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 regular product releases to all customers. To get the latest release, run your “Update Accuro” at your convenience. Note that once you update one of your computers, all of your computers will need the update run so please coordinate with your clinic. Administrators can lock down updates.
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
Performance
Several changes have been made to improve the performance of Accuro. Please refer to the Performance section later in this document for more details.
CDM Mapping Enhancements
CDM mapping has been improved to allow mapping to a deeper level than was previously supported. Mapping can now be done at the detail level of regular medical histories (e.g. Lifestyle and Family History) on the patient chart to specific options within a CDM worksheet element.
Using smoking as an example, previously if a user selected smoking as a Lifestyle to map to a CDM worksheet element, but had sub-details setup for the Lifestyle entry (e.g. Smoker, Non-Smoker: Quit within last 6 months, 2 packs a day) they would not be able to indicate a specific detail and the smoking Lifestyle entry would be shown as a new option on the CDM Worksheet element it was mapped to.
Now, mappings can include the details of the CDM worksheet and the medical history. If a CDM worksheet had an element for Smoking Status with the options of non-smoker, ex-smoker, smoker: actively quitting, smoker: contemplating quitting, smoker: no plan to quit, and smoker: relapse, then a mapping can be made between any of these options and he Lifestyle history of smoking with the appropriate detail. So if the patient has the Lifestyle of Smoker with the detail of Quit within last 6 months on their chart, the CDM worksheet can now be setup to automatically select ex-smoker and the 2 packs a day detail setup to select smoker: no plan to quit.
To access CDM worksheets select the EMR icon > click the Encounter Notes tab > click the down-arrow in the Clinical Notes section. The Lifestyle section is located on the right-hand side of the Encounter Notes window.
CDM Worksheet Display
The following changes have been made to CDM worksheets:
-
Recent Values: When Select Recent Values is used the worksheet now displays the appropriate rows with a pale pink background. Users can click the background to toggle between pink, yellow and green.
-
Next Due: When a CDM worksheet is opened and none of the current value items have rules for next due dates the Next Due and Next Due Indicator columns are now hidden.
To access CDM worksheets select the EMR icon > click the Encounter Notes tab > click the down-arrow in the Clinical Notes section.
CDM Worksheets
Popups can now be added to CDM Worksheets that may include relevant reference information, links to internet references or directly embedded material for display whilst working in a worksheet. For more information on this feature please refer to the User Guide. To edit a CDM form click Tools > select Edit CDM Forms. To access CDM Forms select the EMR icon > click the Encounter Notes tab > click the down-arrow in the Clinical Notes section.
Note: Not all provinces mandated forms can be edited.
Form Editor Enhancements
Following recent changes to forms, the following enhancements have been made to further improve the usability of forms:
-
When being edited multiple components can be selected and moved around together.
-
Once a component has been selected it can be moved by using the arrow keys on the keyboard (use Shift+Arrow for bigger moves).
-
When multiple components are selected users can now use the right-click menu to edit fields that are common across all the selected components (these fields are Name, Tag Name and Font).
-
A new feature which is useful when using formulas is that formula components can be set to hide when they are being viewed on a patient chart.
-
The minimum font size is now 6.
-
If a user tries to load a new form they are prompted to save the current form to prevent any changes from being lost.
-
If a user tries to close a form they are prompted to save.
-
The user interface (buttons etc.) has been tidied up.
-
A Tools menu option has been added (at the top of the Edit Repliforms window), this is where Export Form From File, Export Form To File, Publish/Download and Configure are now located.
-
The Form Component Editor has been updated to allow editing to be quicker and easier.
To access the form editor click Tools > select Form Editor.
Messages and Patient Login (Kiosk Module)
The following changes have been made to the kiosk following feedback from clients:
-
Messages: Messages have been enhanced to allow users to take advantage of full HTML formatting. This means that images can now be used.
-
Login: To make it easier for clients to login the following changes have been made: The patient password field has been unmasked so patients can see their date of birth when it is entered. Not all patients have a health card number and so were unable to use the kiosk. An update has been made so that patients can login provided they have 3 out of 4 of the following: 1. First initial and last name (e.g. jdoe, this is not case sensitive) 2. Health card number 3. Date of birth 4. Last four digits of their phone number
-
Configurable: Kiosks can now be configured so that the steps on each kiosk are different, for example, some can be used solely for forms and others for patient login etc. To do this in the Kiosk settings the user can set the desired functionality per kiosk. To access the kiosk settings click Users > select Manage Security > click System Settings > click the Patient Kiosk tab.
Maintenance and Issue Fixes
Accuro Web:
Launching on SQL2000 Server (Accuro Web)
Accuro Web startup was failing on SQL2000 Servers. This was caused by the way that indexes were being fetched. An alternative method of fetching the indexes has been used to prevent this from occurring anymore.
Update Lists Window, (Accuro Web) (ON)
When a user clicked the Update button in the Update Lists window an error occurred due to a missing handler file. An update has been made to use our own custom handler file to prevent this from happening.
Allergies:
Copyable Medical History and Medical History Tags
Allergy details are now included in both the copyable medical history and medical history tags. The copyable medical history can be found by clicking the EMR icon > click the Encounter Notes tab > click the Copyable History button (top-right of window, button with two pieces of paper). The medical history tags are found in the form editor by selecting the EMR icon > click the Encounter Notes tab > right-click on an entry and select Generate Letter > click the Medical History button > Allergies is located approximately half way down the scrolling list.
No Known Allergies, Audit Logs
The adding and editing of allergies is logged in the Audit Logs, an update has been made to include the addition of “No Known Allergies” when it has been added to a patient’s EMR. To access the audit logs click users > select manage Security > click Audit Logs.
Billing:
Aged A/R Subledger Report (MB)
The following changes have been made to the Ages A/R Subledger report:
-
Billing response codes 71, 72 and 74 that are treated as pending have been added. Previously only billing response code 73 and only partial results were presented.
-
The last pending date is now on the report and displayed in a format that is clearer for users.
-
A header is now displayed on the top of each page of the report (previously it was only on the first page).
-
The report no longer filters out items invoiced today (so it now matches the A/R section in Accuro).
-
In Accuro there is now a report description on the right-hand side of the window explaining what the report does and how it is used.
To access reports from anywhere in Accuro press Ctrl+R.
Claim Querying
When the software is accessing the billing database some scenarios can involve thousands of entries and take a long time. An update has been made to the database to break the queries into smaller batches to enable them to run faster and be more manageable.
Hospital Fee Codes (ON)
Ontario’s hospitals must bill Diagnostic Radiology, Ultrasound and Technical Diagnostic codes at 7% less than the Independent Care Facilities (as instructed by the Health Insurance Act of 1999). Some lists have the 7% included in the price and others don’t. It was also determined that sometimes the 7% isn’t exact. This resulted in billed amounts and paid amounts not matching. To assist with this issue, an override button has been added to the right of the General Practice Fee text field in Manage Procedure Codes. This button is for overriding so that the billed amount can be adjusted to match what was paid. The price that is overridden will be overridden until the next fee schedule update for that code.
Opening a New Bill in Claims Using Ctrl+B
If a user edited directly into a claims table and then used Ctrl+B to open a new bill, the claim table was displayed on the top and the new bill window was hidden. An update has been made to ensure that the new bill window stays on top.
Preferences in the Claims Section
An update has been made to the claims section so that when a user repositions, adds or removes columns etc. all these preferences are remembered for the next time. In most cases this was already being done, but some instances were found where the changes made by a user were not being remembered.
Remittance Totals Report (MB)
When users filtered the Remittance Totals report to run on one remittance date, the report had “For all remittance date” written at the top. An update has been made so that the actual remittance date is now written at the top of the report. To access reports from anywhere in Accuro press Ctrl+R.
Site Field in Claim Details (MB)
The Site field in Claim details has been moved onto the Bill Details tab (note Show Sites must be enabled in System Settings). To access the Show Sites option click Users > select Manage Security > click System Settings > Show Sites is on the General tab. To access the Bill Details tab in Claim Details select the Claims icon > select the appropriate tab > right-click on an item and select Claim Details > click the Bill Details tab.
Year Field
An update has been made so when a user only adds the day and month in the date input field, the year field defaults to the current year (e.g. 09/13 defaults to 09/13/2013).
CDM Worksheet:
CDM New Diabetes and CAD Worksheets (SK) (Not Yet Available, Requires Conformance Testing)
New CDM worksheets have been created for Diabetes and CAD. These forms cannot be edited (patient information entered on the form can be edited, but not the form itself) to ensure that all users are using the same version of the form. The new worksheets are: Diabetes (SK QIP) Coronary Artery Disease (SK QIP). To access CDM worksheets select the EMR icon > click the Encounter Notes tab > click the down-arrow in the Clinical Notes section.
EMR Fee Requested, CDM Worksheet (SK)
When a CDM worksheet is saved EMR fee requested is checked off in the claim details if there is an appointment on the same day. To access CDM worksheets select the EMR icon > click the Encounter Notes tab > click the down-arrow in the Clinical Notes section.
Documents:
Document Updates, HRM (ON)
The following changes have been made to HRM documents as a requirement for attaining conformance.
-
Support has been added for simple animated gifs.
-
An HRM disclaimer has been added when items are printed from the Image Viewer.
-
When HRM documents are opened within Accuro a warning is displayed that if the document is printed out the disclaimer will not be on any of the document pages.
File Documents for a Provider
A change has been made in the Documents area of Accuro. A user can now only file documents for a provider if they have the correct EMR permissions for that provider. Previously users could file documents as long as they had access to the Documents area irrespective of their EMR permissions. To access documents select the Documents icon.
Export:
New Manitoba Bill Response Export Fields (MB)
Location Identifier (e.g. Out-Patient service etc.) and Site (if enabled) fields have been added to the Manitoba Bill Response Export. To access Manitoba Bill Response Export click File > select Export > click Manitoba Bill Response Export.
External Communication:
Web Updater and Scheduled Restart
Accuro Web Updater and a Scheduled Restart cannot be done on the same instance of ACE. The Accuro Web Updater also performs an ACE reboot (which means that both are done), but only the Accuro Web Updater is displayed in the configuration dropdown (even though both were done).
ACE now prevents both from being enabled as separate functions.
Faxing:
Failed Fax Count
A client reported that the fax count for failed faxes had not capturing retries exceeded. The status of faxes sent in the primary column used to be the status of the fax leaving Accuro and the secondary column would display the status from the faxing software (e.g. Sent and Retries Exceeded). This was confusing, so the status in the primary column was updated so that it reflected the status in the secondary column (e.g. Failed and Retries Exceeded). When this change was made the new status of failed in the primary column was overlooked and so reties exceeded faxes were not included in the fax count. An update has been made to ensure all faxes are included correctly in the fax count.
Unite Inbound Faxing
An update has been made to Unite Inbound faxing, when a user retrieves the inbound faxes they can now select to download the faxes to the current directory or a directory of their choice. When a user first logs in to download faxes a window is displayed that enables users to select the current directory or select a folder.
-
The option of –All- has been added to the login list. If –All- is selected then the options displayed are current directory or the last used directory for each login.
-
For offices with JCIFS downloading to a restricted folder a dropdown of the folders contained within the restricted folder is displayed (instead of the select folder button).
-
User selections are recorded in the activity log.
Forms:
Generating a Letter from a Form
A client reported that when creating a form with checkboxes and then creating a template containing the checkbox tags, not all the tags were being displayed in the generated letter. This issue was found to be caused the checkbox component not having anything in the ‘Select Text’ field and also there was a newline after a pipe character “|” in the list. An update has been made so that any selection that is a single white space character (or selections that only contain newline characters) are ignored. This ensures that all the correct fields are transferred from the form to the generated letter as expected.
Labs:
Abnormal Result Font Color Change
The font color for the entire line of text for an abnormal result is now red. Currently only the test name for an abnormal result has a red font color. This is a global change for all lab interfaces.
Gamma Dynacare Feedback Lengthen Poll Interval
Updated the poll interval for the MB Gamma Dynacare lab feed to every 60 minutes at the request of MB Gamma Dynacare.
Lab Categories Expanded to Include Attachments
Some reports (e.g. YCH) are filed as documents in the virtual chart but were being listed as labs when generating a letter. An update has been made to treat these types of reports as documents in the attachment window. To generate a letter select the EMR icon > click the Encounter Notes tab > right-click on a note and select Generate Letter.
Lab Tracking Window
An update has been made to the software to prevent multiple users from opening the lab tracking window at the same time. This change is to prevent the possibility of items being duplicated or overwritten when lab values are saved. To access lab tracking select the EMR icon > click the Encounter Notes tab > in the labs at the bottom of the window click the INR button.
Lab Viewer Display, Gamma Dynacare (MB)
Following requests to improve readability of labs the following improvements have been made to the lab viewer display for Gamma Dynacare:
-
The larger bolded title of the test is no longer included when there is only one observation and the name of the test is the same as the result.
-
Slight indenting has been added in front of observations under a test which has the title displayed to help identify when the group ends and other observations are listed
This update is a pilot and is currently being tested at selected sites.
Mark as Unread
Users can now mark items as unread; this can be done in Labs, Documents, Tasks, Messages and in the MB eReferrals inboxes. To mark an item as unread, right-click on the appropriate item and select from the menu displayed.
Other:
eReferral Shortcut (MB)
For users with the eReferral module enabled an eReferral shortcut has been added to the Navigation bar. This shortcut is located at the bottom left of the Accuro window next to the Mail, Tasks, Faxes and Letters shortcuts.
Lock to Current Version
A description has been added below the Locked to Version field to describe what this feature does. To lock to a version click Help > select About > click the Version tab.
Performance:
Allergen Groups
An update has been done to the allergen groups’ code to improve efficiency in this area of Accuro. To access allergies select the EMR icon > click the Encounter Notes or Medications tab.
CDM Worksheet Updates
The workflow Accuro uses for automatically updating CDM Worksheets has been improved to improve the responsiveness and performance.
Faxing
An update has been made to the way Accuro looks up faxes. There are no physical changes to the appearance of the fax module, only to the way it works “behind the scenes”.
Initialize Requisition Order
The initialize requisition order form was being called more times than was needed. As this uses resources and affects performance an update has been made to make accessing the requisition form more efficient.
Note: This was affecting any forms that are in the Requisition Forms category. Once these forms are completed for a patient they are saved in Outstanding Requisitions, Referrals and Orders (which is located under Reports on the Tool bar).
Lab Loading
Updates have been made to loading the labs to improve the performance and efficiency.
Office Physician Verification
An update has been made to the way the office physician is verified in the database to make it more efficient and improve performance.
Scheduler Locking
An update has been made to the scheduler locking (that prevents other users from editing a slot when another user is already in it). The scheduler locking now has its own space in the database and there is only one lock for each appointment slot (previously there was one lock for each 5 minute time interval). This new method of locking the scheduler improves the performance of the scheduler.
Submission Performance (ON)
Updates have been made to improve the efficiency of the submissions area of the software when searching for claims in the database. This is to reduce the number of times when the database is accessed when it did not need to be.
Transferring Documents
An update has been made to the database used to register where documents are in Accuro to improve efficiency and performance.
Physician:
New Fields in the Address Book
Following requests from users the following fields have been added to the address book:
-
Provider Address Book: Alternate Number and Email Address have been added. These fields have also been added to the Provider section and the provider window that is launched from the address book.
-
For all Address Book types (i.e. Contact, Pharmacy and Provider): Phone Number Extension has been added for both main and alternate numbers.
To access the address book click Tools > select Address Book.
Prescriptions:
Duplicate Therapy
A message has been added to the Prescription management window to remind users that the management option they select does not actually perform the action. By selecting the option they are stating their intentions in managing the duplicate therapies. When one of the managements listed below apply, an information icon is displayed (between the management dropdown and the Print on Prescription checkbox) and a tooltip reminding the user that the management is not automatically performed:
-
Put Profile Drug on Hold
-
Discontinue existing Rx and proceed with new pending Rx
-
Start new pending Rx after existing Rx
-
Add new pending Rx to existing Rx
Printing Pharmacies on Prescriptions (MB)
An update has been made to default the “Include Pharmacy on Printed Prescriptions” to off in MB, previously it was defaulted to on. To access the “Include Pharmacy on Printed Prescriptions” option select the EMR icon > click the Encounter Notes tab > open a prescription in the Active Medications tab > click the Gear icon.
Printing:
Default Printer Fallback
When the default printer was not available an error message was being generated and the user could not print. An update has been made so that if the default printer is not available a message is displayed informing the user and asking them to select another printer.
Security:
Database Space Warnings
Because of the way the database space was calculated some false messages about running out of space were occurring. The warning message has now been updated to include two checks (for MDF and LDF); either reaching capacity causes the message to be displayed. But if it is the LDF that is reaching capacity then it is cleaned up rather than having a site have to upgrade to the full version of SQL. The warning message is displayed again when MDF is nearing capacity.
Waitlist:
Cancelling an Appointment Made from the Waitlist
When an appointment is cancelled that is tied to the waitlist the user is asked if they want to put the patient back on the waitlist. If the user clicks Yes then a window is displayed and they are given the option of changing the waitlist status to one of the following: Booked, Completed, Cancelled, Deceased, Tentatively Booked or Re-Book. To access appointments click the Scheduler icon.