RevolutionEHRinsight.revolutionehr.com/wp-content/uploads/ReleaseNotes_6_2_0.pdf · RevDirect is an optional RevolutionEHR integrated web service that provides secure messaging between

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of Health Innovation Technologies, Inc.

Phone: 877-REVEHR-1

www.revolutionehr.com

[email protected]

Release Notes 6.2.0

April 11, 2014

RevolutionEHR

http://www.revolutionehr.com/

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Table of Contents

Release Summary ................................................................................................... 3

1. New Features ...................................................................................................... 4

1.1 Messages ................................................................................................... 4

1.2 Family Medical History and Family Ocular History ............................................ 4

1.3 InfoButton ............................................................................................ 9

2. Enhancements .................................................................................................. 10

2.1 Claims ..................................................................................................... 10

2.2 Search Notes ............................................................................................ 11

2.3 Administration .......................................................................................... 12

2.4 RevolutionPHR .......................................................................................... 16

2.5 Encounters ............................................................................................... 18

2.6 Reports.................................................................................................... 21

2.7 Patients ................................................................................................... 22

3. Fixes ................................................................................................................ 29

3.1 Patient File ............................................................................................... 29

3.2 Encounters ............................................................................................... 30

3.3 Searchable Notes ...................................................................................... 30

3.4 Reports.................................................................................................... 31

3.5 Administration .......................................................................................... 31

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Release Summary

This release has a significant number of new features and enhancements we are excited to announce.

The list below provides a quick overview of each new feature and enhancement along with the section

within these release notes you can find the details.

An updated and refreshed on-screen user experience; delivered by an evolutionary and

incremental migration away from Adobe Flash.

o Refreshed login screen

o Refreshed application header

o A new way to change your location

A new messaging feature that is accessible through a new Messaging module within

RevolutionEHR and is also accessible through RevolutionPHR. The Messaging User Guide

can be downloaded at http://insight.revolutionehr.com/wp-

content/uploads/Messaging_User_Guide_6_2_0.pdf

RevDirect is an optional RevolutionEHR integrated web service that provides secure

messaging between your practice and external providers. Learn more about RevDirect on

RevMarket at http://market.revolutionehr.com/revdirect/ Details are in section 1.1.

SNOMED AND ICD-10 Codes: RevolutionEHR has added two new databases of diagnosis

codes. Detailed information is provided immediately below section 1. New Features and in

section 2.3.2.

PFSH: Two new screens have been created to replace ‘Family History’ within the current PFSH

screen. These screens are Family Medical History and Family Ocular History and are detailed

in section 1.2.

A hyperlink has been added to provide easy access to patient educational materials. Rx-

Medications, Diagnosis History, and Orders - Medical have an “InfoButton” as a new function.

This button will link to MedlinePlus. Details are in section 1.3.

The 1500 Claims form has been updated to its most current version. Details are in section

2.1.

For Meaningful Use, RevolutionEHR has added a category of Clinical Decision Support rules

called “MU CDS Rules.” This new category has five rules that have been assigned Care Plan

Items. Each of these rules is related to Clinical Quality Measures. Details are in section 2.3.3.

The ‘Medications’ screen has been divided into two sections. There is an area for “Med

Prescriptions” located in the upper half of the screen and there is an area for “Other

Medications” located in the lower half of the screen. Details are in section 2.5.1.

The database used for adding a medication to the patient file has been updated to a new

format. This new format will no longer require the selection of a strength for the medication.

In addition it will display the type of drug (Brand name, Synonym, Brand drug group, etc).

Details are in section 2.5.2.

A new eCQM report type has been added to calculate Clinical Quality Measures for

stage 2 MU. Details are in section 2.6.1.

Lab results within Orders – Medical can now be uploaded from a HL7 LRI file. Details are in

section 2.7.2.

C-CDA: Transition of Care, Clinical Summary, and Patient Record reports can now be

generated. Details in section 2.7.1.

http://insight.revolutionehr.com/wp-content/uploads/Messaging_User_Guide_6_2_0.pdf


http://market.revolutionehr.com/revdirect/

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1. New Features

This release introduces the use of SNOMED codes. SNOMED-CT is an acronym for

Systematized Nomenclature of Medicine – Clinical Terminology. It is recognized throughout

the US and internationally. Using SNOMED-CT enables providers and electronic medical

records to communicate in a common language, thus increasing the quality of patient care

across many different provider specialties. SNOMED-CT will also improve the accuracy of

patient data analysis. Knowing that a standard medical terminology is being used across

the enterprise, and within other hospitals, simplifies the query and resulting report.

Stage 2 Meaningful Use criteria expands upon the Stage 1 requirements to further improve

and utilize healthcare IT and EMRs to provide consistent, collaborative care among different

provider groups for any given patient. This means these electronic systems need to talk to

each other and more importantly they need to understand each other. The only way for

them to reach this understanding is to speak a common language. Stage 2 of Meaningful

Use has defined this language as SNOMED-CT – specifically for the problem list within a

patient’s chart.

1.1 Messages

RevolutionEHR has added a new messaging feature that is accessible through a new

Messaging module within RevolutionEHR and is also accessible through RevolutionPHR.

The messaging feature, currently only available through the Polaris experience, allows

you and your staff to communicate securely within your practice – even between

multiple locations. It also provides secure communication between your practice and

your patients through RevolutionPHR. The Messaging User Guide can be downloaded at

http://insight.revolutionehr.com/wp-

content/uploads/Messaging_User_Guide_6_2_0.pdf

RevDirect is an optional RevolutionEHR integrated web service that provides secure

messaging between your practice and external providers. Learn more about RevDirect

on RevMarket at http://market.revolutionehr.com/revdirect/

1.2 Family Medical History and Family Ocular History

Two new screens have been added to the screen library in Administration. They are

‘Family Medical History,’ and ‘Family Ocular History.’ These two screens will replace the

function of the “Family History” section that is currently located within the PFSH screen.

The purpose of these screens it to allow data entry of family history information that is

relevant to specific family members based on their relationship to the patient.

These new screens will utilize SNOMED codes for recording the patient’s family history.

The instructions on the use of these screens are consistent whether you are using

‘Family Medical History’ or ‘Family Ocular History.’ For ease of instruction, the following

information will frequently reference Family Medical History only. However, keep in

mind Family Ocular History is used in an identical fashion.



http://market.revolutionehr.com/revdirect/

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1.2.1 Administration – Configure SNOMED options for new History screens

Access Administration Data Configuration Family History Filters.

RevolutionEHR has populated default SNOMED codes and descriptions. These

defaults can be removed if you do not wish to include them as options in your

history screen. You can also add more codes to the list by searching for available

Family History SNOMED codes on the right of the screen.

1.2.2 Administration – Add New History Screens to Encounters

The new history screens are available in the Screen Library. Access Administration

Encounters / Interviews Screen Library History. By default, these new

screens have been added to any workflow step in your Encounter Step

Library that contains the PFSH screen.

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1.2.3 Encounter – Screen Overview

Open an encounter and access the History workflow step. If the family medical

and family ocular screens were not present in your encounter template before this

encounter was started - you can – use the ‘add screen’ feature at the bottom of

any screen. Remember that when adding a screen on the fly the screen will be

added directly below the current screen being accessed.

Review the screen image below and the corresponding numbers for details on each

field. As a reminder – this is referencing the family medical history screen;

however, the family ocular history screen has the same information and function.

1. Default SNOMED list created in Administration.

2. Relationships:

a. Categories: U-unknown, Y-yes, N-no

b. Types: F-father, M-mother, S-son, D-daughter, Sis-sister, Bro-brother

c. Until specific information is entered for the condition, the default will be

Unknown for all relationships.

3. In an encounter the use of the ‘Review’ button is for providers only. All other

users will see this button but it will be grayed out and inaccessible. After a

provider has reviewed the list of conditions, he or she will click the ‘Review’

button, the exclamation point will change to a green checkmark, and the button

name will change to “Reviewed.” In the Show More view, the "Reviewed"

button essentially acts as a Save button, to save the review set. It is grayed

out unless you are viewing the "Latest History" and have added content to the

review set comment. Then it should become enabled, allowing you to save the

review set.

4. Latest History button shows you the latest set of Family Medical (or Ocular) History conditions, which is the only set of data that can have information added or edited.

5. ‘Review Set History’ dropdown menu—This dropdown will display a list of all dates/times a set of Family Medical History conditions has been saved as a "snapshot" of a patient's history. The system captures and stores a snapshot of the history information each time you move from this screen when viewing the Latest History within an encounter. The user can choose to display the data captured from a previous update. However, to make any changes, you must enable the ‘Latest History’ button.

6. Comments:

1. This comments area applies to the entire history screen. It is optional and

searchable.

2. This comments area applies to the specific SNOMED History Detail. Once

saved, it will be viewable within the comments area in the History List. It

is optional and is not searchable.

7. History Detail—This area becomes accessible once you have enabled a line-item

(with a single-click) in the History List. Detailed processing instructions are

provided in section 1.1.4.

8. New—Add a new SNOMED code to the list.

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9. No Problems – If all conditions are no, for all relationships, click ‘no problems.’

It might also be helpful to click ‘no problems’ and then change only those

conditions with exceptions.

1.2.4 Encounter – History Detail

Enable a SNOMED code/condition within the list with a single-click on the

appropriate Family History item from the grid. The History Detail section of the

screen will open to the right for data entry.

1. Enable the checkbox beside “Unknown For All Immediate Family Members” to

indicate the condition is unknown for all relationships.

2. “Unknown” is the default setting for all relationships. Use the ‘yes’ and/or ‘no’

buttons to change the selection for individual family members based on the

relationship. Enable ‘Yes’ immediately under the checkbox area to indicate all

family members have this condition; or, enable ‘No’ to indicate all do not have

this condition.

3. Comments—Refer to number 6.2 in the prior section.

4. Save must be enabled or use cancel if appropriate to exit the condition. If you

do not click ‘Save’ before going to the next condition, no data will be

updated.

1 2

3

1

4 5

6.1

6.2

7

8

9

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Example of entries into the History Detail area.

Example of how the condition indicators will be displayed within the

‘Relationships’ column of the “History List.”

1.2.5 Encounter - PFSH

For any encounters started after this release the PFSH screen will display a message indicating that the Family Medical and Ocular History sections have been moved to new screens. The most recent Family History entered into the PFSH encounter screen will be converted to data for the new Family Medical and Ocular

History screens.

2

3 4

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1.2.6 Patient File – Show More

The Family Medical Hx and Family Ocular Hx screens have been added as new

components to the patient file and can be found in the ‘Show More’ menu within

the patient file.

All functionality that is available for these screens within the encounter is also

available when accessing the component from ‘Show More’ with the exception of

Review. Review can only be completed by the provider within the appropriate

encounter.

1.3 InfoButton

A hyperlink has been added to RevolutionEHR to provide easy access to patient

educational materials. Rx-Medications, Diagnosis History, and Orders - Medical

have an “InfoButton” as a new function. Enable this button and RevolutionEHR will

link to MedlinePlus®. As you are linked to the website, a search for the

medication, diagnosis, or medical order will be processed automatically.

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Important Note: If the medication was entered from the previously available FDA

database the Infobutton will not be displayed. Only those medications added using

the new database described in section 2.4 will be linked to the MedlinePlus website.

2. Enhancements

2.1 Claims

2.1.1 Claim Form 1500

RevolutionEHR has the updated the 1500 claim form to its most current version

(02/12). Resources detailing these changes are provided in the list below this

section. It is highly recommended you review all of the information.

Powerpoint presentation from the National Uniform Claim Committee

(NUCC) with background information about the organization, the form, and

the form changes.

http://www.nucc.org/images/stories/PDF/understanding_the_changes_to_t

he_0212_1500_claim_form.pdf

NUCC website. www.nucc.org. Access the 1500 Claim Form tab. All

resources under this tab are recommended.

http://www.nucc.org/images/stories/PDF/understanding_the_changes_to_the_0212_1500_claim_form.pdf

http://www.nucc.org/images/stories/PDF/understanding_the_changes_to_the_0212_1500_claim_form.pdf

http://www.nucc.org/

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2.2 Search Notes

2.1.1 Added to Assessment Screen and Comments Screen

Two additional notes fields have the search function.

Access Encounter Assessment & Plan Assessment

Access Encounters Assessment & Plan Comments

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As a reminder, searchable notes were added in Release 5.4.8. Details can be found

in section 1.5.2 of the release notes for 5.4.8:

http://insight.revolutionehr.com/wp-content/uploads/ReleaseNotes_5_4_8.pdf

2.3 Administration

2.3.1 View Clinical Decision Support (CDS) Interventions

In compliance with 2014 certification requirements a permission access setting has

been added for the Clinic Decision Support screen within the encounter. A user

role can be denied access to viewing this screen. When access is denied the

employee with that user role will simply see a message displayed stating “No

access, login does not have access to this screen.” To deny access to the Clinic

Decision Support information within an encounter. Access Administration

Employee/Roles User Roles open a user role access Permissions Patient

Module. By system default all users have the access to view CDS Interventions.

The checkbox must be unchecked to disallow access to this feature.

2.3.2 ICD-10 and SNOMED codes

With the addition of ICD-10 and SNOMED coding systems we have added the

ability to manage these codes within Administration. Access Administration Data

Configuration Diagnosis Common Diagnosis.

http://insight.revolutionehr.com/wp-content/uploads/ReleaseNotes_5_4_8.pdf

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2.3.3 Clinical Decision Support – MU Rules

For Meaningful Use, RevolutionEHR has added a category of Clinical Decision

Support rules called “MU CDS Rules.” This new category has five rules that have

been assigned Care Plan Items. Each of these rules is related to Clinical Quality

Measures. The rules are created and active by default for all practices, however,

each practice can set the rule to “inactive.” They will be locked and cannot be

edited. Access Administration System Rules Clinical Decision Support.

If a MU CDS Rule applies to a patient it will be listed within the Clinical Decision

Support screen of the Assessment & Plan workflow step within an encounter. The

‘confirmation status’ column has been updated to ‘confirmation status/exception.’

If ‘Defer’ is chosen within the confirmation status dropdown menu – a link to ‘Add

Exception’ will be available.

Access the ‘Add Exception’ link to complete ‘Clinical Exception Details.’ The ‘Add

Exception’ link will change to the SNOMED name.

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The ‘Add Exception’ link will change to the SNOMED name when you have saved

the entry into the Clinical Exception Details window.

Certification for Meaningful Use requires specific source attribute information be

associated to these CDS rules and available for viewing. From the Clinical Decision

Support screen you can click on the underlined Rule Name to display the attributes.

This information has been added by default for the new rules. However, the user

does have the option to add attributes to any new Clinical Decision Support rule

built by the user in the Administration Module. A new slider for Source Attributes

has been added.

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2.3.4 Clinical Decision Support – Vitals

“Vitals” has been added as an ‘Available Fields’ within the Rule Builder for Clinical

Decision Support. The “Vitals” folder provides options for weight, height, BMI,

systolic, and diastolic.

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2.3.5 Care Plan Item Categories

In compliance with 2014 MU requirements two new categories have been added to

the Care Plan Item Library for Orders – Medical and Goal. Access Administration

Data Configuration Care Plans Care Plan Items Library Orders – Medical

and/or Goal.

2.4 RevolutionPHR

2.4.1 ‘About Me’

RevolutionPHR has added a “Medical Record” area within the ‘About Me’ screen.

This area has four functions: view, download, send info, and view access log.

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View: The client can view the ‘Clinical Summary’ information your practice

has on file. This is a static screen and cannot be updated or changed by the

client.

Download: This will allow the client to download a pdf (easily readable) of

the ‘Clinical Summary,’ or an xml (e-sharing format).

Send Info: The ‘Send Info’ link will automatically create and attach the

patient’s clinical summary to a message. Within the ‘To’ field, the patient

will only have the option to send the message to an outside provider that is

setup within RevolutionEHR with a “Direct” email address. Refer to

Messages in section 1.1 for more detailed information.

View Access Log: This will record the date and time, the user, and the

action taken within the ‘Medical Record’ area.

Your practice name

Area for patient to

write message content.

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2.5 Encounters

2.5.1 New Medications Screen

The ‘Medications’ screen has been divided into two sections. There is an area for

“Med Prescriptions” located in the upper half of the screen and there is an area for

“Other Medications” located in the lower half of the screen. By default, the

medications listed will have a status of ‘active.’ Enable the checkbox beside ‘show

all’ to view the list of all statuses. Note: The ‘Review’ button has been moved from

the left bottom corner to the right bottom corner of the screen. It is only required

for Stage 2 Meaningful Use, thus, the button will not be displayed for any

encounters with an encounter date prior to 2014.

Screen image before current changes.

New screen image.

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2.5.2 New Medication Database

The database used for adding a medication to the patient file has been updated to

a new format. This new format will no longer require the selection of a strength

for the medication. In addition it will display the type of drug (Brand name,

Synonym, Brand drug group, etc). With this new database many prior requests

from users to have medications added to the database have been fulfilled. If you

have made a medication addition request, please review the new database options.

In the search example – notice the results in Image #1 show the drug description

that matches the search name. The search results in Image #2 include all

instances of the search name.

Former ‘Choose a Medication’ search window.

Image #1 of new ‘Choose a Medication’ search window.

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Image #2 of new ‘Choose a Medication’ search window.

2.5.3 Gonioscopy 360 Test

Our library of tests has been updated to include Gonioscopy 360.

2.5.4 Retinoscopy with Vas

Our library of tests has been updated to include Retinoscopy with VAs.

Unchecked

Checked More results than

previous example.

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2.5.5 Accommodative Facility

Our library of tests has been updated to include Accommodative Facility.

2.5.6 Red Desaturation

Our library of tests has been updated to include Red Desaturation.

2.6 Reports

2.6.1 Clinical Quality Measures (CQMs)

Access Reports Administration Providers Clinical Quality Measures. A new

eCQM report type has been added to calculate Clinical Quality Measures for

stage 2 MU.

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2.7 Patients

2.7.1 Consolidated-Clinical Document Architecture (C-CDA)

C-CDA compliant documents can be generated, saved, and shared with other

providers. (Sharing with other providers is only available if your practice is setup

with RevDirect and the external provider also has direct messaging. See

RevMarket for more information about this service.) Before initiating the processes

you can access Administration to setup default ‘save’ folders and default ‘checked

items.’

Administration General Practice Preferences Additional Preferences

C-CDA Documents. RevolutionEHR has defaults set in this area; make changes as

appropriate to your needs. For our example – we will use ‘Clinical Summary.’

When you set defaults within Administration, you will save time when generating

the reports.

ClinicalSummaries is the name of the folder that will automatically populate in

the dropdown menu in the ‘Clinical Summary’ popup window (see below).

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Screen image of the default settings reviewed above (when accessing ‘Clin Summ’

within an encounter).

2.7.2 Referrals – Generate Transition of Care Document (TOC)

Open a patient file Show More Referrals Open an existing referral. Click

‘Generate Transition of Care’ button.

Default folder setup within

Administration (see above).

Check the items to

default as ‘checked.’

Items checked within

Administration will

automatically be checked.

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The default choices setup in Administration (previously described above) will be

filled out in the popup window. You will need to choose ‘Requested by’ and ‘File

Format.’ Click ‘Generate’ and click ‘Done.’ A copy of the report will be saved

automatically within the chosen folder.

To send TOC documents through direct messaging - Enable the checkbox beside

‘Document(s) Provided’ and click ‘Send Transition of Care’ button. (Sharing with

other providers is only available if your practice is setup with RevDirect and the

Default folder set

in Administration.

Items checked within

Administration will

automatically be checked.

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external provider also has direct messaging. See RevMarket for more information

about this service.)

2.7.3 Orders – Medical

Access a Patient Show More Orders – Medical. There are two new columns

added to the Orders-Medical screen.

Interpretation: This column will have a checkmark to indicate the “Order

Interpretation and Report” field has content. This field is located in the

“Interpretation and Report slider” of the medical order.

File Count: This column will have a number to indicate how many

“Docs/Images” have been added within the “Interpretation and Report

slider” of the medical order.

2.7.4 Orders – Medical: HL7 LRI File

Lab results within Orders – Medical can now be uploaded from a HL7 LRI file.

2.7.5 Diagnosis Codes

New code type options are now available when adding a new diagnosis code to the

patient file from the Assessment screen within the encounter, or from the

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Diagnosis History component found in the ‘Show More’ drop down. SNOMED and

ICD-10 databases are now available in addition to the existing ICD-9 database.

As is currently available for ICD-9, you can use the blue look up button or you can

simply start typing the code or a keyword and a drop down will auto-fill with

selections matching your entry.

With the addition of these two new databases, RevolutionEHR has added a color

identifier and descriptor to the different code types for easier recognition.

2.7.6 Allergies

‘Allergen group’ has been removed as an option when adding a new allergy. The

removal of the allergen category was necessary to accurately map allergies for

drug allergy interaction checks as that cannot be done without the allergy being

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selected from a database. However, the new mediation database, referenced in

section 2.5.2, now contains not only drugs but ingredients which can be selected

for the allergy which allows you almost the same functionality as selecting an

allergy category.

Screen image of former ‘new allergy’ screen.

Screen image of new ‘new allergy’ screen.

As referenced in section 2.5.2. The new medication database and

the new way to select an allergen. If a patient is allergic to sulfa the

option to select the ingredient Sulfanilamide is within the medication

database:

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2.7.7 Recall

An email reminder can sent on any active Recall. Access the patient

file Show More Recall. Enable a recall line-item with a single-

click and an “email envelope icon” will be available for use.

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3. Fixes

3.1 Patient File

3.1.1 Demographics Pod

Access a Patient Demographics Referral Information Slider. The ‘Referred by’

patient hyperlink opens a window that has the contact information of the ‘Referred

by’ patient. Within this window, there is a hyperlink to the file of the referred by

patient. This hyperlink was not fuctioning and has been fixed.

Hyperlink to ‘Referred by’

patient’s contact information.

Hyperlink to ‘Referred by’

patient’s file.

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3.2 Encounters

3.2.1 Keyboard Shortcut Ctrl-T within Tests

Some encounter tests use the keyboard shortcut of ctrl-t to input the current time

within a chosen time field. This shortcut was not working when using a Mac

computer. This has been fixed for browsers Chrome, Safari, and Firefox – when

using a Mac computer. However, Internet Explorer and Chrome do not support this

keyboard shortcut when using Windows. (A double-click with your mouse will still

populate the current time.)

2.2.1 Phorias Test

The Phorias test was not correctly populating the data from Marco NIDEK RT-5100,

NIDEK RT-3100, NIDEK RT-2100. This has been fixed.

3.3 Searchable Notes

3.3.1 Keyboard Shortcut Ctrl-F

There are some older versions of internet browsers and flash players that do not

support the keyboard function of ctrl-f to open a Searchable Notes Field. If this is

a problem on your system, right-click within the searchable notes field and choose

“Search Note” within the pop-up menu. All browsers support the ‘right-click option’

for accessing searchable notes.

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3.4 Reports

3.4.1 CQM Stage 1 Scorecard

The MU stage 1 scorecard did not change the CQM radial button from ‘no’ to ‘yes’

when the CQM report was actually completed. This has been fixed.

3.5 Administration

3.5.1 Clinical Decision Support

The list of active and inactive clinical decision support rules was not populating

correctly when the “Active Only” checkbox was enabled. If the “Active Only”

checkbox was enabled the list continued to show both active and inactive rules.

This has been fixed.

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3.5.2 Query Builder

In the last release, Labs/Imaging Orders was renamed Orders-Medical. However,

the name of this area was not changed within the Query Builder located in

Administration. This has been fixed. Numerous new field options have been added

within this folder.