Release Notes For 2013.01

Accuro©EMR is the most recent version of Accuro available. The reason for no version number is because Optimed is going to a more regular release schedule to avoid large annual releases. Optimed is now offering updates every two months to all customers. This means that every two months we will provide a release in the form of “Update Accuro” which you can run at your convenience. Note that once you update one of your computers, all of your computers will need the update run.

The release notes below are dated. When you apply the update, you will receive all changes since your last update. To find the last date you updated, login to Accuro and click Help > About > Details.

Accuro Release Notes Index by Iteration

Features

Unread Messages and Tasks

Messages and Tasks in the Home section that have not yet been read are now bolded. This makes unread messages and Tasks easier to see at a glance. To access the messages and tasks folders, select the Home icon.

Displaying Medical History Items in Clinical Notes and Generated Letters

Within clinical notes, you can set up your templates to include medical history. The format of this was listing all the items separated by commas. This function has now been expanded so you can choose how the items display to allow for more detail and vertical lists.
To try this out, first go to the Template Wizard (Tools > Template Wizard).

The Query button (at the top with the “i”) when clicked now displays two tabs: Labs and Medical History. The Labs tab is unchanged. The Medical History tab allows users to insert a query for a selected history item and to specify how the item is displayed. The display options are:

Comma Separated list: Items listed one after another, separated by a comma.
One per Line: Instead of a comma separated list, separate each medical history item of a given medical history category with a new line.
One per Line with Details: Same as One per Line with the additional details from the Medical History Item.
One per Line with Details and Date: Same as One per Line with Details except the appropriate date from the medical history item is included. Put the date in front of base medical history item text separated by a tab.

There is also the option of selecting a checkbox “Start Medical history Details on a New Line” (default not selected): to start each item on a new line.

The same options are available when adding Medical History in the Introduction of Generated Letters. To add Medical History to a Generated Letter, click the Medical History button within the Generated Letter window. The same display options are available and selected Histories will be included in the Introduction of the letter.

Faxing Selected Pages

Documents from your fax or scanner are saved as PDFs in Accuro typically. A document can be many pages and is stored as one single line in the Virtual Chart. If you right click the document, Accuro gives you the option to fax that document out to someone else, but until now you had to fax the entire thing. New to Accuro is the ability to right click and fax a document, but before sending it you can choose to just send certain pages. Here is how to do this:

Right click the document form the Virtual Chart and select Fax. An icon button has been added to the fax recipients window that appears. When clicked, this button opens a window displaying all the pages on the left as being selected for sending. Drag and drop pages you don’t want sent with your mouse to the right of the window to remove them from the pages being sent. The purpose of this is to allow you to send only a few pages of what may be a large document.

Another option on the screen is to enter a page number range and the pages included are adjusted automatically. If you have a fax cover page, this is not included in the page selection window or in the page range when filtering. The fax preview only displays the pages that will be sent. The new page selection feature is available when faxing from the Virtual Chart (Fax and Chart Print > Fax) and from Encounter Notes (in the Forms and CDM worksheets).

Prescription Printout Changes

Prescription printing is a set format in Accuro, and includes what we researched to be the important fields to include on a script. Due to some of the provincial requirements, fields like ‘masked’ and ‘Cmplnc Pkg’ were added and this has confused some Pharmacists. To address this, the Accuro prescription format has changed to make the information clearer and leave out information that is not being used.
The following changes have been made to the printed prescription:

Allow Substitutions has been moved to the top of the prescription. Note that to change the default for this, go to User Preferences, Display, EMR Workflow.
The Quantity and Refill are now bolded so they stand out more.
The number of refills now have the numeric value followed by the written value in brackets (e.g. 11 (eleven)).
The Qty per Refill is only included if it is different from the quantity. What this field is meant for is if you write a prescription where you want a different quantity dispensed on the refills that the original script.
Qty per Refill now has the numeric value followed by the written value in brackets (e.g. 11 (eleven)).
If a prescription is faxed to a pharmacy directly from Accuro, the following changes are applied:
- The pharmacy name, address and fax number are included on the prescription.
- The words “Please take this prescription to your pharmacist” are no longer included on the prescription.
The “Cmplnc Pkg” is no longer shown. This was a specific requirement from many years ago, linked to a checkbox in the prescription details screen. We have found that sites that need this can enter it in a instructions to pharmacist so have removed it from the main prescription printout.
“Masked” is no longer shown. This was originally meant to reflect that the medication was hidden from view in the EMR to other users, but has no relevance on a printed prescription and was confusing to pharmacists.

Maintenance and Issue Fixes

Billing:

Edit Procedure Code Categories

Users can no longer add identical category names in Edit Procedure Code Categories. Each name added has to be unique. To access the procedure category manager click Billing > select Options > click Procedure Category Manager.

Incomplete Bills (ON)

When a user started a bill and indicated the submission was unsuccessful and then later sets the submission to successful, the accounting number was not being applied to the bill. An update has been made to ensure that the appropriate accounting number is applied to the bill. To access bills select the Claims icon and select the appropriate tab.

Manage Tariffs (MB)

The service amount in the Manage Tariffs window was incorrectly displaying to only one decimal place (e.g. 1,738.10 was being displayed as 1,738.1). An update has been made so the amounts now display correctly. To access the Manage Tariffs window click Billing > select Options > click Manage Procedures.

Override HST/PST

When a user went to override HST/PST and then canceled the window that was displayed, an error was displayed. An update has been released to ensure that this error is no longer displayed. To override HST/PST select the Claims icon > select the appropriate tab > right-click on the claim and select Options > select Override HST/PST.

Practitioner Number Rule with Zero Value Facility Number (MB)

An update has been made so a Practitioner Number rule can now be created with a zero value facility number. To create a practitioner number rule click Billing > select Options > select Manage Pract # Rules.

Resubmit Bill, Billing Controls

Resubmitting a bill was not following the billing controls, the following changes have been made to ensure that resubmitting a bill complies with the billing controls (these rules assume the user has permission to perform the following actions): Where a bill is marked for resubmission a check is made to ensure the resubmission is valid; A bill that is marked for resubmission can be unmarked for resubmission; A bill that has not been submitted cannot be marked for resubmission. To resubmit a bill select the Claims icon > select the appropriate tab > double click on the selected claim to open the Claim Details window > click the Resubmit checkbox.

Submission Management (MB, ON)

Submission management was displaying all submissions that were made even if the submissions are for other offices providers not accessible from the current office. Submission management has been updated to only display claims in the submission where the current user has billing access for the providers of the claims. To access submission management select the Claims icon > click the Gear button in the bottom-right of the window.

EMR:

Changing Day Sheet Cells

When changing a cell in the EMR day sheet the edit was not being saved immediately after it was complete. This caused an issue when a user then sorted by a column header and the edit had not been saved. An update has been made so that when a cell is edited the value is saved before any other action is performed. To access the day sheet select the EMR icon > click the Day Sheet tab.

Lab Queries in Encounter Notes

An update has been made to lab querying in Clinical Notes and Forms as they were including observations from providers that the current user did not have permission to see. Clinical Notes and Forms now only include lab results for providers the user has permission to see.

Linking Lab Results in Encounter Notes

Linking lab results manually entered in encounter notes was not functioning correctly. An update has been released so the lab results can now be linked correctly. To link lab results select the EMR icon > click the Encounter Notes tab > highlight the appropriate lab result > click the Edit button (pencil) > click the Linking button, the Lab Results Search window is displayed > select the appropriate lab result.

Medication Names in the Manage Prescription Window

If a medication had a very long name it was not displayed very clearly in the Manage Prescription window. An update has been made so there is as much space as possible for the medication name to be displayed and … will be displayed if it is too long. To access the Manage Prescription window select the EMR icon > click the Medications tab > double-click on a medication.

Medication Search Window

The medication search window has been updated to allow only single selecting of medications. Previously users could multiselect, but this was not supported. When making the medication search window bigger (to view long medication names), the list now expands to display correctly in the window. To access the medication search window select the EMR icon > click the Encounter Notes tab > click the Add button on the Active Medications ribbon.

Note Templates

An update has been made so that the Complete Selections button and double-clicking on the word now behave in exactly the same manner. Previously although both actions should have been the same, they behaved slightly differently.

Printing Prescriptions that Span Multiple Pages

There was an issue with printing prescriptions when a single prescription of the script would span multiple pages the tops of the pages were unreadable. An update has been released so that prescriptions now print correctly. To print a prescription select the EMR icon > click the Medications tab > right-click on a medication and select Print/Fax.

Refractive Details in Letter Introduction

In earlier versions of Accuro the refractive exam details were included in the generated letter introduction. This was subsequently removed. As requested by clients this feature has now been re-introduced. To generate a letter select the EMR icon > click the Encounter notes tab > right-click on an entry and select Generate Letter.

Export:

iCalendar

An update has been made to remove the physician name from the appointment header in the exported calendar. As the calendar is physician specific the name is not required on the iCalendar export.
By default the Physician Name will not display. To include the provider name in the export, the following needs to be added to the iCal URL: ?providername=true

Forms:

CDM Forms

An update has been made so CDM forms now recognize lab linking. Previously the form would populate with the original linked result even if a newer secondary value was available.

Formulas on Forms

Three new functions have been added to formulas on forms (Tools > Form Editor): MIN, MAX and AVG.

MIN returns the lowest value of a series of numbers (separated by a comma (e.g. MIN(1,3,5,7) would return a value of 1).
MAX returns the highest value of a series of numbers (separated by a comma (e.g. MAX(1,3,5,7) would return a value of 7).
AVG returns the average value of a series of numbers (separated by a comma (e.g. MIN(1,3,5,7) would return a value of 4).

Labs:

Filtering Outstanding Lab Ordering Tests

When the recent changes were made to the Outstanding Requisitions, Referrals and Orders window, a previous filtering option was unintentionally removed. Users could no longer filter specific tests within an outstanding lab requisitions. An “Orders” dropdown has been added that lists all outstanding lab tests within a lab requisition that are outstanding. This enables users to be able to filter once again. To access Outstanding Requisitions, Referrals and Orders click Reports > select Outstanding Requisitions, Referrals and Orders.

Northern Health Labs BC (AB)

Northern Health Labs BC interface has been made available to AB clients. This is because some clinics see a significant number of patients from BC and this allows cross provincial lab feeds. If Alberta clients would like the Northern Health Labs feed, they will need to contact Northern Health to sign up.

Other:

License Expiry

The License tab has been updated to show the correct date that the license is going to expire. To view the license expiry date click Help > select About Accuro > click the License tab.

Sending Feedback

An update has been made so that any response email address containing @optimedsoftware.com is no longer allowed. Some users had been putting the Optimed email address in this field when it is for their email address. To send feedback click Help > select Send Feedback.

Patient Demographics

Exporting Patient Information from the Patients Section
Errors were being generated in the log where a user was trying to export patient information to a folder that does not exist on their computer. A warning message is now displayed.

Performance:

Archived Appointment History

When the Archived Appointment History tab was selected it was loading three times. An update has been made so that it only loads once. To access the Archived Appointment History press F4 (Quick Patient Appointments View) > click the Archived Appointment History tab.

Performance Improvements

Changes have been made to the following areas: activity log, user preference, update locks, waitlist requests and waitlist to improve loading, updating and saving to improve memory use and performance.

Physician Search

When the physician search window was loading office physicians as the default selection options, each physician was loading separately. An update has been made so that all physicians are loaded at the same time.

Printing Letters and Notes in the Virtual Chart – Grouped by Accuro when Printing is at 10

When printing a large number of items from the Virtual Chart, Accuro will now group the items behind the scenes in groups of 10. This is because printing more than 10 items at a time will be very slow. Users can still select as many items as they choose to print at once, however a better workflow when printing out a chart is to specify a date range to filter out items not required.

To print from the virtual chart select the EMR icon > click the Virtual Chart tab > select the appropriate items > right-click and select print. To print the entire virtual chart right-click and select Print Entire Chart (a window is displayed allowing the user to select what is printed out).
Note: There is still a known issue that printing very large chart items is slow. Optimed is currently investigating this issue.

Searching in the Patients Section

For large sites, searching in the patients area of Accuro was very slow when searching for a patient by patient identifier. Changes have been made to the way Accuro searches in order to improve the speed. A System setting must be used to enable this. When enabled it searches for IDs starting with the value only and when disabled, searches for IDs containing the value anywhere.
The system setting can be found under Users: Manage Security: System Settings: Performance Tab: Other Performance Settings: “Patient Identifier searches match with ids which start with the search instead of containing the search”. Default setting is On.
To access the Patients section click the Patients icon.

Tasks Performance Improvement

An update has been made to the task lookup in the Accuro database which means a performance improvement for clients.

Physician:

Deleting Physicians

When a physician is deleted from Accuro it is now a soft delete where they are no longer visible in Accuro but their details remain within the database. Previously when a physician was deleted they were removed from the Accuro database.

Merge Providers in Address Book

Provider records can now be merged provided they do not have patient or schedule records or are in an office. Providers can be merged in the Provider Section (Tools: Providers: Configuration). Users have to have permissions to be able to merge providers; the default is administrator roles only.

Prescriptions:

CDM Group Names

An update has been made to the area of Accuro where CDM group names are created to ensure that names with special characters (e.g. “&”) are supported.
Reporting

Advanced Access Reporting (WRHA Only)

The month dropdown in the advanced access reporting area of Accuro now allows users to go back 36 months (previously it was 12 months from the current month). To access advanced access reporting click Reports > select Advanced Access Reporting.

Administer Medication (WRHA)

A new right-click menu option has been added on the Medications tab called Administer Medication (EMR > Medications > right-click on medication and select Administer Medication). This option is a feature permission that needs to be enabled by Optimed. Once enabled access to this feature is controlled in the Manage Security area of Accuro (Users > Manage Security > Feature Access > Medication Administration is listed in the EMR section). Right-click on a prescription item to select Administer Medication, in the window displayed the user can enter the medication lot, administer date, clinic the medication was administered at, medication site, medication route, reaction, dose, notes and when the next dose is due.

Security:

Change Password

Users with an administrator role now have the ability to change the password for users in offices they (the administrator) have permissions to by clicking Users > select Change Password. Passwords can still be changed using Manage Security > Users.

Traffic Manager:

Add, Edit and Delete Buttons in the Traffic Manager

In the Traffic Manager (side by side view) the Add, Edit and Delete buttons have been moved so they no longer overlap onto the Name column. To access the Traffic Manager select the Traffic icon > click the button to the left of Provider if the side by side view is not already displayed.

Appointments Created in Traffic Manager

Appointments created in the Traffic Manager are now included in the audit log. To access the log click Help > select manage Security > click Audit Logs.

Traffic Manager Room Icons

Rooms in the traffic manager can be assigned icons. The selected icon is now displayed at the top of the room window as well as in the background when the layout is not locked. To select room icons click Scheduler > select Manage Rooms > select a room and click Edit.

Waitlist:

Removal of Providers from the Waitlist

Users can now remove a provider from the waitlist. When selecting to remove a provider it removes all their patients from the waitlist and also removes them as an option in waitlist requests. A warning message is displayed prior to removing a provider form the waitlist that also warns if patients need to be contacted or the user wants to print a list of patients for this provider as it must be done before the provider is removed from the waitlist. To remove a provider from the waitlist select the Waitlist icon > click Tools in the top-left of the Waitlist window > select Provider Management > select the provider and click Remove.