When you include a CC list for a note, the CC List button text turns red indicating that there is a list associated. See Working with CC Lists for more details.
Place the cursor over the CC List button to view the names of providers in the CC list.
This screen, accessed by clicking the CC List button from any LMR note, includes the following enhancements:
The CC column has been replaced with four columns: print, fax, email, and clinical message. Select one or more check boxes for each provider to add them to the CC list and designate how to send them the note. You can only fax notes to providers who have a fax number recorded. If your practice does not have an authorization code, you are unable to fax a note. When you select clinical message, the LMR application sends a message to the provider stating that there is a note for the selected patient that is available to be viewed. This option is only available for providers in the Partners network.
The Check All link for selecting all providers has been removed.
The "Include CC List into a Note when printing from DocMan" checkbox has been relabeled. Now, when you select the new checkbox, the name and degree of every physician in the CC list is added to the end of the note. You can view the CC list whenever the note is viewed or printed. To automatically select this option for every note, see Setting Your Preferences.
The Add button, used to add a provider to the CC list, has been renamed Add New.
The provider lookup now includes providers from all of New England, New York, and Ohio.
Additional fields have been added to the Physician pop-up to let you capture more accurate data when adding a physician. To send notes to a physician by fax or email, you must enter all ten digits of the phone number or the full email address (example: w.test@partners.org).
An "Additional CC List for this note" grid appears if a provider has been deleted from the patient's Physician grid on the Summary 2 screen. The grid does not appear if no physicians have been deleted.
Additional fields have been added to the Physician pop-up to let you capture more accurate data when adding a physician. To send notes to a physician by fax or email, you must enter all ten digits of the phone number or the full email address (example: w.test@partners.org).
There is a Fax column in the physician grid that displays the fax number for the physician, if one has been recorded.
When you delete a physician from the grid, their name appears in the "Additional CC List for this note" grid on the CC list window.
You can now fax notes and send clinical messages to physicians on your CC list. See Working with CC Lists for more information.
The Print CC and Email CC buttons have been replaced by one Distribute CC button that sends the patient's note via email, print, fax, and clinical messages according to the selections made in the CC List screen.
Additional icons may appear in the CC column. The checkmark still appears for notes with a CC list. Place the cursor over the checkmark to see the name of the providers in the CC list. In addition, now, when you send a note by clicking the Distribute CC button, icons representing the distribution methods appear in the CC column. For example, if you print a note, a printer icons appears in the CC column. Place the cursor over the icon to view the name of the person who sent the note, the date and time the note was sent, and to whom the note was sent.
You can now set a preference to automatically carry forward the CC List from the previous note you created for the patient. If you copy a note forward, you override the current CC list with the CC list associated with the note copied. Only those providers in the patient's Physician list as of the date the note is created are displayed.
You can now set a preference to add the providers (names and degrees) in the CC List to the bottom of the note when distributed.
You can now select whether to view the existing Medications view by selecting Traditional from the RX Pad section, or view the new Medications view with pediatric weight-based dosing options by selecting Advanced.
Note: The Pediatric weight-based dosing module is currently being piloted at selected Partners practices.
Lower cost alternatives are now suggested for Protein Pump Inhibitors (PPIs) during the medication ordering process. The suggested substitutions will have similar medicinal benefits. See Responding to Prescribing Alerts for more details.
A new adult Medications screen will be available. To access this screen, select the Rx Advanced option in the My Preferences module.
The Order by Strength and Form section has been replaced with a Dose section to allow for customizable Sigs. Initially when you select a medication, the dose marked as the default is highlighted in yellow. If no dose is marked as the default, then no line appears highlighted.
The Rx Print/Fax section in the upper left corner has been removed. These options are still displayed in the lower right corner.
A display only field has been added to the left of the Additional Directions field. This field displays the milliliters-to-teaspoon or tablespoon conversion based on the take amount. The conversion prints on the prescription and is saved in the record.
The Additional Directions field now includes instructions and information, such as "Take with meals," for certain medications.
Medication warnings regarding splitting forms and nonrecommended doses are now in one alert pop-up and only display when you click Ok to save the medication.
Predefined "dosing strings," the combination of dose and frequency, are now supported in the application.
Recommended dose checking is now based on the range of doses defined in the dictionary instead of the exact dose amount.
Pediatric weight-based dosing functionality will be added. To access the pediatric medications screen, select the Rx Advanced option in the My Preferences module. This functionality will be piloted at selected Partners practices.
A new pediatric medication dictionary has been added to separate pediatric and adult medications. New option buttons allow you to select which dictionary to view when searching for a medication. Also, you can switch between adult and pediatric medication views when entering medication information for a pediatric patient.
You can now select a weight-based or nonweight-based dose pulled from the medication dictionary. Initially when you select a medication, the dose marked as the default is highlighted in yellow. If no dose is marked as the default, then no line appears highlighted.
A range of dispensable calculated doses determined by the patient's weight is displayed in a drop-down list. The single dose amounts are calculated by multiplying the weight-based dose (mg/kg) by the patient's weight. Doses that are 10% greater or less than the calculated dose appear in red. The patient's weight must be recorded for these values to display.
The patient's last recorded weight and date the weight was recorded now display. You can record the patient's new weight from this view by clicking Update. Any changes made here are filed to the flowsheet and used to dynamically update the dose values on the Medication view.
The Rx Print/Fax section in the upper right corner has been replaced with a Total Daily Dose section (print and fax options are still available from the lower right corner). The total daily dose values are based on the dose you select. Use the calculator to find the single dose value based on a daily dose and frequency. When you use the calculator, the values are not carried into the Medications view. This calculator is for your information only.
A display only field has been added to the left of the Additional Directions field. This field displays the milliliters-to-teaspoon or tablespoon conversion based on the take amount. The conversion prints on the prescription and is saved in the record.
The Additional Directions field now includes instructions and information, such as "Take with meals," for certain medications.
Medication warnings regarding splitting forms and nonrecommended doses are now in one alert pop-up and only display when you click Ok to save the medication.
Predefined "dosing strings," the combination of dose and frequency, are now supported in the application.
Recommended dose checking is now based on the range of doses defined in the dictionary instead of the exact dose amount.
A new feature is being piloted with this release to allow providers to document services associated with a patient encounter. This EOV (end of visit) documentation includes the following:
- Level of service provided (Professional Evaluation and Management codes)
- One or more diagnoses
- Procedures and injections performed during the visit
- Orders or referrals the provider determines are necessary as an outcome of the visit
- Patient instructions, such as when to return for a follow-up appointment
EOV templates provide a point-and-click method of quickly providing comprehensive and accurate documentation.
Once all encounter information is complete, the EOV module allows you to quickly generate all pertinent forms associated with your practice and that specific provider.
This pilot is currently limited to a small number of Partners practices.
A new feature is being piloted with this release to allow users to view a composite view of all data elements required to quickly assess a patient's condition and begin treatment. This Health Profile view is a highly configurable module that presents results data as well as LMR data in multiple views. The initial version has been configured based on the requirements of BWH Infectious Disease and displays graphed results along with medication information, vital signs, and last known values.
A new feature is being piloted with this release to allow users to include simple diagrams in a patient note (both free form and structured), and to annotate those diagrams. You can select from a repository of LMR clinical diagrams or import a photograph or graphic file. Annotation can include adding callouts as well as text. This feature is currently limited to a small number of specialty providers.
Enhancements include the following:
The Summary display for Oncology Staging information has been redesigned according to user feedback. Staging data is now presented in columns.
The Oncology Staging module now uses pN values for calculating staging. Previously, N values were used.
A new report of Oncology Staging data is now available. Contact your LMR support analyst to request this report.
The LMR's Transaction Report has been updated to include EOL and Oncology Staging related transactions.
The Infusion Flowsheet module has been updated for extravasation-related enhancements. Extravasation Follow-Up is added to the list of visit types (indicated by EXT F/U). The Administration Complications section has been updated to allow you to indicate if the patient has no blood return, as well as IV site history/documentation. Additionally, a new Extravasation Follow-up section has been added to the flowsheet. See Documenting Extravasation Follow-up for details.
The Infusion Flowsheet has been updated to add fields for Time Down and Total Infused when documenting chemotherapy administrations with a route of intraperitoneal.
When generating reports from the Infusion Flowsheet, you can now select to include data regarding take home oral medications and extravasation follow-up.
The following enhancements have been included for users who use the Web version of the LMR, displayed from within the CAS shell (referred to as "WebinCAS"):
A Location identifier has been added to the top of the screen. This identifier indicates the logged on user's LMR location.
The WebinCAS now displays an alert to prevent the loss of unsaved notes data. This alert is displayed if you attempt to exit the CAS or change patients without first clicking the Ok button to accept your previously input changes to a patient note.