Clinical Update 2013-01-15 Release Notes January 2013

1. Clinical Update 2013-01-15 Release Notes January 2013

2. CNA CHANGES • Made BM report available in the CNA4CNA TS will be available • Cursor now changes to an HOURGLASS when I&O/Output Report is running • When “Account For” is set to ‘No,’ ‘Bracelet On’ will be grayed out

3. eMAR/eTAR Changes • Added ‘Dosage’ and ‘Meaning to the System’ columns to the Schedule screen for sliding scale orders • Refer to Appendix I in Release Notes • An 'X' is now placed in the eMAR History screen to denote "Not scheduled" for time sensitive orders which have administration times with sensitivity time portions that are less than the order creation time. • Refer to Appendix II in Release Notes

4. Appendix I • BS Sliding Scale (Before)

5. Appendix I • BS Sliding Scale (After)

6. Appendix II An ‘X’ is now placed in eMAR history screen to denote “Not Scheduled” for time sensitive orders

7. eMAR/eTAR Changes • Discontinued orders can now be documented when dc_date intersects the allowed admin window and orders are allowed to span shifts in eMAR. • This means… D/C’d orders will now be available in eMar along with Active orders. • Streamlined Missed Administration process, eliminating the need to hit ‘Save’ twice in order to record the administration of a missed order.

8. eMAR/eTAR Changes This button is now disabled, eliminating the need to click on the save button twice after a missed administration is administered

9. eMAR/eTAR Changes • Improved performance of Resident Lookup, Change Unit and Change Resident operations in eMAR/eTAR • This means… changing Unit or Resident is faster than before. • Modified time format for START, END and D/C date and times on the eMAR/eTAR Main Screen. • This means….. When the system Parameter is set to ‘show TIME with start ,end or DC date’ TIME will display along with dates.

10. eMAR/eTAR Changes • Supported displaying Time & Date in the eMAR History view. • Refer to Appendix III in Release Notes

11. Appendix III After • Before

12. Docs Manager Changes • Categories sort alphabetically.

13. MAR/TAR Report Changes • Added support for Injection and Patch sites. • This means… From History >>Print , additional rows for Injection and Patch site is added. It is now available for those using Printed MAR but not yet available for the eMAR

14. Order Entry Changes • Added ability to remove DEA and License Number from Various Orders Report.

15. Order Entry Changes • Added 'Rotate Injection Sites' and 'Rotate Patch Sites' flags>>Formulary Editor

16. Order Entry Changes • Rotate Injection/Patch Sites

17. Order Entry Changes • Added the ability to choose a D/C time when discontinuing an order • Carried over new 'Rotate Injection Sites' and 'Rotate Patch Sites' flags from Formulary Manager to Orders Entry

18. Order Entry Changes • Changed "<" sign to "<=" sign everywhere in CPOE. • Changed routine for printing short term orders in the Recent Orders screen • Changed the way 'On Hold' orders are displayed so that holds which expire naturally get the label "HOLD EXPIRED" and orders that have the hold removed get the label "HOLD REMOVED

19. Order Entry Changes • Disabled Confirm and Renew / Reorder actions for discharged residents • Doctor signature now display on the Recent orders report

20. Order Entry Changes • Enhanced 'Copy Prior Orders' function to show all orders from a prior stay and allow users to copy specific orders from the list of prior orders. Can Select Specific Orders • Fixed view of Highlighted Order report which affected third level drug display.

21. Order Entry Changes • Implemented adding barcodes to documents saved to the pharmacy folder. • What this means…There’s no system parameter for this feature, however we should point out that barcode images should be saved in the “\GRAPHICS\Barcode” directory • Note: Barcode file names should be MonthlyRecert.jpg and NewAndDCOrders.jpg in order for the appropriate barcode to display on the report. Otherwise the regular MRN-driven barcode will display.

22. Order Entry Changes • Implemented scheduling for a particular day every month

23. Order Entry Changes • Implemented security for order types and order entry screens. • Note: There are 24 Order Entry screen screens to which read or write access can be granted or limited. “Order Types” present on this screen will reflect the order types set up in Orders Management. By default all roles will have Read and Write access to all “Screens” and “Order Types.” • Refer to Appendix V in Release Notes

24. Appendix V Orders Security by Screen/Order Type

25. Order Entry Changes • Implemented linking ‘Sign Off’ to physicians flagged as ‘Attending,’ ‘On Staff’ or ‘Medical Director.’ • Note: Optimum Financial is required. • Once this feature is setup in Optimum Financials, additional setup in Security • Refer to Appendix VI in Release Notes

26. Order Entry Changes • Improved display of Draft Orders by Unit • Improved wording of popup returned when validating sliding scales parameters • Orders Management now supports different schedule times per section and Order Entry will show schedule time for each resident depending on the section to which the resident belongs (Beds/Units) Screen Shot • Refer to instructions for setting Unit, Section and Bed groups at the end of Release Notes.

27. Order Entry Changes • Prohibited renewing or discontinuing 'On Hold' orders using the Monthly Recert screen. • Note: On Hold orders can still be viewed on the Monthly Recert screen, but any further action on that order will be handled separately on the second level. Also, users must first remove the hold to either “Renew” or “D/C” that med. • What this means…When Med is on HOLD, Renew and DC options are not available from Monthly Recert or 2nd level window

28. Order Entry Changes • Set default facility when switching facilities. This is used when a session expires if application is idle and user needs to re-login. • What this means is that if you change facilities while logged into order entry, then walk away from the terminal and the system logs you out after being idle for 15 minutes, when you log back into Order Entry, the facility you log back into will be the same facility you were logged into at the time the system timed out.

29. Order Entry Changes • System now displays 'active' orders with future start date on the first level CPOE screen • System now displays expired orders in the 'Note Orders for each shift' screen • Supported using both "<=" and ">" signs and wording. • This refers to the ‘Dosage’ and ‘Meaning to the System’ columns that were added to the schedule screen for sliding scale orders

30. Order Entry Changes • The 'Sign Orders' screen now displays a complete list of all doctors at a facility-- not only the ones that have orders in the chosen time--providing a way for covering physician to sign all orders

31. Order Entry Changes • Thru Date' on the 'Sign Orders' screen automatically adjusts to display future order dates for trusted physicians • This means that ‘trusted physicians’ which are allowed to sign for other doctors at a facility no longer have to adjust the ‘thru’ dates on the sign orders screen in order to see future orders written by other physicians at the facility.

32. Order Entry Changes • When editing active orders, start date will now automatically change to the current date and end date will automatically adjust based on order duration

33. Order Management Changes • Added ability to specify Injection Rotation Sites and Patch Rotation Sites.

34. Order Management Changes • Added another method for sending reports to recipient's remote folder. • Refer to Appendix X in Release Notes

35. Order Management Changes • Added ‘Dosage’ and ‘Meaning’ columns to the Sliding Scales / Parameters screen • Refer to Appendix I in Release Notes • Implemented scheduling for a particular day every month. • This refers back to Slide 23

36. Order Entry Changes • Implemented scheduling for a particular day every month

37. Order Entry Changes • Made the Orders Management application resizable and maximizable • System now supports schedule times per unit sections. • This refers back to Slide 27

38. Order Entry Changes • Orders Management now supports different schedule times per section and Order Entry will show schedule time for each resident depending on the section to which the resident belongs (Beds/Units) Screen Shot

39. Security Changes • Added exception to current sliding scale / parameter validation process to allow upper limit to be equal to the previous "To" value. • This means that users can enter a sliding scale value that is ‘less than or equal’ to a specific value • Added "eMAR Force Save on Resident Change." • This means that users will be prompt to save changes made in eMAR when they moves to the next resident.

40. Security Changes • Added "eMAR SHOW TIME with dates" parameter to enable drawing an 'X’ in the eMAR History screen. • This parameter refers back to Slide 2: Appendix II

41. Appendix II An ‘X’ is now placed in eMAR history screen to denote “Not Scheduled” for time sensitive orders

42. Security Changes • Added security for viewing reports and noting / signing / approving functions. • Refer to Appendix VIII in Release Notes

43. Security Changes • Created a facility level sliding scale parameter for error checking.

44. Security Changes • Separated 'Confirm/Delete recommended orders' into two parameters. • Refer to Appendix IX in release notes

45. Security Changes • Added system parameter to enable displaying Doctors’ signatures on the Recent Orders Report.

46. Send Orders • Implemented copying new orders report to a remote folder as a backup method for HL7 messages • Implemented sending allergy change reports to remote recipients. • Implemented copying POS report generated from a Monthly Re-cert to a remote folder and display the doctor signature on the report. • Refer to Appendix X in Release Notes

47. Appendix X • Setup instructions for: • Displaying Doctor Signature on Recent Orders Report • Copying POS report from a Monthly Recert to remote folder • Removing DEA and License Number from Order Reports • Implementing scheduling for a particular day every month • Enable auto-adjusting end dates for active orders