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.
IMPORTANT NOTICE:
The 2014.03 release of Accuro EMR can take longer than usual to launch Accuro after the first update.
The first update can take between several minutes and an hour depending on how long your clinic has been using EMR and how many doctors are in your clinic.
While Accuro applies change from the update, Accuro will be unavailable for other users.
Please consider this and wait to run the update to 2012.05 at a time of day when it will not impact the operations of your clinic. Be sure to launch Accuro after updating to apply the changes.
Accuro Release Notes Index by Iteration
The largest change in this release is with the Waitlist. QHR has been working on a project to improve the Waitlist module.
These changes primarily to allow you to more easily track both your consult waitlist and your surgical waitlist in single patient requests as opposed to having a separate item for each. For those that are only consults, there is little difference. For those that have both components to your practice, this will offer much improvement.
Here is a brief video explaining the changes: http://youtu.be/dBZuj5zPRTU
A User Guide has been developed for this as well: http://tools.optimedsoftware.com/UpdateNotes/2014.03/Waitlist.pdf
Applying and Editing Templates are now in a different area. The Scheduler Suggestions and Template management are now displayed on their own (this is accessed by clicking Scheduler > Templates and Suggestions). Schedule Template suggestions has also been added to the new Scheduler Suggestions and Template Management window.
For clinics that use schedule templates (color coded schedule backgrounds), we have more options to make it easier and more powerful to apply these.
In the Multiple Day tab, options are now available for Weekly, Monthly and Yearly.
Priority Templates: Primarily built to protect your “clinic closed” (like stats) templates, this is a new property that can be applied to a template and it indicates this template has priority over others. It means that once a Priority Template is on a day, Accuro will protect it from being overwritten if you attempt to apply another template on that day.
When applying the new schedule template series, if there is already a priority template on one of the days, a window is displayed showing the date of when the priority template conflicts with the template the user is trying to apply.
A feature permission allows some users to overwrite the priority template (the default is off). If a user does not have permission to overwrite a priority template, the template is applied as normal, but not to where priority templates already exist. When the message to override priority templates is displayed, users can override specific dates or select override all. If they press cancel, the template is not applied to any days.
Schedule Template Suggestions: The Limit Ad-Hoc Schedule…” checkbox has been removed as this is always valid. Non-active suggestions are no longer displayed on the Schedule Template Suggestions window (there is an active checkbox in the main window where suggestions are added).
In the Scheduler, did you know you can right click the patient demographics and choose what you want Accuro to display? Now there is the postal code available as an option that can be displayed. To access the options, right click then Select Options.
Recently the office phone number extension field was added to the address book. In this release, that extension will now be included in the phone number tag (used in Encounter Notes Templates) and queries (used in Forms).
The Kiosk module has had an enhancement that makes it more user friendly for clinics that have more than one office. The systems administrator can now set a specific office for a kiosk configuration. If an office is set, the patient can be arrived in the corresponding office when there is no appointment. An option has been added that restricts appointment arrival to only the selected office; this means that patients cannot arrive themselves (in one office) for an appointment they have at a different office. To access kiosk configuration click Users > select Manage Security > click System Settings > click Kiosk > click Configuration.
You can upload your EDT submissions to one account, but when ON Health processes the files the responses are put in the appropriate accounts for downloading (if you are in a larger clinic you many have a large number of users with their own EDT accounts). The EDT login selection has been updated to have an “All” option which cycles through all of your clinic’s EDT accounts and download the files for all of them at the same time.
An update has been made to ensure the archived flag is removed from appointments after remittance matching (manual and auto). To access remittances select the Claims icon > click the Remittances tab (Unmatched remittances are located on the Unmatched Remittances tab).
An update has been made to the way the claim details window updates. If a user changed the provider, the new provider’s details were not applied to the fields in the claim details window (if the default information was different e.g. Location, Facility, SCC etc.) Now if a provider is changed all the fields are updated to reflect the new provider’s details. To view claim details select the Claims icon > select the appropriate tab > right-click on a claim and select Claim Details.
An update has been made to replace the process of writing files to disk with storing them as data in Accuro's memory. Previously they were written so they were collected and submitted through a web site; files were retrieved and processed in Accuro.
An update has been made to the Remarks Editor window to allow users to use the OK and Cancel buttons via keyboard shortcuts. To access the Edit Remarks window select the Claims window > click the appropriate tab > right-click on a claim and select Claim Details > click the Edit Remarks button (in the Claim Details section).
Accuro uses the received date as the payment date because a payment date is not assigned to the remittance file returned by MB eHealth. This is not accurate unless the responses are retrieved on the actual payment period date (15 or last day of month). A right-click option has been added to the payment period list called “Edit Payment Period” if selected this opens up a separate window that allows users (with administrator permissions) to be able to select and assign different dates for payment dates. Any changes are recorded in the audit logs.
Note: If a site is using billing periods they can only change the payment date of a remittance in the current billing period to another date (also in the current billing period). In addition, if a client is not using billing periods, the payment date cannot be any date that is earlier than the date of service on the bills.
This feature permission is only enabled by default for administrator, for other users it has to be enabled in Users > Manage Security > Feature Access.
While investigating another issue a developer identified a few issues, these issues have been fixed as described below:
MSP Response Files (BC)
All MSP response files were left marked as unprocessed even after processing. An update has been made to ensure that once the files have been processed, they are marked as processed.
Error Handling for MSP Response Files (BC)
When error occurred in the handling of MSP response files a success message was being displayed. An update has been made to ensure that when a response file is not handled correctly, the appropriate message is now displayed.
Error During Processing (All Provinces)
If there is an error during processing; the error is now added to the file that caused the processing error.
XSD Validation (AB)
When an error occurred running the XSD validation on a submission file, the submission file was output to a log file. An update has been made so this is no longer done (for privacy reasons) and the XSD validation file is now logged in the error logged.
Following a recent update that introduced the new remittances panel users were able to match error items to claims and there was no way to undo these items matched in error. An update has been made to enable users to undo manual matching in Accuro. To unmatch an error item right-click the error item on the Remittances tab and select Undo Manual Matched Response.
Accuro has a very comprehensive activity log which can grow in size over time. This can cause performance issues and also disk space issues. An administrator can now archive old activity log entries. If a user tries to search for an activity that is in the archived log, a message is displayed saying that some activity logs have been archived and therefore aren’t included. Should information be required from an archived log, they can be restored. To access the activity log archive click Users > select Manage Security > click Audit Logs > click the Archive tab.
An enhancement has been made to the CDM/QIP Export window; users can now view their previously exported CDM forms. The view of previously exported forms can be filtered by provider and by date range. To perform an export click Reports > select QIP CDM Worksheet Report Activity Note: Users can only select providers that they have EMR access to.
An update has been made in the lab panels of CDM forms to allow non-numeric lab values (e.g. < 3). The fields that can now accept non-numeric values are:
eGFR
Urine ACR
Lipid Panels (HDL, LDL etc.)
Microalbumin
If your export includes masked data Accuro will now let you know. The data that is being included in the export is now checked and if something is masked in any way (e.g. the current user does not have access to) then an exclamation mark is displayed next to the Review button (on the CDM worksheets). If you then hover over the button, a tooltip “this patient has data that may be excluded in the export” is also displayed. This icon is only displayed for SK QIP/CDM worksheets and only if the CDM Export module is enabled. To access CDM worksheets select the EMR icon > click the Encounter Notes tab > click the dropdown in the Clinical Notes section.
The following indicators in the CDM forms now have additional mapping:
CHF (Chronic Heart Failure) worksheet: ACE and ARB (this is a mapping to medication ATC code
CAD (Coronary Artery Disease) worksheet: Acute MI (this is a mapping to the problem in the history of problems).
Mapping of lifestyle to a date field (if there is no date on the lifestyle item then it does not get mapped).
For clinics printing batch charts sheets where there were a large number of sheets being printed sometimes these were not printing. This occurred because all the chart sheets were being loaded into the memory at once even though the actual printing was broken down into printing batches of 100 at a time. An update has been made to ensure that loading the chart sheets is now also broken down into chunks to prevent the memory issues associated with loading them all at one time. To print chart sheets press Ctrl+F9.
An update has been made to lab ID management to set a parent group on lab sources. This has been added because some provinces receive labs from several lab sources and the same lab id was being used across all of the lab sources.
The diagnosis codes are based on the official ICD-9 list, but they were not getting updated when the ICD-9 list is updated. An update has been made to ensure that when the ICD-9 list is updated, the diagnosis codes are also updated.
Where an allergy has been marked as inactive, the status of the allergy can now be restored. Restoring an inactive allergy is done in the activity logs and a user needs administrator permissions. To restore an inactive allergy click Users > click Manage Security > click Audit Logs.
Labs and other interfaces that process files from the file queue have now been given minimum processing version control. This is because sometimes an update is required to the software that processes the files from the queue, the changes are released, but sometimes not all workstations update. This means there is a possibility that files could be processed using both the new and the old version of the interface software. This control has been added to ensure that files are all processed with the same version of the software.
Audit Logging has been created for Ontario Health Card Validation web service activity. This includes:
Transaction id
Service User
End User identifier
Time / date / duration
Action / event detail
Simple success or failure
Exit status / messages
Error Messages
A new column has been added to the Fee Code Revenue report (between Fee Code and Billings) displaying the total of the billing quantities for each billing of a fee code. To access reports from anywhere in Accuro press Ctrl+R. Note: These reports are only available to sites with billing periods enabled.
A system setting has been added for the default availability of new ad-hoc schedule suggestions for an office (the default is enabled). Where clinics want to be able to use separate lists, this system setting should be disabled to prevent users randomly adding new schedule suggestions. To access Limit Ad-Hoc Schedule Suggestions checkbox click Scheduler > select Preferences > click the Schedule Template Suggestions tab.
When validating a health card in the traffic manager the results window was not displayed, a tooltip was displayed instead but this contained less information. An update has been made so that the same results window displayed when validating in the scheduler is now also displayed in the traffic manager. To validate a health card in the traffic manager select the Traffic icon > right-click on the patient on the list and select Validate Health Card.
Warning messages have been added to Accuro that will be displayed if a user isn’t running Java 6 or Java 7 or if users are using a trial/evaluation version of SQL or when a non-Oracle version of Java is used.
Open Provider Permissions Changes Following feedback from clients, the following changes have been made:
Any reference to Physician has been replaced with provider.
The “Select New Providers for Open permissions” window is now displayed in alphabetical order (previously it was alphabetical order per office for clients with more than one office).
The lists of providers listed by Provider or by Role are now also listed in alphabetical order (previously these were also listed in alphabetical order per office for clients with more than one office).
To access open provider permissions click Users > select Manage Security > click the Open Providers tab.
Following the recent branding changes the Accuro Updater has been updated with the new icons and company logos.
Once a bill has been submitted, Accuro prevents the bill from being deleted. It was found that with one specific and unusual workflow it was possible to delete a bill that had been submitted. An update has been made to ensure that should a user happen to use this workflow, bills can no longer be removed.
The bill submission table is not used in Alberta, Manitoba, Ontario and Nova Scotia so it has been removed from the database. Cancelled Appointments in Quick Patient Appointment View (F4) When viewing a patient's cancelled appointments in Quick Patient Appointment View (F4) they were being displayed in no particular order. An update has been made so that cancelled appointments are now displayed by their date in descending order.
When a user changes an insurer in appointment details and then saves, the insurer was being updated but billing controls were not being checked. An update has been made so that if an insurer is changed in appointment details, billing rules are checked to see if the change is permitted. To access appointment details select the Scheduler icon > double-click on an appointment to view the Appointment Details.
When the Lab Viewer or Encounter Notes were open and the user switched patients, no warning was given about the open documents before the patient was switched. An update has been made to ensure that when a user switches patients a warning message is displayed reminding them that they have other windows open containing patient notes.
Custom diagnostic codes were incorrectly labelled as ICD9 instead of CUSTOM. An update has been made to ensure they are correctly categorized as CUSTOM.
When a user had grouped components and then one component was deleted, the next component was inheriting the properties of the deleted component. An update has been made to ensure that when a component is deleted its properties are removed and all other components in the group remain unchanged. To access the form editor click Tools > select form Editor.
The form under construction icon was easy for users to miss. The button has been changed so that the under construction is a red tool box and the form when it is not under construction has a black toolbox. The button toggles between the two states. To view the under construction button click Tools > select Form Editor > open form and the button is located at the top of the window.
When a form was opened in the form editor or on a patient’s virtual chart, Accuro was prompting the user to save the changes, even if the form had not been changed. An update has been made to ensure that if a form has no longer changed, users are no longer prompted to save any changes. To access the form editor click Tools > select Form Editor. To access the virtual Charts select the EMR icon > click the Virtual Chart tab.
When a user selected to add an immunization in the Immunization Summary area of encounter notes; if no lot and expiry are selected and they clicked OK, the immunization was recorded in the immunization history band. This was a bug where the “Administered/Completed” checkbox was pre-ticked when it should not have been. An update has been made to ensure that the “Administered/Completed” checkbox is not selected. To access the Immunization Summary select the EMR icon > click the Encounter Notes tab > the Immunization Summary is located on the right-hand side of the window.
Lab Results were always being loaded with metric values (even if the user’s preference was imperial). An update has been made to ensure that any lab results values are loaded as per the user’s preference.
An issue was identified when a user adds or changes insurer information in their Accuro. If the local time on a user’s computer was ahead of the computer on which the changes were being made the insurer information (or changes) were not available to the user and this would prevent the insurer from loading. An update has been made to ensure all users are updated at the same time to prevent and issues with loading insurer details.
When a site had legacy printing enabled and printed a label from the scheduler, the label was not printing as expected (they selected centered and it wasn’t). An update was made to the label manager to ensure that label printing would be correct. To print a label from the scheduler select the Scheduler icon > right-click on an appointment and select Labels.
A very large site reported they were unable to run the Manitoba Bill Response Export on many months’ worth of data (for all providers). An error was being generated saying that the query processor had run out of resources. An update has been made to the way the export works, it now works on groups of 1000 records at a time to reduce the memory required to run the export. To run the Manitoba Bill Response Export click File > select Export > click Manitoba Bill Response Export.
An update has been so when the documents of two patients being merged are copied from the original patient’s folder, a check is now made to ensure the files have been copied successfully before they are deleted. To merge two patients select the Patients icon > The Merge button is located at the bottom of the window.
A client reported that office provider assignment seemed to be freezing as the progress bar was not moving. An update has been made to ensure the progress bar displays more accurate information for the user. To mass assign click Tools > select Admin Tools > click > Office Provider Assignment.
When a user opens a document that is already being edited by another user a message is displayed saying that the document is locked for editing. The message displayed was not taking into consideration the user’s time zone and so in some instances the time could appear off. An update has been made to ensure that the time displayed in the message uses the correct time zone.
An update has been made to the Patient Billing Summary and Outstanding Invoices reports to ensure both reports display HST in the provinces where this is applicable. To access reports from anywhere in Accuro press Ctrl+R.
Whilst QA were testing some software changes they found that it was possible to break a patient search by attempting to search by patient name and health number at the same time. An update has been made to ensure that if multiple fields are completed Accuro will search without any errors being generated.
An investigation found that not all deleted transactions were removing the amount from paid bills. This was because there are two ways in which a delete could be marked by the government; one way was supported and the other was not. An update has been made to ensure that both methods of marking a deleted transaction are supported.
Referring Physician could always be selected on the Query Alert rules; this change was to fix it so that users could find patient records which did not have a Referring Physician. The search for an absence of the physician was broken.
When an invoice was created, in some circumstances it was saved automatically to the virtual chart, in other instances the user was prompted to save. An update has been made to ensure that users are now always asked if they want to save an invoice to the virtual chart. To generate an invoice select the EMR icon > click the Day Sheet tab > right-click on a claim and select View Bill > make any changes > press Save and Close > The Generate Invoice window is displayed.
Note: When an invoice is saved to a chart, there is a prompt “always perform this action” if this selected all invoices are automatically saved to a patient’s chart. A User Preference has also been added that has the same effect (File > User Preferences > Display > EMR Workflow tab)
On the Unmatched Remittances tab in Claims if a user adjusted the width of any of the columns, left the tab and then returned, the width of the columns was reset. An update has been made so that when a user adjusts the column widths, the settings are remembered for the next time the Unmatched remittances tab is accessed. To access the Unmatched Remittances tab select the Claims icon > click the Unmatched Remittances tab.
If the single provider mode is selected in the documents area of Accuro (Documents > Gear button) and the user changes the selected provider, the global provider is now changed to be the provider that the user has just selected.
With clients that have an extremely large number of patients, a developer saw that patient search was taking a long time. An update has been made to the way that the search functions to improve the efficiency in the way the software runs and to decrease the time taken to search for a patient.