You can now reconcile medications from discharge orders for patients who have had recent hospital stays at the MGH or BWH. See Reconciling Discharge Medications for details.
(For pilot users only) The LMR now displays alerts (drug-allergy, drug-drug interactions, and so on) when you renew or activate medications. Previously, alerts only displayed when you added medications.
The Medications module has been reorganized to improve usability. It now includes a column for Last Updated, indicating the last time a medication was edited. The Start and End dates have been combined into a single column. For medications set to auto-expire, the expiration date is displayed in the medication description, outlined in a red box.
National Provider Identifier (NPI) numbers are now included on faxed/printed prescriptions.
A user preference (Clinic Info) has been added to allow clinicians to override the practice default phone/fax number if they prefer to have their direct numbers appear on prescriptions. For details, click here.
The LMR now considers the remaining number of refills when calculating the end date for a medication. Previously, the end date of a medication was based only on the start date and duration.
A link for Oncology Meds has been added to the Medications module, if applicable. Clicking this link displays all active and inactive medications in the Pre-medications, Chemotherapy, and Other medications sections of the Infusion Flowsheet.
The name of this menu option has been renamed from "Rx Refill Queue" to "Rx Renewal Queue." The new name better reflects the functionality provided.
An alert is now displayed if you initiate a task for any patient who has a task that has been closed within the past 7 days. Previously, an alert only displayed if the patient had active tasks.
The Enter/Edit Task Detail screen has been significantly redesigned for ease of use. The Comments field can be expanded or collapsed, as needed. The logged on user's name now appears at the top of the assignment list for easy access. Additionally, a new field has been added to indicate a patient's preference for the prescription (Fax to Pharmacy, Pick up, or Mail).
The Medications pane of the Enter/Edit Task Detail screen has been modified to more closely match the Medications module. You can now edit, add new, or discontinue medications directly from the queue by clicking the medication name.
You can now enter renewal tasks for non-medications. Previously, tasks could be entered for medications only.
The steps for processing a task have been changed to allow additional workflow options. A checkbox has been added (App No Rx) to indicate that a renewal request is approved but the prescription has not yet been generated. To indicate that a renewal request is approved and the prescription has been generated, click the Renew button. Previously, the application only supported a single approval option. This meant that the provider could not approve a request without also generating the associated prescription. For details, see Updating an Rx Renewal Task.
A number of enhancements have been made to the way preliminary notes are displayed so that they are easily recognizable. On the Notes list screen, the note status column (Sts) has been moved to the second column of the notes list. The preliminary note status abbreviation has changed from "P" to ”Prelim". The abbreviation for uploaded notes has changed from "U" to "U".
The note icon has changed to
if the note is preliminary or 
if the note is final. These icons can be found in the following
modules: Notes, Schedule, Summary (only for Notes, not Problems),
and OB Record.If a note was auto finalized, it will now display with an auto finalized status. The note status abbreviation for auto finalized notes is now "AF" and is displayed in the Sts column in the main Notes and Document Management modules. Hovering your mouse pointer over the letters displays the ToolTip "Auto Finalized." The status "Auto Finalized" displays in the Notes Edit, View, History, Print Preview, and Print screens. This change effects all previously auto finalized notes.
You can now select a default note template from your Custom Templates. For more information see Setting a Default Template. In addition, the Add New Free Form button has been replaced by the Add New button. If you have a default template selected, clicking the Add New button creates a new note using your default template. (If you don’t have a default template selected, clicking the Add New button creates a new free-form note.)
A number of enhancements have also been made to button placement in the section selection screens for structured notes (including pediatric point and click notes). Now the buttons are aligned on the left instead of centered on the screen for ease of use. If you navigate through the screens using Ok-Next or Ok-Previous, button placement remains the same and no cursor movement is needed. Cancel is always visible, and it is placed to the far right of the screen. Furthermore, the Check All checkbox has been moved to the table header directly above the list of checkboxes and retains the check all functionality.
In the Notes module and the Summary screen, the author’s name now appears with the last name first to make it easier to sort the list by author.
Health Maintenance items are now alphabetized when imported into a free-form or structured note to improve readability.
When editing Problems, you can now access KnowledgeLink information for the problem in the Edit Problems dialog box. You can also add a problem to your Favorites list from the Edit Problem dialog box.
The dispense amount and units are now included when importing medication information into your note.
There is a new Non-Medications section in the Pt. Data tab allowing you to add, renew, or discontinue non-medication items (such as durable medical equipment) from your note, or import information about non-medications into your note text.
For free-form notes only, a Physician Address section has been added to the Pt. Data Tab. Clicking Physician Address displays a dialog box allows you to select a physician from Summary 2 and pull that physician’s name and address information into the top of your note.
When including patient information in a note header, the patient's gender now displays. The patient’s gender also displays when you add MRN information to a note via the MRN link.
You can now add a brief comment to an addendum to describe the reason for the addendum. The comment can be up to 20 characters and is displayed in the addendum subject. For more information, see Adding an Addendum.
There have been many enhancements to the notes e-mail functionality. For more information, see Sending a Note Using Email. There are now options to include yourself or the patient’s PCP in the list of email recipients. A function button has been added to allow you to get more information about a provider from the CPM (Corporate Provider Master). Various fields and buttons have been renamed and ToolTips have been added to some buttons for clarification.
The E-mail History (renamed from E-mail Info) screen has been enhanced to include the time an email was sent and an option for printing the history list. Additionally, the size of the Comments field has been increased for easier viewing.
When you send an e-mail to multiple recipients, a recipient will now be able to a list of all recipients in the To field.
The LMR now uses a more comprehensive dictionary for looking up problems and procedures. Performing a search now draws from a dictionary that is ten times larger than previously.
"Display as typed" no longer displays as an option when selecting problems and procedures. Instead, you can now enter a customizable description that is appended to the entry name wherever it displayed (such as from the Summary, Problem, or Procedure screens). You can enter this customizable description on the search results screen. It is not applied to other patients or subsequent searches.
You are now alerted if you attempt to add an uncoded problem.
The Edit Name buttons on the problem and procedure detail screens have been relabeled Refine Problem and Refine Procedure, as appropriate. This change has no affect on functionality.
The icon
displays on the schedule to identify patients that are on
precautions related to antibiotic-resistant bacteria or enhanced
precautions.Authorized users from HMA now have access to the MedAptus© application from links within the LMR. Previously, links were only available to authorized users from DFCI.
Clicking the stork icon (
) now displays only the patient's estimated delivery date,
current gestational age, gravida, and parity. Double-clicking
the icon brings you to the Open Pregnancy Summary screen of
the OB Record.If a patient has an open pregnancy in the OB Record, the Open Pregnancy Summary screen now displays by default upon navigating to the OB Record module.
Clicking a Closed Pregnancy link on the OB Summary screen brings you to the OB Reports module.
The OB Record Header on the Open Pregnancy Summary screen has been updated to include the patient’s preferred phone number and all GTPAL scores. The bedrest information has been removed.
The order of the tabs on the Open Pregnancy Summary has changed. Now the To Do, OB Problems, and OB Labs tabs display above the Allergies, Medications, and Family History tabs. The Allergies, Medications and Family History tabs always are minimized upon entering the Open Pregnancy Summary. You can still maximize and minimize the tabs enabling you to hide or view applicable information.
OB Notes, BWH Information, and OB flowsheet data now display separately when entered for the same date in the OB Flowsheets tab. You can view the author and status of the note by hovering your mouse pointer over the note description. You can also click the associated View link to read the note.
When you edit a flowsheet by clicking the associated date, the current flowsheet data is displayed at the top of the add flowsheet screen. The new data can be entered in the lower portion of the screen.
All OB Flowsheet fields now display on the screen with no need to scroll if you have your screen resolution set to the recommended 1024 x 768. An Initial field has been added to allow you to enter your initials.
Full comment text from OB Flowsheets and OB Problems can now be viewed via tooltips. To view comment text, hover your mouse pointer over the associated comment field (for OB Flowsheets) or problem name (for OB Problems).
You can now click the title of the OB Labs tab to display the full list of OB labs in the Health Maintenance view. You can also click the See Results link to view result details for microbiology results.
When you are working with OB Forms, you can now navigate to the next or previous form by clicking Ok Next - [next form name] or Ok Previous - [previous form name]. Also, the Current Pregnancy Outcome (previously known as Current Delivery) and End of Pregnancy forms are now linked for ease of use. A warning message now displays before you try to end a pregnancy.
On the Demographics form, the Father's Details section has been renamed Father's/Partner's Details. The word "partner" has also been added to various fields in that section.
The format of the U/S EGA field on the Pregnancy Dating has changed to weeks/days (example 26 1/7), and the U/S EDD is now automatically calculated from the U/S Date and the U/S EGA fields.
In the Menstrual History form, you can now add height data including a decimal point for fractions of an inch. (Example: 5/6.5 or 66.5).
You can now choose Select all No to respond ’r;no’ for all items in the Genetic History form to reduce clicks. If you select a Yes response, the checkbox is deselected.
The Gestational Age field on the Past Pregnancy and Current Pregnancy Outcome forms now must be entered as a number (example 36 or 40 5/7).
If the Initial EDD or Final EDD is entered in the Pregnancy Dating form, the Gestational Age (GA) field is automatically populated when entering data into a general LMR flowsheet if that flowsheet has the GA concept.
A new filter option has been added (Patient View). This option allows you to see (and act on) all test results from open and closed visits for a single patient.
If included in your Summary, the Code Status tab now includes entries for each institution that has documented information for the patient. Clicking any entry provides a link to the detail for that institution. Previously, the Summary screen did not indicate if other institutions have recorded code status information for the patient.
Authorized users from HMA now have access to the MedAptus© application from links within the LMR. Previously, links were only available to authorized users from DFCI.
Pediatric reminders are now available and address the following areas:
- Lead screening and follow up for elevated levels
- Chlamydia screening (for adolescents)
- Anemia screening, asthma action plan review
- ADHD plan review
- Influenza vaccine
- Weight management
Note: These reminders display only if specific conditions (such as age or problems) are met in the patient chart.
Flu shot reminders are now active from September through February. Previously, they were active from October through February.
HealthCoach reminders are available to encourage referrals to the Partners HealthCare Connection Program for Medicaid patients. The program provides personal health coaching for patients with chronic medical conditions. For details, click here.
Selected providers will also see a reminder to document second-hand smoke exposure to all pediatric patients.
The Health Maintenance view has been updated to allow you to document second-hand smoke exposure for pediatric patients.
You can now specify the social worker associated with the patient, in the header of the Infusion Flowsheet. This field is available for all new or edited flowsheets.
A new visit type (RO) is added. Use the RO option to indicate a repetitive order.
For DFCI only, you are now prompted to update the patient's height if it has not been updated within the past 5 years. Previously, the last recorded height was carried forward to the current visit, and no prompt displayed.
For DFCI only, the LMR automatically calculates the patient's body mass index (BMI) when you update a patient's height and weight. All applicable reports are updated to include the BMI calculation.
The LMR backup/failsafe process has been enhanced to include the last three visits documented through the Infusion Flowsheet and BMT Flowsheet. Backup/failsafe processing has also been enhanced to include code status and pain level, if documented.
The Oncology Staging screen has been enhanced to include new options for primary tumor locations for Sarcoma Soft Tissue (Uterus, Pelvis, Lung, Intrabdominal, Local, Liver, and Bone). The option "Unclassified spindle cell, phomorphic spindle cell sarcoma" has been added to Histology, and the Date of Visit field has been removed. Also, tumor type "Mesothelioma" has been moved from Sarcoma to Lung.
You are now able to add comments to a note that you forward using Document Management. A new dialog box for adding comments appears when you select a recipient in the Forward To drop-down list. For more information, see Forwarding a Note to Another User's Queue.
A
icon next to the subject
of a note in your Document Management queue indicates that
a note has been forwarded to you from another user. If you
hover your mouse pointer over the icon, the name of the person
who forwarded the note, the date the note was forwarded, and
any comments appear as a ToolTip.Auto Finalized notes display now display with the status AF in the main Notes and Document Management modules, and hovering your mouse pointer over the letters displays the ToolTip "Auto Finalized." This change effects all previously auto finalized notes.
You can now automatically add a patient’s PCP to the table of physicians by clicking Add PCP. The button is active if 1) the PCP the patient’s PCP data is from the EMPI and 2) the PCP is not already listed in the table of physicians.
Preferences are now grouped by type (such as Medications, End of Visit, Shell Icons, etc.) making it is easier to navigate through the preference options.
You are now able to set preferences for notes including activating automatic spell check when a note is saved and inserting an auto signature into notes or letters.
There is a new Miscellaneous preference that allows you to remove family history information from displaying on the patient's problem list.
There is a new Medication preference that allows you to override the clinic information that displays at the top of prescriptions.
When performing a diagnosis search, a more extensive and standardized list of diagnoses is now available as a part of the PETS 2 project.
Coming soon after the June 2008 release, the LMR will be able to specify an HL7 message that transmits order data from the EOV module to lab systems at Partners institutions.
Report printing has been streamlined to reduce unnecessary clicks.
The size of the patient header area has been reduced.
The Physical Exam section now includes the exam date.
References to "student" have been changed to "patient."
The signature line has been changed from "physician" to "provider," and a line for the date is added.
Patient-declined immunizations are now more clearly indicated. Instead of displaying a "D" next to the date, the words "patient declined" are now included.