimen section for new treatment plans. When stopping a plan, a field has been added (Last Administration/Stop Date) to the Reason for Stopping dialog box. Previously, the dates assigned were based on the date of signing the plan. The LMR uses these dates in the Notes module for treatment plans saved as Final or Stopped.
When creating or updating a treatment plan, the LMR now prevents you from continuing if you select a regimen, but do not specify a medication from that regimen. Previously, users had created plans with a regimen name but without any specified chemotherapy.
When using the Oncology Form Builder to create an Oncology Consent Form, macros have been updated to allow you an option (Short) to include only the medication name. To use this option, click to select the check box. Previously, the macros included additional information, including the dose, cycle, and days of therapy.
You can now add placeholders to flag areas of a note, template, or custom paragraph that you want to remember to complete before saving a note. Do so by typing ### in the body of the note or custom paragraph. Press the F2 key to move between placeholders when editing and completing your note. The LMR checks the note for any ### placeholders when you attempt to finalize a note. If the note contains at least one of these placeholders, the note cannot be signed. Instead, the LMR displays the message: "Required field(s) missing (identified as ### in the text of the note). Please enter text in these fields before saving the note as final. (Use the F2 button to go to these fields.)"
The LMR now allows you additional options for including data from medications when they are added to Notes. The Customization option, displayed in the lower right corner when importing patient data, now includes options for Action, Reconciliation Description, and Pharmacy Type. When checked, these options include additional information about actions taken for each medication (such as Edited, New, Discontinued, and so on). By default these options are not checked; to include this information when importing medications, you must enable these options.
The integration between EOV and the Notes module has been enhanced. You now have access to the full EOV module from any note, including the ability to run medical necessity checking and other order validation.
-
Individual sections on the Pt. Data tab have been consolidated
into a single section (EOV), which allows you to import or add
items for any individual section. The EOV section also includes
a new section, EOV Additional Information, for importing other
EOV concepts (such as copay information) from custom templates.
(Previously, this information could not be imported into a Note.)
Click the at the EOV section to
import only EOV information for the same practice and same date
as the service date of the note. Click the section name (EOV)
to access the EOV Summary screen, with access to all individual
sections as well as access to the full EOV module (by clicking
Add New).
-
For structured notes, the list of available sections now
includes "EOV Additional Information." Click the to
access the EOV Summary screen, with access to all individual sections
as well as access to the full EOV module (by clicking Add
New).
For practices using autodistribution functionality, the author of a note will no longer receive a copy via the autodistribution process if he or she is on the CC List. Previously, if the author was on the CC List, he or she would receive a copy of his or her own note.
The following pilot projects are included with this release:
Patient Reported Outcomes Measures - Patients associated with pilot practices receive email notifications and surveys via Patient Gateway or telephone interviews. The creation and distribution of supporting material is managed by a third-party vendor. Information submitted by patients can be viewed by clicking the Patient Reported Results link on the Summary screen.
Center for Connected Health Integration - This pilot eliminates the need to toggle between multiple aplications when providing care for patients enrolled in the Center for Connected Health remote monitoring programs (Diabetes Connect and Blood Pressure Connect). A provider can see all the patients for either program by clicking the associated list on the Practice tab in the My Patient List module. By clicking the date column, he or she can see the last uploaded results. Uploaded results can also be viewed by clicking the Home Monitoring Results link on the Summary screen.
Patient Satisfaction Survey - Patients associated with pilot practices receive a task in Patient Gateway inviting them to provide information about their latest visit. An invitation to complete the survey is sent to the patient 7 days following a qualifying visit, as well as 14 and 21 days after if the link has not been clicked. Tasks appear on the Patient Gateway Home Page for the patient.