NextGen EHR Medications and eRx Enhancements …ezoutlook.com/userarea/EHR_58_Medications_ and_eRx_Module...NextGen EHR Medications and eRx Enhancements Workbook Version 5.8 09/26/2013

NextGen® EHR Medications and eRx Module

Enhancements Workbook

Version 5.8

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The following terms may be used interchangeably throughout this document:

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Address comments concerning this document to: [email protected], Web site: http://www.nextgen.com

NOTE: At the time of publishing, this EHR Enhancements Guide was created using a BETA version of the NextGen EHR 5.8.93 release and KBM version 8.1. Slight variations in the steps performed, graphic images, and screens depicted may occur depending on the versions of the EHR and KBM being used. Please be advised that additional changes may occur prior to General Release, however the fundamental concepts remain the same. The Core Documentation published after General Release will reflect the final developed functionality within the 5.8 release.

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Document Revision History App Version

Build Number

Author* Date Document Version

Summary of Changes

5.8 5.8.93 Corporate Training

06/2013 .1 Draft


07/2013 1.0 Approved for Internal Use Only


07/2013 2.0 Final Approval

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NextGen EHR Medications and eRx Enhancements Workbook Version 5.8

09/26/2013 Confidential – Proprietary Information – For Use By Authorized NextGen Healthcare Clients Only. Do Not Distribute. Page 3 of 27

Contents Introduction 5

About This Guide ................................................................................................................... 5 Assumptions ........................................................................................................................... 5

Manage Renewals 7 Single/Multi Select option ...................................................................................................... 7 Unmatched Prescriptions ........................................................................................................ 9 10.6 e-Prescribing Standard .................................................................................................... 9

Sig Builder/Sig Editor GUI 11 General Information.............................................................................................................. 11 Prescription details ............................................................................................................... 11 Sig Editor ............................................................................................................................. 12

Pharmacy Download Search 13 File Maintenance Pharmacy Download Search ..................................................................... 13

Manual Search .................................................................................................................. 13 Bulk Search ...................................................................................................................... 13

File Maintenance Pharmacy Download matching GUI .......................................................... 14

Pharmacy Destination Search 15 General Information.............................................................................................................. 15 Search Functionality ............................................................................................................. 15 Search Results ...................................................................................................................... 15 Ability to Save a Mail-Order Pharmacy as Patient Default .................................................... 16

eR/Fax Functionality 17 General Information.............................................................................................................. 17 Send Functionality ................................................................................................................ 17 Practice Preferences .............................................................................................................. 19 User Preferences ................................................................................................................... 20 Configuring Delegates .......................................................................................................... 20 MU2 Requirements............................................................................................................... 21 Overview .............................................................................................................................. 21 Clinical Reconciliation Module............................................................................................. 22 Clincal Reconcillation Process .............................................................................................. 22 Additional Information ......................................................................................................... 23

Contents

Page 4 of 27 Confidential – Proprietary Information – For Use By Authorized NextGen Healthcare Clients Only. Do Not Distribute. 09/26/2013

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The NextGen® NextGen® Medications and eRx Module 5.8 Enhancements Guide explains how to use the NextGen® 5.8 Medications and eRx enhancements.

About This Guide This guide contains information on those enhancements as described in the 5.8 release notes as per product development. This guide is intended for Corporate Trainers and the Implementation Training team.

Assumptions This guide assumes that you have the following basic and advanced computer skills:

Microsoft® Windows® operating systems

Microsoft® Office applications

All applicable NextGen® Ambulatory products

A general understanding of the practice’s clinical workflow

C H A P T E R 1

Introduction



There is a new Manage Renewal screen for Electronic Refills.

The following new options are available:

New right click option in the Workflow (Inbox) provides a centralized screen for managing refill requests for matched medications

The inbox allows for the approval/denial of a single refill request

Medication module pop up will utilizes the same GUI

The medication module pop up allows a user respond to refills by single or multi selecting

The manage renewal screen displays demographic information and refill request detail

The refill count and pharmacy notes are the only items that can be edited upon responding to a refill request

Single/Multi Select option Users are able to select single or multiple medications for renewal. When multi-selecting medications to approve/deny, the refill request and pharmacy detail will be cleared.

C H A P T E R 2

Manage Renewals

Manage Renewals


The send refill response screen populates once for each medication selected.



Unmatched Prescriptions Users are now able to add unmatched prescriptions to the patient chart. A new ‘Create Medication Entry’ button has been added to the unmatched dialog. This prevents users from having to deny the unmatched prescription and the re- launch the medication module to prescribe if needed. This functionality is available for refill requests that have a type of unmatched prescription

Users must have some level of prescribing rights (Add medication and/or erx). The identified medication will be added ‘as is’ and status will update to a status of successfully matched. The medication can be committed which adds to patient’s chart – a task generated for approve/deny

10.6 e-Prescribing Standard 10.6 is the latest messaging standard from NCPDP. The previously used standard is 8.1. The major difference is that the 10.6 standard provides the ability to codify drugs in the RxNorm and supports a codified SIG. The codified SIG is not yet used in EHR.

Manage Renewals


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General Information The Sig Builder has been updated to provide 2 new methods to modify a sig:

1 The prescription details window will allow a user to quickly modify the quantity and/or interval fields as needed

2 A new sig editor/builder control will display upon clicking on the sig line or the edit sig link in the prescription details screen

Prescription details The following enhancements have been made when entering prescription details:

Using the up/down control arrows which will increment/decrement the field by 1 whole number or by typing in a numeric value

The sig quantity field can accept a decimal value in the prescription details window

The sig interval can only accept whole numbers

C H A P T E R 3

Sig Builder/Sig Editor GUI

Sig Builder/Sig Editor GUI


Sig Editor

The following enhancements have been made to the Sig Editor:

1 The sig line can be used to select an existing fdb, custom or most used sig, or to create a free text sig 2 A sig can be modified by selecting a specific column(s) and choosing a value 3 A new character count item has been added and will alert a user if the sig is over the 140 character

count limit for e-prescribing 4 Additional checkboxes at the bottom of the gui allow sig elements to be shown/hidden 5 Improved ability to perform range dosing 6 The current field being modified or updated will appear bold in the sig line 7 When creating a free text sig, the individual elements will become disabled 8 New button to allow providers to remove custom sigs as needed



File Maintenance Pharmacy Download Search File Maintenance has a new process for downloading/updating pharmacies. Within the Download Pharmacies dialog a new ‘Manual Pharmacy Search’ tab added and the existing zip/radius search has been renamed ‘Bulk Pharmacy Search’

Note: Users must have the appropriate rights in System Administrator to utilize these enhancements.

Manual Search In the manual search, users can search for a pharmacy(ies) using single or multiple criteria. The search supports wildcard search options of % and *. Search results are grouped by how the pharmacy is known to the system:

{New to System, Can be Mapped} – All checkboxes selected by default

{Expired, Already in System, Manually Mapped} – Auto Collapsed/ For expired, all xref links will be broken

Bulk Search In the Bulk Search, no restriction on how many zip/radius pairs can be stored. There is an All or nothing approach to add/update pharmacies

C H A P T E R 4

Pharmacy Download Search

Pharmacy Download Search


File Maintenance Pharmacy Download matching GUI A new ‘Mapped’ column has been added to File Maintenance > Pharmacies to denote if the listed pharmacy(s) are currently mapped to an e-prescribing pharmacy.

Users can manage pharmacy mapping by double clicking on a pharmacy within the pharmacy master file and navigating to the e-prescribing tab. A new ‘manage mapping’ button was created, to launches a new mapping process that replaces the original 4 square tool.

The mapping tool provides the following options:

The new mapping tool will limit mapping to one pharmacy at a time

A user must manually invoke the mapping tool

User can perform a pharmacy download if no existing e-prescribing pharmacies are available to map to

Tool also provides ability to unmap pharmacies



General Information The EHR has the ability to search and download an electronically enabled pharmacy within the send prescription screen.

Search Functionality The following functionality is now available in the Pharmacy Destination Search:

User can also access the ‘Add Pharmacy to System’ button from the manage patient pharmacy link

Users no longer have to exit EHR and log into File Maintenance to download a pharmacy

User can only select and add a single pharmacy

New security permission

Operations>Medications>Allow Pharmacy Downloads

Search Results The following enhancements have been made to the Pharmacy Destination Search results:

C H A P T E R 5

Pharmacy Destination Search

Pharmacy Destination Search


The pharmacy search results will now be grouped by category (Retail or Mail Order)

The system will indicate if a pharmacy search result matches an existing patient default pharmacy

The patient demographic template does not support the same controls when adding a pharmacy to patient’s chart

Ability to Save a Mail-Order Pharmacy as Patient Default Can be added upon clicking the manage pharmacy link within the send prescription screen. The field will only search and display pharmacy mail-order pharmacy types



General Information The system has been enhanced by consolidating the Fax and eRx functionality.

Send Functionality System has consolidated the Fax and Erx option for new and renewed medications with a single button called ‘Send’. The system will determine the specific route of transmission

When the consolidated Send button is clicked, the system will have a modified send prescription dialog that will support both erx and faxing. The system will then perform validation checks against the user permissions, prescription and pharmacy selected to determine the route of the prescription. Users are able to override an erx route by selecting the force to fax checkbox

C H A P T E R 6

eR/Fax Functionality



This new functionality provids the following options:

User has the ability to send multiple prescriptions

The system will validate each prescription and transmit appropriately

The user can see the default route within the send dialog screen



Practice Preferences New practice preference “Allow Prescribing Delegates” has been created to lock down who can ‘send’ prescriptions (print/fax/erx). The preference will be shipped in TRUE state (checked) at upgrade. This allows the current prescribing process to remain in place - Any user with prescribing rights can add/send medications for any provider. If the value is unchecked (set to False), only the provider with a self-relationship can prescribe with his/her provider name.

. C H A P T E R 6

Prescribing Delegates



User Preferences A new EHR user preference was created to allow a single provider to further restrict which user(s) or group(s) of users can send medications using his/her name

Configuring Delegates The application has been enhanced so that a a provider can determine which user(s) or group(s) of users can send medications with his/her name by clicking on the Manage Delegates link. Any user attempting to send a medication, where he/she is not defined as a delegate, will receive a warning that the medication cannot be sent. Delegates are not considered in the electronic refill approve/deny process



MU2 Requirements The Clinical Reconciliation Module was developed in support of the following MU2 Requirememnts:

Must be able to reconcile Medications, Medication Allergies and Problems

Electronically and simultaneously display data from 2 or more lists in a single view

Create a single list of reconciled information

Review, validate and confirm the final reconciled data

Note: Each data type must be viewed, reconciled and confirmed separately

Overview The following list provides a very high overview of the Clinical Reconciliation Module features:

Permissions to access the reconciliation module are derived from existing Discrete Data Import permissions

Reconciliation can be launched from a new VIEW menu item (opens in ALL mode)

C H A P T E R 7

Clinical Reconciliation



Reconciliation can be launched from each respective EHR module (opens in module only mode)

Reconciliation can be launched from a template trigger (opens in ALL mode)

3 tabs View, Import Reconciliation History

View – displays CCD data in raw xml format Import – this will main tab for reconciliation process Reconciliation History – will record and display action history events

Clinical Reconciliation Module

Clincal Reconcillation Process To perform the Clinical Reconciliation Process: 1 Click Reconcile. 2 The Clinical Reconciliation module displays. 3 Select a file. 4 Select the appropriate data type(s) to be reconciled. 5 The system applies some backend matching algorithms to try and identify duplicate information

between the EHR and data to be reconciled.



Additional Information A user can also manually match data

EHR action types consist of Keep, Resolve/Stop and Delete

Actions will be set to Keep by default Import action types consist of Ignore, Add, Replace

Any data that is not matched and would be considered ‘new’ to the EHR will have a default action of Add

Any data that matches an existing EHR record will have default action of Ignore Any data added from the selected file will be added to EHR as prescribed/recorded elsewhere

Documents

NextGen EHR Medications and eRx Enhancements …ezoutlook.com/userarea/EHR_58_Medications_ and_eRx_Module...NextGen EHR Medications and eRx Enhancements Workbook Version 5.8 09/26/2013