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EHR Patch Updates Office Hours EHRv1.1p9

EHR Patch Updates Office Hours EHRv1.1p9. What ’ s new, What ’ s changed. IHS-Office of Information Technology EHR Program. Office Hour Presenters. CDR Susan Pierce-Richards, ARNP, OIT EHR Project Lead CDR Mary Ann Niesen, PharmD, OIT, ARRA Deployment Pharmacist

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EHR Patch Updates Office Hours EHRv1.1p9

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  1. EHR Patch Updates Office Hours EHRv1.1p9 What’s new, What’s changed IHS-Office of Information Technology EHR Program

  2. Office Hour Presenters CDR Susan Pierce-Richards, ARNP, OIT EHR Project Lead CDR Mary Ann Niesen, PharmD, OIT, ARRA Deployment Pharmacist Barbara Hess, DHA, OIT EHR Project analyst

  3. Agenda Introduction Presenters Office Hour Presenters have different specialties within the EHR system who will be responding to your questions Questions/Answers Please do not put your phone “On Hold” during the conference call “Raise your hand” through the WebEx features provided Please state your name/site Please state your question clearly Please keep background noise to a minimum to better hear the questions/answers Patch 9 Resources Patch 9 resources will be placed on FTP site (RPMS patch folder) for your review after session If you can not access the FTP site please e-mail barbara.hess@ihs.gov for a copy

  4. Fixes

  5. Fixes

  6. Fixes

  7. Fixes

  8. New Features/Changes

  9. New Features

  10. New Features

  11. Med order dialog

  12. Clinical Indication prompt ICD9 coded clinical indication now required for medication orders *** The changes for Med Orders were done to comply with eRx requirements *** • You must select an indication for each med order • New med order will display a blank clinical indication • Not pre-populated with the last entered • This is a change, please alert your providers • Offers Problems, POV’s after filtering out un-coded diagnoses, “Other” • “Other” search returns only coded entries for selection • Renew, Copy and Change pre-populates with clinical indication of the original order

  13. Clinical Indication prompt

  14. Med order field restrictions • Character limit is 140 characters for transmitted prescriptions • Character limit for comments is 210 characters for transmitted prescriptions

  15. Setting Pharmacy type The APSP AUTO RX parameter sets the type of pharmacy you have. You will be required to set this for electronic prescribing.

  16. Benefits of setting APSP AUTO RX • Enhanced Med Order dialog with pick up locations presented to prescriber based on facility type and other configurable settings. • Can enable “Internal/External” and “External” without using ePrescribing • Meds for outside fill are auto-finished and queued for printing • Can help sort out workflow issues prior to eRx • Enhanced printing • CII order for signature, CII prescriptions, Non CII prescriptions and receipts for electronically transmitted prescriptions “queued” • Configurable default settings for formats and printers. • Click sends all jobs to appropriate printers.

  17. Pharmacy Type Settings

  18. Pick up locations Med order dialog has 5 pick up locations exposed to the user depending on APSP AUTO RX parameter settings

  19. Setting Pharmacy Type APSP AUTO RX • set at division or system

  20. CII-V electronic prescribing parameters APSP AUTO RX ERX OF CII • Pre-placed for eventual allowance of electronic transmission • Defaulted to “null” which disallows transmission • Not editable at this time APSP AUTO RX SCHEDULE RESTRICT • Pre-placed for eventual allowance of electronic transmission • Defaulted to schedules 2,3,4 & 5 to disallow transmission • Not editable at this time

  21. Med Order Dialog examples:Pick up locations Internal – Legend and Controlled drugs

  22. Pick up locations Internal/External – non CII, provider has SPI Internal/External – CII or Non CII and provider has no SPI

  23. Pick up locations External – non CII, provider has SPI External – CII and/or provider has no SPI

  24. CII prescribing APSP AUTO RX CII PRESCRIBING You may now restrict CII ordering at the following levels *** • User • Class • Division • System

  25. Printing functionality

  26. Printing functionality • “Smart logic” is used to determine which order requires a print job and if so which type based on • Status (Active or Pending) • Pick up location • Type of drug (Controlled or not) • “Queues” the print jobs for printing • Formats may be defaulted to specific templates • Formats may be defaulted to specific printers at the User, Location, Division and System level

  27. Queue Print

  28. Queue Print

  29. Queue Print After signing, the meds that have print jobs are highlighted and the Queue Print button is active

  30. Queue Print Click the Queue Print button and the print jobs are displayed, associated with pre-defined templates for each format and default printer (user may change)

  31. Reprinting If you need to print a prescription due to failed transmission, re-print due to printer failure, or destruction of prescription you may do so. You may only print the day the prescription was finished and must put in a reason. Reasons for re-printing are logged. • Highlight med you wish to reprint • Click PRINT button • Select Prescription (New Format) • Click “Print” • Select reason • Enter comment (optional) • Select printer (or accept default) • Click “OK””

  32. Order Detail

  33. Rx Print Format (Template) editor Set up: • Design mode> Desktop Properties> Custom Menus • Add Menu item “Rx Template Editor” • Add the following in Action (lightening bolt) $(BEHRXGENERATORSERVICE.RXGENERATOR.edittemplates) • Click Apply and Ok • Make sure you have BEH Rx Generator Service checked under “required services” • Only place on EHR GUI templates of those who are responsible for editing Prescription formats (ie. CAC, pharmacy Ad Pac)

  34. Rx Print Format (Template) Editor Design Mode Rx Template Editor

  35. Rx Print Format (Template) Editor • Template type (format) • Prescription (Non-CII) • Prescription (CII) • Order for signature (CII) • Order for signature (Non-CII) • Receipt (Non-CII) • Receipt (CII) • Template • Default template for each template type delivered with EHRp9

  36. Rx Print Format (Template) Editor Importing template: The files are .ptxml files • Save the files to a local drive • Open Rx template editor • Select template type • Click Import • Change the name if desired, click OK • Click “active on” • Select Yesterday at 6:00 am, then OK • Now you may edit the template • Click OK to store

  37. Rx Print Format (Template) Editor • Active on – set activation date (usually Yesterday at 6:00am) • Preview – Display preview of current template • Import – import template • Export – export template • Add Free Text – you may add as many as you like. May include header info for format, alternate signature lines, etc. • Mark Inactive – inactivates template so users cannot select

  38. Rx Print Format (Template) Editor • Change font • Set fields for inclusion, change print labels, and set columns in the Fields section

  39. Rx Printer Configuration In RPMS set the BEHORX PRINT FORMATS parameter • Associates the Format type with the Format (Template) • May set at User, Class, Location, Division and System level • Most commonly will be set at System or Division level Select Format Type: ?? Instance values are (Commonly set format types) : PC:RX CII PN:RX NON-CII OC:ORDER CII ON:ORDER NON-CII RC:RECEIPT CII RN:RECEIPT NON-CII LC:LABEL CII LN:LABEL NON-CII

  40. Rx Printer Configuration

  41. Rx Printer Configuration Populate the BEHORX PRINT FORMAT TYPE This associates the Format type: Order for signature (CII) Prescription (CII) Prescription (Non-CII) Receipt (Non-CII) with a default printer. • Set at User, Location, Division or System level • In RPMS or in EHR Printer Preferences tool

  42. Rx Printer Preferences Editor Set up: • Design mode> Desktop Properties> Custom Menus • Add Menu item “Rx Printer Config” • Add the following in Action (lightening bolt) $(BEHRXGENERATORSERVICE.RXGENERATOR.EditPrinterPreferences) • Click Apply and Ok • Make sure you have BEH Rx Generator Service checked under “required services” • Users will only be able to set their own defaults • Assign the BEHORX PRINT key for CAC/IT staff who will set Location, Division, System settings

  43. Rx Printer Preferences Editor Design Mode Printer Preferences

  44. Rx Printer Preferences Editor Use dropdown to select level, template type, printer settings. Click APPY to store the parameter. To remove a parameter level, bring up the level and click REMOVE

  45. Rx Printer Preferences Editor RPMS display parameter BEHORX PRINT FORMAT TYPE RPMS enter/edit parameter BEHORX PRINT FORMAT TYPE

  46. Configuration summary

  47. Configuration steps – All Sites *** This is in addition to pharmacy package optimization for eRx and Surescripts® credentialing/set up/deployment ***

  48. Configuration steps – All Sites *** This is in addition to pharmacy package optimization for eRx and Surescripts® credentialing/set up/deployment *** • Review Formats (Templates) for Prescriptions, CII order for sigs and Receipts using the Prescription Print service Template Editor tool and copy/edit accordingly • Set BEHORX PRINT FORMATS parameter to set default format (template) for print Format types • Determine printers for system, division and/or locations and set using Prescription Print Service Printer Preferences tool or the BEHORX PRINT FORMAT TYPE parameter.

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