What's New in this Release - November 2009

• Medications

  The Medications module has been integrated with Surescripts (RxHub), a nationwide network of pharmacies and pharmacy benefit programs. This integration qualifies the LMR as a full featured e-prescribing system, and involves the following changes:

  • Medication screens now include a banner with allergy, patient-specific eligibility, and pharmacy information. For additional information on this banner, click here.

  • Note: Patients with pharmacy benefits from MassHealth and Harvard Vanguard include "Unknown" in the payor field. These payors are not currently integrated with RxHub.

  • To view prescription history, click Rx History. For details, click here.

  • The Pharmacy Info link has been replaced by the pharmacy section of the medication banner. Selecting a pharmacy from the drop-down list changes the patient's default pharmacy. To print or delete pharmacy information, you must go to the Summary2 screen.

  • The Print Med/Allergy button has been replaced with the icon. Click this icon to print the Patient Med/Allergy report.

  • The traffic light indicators have been redesigned for easy identification. They now indicate patient-specific formulary guidance, based on the plan selected in the banner. (Previously, the indicators were based only on Partners preferences.) For additional information, click here.

  • Detailed copay information (and coverage restrictions) no longer display on the initial medication list, and no longer appear as $/$$/$$$. Display information by clicking an indicator. Copay information coverage restrictions display on the Lookup screen and Rx pad in the medication banner. For details on new indicators for copay information and coverage restrictions, click here.

  • The "take as typed" option has been modified to encourage users to select coded medications.

  • When looking up a medication, the search results now include the generic medication (if available) if the brand name medication is not covered or unknown. Additionally, if you select a medication that is not covered or that is unknown, the LMR now displays a new Alternatives screen. This screen incudes the selected drug, generic alternatives, as well as other alternatives, sorted by payor preference.

  • Medications that can be given via multiple routes now appear as a single entry in the search results, with a default of PO (if applicable). If another route is desired, select it using the drop-down list before selecting the medication from the search results.

• LMR Home Page

  The LMR Home Page is a virtual desktop displaying your outstanding tasks at-a-glance. Initially, the following modules are available: Schedule, Clinical Messages, Document Management, Results Manager 2 (Results Manager 1 is not available), Rx Renewal Queue, and To Do. The Home Page can be found under the Desktop menu and may be setup as the default page when the LMR is launched.

  If you have customized your Desktop menu options in the past, the Home Page may not appear in the list of options available under the Desktop menu. If the Home Page option does not display, see Add the Home Page Option to your Desktop Menu.

• Visit Summary Report

  • Sections have been added for Today's Referrals, Care Reminders, and Patient Education Material, as applicable. Today's Referrals includes information on referrals entered from the Referral Management module. The Patient Education Material section allows providers to include a variety of educational material to patients. These sections are suppressed from printing if there is no data to report.

  • You are now allowed to suppress any item from the report by deselecting a checkbox before printing.

  • The Visit Summary Report can now be printed from the End of Visit (EOV) module. The Select Forms screen in EOV now includes an option for the Visit Summary Report.

  • Medications can be listed with two new statuses: Renew and Change and Renew. Additionally, the status for stopped medications has been reformatted to all caps and bold.

  • The Provider Comments section has been enhanced to allow the use of custom paragraphs.

  • The History screen for the Visit Summary Report now includes instances when the report was printed from either the Schedule or EOV module. Previously, the History screen only included when the report was printed from the Reports menu.

• Allergies

  • You can now mark allergies as reviewed. This can help you determine how up to date the allergy list is. For details, click here.

  • The steps for adding drug allergies have been modified to encourage the use of coded allergies when available. The LMR now displays a warning if you pick an uncoded medication as a drug allergy.

• Health Maintenance

  You can now refer current smokers to cessation program coordinators when documenting Smoking Status. This is initially released to pilot users only.

• End of Visit (EOV)

  This release includes optional enhancements for the End of Visit (EOV) module. To have one or more of these enhancements activated for your practice or subset, contact your LMR Analyst

  • You are now able to associate CPT codes to ICD-9 codes in the EOV Shopping Cart to indicate medical necessity. For more information, see Linking a Diagnosis to an Order or Procedure.

  • Practices now have the ability to set prompts to display when specified orders, in-office procedures, E&M levels, or modifiers are added to an EOV encounter. This ensures that important instructions are available. A prompt icon [] displays next to an item that has a message associated with it. Click the icon to read the message.

  • An order reconciliation module has been developed allowing users to review test results and indicate that corresponding orders have been completed.  The Incomplete Orders report is also available to review order status. For more information, see Reconciling Orders with Results.

• Notes

  Practices authorized to create restricted notes now have the option to scan restricted notes into the record. For more information, see Scanned Documents.

• Flowsheets

  The LMR now displays alerts if you enter values that are out of the normal range for pulse, blood pressure, respiration rate, or temperature for adult patients.

• Oncology

  • A tab can now be added to the Summary to provide a link to the Treatment History module. (See Creating a Custom Summary for details.) Treatment History information is also available from the QuickLook menu (displayed by pressing the F8 key after a patient is selected.)

  • For the BMT Flowsheet module, the column header for each visit now indicates the institution where the visit was initiated. The institution is not included for visits initiated prior to this release.

  • The BMT Flowsheet module now prompts whether you want to carry forward results from the previous visit, as applicable, when you click New Visit.

  • BMT Flowsheet data is now sent to QDM (Quality Data Management) for reporting purposes.

  • The medication documentation screen has been enhanced to allow for the point-and-click recording of details of a hypersensitivity/adverse reaction. The flowsheet includes the indicator "HSR" next to documentation within the visit column to indicate that a reaction has been documented.

  • You are now prevented from creating a new flowsheet if one already exists for your institution. Except for patients treated at both MGH and the DFCI, no patient should have more than one flowsheet.

  • The clinic/subset name is displayed for each visit to indicate where in the clinic the visit took place. It is included in the heading of the Enter/Edit Visit screen as well as in the Visit Type section of the expanded flowsheet.

  • A new report has been added to list all patients (and MRNs) with more than one flowsheet. It can be run for any clinic, as needed.

• Treatment History

  A tab can now be added to the Summary to provide a link to the Treatment History module. (See Creating a Custom Summary for details.) Treatment History information is also available from the QuickLook menu (displayed by pressing the F8 key after a patient is selected.)

• BMT Flowsheet

  • The column header for each visit now indicates the institution where the visit was initiated. The institution is not included for visits initiated prior to this release.

  • The BMT Flowsheet module now prompts whether you want to carry forward results from the previous visit, as applicable, when you click New Visit.

  • BMT Flowsheet data is now sent to QDM (Quality Data Management) for reporting purposes.

• Schedule

  • The LMR no longer includes the icon  to the left of a patient's name to access the QuickLook option. You can now access the QuickLook option by right-clicking any underlined patient's name and clicking QuickLook.

  • You can now include pharmacy information when batch printing the Med/Allergy report. For details, see Printing Med/Allergy Reports from the Schedule.

• Health Form

  The Health Form report now includes an exam date field. If you do not use this field to add the date before printing, the label "Exam Date:" is added to the report to allow you to add it manually.

• General

  • The LMR now displays a warning message if you attempt to sign for an update to data that is also being updated by another user. Click OK to continue or Cancel to return to the Sign page without signing your updates. (You may choose to repeat your updates at a later time, after the other users have completed their updates to avoid having your changes overwritten.)

  • Pharmacy info printed from the Summary or Summary2 has been enhanced. Printouts now include patient identifier info in the header and multiple pharmacies per page.

  • You can now generate a paper copy of the displayed list of visits by clicking Print.

  • The LMR no longer includes the icon to the left of a patient's name to access the QuickLook option. Instead, QuickLook can be accessed by right-clicking any underlined patient's name and clicking QuickLook. (You can also access the QuickLook option from the Popup menu, or by clicking the QuickLook tab in a clinical message or note, or by pressing the F8 key.)

  • You now have the ability to change the width and add or remove columns when creating a custom layout for the Summary, Summary Popup, Desktop Bar, and Home Page. For more information, see Create a Custom Summary.

  • The following column names in various Custom modules (e.g. Custom Template, Custom Header) have been updated to accommodate this change: Author has changed to Last Edited By and Created has changed to Last Edited. A link icon now displays in the Multiple Practice column on the Practice tab if the template has been saved to multiple practices. Hover your mouse pointer over the icon to display the list of practices.

  • Faxed documents are now sent using PDF format. This should allow the recipient to view the note as the author intended. Documents were previously faxed as plain text. This is initially released to pilot users only.