Release Notes For
2013.03
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
HST to GST (BC)
In preparation of HST reverting to GST on 1 April 2013 changes have been made so that on that date the 12% HST will be replaced with 5% GST. For Government information on the re-introduction of GST refer to their website: http://www.cra-arc.gc.ca/harmonization/.
To override HST/GST follow the steps below:
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Select the Claims icon and select the appropriate claims tab.
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Right-click on the claim and select Options.
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Click Override GST or Override HST, as required.
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Enter the override percentage and click OK.
ACE 10 Digit Dialing
An update has been made to ensure that ACE is able to handle 10 digit dialing. This change is being introduced because Saskatewan is going to 10 digit dialing in 2013. SaskTel is already able to handle it; however, all telephone providers must be able to handle it by February. There is also a mandatory switch over by May 2013. Manitoba switched over in Oct. 2012. As this becomes mandatory in Canada, the "Remove Area Code for Local Numbers" in ACE will be removed.
For further information refer to the following websites:
SaskTel: http://www.sasktel.com/about-us/news/2011-news-releases/local-10-digit-dialing-and-new-area-code-coming-to-sk-2013.html
CRTC: http://www.crtc.gc.ca/eng/info_sht/t1000.htm
Table Row Colors
In the Claims section and A/R by Insurer users can now double-click on any of the colored legend descriptions (at the bottom of the window) and a color selector is displayed. Users can then select another color, if required. Once the user clicks OK, the new color is saves as a user preference. This updates the colors used for the rows.
Ontario Drug Benefit Formulary and Limited Use Codes (ON)
When searching for a medication in Accuro drugs covered by drug benefit program are indicated by an icon and a tooltip (when the user hovers the mouse over the drug). Additionally some drugs are covered in limited situations where specific medical conditions exist. These require a limited use code to be recorded on the prescription. A Limited User dropdown has been added to the Prescription tab in the Add Prescription window for users to select the appropriate Limited Use code. The Limited Use criteria are only visible when available for the selected medication to ensure the user selects the correct Limited Use code when multiple options may be available. A tooltip describes the Limited Use code when a user hovers the mouse over the appropriate medication.
To access the Add Prescription window select the EMR icon > click the Encounter Notes tab > click the “+” in the Active Medications ribbon.
Appointment Status
Following feedback from users an update has been made to allow the appointment status to be configured to make it more visible in the scheduler. Users now have the option to change the appointment status notification from an abbreviation (e.g.[A]) to customizable colored icons. The new icons display in the scheduler, day sheet and in the encounter notes. To customize the appointment status click Scheduler > select Preferences > click the Priorities and Settings tab.
Current Time in the Scheduler
In the time column of the scheduler the cell containing the current time is now highlighted in yellow to make it easier to locate the current time for referencing appointments.
Note: Custom time slots do not have a set length and so are only highlighted for 5 minutes (the default length of an appointment).
Cut or Copy Appointments from Appointment History
Users can now cut or copy appointments from the appointment history tab in the Quick Patient Appointments View window (F4) and paste into the scheduler. Cut and Copy appointments are available on the right-click menu. This feature is to allow users to copy multiple appointments (that may be with different providers and on different days) at the same time, rather than having to keep going backwards and forwards in the scheduler
Group Appointment Functionality
Group appointments are now displayed in Quick Patients Appointment View (F4) and Encounter Notes (EMR > Encounter Notes tab). An indicator has been added to show that an appointment is a group appointment.
In the Day Sheet (Claims > Day Sheet) an indicator is next to an entry to indicate that it is a group appointment and each patient is listed (on a separate line) in the group appointment.
Group appointments can be copied and pasted, the appointment length can be edited, patient cohorts can be added when adding patents in a group appointment and the Arrived/Confirmed/No Show now indicates a count of how many of the group it is applicable to (e.g. [A 5/10]).
Patients can be arrived in multiples from within the group appointment window.
Waitlist Changes
The following changes have been made in the waitlist to improve the functionality and look of the New Request form:
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Checkboxes have been added to the New Request window for “Fast Track” and “Referred Out”. The default for these is not selected.
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Procedure at the bottom of the New Request window is no longer a required field.
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Droplists have been added for Referral Complaint and Refused Reason. Reasons can be added by clicking the arrow to the right and selecting Manage.
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The grey shading has been removed from the Notes and Special Equipment fields.
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F3 (Quick Summary), F4 (Quick Appointment View) and F5 (Quick Documents view) can be accessed whilst in the waitlist.
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The patient demographics information has been removed from the window. This has been replaced by a Demographics button to the right of the Patient field.
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The Patient field will search for a patient once a user starts typing in the patient name.
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Referring Provider and Specialty fields have been added to the form.
Waitlist Date Ordering and Descriptions
Dates in the waitlist requests can now be ordered by users in the date management window. Descriptions have been added to tooltips for each of the dates. To view a tooltip for a date hover the mouse over the date. The default order of the dates and the tooltip descriptions are below:
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Referral Date: Date the referral was made
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Request Date: Date the referral was accepted onto the waitlist
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First Contact: Date the patient or referring provider was contacted with the appointment date
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Patient Available: Date patient is available if not immediately available
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Tentative Date: Date booked, but not confirmed
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Booked Date: Date booked for next appointment or surgery
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First Consult: Date of first consultation appointment
- Decision Date: Surgical Decision Date (Use Type to select Surgical vs. Non-Surgical) To access the Waitlist select the Waitlist icon.
Maintenance and Issue Fixes
Billing:
Claim Remarks Field (MB)
A claim remarks field has been added to invoices. When the invoice is created, if claim remarks field (in the claim) has text then the invoice populates with the remarks from the claim into any Text Field or Text Area with the "ClaimRemarks" component name.
Default Time in a Claim (MB)
When a claim is created that is not from an appointment the default time field for the claim is now left empty (previously it had the time 12:00), unless the office default has been setup. This field does not have to be completed prior to saving. If the start and end times are not completed in the claim a space is now included in the submission file instead of the times. To create a new bill select the Claims icon > click the Daily Claims tab > right-click and select New Bill; alternatively press Ctrl+B.
Edit Patient Demographics in the Claims Section
A new right click menu option has been added to allow users to edit patient demographics from within the claims section (available on all tabs). When selected this opens up the Quick New Patient Window with the claim’s patient details loaded. Users can edit the details and then save the changes. To access the new Edit Patient Demographics option select the Claims icon > select the appropriate tab > right-click on a claim and select Options > click Edit Patient Demographics.
Filter Unmatched Remittances (SK)
An update has been made so that only unmatched remittances for the providers that the user has permission to see are displayed when using -All- provider selection. To access unmatched remittances select the Claims icon > click the Not on File Matching tab.
Future Date of Service Warning Message
Claims allow a date of service to be entered that is in the future, a warning message is displayed to notify the user. An update has been made to the message so it now says, “The selected date 1s <# years="" months="" days=""> in the future”. This change is to allow more clear distinction between an intentional future date and a mistake that is far into the future.
Health Card Version Code (ON)
The health card version code can now be overridden on a claim waiting to be submitted. The purpose of this change is for when a patient’s health card version code changes but they still have old claims under the previous version code being processed. If an override code is not required, then leave the field empty. The override code is a maximum of two characters and both must be letters. To access claim details select the Claim icon > click the Daily Claims or Unsubmitted Claims tab > right-click on a claim and select Claim Details.
Matched Refusals in the Unmatched Remittances (ON)
Whilst investigating another issue a developer found it was possible to have matched refusals displaying in the Unmatched Remittances tab if they have the same claim error ID (but a different response ID) as an unmatched refusal. An update has been made so that only unmatched refusals are now displayed. To access Unmatched Remittances select the Claim icon > click the Not Reconciled tab > Unmatched Remittances are located halfway down the window.
Pending Date and New Accounts Receivable Subledger Report(MB)
A column has been added to the new Accounts Receivable Subledger report called Days Pending. A days pending bill is a bill where the last received response from MB Health was the explanatory code 73 meaning that the Claim is under32 investigation at Manitoba Health and payment is pending.
Note: The pending date only exists for a bill if the last response was a 73 code from MB Health. A response of any kind after that means there is no longer a pending date for the bill.
To access reports from anywhere in Accuro press Ctrl+R.
Pre-submission Demographics Validation (MB)
Prior to billing submissions Accuro now checks that a patient’s first name, last name, date of birth and gender all exist for all patients in the submission. For non-reciprocal billings for MB patients Accuro also checks that the MHSC# is populated.
Processing Remittance Files (ON)
Accuro now checks the file length of a remittance file. This is to ensure that partially downloaded files do not get processed. Previously a partially and fully downloaded file would both be processed resulting in duplicate remittances.
Submission Rounding Errors (MB)
An update has been made to Accuro to change the way that calculations are performed to prevent the rounding errors that were occurring when totalling the bills in a submission.
Tariff Decreasing Percentages (MB)
When billing for surgery, the value of repeat procedures during one surgery can decrease the more a procedure is done. The percentage decrease varies and is not included in Accuro; support has been added to allow users to define the decreasing percentages in Accuro.
In the Manage Procedure window is a new Procedure Percentages table where a user can add the changing percentages. The table has two columns: Quantity Start, the quantity billed at which that percentage starts and Percentage, the percentage paid when the surgery reaches that many units.
An example of tariff decreasing percentages is 10 tendon repairs and they would be billed as follows: 100 % for the first tendon 75% each for next 4 tendons 50% each for the next 5 To access the Manage Procedures window click Billing > select Options > click Manage Procedures.
Encounter Notes:
Clinical Notes Without a Type
Clinical notes without a type were causing errors. An update has been made to that if a clinical note does not have a type it loads correctly and no errors occur. When saving templates if there is not a type then the templates are saved to “Clinical Notes”. To access clinical notes select the EMR icon > click the Encounter Notes tab.
Immunization Summary in Templates and Letters
An immunization Summary tag has been added that is available for use in letters and templates. The new tag is . To access the tag in the template wizard click Tools > select Template Wizard > select the appropriate template > right-click in the appropriate area of the document and select Medical History > select the tag Immunization Summary .
Faxing:
Print/Fax Summary Enhancement in the Virtual Chart
An update has been made to the Print/Fax Summary in the virtual chart so that it reflects the MS Fax Status (for faxes only). The status is now displayed in rounded brackets (e.g. “Sent” is replaced with “Sent to MS Fax”). To access the print/fax summary in the virtual chart select the EMR icon > click the Virtual Chart tab > right-click on an item and select Print/Fax Summary.
Forms:
Changing Font Size of Components in the Form Editor
An update has been made so that query components in the form editor can now have their font size changed. To change the font size select Tools > Form Editor > open a form > right-click on a component in the form and select Edit > click the Font button and select form the options displayed.
Custom Histories in Template Wizard Letters
Users can now add tracking type custom histories into letters in the Template Wizard Letter Introductions. Previously only custom histories that were not tracking type could be added into the introduction. To access the Template Wizard click Tools > select Template Wizard.
Downloading Lab Forms from the Form Publisher
Downloading forms from the publisher that contain lab test names that already exist was causing error to be generated. An update has been made so that only tests that do not already exist are downloaded. To access the form publisher click Tools > select Form Editor > click the Publish button.
Font Formatting in the Template Wizard
When selecting text and multiple medical history queries at the same time and changing the font, only the font of the last item selected was being changed. This was found to be caused by new medical history tags that had been added causing the font style to be lost. An update has been made to ensure the font style selected is correctly applied. To access the template wizard click Tools > select Template Wizard.
Medication Reconciliation & Order Form (MB)
A form has been created for specific regions of Manitoba called the Medication Reconciliation and Order Form. This form is only visible if your site has the appropriate module enabled in your Optimed software. This form is generated from a button in the medications tab (EMR > Medications tab). When the form has been created it can be printed or faxed. When a user closes the form they are prompted to save it to a patient’s chart.
This form includes all the patient demographics in the top-right corner, a list of allergies/intolerances and medications that the patient has been taking (active and external medications). If there are too many medications for one page, then the report will carry on to a second page.
Labs:
Lab Reconciliation, Requisition Dates
An update has been made so that when reconciling lab results only outstanding requisitions with a date in the past are automatically checked. Previously all outstanding requisitions were checked by default (including those with dates in the future). To reconcile labs select the Home icon > open the Labs folder.
Medical History:
Order of Vaccinations in Medical History
Vaccinations in the copyable medical history and immunization summary are now listed in alphabetical order and the administrations are in reverse chronological order by administered date. To access the copyable medical history select the EMR icon > click the Encounter Notes tab > the Copyable History button is located towards the top-right of the window (button with two pieces of paper).
Other:
Accuro Database Backup
The Accuro database backup utility has been updated to allow users to select what to back up (this includes the documents database and the activity log database when they are setup to be different databases). To access the backup area of Accuro click Backup > select Create Backup.
Always Show Tasks Sent by Current
User A new system setting “Always Show Tasks Sent by Current User” has been added (default is off). When selected this setting includes tasks that the user created in the Tasks-Home area and also in the Tasks window (F7) even if they are not the current owner of the tasks. The purpose of this setting is to allow the user who created the task to keep the task visible even when they are not the current owner. To access system settings to turn this option on click Users > select Manage Security > click the System Settings tab.
File Types in Accuro
An update has been made in various areas of Accuro to restrict the file extensions that are displayed when selecting files to only those compatible with Accuro.
Mass Archive Patient Window
The wording in the archive patient window has been updated to make it easier to understand and also correct a spelling mistake. To mass archive patients click Tools > select Mass Archive Patient.
Patient Demographics:
Changing Patient Demographics in Bills
When patient demographics were updated in a bill, the status bar was not being updated to reflect the updates. An update has been made so that when patient information is updated the status bar is updated.
Health Card Validation (ON)
Manual health card validation which was only available in the traffic manager has been expanded so that health card validations can now also be done in the scheduler and in patient demographics. To validate a health card in the scheduler click the scheduler icon > right-click on the appropriate appointment and select Validate Health Card. To validate a health card in patient demographics select the Patients icon > click the Demographics tab > click the button with the blue tick (to the left of the patient’s health card number).
New Patient Window (F6)
A new button called “Aliases” has been added to the bottom of the quick new patient window. When pressed this button opens a new window that shows the same alias bands as in the patients section of Accuro (Patients > Other tab)
New Patient Window (F6)
An update has been made to the last name field in the new patient window so that it now starts searching after three characters have been entered (previously four characters had to be entered for Accuro to start searching).
Patient Demographics Bar
When the Accuro window was resized and the window was too small the first line of the patient demographics bar was getting cut off. An update has been made so when the window is resized the patient demographics bar displays correctly.
Update All in the Provider Area of the Address Book
If providers with similar demographics are found users are prompted to “Update All” or “Update Current”. If “Update All” is selected a window notifying the user of how many providers are being updated is displayed. The user then has the option of selecting OK to proceed or Cancel to exit without updating. To access the provider area of the address book click Tools > select Address Book > click the provider tab.
WCB Billing Numbers in the Provider Wizard (AB)
An update has been made to combine the two WCB billing number fields that were in the Billing Details section of the provider wizard. To access the provider wizard click Configuration > select Configure Accuro > click Next > select the Provider Wizard.
Performance:
Activity Log User List Changes
Updates have been made to the activity log user list so that it no longer finds all names ever used. A new -All- option has been added and free text is now available. This improves the speed and performance. To access the activity logs click Tools > select Manage Security > select Audit Logs.
Database General Maintenance
To improve database usage and efficiency of Accuro many queries have been converted to use prepared statements (prepared statements are used to execute the same or similar database statements repeatedly with high efficiency).
Insurer Querying Performance
An update has been made to improve the performance of queries in reports; this will benefit sites with very large numbers of insurers in their system.
These changes will improve the performance of the Billing Account Summary report in BC and the A/R Summary report for all provinces. Additional reports will be improved in future releases.
Insurers
Insurer information is now cached, this saves time taken to search for insurers all the time. A record is kept of when insurer details were last modified.
Natural Health Product Searches
An update has been made to the Natural Health Products table in the Accuro database. This has been done to improve efficiency and use when performing searches.
New Indexes
New indexes have been created to improve the performance of Accuro and make things run faster. The new indexes are for:
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Reconciled Orders
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No Known Allergies
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Permissions
No Limit Connections (Connection Pooling)
Running reports has been switched to use pooled connections to the database to minimize the number of connections made to the SQL server.
Not Reconciled (MB)
An update has been made to the way not reconciled bill information is stored and the number of times that the bill information is accessed to improve the performance times. To access the not reconciles select the Claims icon > click the Not Reconciled tab.
Prescriptions:
Manufactured Drug Search When Selecting a Vaccine
An update has been made to the manufactured drug search, two buttons have been added and the user can select whether to search by name or by classification. When the search is run only the search type selected is searched (previously each search searched both names and classifications). This will speed up time and efficiency of manufactured drug searches.
Prescription Last Modified Date
The prescription last modified date has been added to the tooltips in encounter notes. To view the tooltip select the EMR icon > click the Encounter Notes tab > hover the mouse arrow over the specific medication.
Refactoring:
AccDocs Folder
The message displayed when the AccDocs folder is unreachable (usually due to permissions issues) has been updated to make the reason a document cannot be accessed more easily understood. The message now says, “Accuro cannot connect to the location specified or the file no longer exists. Please confirm that is available from this workstation or contact IT services for assistance.
Note: If restricted folder access is enabled and the password is invalid or the login is incorrect or AccDocs can be reached but the file does not exist in the patient folder then a different message is displayed to identify the issue.
Graphical User Interface (GUI)
Some updates have been made to how Accuro updated the display GUI to prevent possible issues of display fragmentation.
Patient Search Performance Improvements
Changes have been made to patient searches to improve the performance and reduce the time taken to return patient search results.
Reporting:
Accounts Receivable Subledger Report (MB, ON)
A new aged accounts receivable subledger report has been added. This report is organized by aging columns for days outstanding from the date the report was generated. The days outstanding are grouped into 0-30, 31-60, 61-90, 91-120 and 121+ days. This report is based on submission dates and so billing period (whether enabled or not) have to effect. To access reports from anywhere in Accuro press Ctrl+R.
Billing Period Report Header (MB, ON)
An update has been made to the billing period report headers to ensure they all have the text “For Period Ending ” in the header and to print out on every page. Previously the billing period end date was only printed on the cover page of each billing period report.
Medical History by Date in Alerts (Query Builder)
When using the Alerts (Query Builder) to run a report on Medical History by Date only the start date displays in the results. An update has been made so that the end date now also displays in the report. To access Alerts (Query Builder) click Reports > Select Alerts (Query Builder).
Private Payment Summary Report
Updates have been made to the way the Private Payment summary report is run to reduce the time taken for the report to be generated. To access reports from anywhere in Accuro press Ctrl+R. Scheduling: Apply Appointment Status to Multiple Appointments Users can now apply the appointment statuses of Arrived, Confirmed and No Show to multiple appointments at the same time. This new feature can be controlled as an office specific preference and is configured in Users > Manage Security > Offices > Preferences > Scheduling.
The options available are:
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“Never Apply”, only apply the status to the selected appointment;
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“Ask Each Time”, if the patient has multiple appointments for the day the user is asked if they want to apply the status to all appointments and
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“Always Apply”, if multiple appointments are found the status is automatically applied to the patient for this day.
The default is Never Apply. To access appointments select the Scheduler icon.
Deselect Appointment when Changing Patients
An update has been made to that when a global patient is changed any appointment that may have been selected is deselected when the patient is changed.
Jump Ahead in the Scheduler
The jump ahead feature has been expanded so users can now jump ahead by days, weeks or months (previously users could only jump ahead by days). To access the jump ahead feature select the Scheduler icon > right-click on an appointment clot and select Jump Ahead.
New Additional Scheduler Header Title
An option has been added to enable the current date to be displayed at the top of the scheduler window. When this option is enabled and the scheduler is in Single Day mode, the date is displayed in a header at the top of the window (e.g. 13-Feb-2013 (Wed)) .To display the current date click Scheduler > select Preferences > click Priorities and Settings > select the Display Date in Single Day Mode checkbox in the Schedule Titles section.
Stat Holiday Display
An update has been made to the header in the scheduler for stat holidays. When a day is a stat holiday the column header in the scheduler is colored green. This is to assist clients and to help prevent them from inadvertently booking appointments on a stat holiday.
Security:
Managing Document Sub-Types
Permissions for document sub-types are now controlled by the same permissions as full document types (Users > Manage Security > Roles).
Using Save As in Clinical Note Templates
The permissions to use “Save As” in a clinical notes template has been changed to require the same permissions as required in the template wizard. This is to prevent users who do not have template permissions from saving templates under new names and effectively creating new templates. To access a Template from clinical notes select the EMR icon > click the Encounter Notes tab > click the down-arrow in the Clinical Notes section.
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.
Waitlist Audit Logging
Expanded the waitlist activity that is tracked in the audit logs. To access the audit logs click Users > select Manage Security > click Audit Logs.
WaitOne Module (BC)
The new WaitOne - Orthopedic module has been added to Accuro. This module is designed to standardize the data collection for Orthopedic Referrals in order to extract and combine data to achieve accurate statistics on wait times. Accuro creates data that is maintained and delivered as an update list to WaitOne clinics. The complaint and refusal reasons are lists that are maintained by Optimed. Users cannot manage and add items to these lists. If a site requires further choices to be added to the list they must contact Optimed. This is because the data being collected is standardized and all WaitOne clinics therefore have access to the same droplists. Once the WaitOne module has been activated users can select WaitOne – Orthopaedics for appropriate waitlist entries and select the complaint and refused reasons.
To update an item on the waitlist for WaitOne follow the procedure below:
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Click the Waitlist icon.
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Double-click the appropriate entry on the waitlist. The Edit Request Window is displayed.
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In the first dropdown (at the top of the window) select WaitOne – Orthopaedics.
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In the referral section towards the bottom of the window click the arrow to the right of Complaint and select from the list displayed.
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In the referral section towards the bottom of the window click the arrow to the right of Refused Reason and select from the list displayed, if appropriate.