The LMR Schedule now includes an additional column for "Reason for Visit." This column displays a more detailed explanation for the patient's visit, when available from your Practice Management (PM) system. If your PM system vendor does not yet send this information, contact your support analyst for assistance working with the vendor to get this information into the LMR. When available, this information can also be added to the Schedule display on the LMR Home Page. See Customizing Your Home Page for details.
If one or more alerts were displayed when a medication was added or renewed, you can now display the override reasons entered. The Medications History view now includes a column for Alerts. Click the icon
,
if applicable, to display override reasons as well as details
associated with the alert.The LMR now transmits narcotic prescriptions separately from non-narcotic prescriptions for eRx transactions. Previously, if a multiple prescriptions were being transmitted to a pharmacy for a patient, and if one of the medications were a narcotic, the entire batch would default to fax. Now, any non-narcotic prescriptions are sent via eRx as long as other requirements for eRx transactions are met.
The LMR and Patient Gateway now use a common list of pharmacies for the patient. Previously, the lists were not integrated, resulting, at times, in delays in processing renewal requests, and in inconsistencies when displaying information between the two applications.
The module now includes color coding of items based on due dates. Items that are due are highlighted in pink; items that are almost due are highlighted in yellow.
Due status is automatically set for items associated with decision-support reminders. You can also set a due date for any item (except immunization-related items, such as Influenza Vaccine). For details, click here.
Note: The tool tip indicates how the reminder was set. The tool tip for decision-support reminders indicates "Reminder Overdue" or "Reminder Due." The tool tip for user-set reminders indicate the name of the user who set it and the date.
The coded responses for Smoking Status have been modified to meet the Meaningful User requirements.
A new Care Reminders section has been added to the Previsit Form and Visit Summary report. This section lists items from HM that have a due date set by a decision-support reminder or user-set reminder. If there are no items that are almost due or overdue, this section does not display.
For GE Centricity users that are included in a CC List, you must designate the note to be sent using either print or a clinical message. Options for email and fax are no longer available. GE Centricity users have requested that patient notes be routed to them solely via ChartLinx as a clinical message.
Note: If any CC Lists included options for email or fax for GE Centricity users, those options have been removed by a conversion program. You will need to redesignate options for these users, if applicable.
The LMR Home Page includes enhanced options for looking up patients. A patient search field has been added to the upper left. When looking up a patient by name, the LMR auto-suggests patients you've recently accessed as you type (within the past 180 days). Additionally, a My Recent Patients link allows you to display a list of patients you've accessed within the past 30 days. For details, click here.
Note: These LMR search enhancements will begin accumulating your recently accessed patients starting May 20, 2011. Auto-suggest will not contain the full 180 days until November 16, 2011. Your list of My Recent Patients will not contain the full 30 days until June 20, 2011.
The LMR Home Page now allows you to filter options by either Provider or My Patient Lists. When you filter by Provider, all items display based on the selected provider. You can select any other provider associated with your practice. When you search by Patient List, other information displayed is limited to patients from that list.
You can now update the font size for the entire page. Options include
for small font (10 pt), 
for medium font (12 pt), and 
for large
font (14 pt). The LMR retains you selection for future LMR
sessions (for LMR Home Page only).You can now display your schedule for a day other than the current date directly from the Home Page. Previously, the Home Page displayed the current date and could not be changed.
Several new system macros are available, including the following:
| ..namefirst | Returns the patient's first name |
| ..namelast | Returns the patient's last name |
| ..namefull | Returns the patient's first and last names |
| ..phc | Returns the patient's cell phone number |
| ..pcpph | Returns the PCP phone number |
| ..date | Returns the current date in mm/dd/yyyy format |
| ..datefull | Returns the current date in <month name>, dd, yyyy format |
| ..datetime | Returns the current date and time in mm/dd/yyyy hh:mm format |
| ..time | Returns the current time in hh:mm format |
The LMR now displays a verification message if you click Cancel after beginning a patient note.
For Notes 1.5 pilot users only, the LMR now allows you to control when to include default text or when to carry forward the most recent note data. This applies to notes created from Notes 1.5 templates that are saved as collapsed.
A button for Enterprise templates now displays at the top of the Custom Template screen to display templates created by authorized LMR Knowledge Managers.
For Notes 1.5 pilot users only, the LMR no longer displays all General Sections when you click Add Section when creating or adding a template. Instead, the Custom Template module now includes fields to allow you to search for the specific section/concept to be added. This will allow for quicker page loading. Additionally, the search results displayed after searching for a section/concept includes additional details including the concept ID and the name of the user who last modified the item.
Note: This change does not affect the Patient Data or Template Mode Sections.
Also for Notes 1.5 pilot users only, the LMR now allows additional customization options for concepts at the template level. Options include defining default responses for the concept, defining manual default loading, and defining the Comment Box size and text formatting.
You can now enter an indication of "NKA" (no known allergies) and "Allergies Unknown" from the Allergies tab on the Summary screen. Do so, by clicking Add New and then clicking the associated button. Previously, you needed to go to the Allergies screen to enter "NKA" or "Allergies Unknown." (These options are available only to patients with no documented allergies.)
You can now add Health Monitoring items (such as Smoking Status) to a custom flowsheet. This will allow support staff such as medical students who typically use the flowsheet module to document vital signs to also document other important Meaningful Use and pay-for-performance measures. For additional information about creating custom flowsheets, click here.
Note: If you add Health Monitoring items to a custom flowsheet, it is recommended that they be positioned at the bottom of the flowsheet due to layout considerations.
The EOV module now notifies you of duplicate lab orders across LMR locations and encounters. These alerts display during the validation process, and depending on your setup, may allow you to cancel existing orders. This feature requires some set up by either the lab or your LMR support analyst. (Alerts are for orders only, not procedures, E&M, Modifiers, etc.) Set up includes the following steps:
1. Define lab panels
2. Turn on duplicate order alerts for each lab (such as BWH Outpatient Lab)
3. Enable option to cancel duplicate orders from users within the same subset location
Note: For detailed steps to set up duplicate order alerts, click here.
The EOV module can now transmit new, changed, and cancelled lab orders in real time. Previously, lab orders were transmitted in a batch process, once per day. Real-time transmission of orders prevents unnecessary printing and errors associated with changed and cancelled orders. Contact your LMR support analyst for details on enabling this feature.
The Sign screen now includes a link to edit pending items before you sign for them. Previously, if you needed to edit items before signing for them, you needed to navigate to the associated module.
Continuity of Care Documentation
A new menu option, PHI Request, has been added to the Reports menu to meet federal Meaningful Use Certification criteria. The new PHI Request module allows you to generate a report of a patient’s health record that can be sent to a patient upon request. A patient can request a health record report via Patient Gateway or by contacting the practice. The patient must choose a preferred method of delivery: print out, e-mail (via secure e-mail portal), or Patient Gateway. For details, see PHI Request Help topics.
The LMR can now receive a Continuity of Care Document/Continuity of Care Record from an external electronic medical record, in accordance with federal Meaningful Use Certification criteria. A pilot between Beth Israel/NEHEN and two Partners physicians is implemented to demonstrate this capability.
The Patient Gateway application has been enhanced to allow access for patients between the ages of 13 - 17, as well as their Patient Care Representatives (PCRs). Previously, PCR accounts were automatically terminated once the patient reached the age of 13. For the teen patient to have a Patient Gateway self-managed account, a PCR must also be set up.
Note: Patient Gateway accounts for patients age 13 - 17 have modified capabilities.
A Diabetes Report Card (DRC) has been added to provide selected patients with easy to understand information about their diabetes. This applies only to pilot practice sites and their patients. This 6 month study will seeks to provide improved and more timely communication between providers and patients, and support quality improvement and future Meaningful Use measures.
Certain pediatric screening forms are now available to patients in advance of their visits through Patient Gateway. This applies only to pilot practice sites and their patients. Forms can be filled out and submitted electronically, as well as incorporated into the patient chart.
Patient Gateway and the LMR now use a common list of pharmacies for the patient. Previously, the lists were not integrated, resulting, at times, in delays in processing renewal requests, and in inconsistencies when displaying information between the two applications. Additionally, Patient Gateway now includes separate lists for retail and mail order pharmacies, and users are now able to indicate a primary pharmacy.
When a patient has been removed from Patient Gateway and chooses to re-enroll, the practice can now reactive the Patient Gateway account without having to contact the RRC.
When applicable, practices can use the Practice Portal to add providers from their location to a PG account even if the account is currently associated with another practice. Previously, the Practice Portal only allowed you to add providers from a single practice.
Authorized super users can now edit or delete diagnoses recorded on the header of the Infusion Flowsheet. Previously, corrections needed to be made by LMR developers. When editing a diagnosis, you can also select the visits that should be updated to reflect the change. Only a diagnosis with no associated visits can be deleted. For details, click here.
When entering and editing visits, the Cycle field now accepts alpha and numeric characters. Previously the cycle field accepted only numbers.
When documenting a hypersensitivity or adverse reaction for a medication administration, you can now select additional medications. An Other field has also been added to type any medication not listed.
If any hypersensitivities or adverse reactions have been documented for a medication and visit, they can now be displayed by clicking the HSR link from the main infusion flowsheet.
When documenting the administration of a Route (such as Central Implant or Peripheral), you can now select new options to document dressing changes. Options now include Transparent Occlusive, Non-transparent Occlusive, Catheter Stabilization Device, Skin Prep - Chlorhexadine Gluconate, Skin Prep - Alcohol/Povidone-Iodine, Skin Protectant for Sensitive Skin.
Also when documenting the administration of a Route, selection of "Remains Accessed" carries forward only if selected for the last visit. Previously, "Remains Accessed" was carried forward if selected for any previous visit.
When entering a Staging/Treatment Plan for a tumor type of Breast, you can now type a score of 0 under "Onco Type DX Recur." Previously, this field accepted only numbers 1 through 60.
A new Treatment Plan Summary report can be run from the HIS reports menu. This report provides a listing of all patients, MRNs, Tumor Types, and Treatment Plan Statuses for the date range and providers selected. To run this report for your current logged in location, select the HIS Reports option from the Admin menu. Use the drop-down list to select ***Treatment Plan Summary*** from the List of Reports, and select one or more providers. Then, select the date range and click Submit.