AUGUST 2013 CLINICAL UPDATE

1. AUGUST 2013 CLINICAL UPDATE

2. CNA • Changed login process • CNA for CNA and Nurse have been combined. The new welcome screen has functions based on security settings in CNA touch • Release notes includes instructions for your system administrator to change the launcher

3. CNA Old Look- Nurse Old Look- CNA

4. New CNA-Welcome Screen Overview

5. CNA- Resident Selection Old- Residents appear after clicking/touching record action New- defaults to assigned residents on welcome screen

6. CNA-Add Resident Residents are now filtered by assigned CNA, all residents or only unassigned residents

7. CNA-Missed Data Clicking on the MT will bring up any missed entry

8. CNA- Default Profiles • The edit default profile has been separated from edit profile

9. CNA- Vital Signs • Text on the CNA Vital Sign screen is more legible • Automatically goes to selected vital sign for data entry

10. Docs Manager • Cosmetic changes • Bolded the text in the ‘From’ and ‘Thru’ fields. • Changed ‘All Files’ Label to ‘All Folders’. • Scanned Documents are now listed in Date Order

11. Rehab touch- G-Codes • Added G-Code Prompt for PPS residents

12. Rehab touch- G-Codes • If set to no in security, it is grayed out in non-PPS

13. Rehab Touch- G-codes • Improved display for the selected modifier buttons in the “Report G-Code Data” screen. Selected buttons are now highlighted using light green background color. • Auto-populates to 1

14. Medication Directives • Allocated more vertical space to the Directives Area to reduce the amount of scrolling need to view listed directives

15. Next Day Column eMARhistorywindowdisplaysanextdaycolumninthegrid. Convenientforusersworkingonthenightshiftwhoadministerearlymorningmedications, totheresults of earlyamadministrations.

16. MAR/TAR Report Page Footer Changed MAR/TAR Report page footer to display up to 7 Diagnosis’s, 7 Allergies and 14 Initials A separatepagewillbeaddedforresidentsthathavemoreDiagnosis, AllergiesorInitialsApplied

17. Extended Directions Added Added Extended Directions to the Additional Information Window, which appears when user clicked magnifying glass icon in eMAR, and eMAR History views

18. Changed the midnight time display format from "--:--" to "00:00" in the eMAR/eTAR History window. MidnightTimeDisplay

19. Proximity Card Authentication eMAR now supports Proximity Card Authentication • For device installation and information please read update release notes pages 22-32 • Note: Until the Proximity Card Reader and Servers are configured correctly, the ADL system will return an ‘Authentication Failed’ error message.

20. Precautions Precautions can now be added in four areas of the system. Through Alert button, Services button , also on the Precautions tab. All areas can be located on the order entry home screen. The last area is the bottom of the eMAR/eTAR screen.

21. Rotation of Injection Sites Captures rotation site for injections and patches in eMAR/eTAR

22. Set up for Patch or Injection rotation site • Click in the box next to ‘rotate injection sites or patch sites’ • Select subcutaneous on the route when writing an order Note: The rotate injection site flag can also be setup in the drug profile using the formulary editor also. (see next slide)

23. Setup for ‘rotation of injection or patch site in the formulary 1. Open the drug master editor and lookup the injectable drug you would like to set the rotate injection site flag. 2. Left click on the flags tab and check the box next to rotate injection sites, the same would apply for setting patch site.

24. Rotation injection site once setup in the formulary 3. Left click on the button. Note: The drug will now appear in order entry with the Rotate Injection Site already checked.

25. Email message to ADL Support Added ability to send an email message to ADL Support directly from inside Optimum EMR Please read page 37 of release notes on setup information. Note: In order for this feature to work, am email program must be installed and configured on your system. If no email program is loaded onto the computer or system, a pop up message will appear alerting you that Optimum EMR could not find an email program. If an email program is installed on your system, but not configured to send emails, the program will open and you will be prompted to configure your email settings. In either one of these scenarios, please contact your system administrator or IT – department to install and setup an email program on your system.

26. Host name and user id added to title bar

27. Creating discharge orders Added new function for creating discharge orders from active orders To create discharge orders from Active Orders: 1. LeftclickonServiceandthenCreateDischargeOrders. Note: Creating Discharge Orders can only be done by persons with prescribing privileges.

28. Discharge Orders 2. Left click in the Check Box next to the active orders you would like to create as Discharge Orders.

29. Discharge Scripts 3. Left click on the button to write discharge orders Note: This will create discharge orders.

30. *Discharge scripts* • Facility must contact your state government to obtain legal prescription paper for printing. • Same as when facility orders the facility pad.

31. Set up for Days of the Week Login to Optimum Security 2. Left click on the System Parameter menu item. 3. Left click on the Orders Category. 4. Select a level (Facility or System) from the facility drop down menu Facility 5. Left click on the Days of the week on line item located near the bottom of the list. 6. Left click on the Yes radio button at the bottom of the parameters screen. 7. Left click on the Save.

32. Setup for days of the week

33. Days of the week Order • If Every Other Day option is selected in the Schedule Screen then the order's frequency will be shown as frequency_name (every other day starting with exact_day at scheduled_time) Example: •  Daily frequency is set for Sun, Mon, Tue, Wed, Thu, Fri, Sat in Orders Management (9:00am) •  Daily frequency is changed in Orders Entry to Every Other Day starting with Wed for a specific order As a result, the frequency will show Daily (every other day starting with Wed at 9:00am)

34. Days of the Week Order

35. Days of the week Order

36. Order Type Filtering You can now drill down the order type of expiring order.

37. Diagnosis and Allergies Display Diagnosis and Allergies will now display horizontal on all Order Reports and Physician Orders.

38. Add Doctor • Login to Optimum Security • 2. Left click on the Order User Level • 3. Select a user role in the Role Drop down menu . • 4. Left click on the Functions radio button • 5. Scroll down to the selection that says Add Doctor and place a check in the column next to it.

39. Add Doctor

40. Add Doctor Note: if access to this feature is restricted, the add Doctor button will be disabled as shown in picture above.

41. Notification Button The Notifications button is lit differently based on who is logged into the system. If a doctor is logged in, we used to check orders that need signature for the last 7 days. We will now check orders that need signature for the last Notifications Lookback Period number of days. Therefore the way orders are counted in order to light the Notifications button will now match the way orders are counted when the Sign Orders screen is open. If a nurse is logged in, we used to check orders that need to be noted for the last 7 days for both Note Orders and Note Orders - 2nd Signer screens. We will now check orders that need to be noted for the last Notifications Lookback Period number of days. Therefore the way orders are counted in order to light the Notifications button will now match the way orders are counted when the Note Orders / Note Orders - 2nd Signer screens are open. Also, when a nurse is logged in, we either show the regular Note Orders screen or the Note Orders for Each Shift screen based on the Note Orders option system parameter, which determines how the Notifications button will light up. I

42. Notification Button If Note Orders option = Note Orders, we check orders that need to be noted in the: o Note Orders screen, if 2nd Signer on Confirm = NO (this means the Note Orders - 2nd signer screen is not used therefore we don't need to count those orders) o Note Orders and Note Orders - 2nd signer screens, if 2nd Signer on Confirm = YES (this means the Note Orders - 2nd signer screen is used therefore we need to count those orders) If Note Orders option = Note Orders for each shift, we check orders that need to be noted in the Note Orders for each shift screen To enable this feature: 1. Login to Optimum Security 2. Left click on the System Parameters menu item. 3. Left click on the Orders Category. 4. Select a level ( Facility or System) from the facility drop down menu . 5. Left click on the Note Orders Option system parameter.

43. Notification Button 6. Selecting a setting from the Code Table drop down menu that you wish to set and then click on the Save button.

44. Pay source Checking • AddedsystemparameterforusingNegative - Homesubstitutioncodeforresidentswhicharenotcoveredbyanyinsuranceplan. • To enable this feature: • 1. Login to Optimum Security • 2. Left click on the System Parameters menu item.3. Left click on the Orders Category. • 4. Select a level (Facility or Security) fro the drop down menu. • 5. Left click on the Use Negative Home system parameter. • 6. Left click on the Yes radio button at the bottom of screen. • 7. Left click on the Save.

45. Pay source Checking

46. Pay source Checking

47. Pay source Checking

48. Pay source Checking

49. Medicare Part D Coverage • Note: The resident's main paysource is Medicare if the resident is covered by Medicare or Medicare and Medicaid. If the resident is covered by Medicare Part A and Medicare Part D, Medicare Part A takes precedence and it considered the main paysource, therefore Part D checking will not be performed. For setup information please read Release Notes on page 52-53.

50. Creating Draft Orders for Residents on Bed Retention To enable this feature: 1. Login to Optimum Security 2. Left click on the Orders User Level 3. Select a user role in the Role Drop down menu . 4. Left click on the Functions radio button. 5. Scroll down to the selection on the list and put a check in the ‘A’ Column next to the “CreateDrafts for Res. DischargedtoBedRetention.