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Resource for Training Materials, Tips & Tricks,

EMR Scanning Document List, and more!

Sign in as:

MAs, Receptionist, Med Rec, coders, etc: Username: nurse Password: evolution

Clinic Providers: Username: doctor Password: evolution

CLINICAL SUPPORT SERVICES

MPC Support Newsletter November 2014

MPC Support Team . . . . . . . . . . . . . . . . . . . . . . . . .354-5420

Ambulatory EMR Documentation/Implementation questions, Clinic Employee Training

Fax: 354-5490 Email: MPCSupport@nmhs.org

Tory Lethcoe - MPC Support Supervisor. . . . . . . . . . . . . 354-3365

Email: Tory.Lethcoe@nmhs.org

MPC Clinic Scheduling Maintenance Requests . . . . . . . . 354-4964

Fax: 354-6355 Email: Marcy.Volnek@nmhs.org

MPC Stop Service . . . . . . . . . . . . . . . . . . . . . . . . . 354-6350

MPC Cancel Encounter/Multiple MRN#’s . . . . . . . . . . . . 354-1427 Email: MPC.MRN-EncounterCombine@nmhs.org

MPC Document Scanning Training & Questions/Newsletter . . 354-5636

Fax: 354-6355 Email: Cindy.Johanson@nmhs.org

Deceased Patient Notification: RESDLLMPCDeceasedPatientNotification@nmhs.org

Meaningful Use – Clinic Compliance . . . . . . . . . . . . . . 354-6329

Email: Joshua.Harper@nmhs.org

IT Service Desk . . . . . . . . . . . . . . . . . . . . . . . . 354-2280 opt 2

Computer performance issues, computer or office equipment issues, etc.

Meaningful Use Reminders / Important Information…....... Pg 2-3 Documentation on Clinic Encounters, Health Maintenance, Consult Tasks, & more

Coding Corner – MAR Documentation Reminders…………Pg 4-5

Updates / Common Questions & Answers……………......... Pg 6-7 MRR Tips, MPC Support Training Center Update, Scanning Document Types & more

Scanning Update on Document Types……………................Pg 8 Document Types for Health Maintenance and Meaningful Use

Transcription Tid-Bits………………………………..……………. Pg 9 PowerNote Transcription Pool reminder & contact information

MPC Release of Information (ROI) Clinic Visitations………. Pg 9

MPC Support Training Schedule & Contact Information…. . Pg 10

Contact information, training session times, & important reminders for managers.

Word Search Fun – win a prize!…...…………………….………..Pg 11 MPC Support Newsletter competition drawing - Win a prize! Puzzle answers and

winners of the previous Newsletter drawing.

New Cerner Website for Providers and

Clinical Staff

Information on Cerner Updates!

“Courage…is when you know you’re licked before you begin, but you begin anyway and you see it through no matter what.”

~ Harper Lee

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Meaningful Use Reminders / Important Information

Documentation on Clinic Encounters

All documentation associated with a clinic office visit should be attached to the appropriate encounter. Clinic

office notes, intake forms, patient check-ins, provider letters, chart notes, etc. need to be associated with the

office visit for which the patient was seen at the clinic.

When patients are not at your clinic for an appointment and you need to choose an encounter for phone

messages, medication proposals, or to scan outside documents, etc., it is important to choose the most recent

clinic office visit for your facility/department when selecting the encounter.

If the patient is new to your facility/department, then you will need to create an Outpatient Message

encounter for your facility/department to attach the documentation to. Once the patient has been seen, you

will no longer attach documentation to the Outpatient Message encounter. Instead you will start attaching

documentation to the new encounter which is the most recent office visit for your facility/department.

If you have any questions please call the MPC Support team at 354-5420. Below are some guidelines that will

help outline some examples of what clinic staff should follow:

Examples: If the patient is Encounter type to use

Chart Notes/Phone

Messages

Medication Proposals

Patient Portal Messages

Scanning Outside Records

An existing Patient

Use the most recent clinic office visit appointment for

facility/department.

A new Patient

Use/create an Outpatient Message encounter for facility/department.

Once the patient has been seen, any further phone messages,

scanning, etc. would be attached to the new encounter.

Health Maintenance

Providers - when placing orders from Health Maintenance, be sure to click the ‘Sign Orders’ button at the

bottom of the screen or the orders do not go through.

Example:

MEANINGFUL USE: Documentation such as Patient Portal messages attached to Outpatient

Message encounters do NOT count towards Meaningful Use as those encounters are not

counted on the reports. It is very important to choose the correct encounters for your

facility/department so they count towards Meaningful Use numbers for the appropriate provider.

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Meaningful Use Reminders / Important Information (cont.)

Consult Tasks – New Transition of Care Process

It is very important that all ‘Consult’ tasks are being done by nursing staff. Providers may not be communicating

to their ma’s/nurses that they have entered a consult order or requested their patients set up an appointment

with a specialist consult. MA/nursing staff should check all tasks each day to be sure all tasks are completed

and that consults are set up for patients. This is important for MEANINGFUL USE and patient care.

TIP: If you do not see the ‘Task List Complete/Not Complete’ reminder on the schedule, be sure the box is

checked under the reminders display options:

Example:

After the consult order is placed, the nurse will receive a task in the Task List. They should schedule the consult

and then complete the task by entering the information in the form.

Internal Provider:

If the provider is internal, the nurse should select Methodist provider and still fill in the consult to provider name.

External Provider:

Choose the External Provider option and enter the name of the Provider. (The list will contain both Methodist

providers and outside providers).

If the provider is not listed, enter “No, Ref” for no, referring.

NOTE: MA’s/Nurses need add a ‘Clinic Nurse Documentation’ in Clinical Notes that the consult was scheduled

including the provider, facility and date of appointment. It is also important to note if the patient has been

made aware of this information.

Enter any details you wish in

the Consult Notification Details.

(e.g. if external Provider is

unknown and sent to facility

such as ‘MGI’.)

IMPORTANT: If you know there should be a consult task on a patient, however you are not seeing the task

on your task list, there is a setting that may need to be set on your sign on. Please call MPC Support at

354-5420 and they will set this for you.

The MPC Support team will also be checking this setting while on-site support, please let them

know if you have any questions.

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Coding Corner - MAR Documentation Reminders

When clinic staff are filling out immunization/injection MAR powerforms it is VERY important to be sure these

forms are filled out completely and accurately for insurance, billing and documentation purposes. MPC

Support team will be working with clinic managers make sure MAR documentation is being done correctly by

all clinic staff.

Documentation guidelines to keep in mind when filling out MAR Powerforms:

All fields need to be filled in on the Powerforms for the charges to ‘drop’ and be completed. Only exceptions

are the ‘Witnessed by’ and ‘Waste’ (if there was NO medication wasted after the injection).

Reminder: Check patient insurance before filling out the MAR form.

ADMIN FLU SHOT - Not Medicaid Insurance- Administration (Select this for non-Medicaid patients)

ADM Influenza vaccine-Medicare - Medicare – Administration (Select this for Medicare patients)

INTRANANASAL IMMUNE ADMIN - Not Medicaid Insurance – Intranasal Administration (Select this for non-Medicaid patients)

IA-First Shot - Iowa Medicaid – Administration (Select this for IA MCD VFC patients)

IA-Intranasal/Oral First Administration - Iowa Medicaid – Intranasal Administration (Select this for IA MCD VFC patients)

No Admin Charge - Nebraska Medicaid - No Admin Charge (Select this for NE MCD VFC patients)

Flu Vaccine Powerform Documentation example:

Choose ‘QUAD AMB’ option based on what was given:

Based on insurance, choose the appropriate ‘Intranasal

AMB’ option:

If the vaccine was a ‘High Dose’ vaccine document this

field:

Choose the appropriate ‘TRI AMB’ option that was given:

Choose the ‘Clinic Influenza Admin:’ based on HOW it

was given and what insurance they have:

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Coding Corner - MAR Documentation Reminders (cont.)

If you have any questions on how to document immunization or injection Powerforms please contact

MPC Support at 354-5420.

Enter/select the ‘NDC’ from the NDC dropdown

NOTE: if the NDC you need is not listed, enter the NDC

in the comment field.

NDC Quantity would be 1

NDC Units would be mL

The “Waste” field is to be left blank or marked with a “0” if

there was no medication wasted after the injection.

Fill out Manufacturer, Lot Number, Route, Site, etc. fields as usual.

If Immunizations are NOT given, you can document this by choosing the ‘Not Given’ option choosing appropriate

Exception and reason from options available:

NOTE: more information can be documented in the

comment field as well.

Injection Powerform Documentation example:

Fill out all fields with appropriate information depending

on insurance and injection specific information.

A couple specific items to note with injections:

The “Waste” field is to be left blank or marked with a “0”

if there was no medication wasted after the injection. If

there was medication waste, this field is to be filled out

with the amount of medication that was discarded.

(Example: Botox comes in a 100mg single dose vial; the

patient was injected with 30mg. 70mg must be

documented in the waste field because it was

discarded after the injection.)

If a patient brings their own medication it is important to

note that in the comment field so that the patient is

ONLY charged for the injection fee and not the

medication.

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Updates / Common Questions and Answers

MRR - Medical Record Request Tip

If you need to print documentation that is on a recurring encounter (or hospital encounter) in Medical Record

Request (MRR), you will need to use the Date Range to fine tune what documentation you need to print. Be

sure when looking at the date and time you are looking at the ‘Result date’ line of the header of the result for

this date and time information:

Example:

NOTE: when you enter a date, you must also enter the times.

CMR - Crimson Medical Referrals

CMR is an outside company Methodist has hired to help us with referral tracking process including consult,

radiology, and lab orders. On October 28th, Indian Hills FP & IM, Regency IM and HealthWest Ortho started to

pilot this new process. The nursing staff will enter referral information on a website that will replace the old

papers, stickers and binders they currently use.

The CMR website allows referrals to be sent either internal or external. Staff can attach documents and the

‘Referred to’ provider can send consults and other documents back to us. It also allows clinic staff to see if the

outside referral takes the patient’s insurance. More information on future rollouts in upcoming newsletters.

MPC Support Training Center – 8601 Ste. 116 - Update

The MPC Support Training Center located at 8601 Dodge suite 116 has been redecorated and updated with

new computers! We now have two training rooms, one for large training classes for up to 8 trainees and one

that offers one-on-one training for providers, scanning, or other clinic staff as needed. With the updates and

changes, we hope to make each training experience as pleasant as possible for all trainees.

Training Room ‘A’ (the bigger classroom)

8 workstations and 1 trainer station with all new computers

o New chairs are arriving soon.

o One PC next to training station has SSO, Dragon, and a fingerprint reader

Training Room ‘B’

2 workstations:

o One workstation has SSO, Dragon, and a fingerprint reader.

o One workstation has a scanner installed for scanning training.

New updated main entry

Coffee station with tea and cocoa for trainees

Drinking water dispenser with cold and hot water

Guest Chairs/table

Black & White Printer, color printer, and fax machine

Desk for casual medical records auditor

TIP: Look at ‘Result date:’ when choosing clinical range – you must enter date and time range:

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Updates / Common Questions and Answers (cont.)

Playbooks & Dynamic Documentation

Q: Is there a way using Dynamic Documentation that will satisfy the Diabetic Foot Exam in Health Maintenance

like there is when using PowerNotes?

A: Unfortunately, right now there is not. According to Cerner, they have future functionality with Structured

Doc that will allow this however, there is no information and there have been no demos for us to see at this

point. We would suggest providers continue to use PowerNotes for all Diabetic Foot Exams at this time.

Otherwise, they can be satisfied in Health Maintenance manually.

Q: In Playbooks when using Dynamic Documentation, is it possible to ‘tag’ multiple items in lab?

A: Currently is it not possible, however, we have heard it might be possible in a future upgrade.

Protime Future Orders Issue Identified

Within the Future Orders functionality for lab orders, a potential problem has been identified with Protime orders

when they are placed as “recurring”.

When these are placed, we run the following risk: If a patient comes in for other lab draws, the lab staff will also

see the recurring Protime order and may draw for that test as well, even if it is not necessary at that time.

Because these are dependent on the patient’s INR and not on a set schedule, please advise your staff to only

place Protime orders as one-time orders. The Future functionality can still be utilized as long as they are using

single, one-time orders.

Clinic Managers - MultiMedia Manager – Granting Clinic Staff access to department folders

IT has added a new section to the Sign-On eform on mhsintranet for MultiMedia Manager. Be sure to check this

box and document that the department staff will need access to on the x:drive for person and clinic photos.

This will need to be done by management for new employees and existing employees who need new access.

Please let MPC Support know if you have any additional questions (402)354-5420.

Receptionists – Reason for Exam Quotation Mark Issue Identified

It is important when booking appointments that staff does not use quotation marks when entering a Reason for

Exam. I.T. has identified that the quotation marks are causing an issue with the Visit Summaries from printing out

correctly. If clinic staff wants to quote a patient when entering a reason for the exam, they can enter

identifying wording such as per patient or other identifying wording instead of using quotes within this field.

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Scanning Update on Document Types

Over the last year there have been some changes with document types because of Health Maintenance

requirements and Meaningful Use. The EMR Document List is constantly being updated to reflect these

changes as new document types are created, or definitions are updated with examples. Emails are sent

periodically to clinic managers with these updates.

However, with the amount of changes that are happening there are bound to be changes that some scanning

staff may not be aware of so we encourage all staff to check for updated versions of the EMR document list on

the MPC Support website a few times a year.

Health Coaches are relatively new to Methodist Health System and help monitor patient care; they may ask

medical record staff to scan results/forms to specific document types, especially outside documentation.

Please support them in their requests as much as possible. There are multiple reasons they might be asking for

this to be done. Some document types fall under different ‘Review’ tabs, help satisfy Health Maintenance,

Meaningful Use, or other necessary criteria.

The following document types are VERY important as they help satisfy the Health Maintenance or Meaningful

Use requirements based on the date of the exam so the document types and date of the exams are both

important:

Mammography Note - Outside Mammogram reports/breast cancer screenings

Colonoscopy - Colonoscopies, Panendoscopies, and Sigmoidoscopies results regardless of source.

Diabetic Foot Exam – Diabetic Foot exams - regardless of source

Flu Shot Documentation – Flu shot documentation forms filled out by MA and signed by patient at time

of injection or outside flu shots such as Walgreens, Bakers, etc.

Vision Screening – specifically diabetes eye examination reports, do not scan those to Optho Consults

Depression Screening - Mini mental health/Depression assessment forms filled out by Clinic providers (ex:

VNA Mini mental health assessments, “Mood Assessment Scale” forms, “Alert” Wellness Assessment

forms) - regardless of source

Separating these and other types of documents out (such as EKG’s) and scanning those individually when you

get outside records may seem time consuming, however for the care of the patient, Health Maintenance and

Meaningful Use requirements it is vital that this information is entered into the patient chart as carefully and

appropriately as possible.

If you have any questions, please feel free to contact Cindy Johanson at 354-5636 or MPC Support at 354-5420

with scanning questions. Thank you!

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Transcription Tid-Bits – for Providers

‘PowerNote, Transcription’ Pool Reminder

When sending a document to the ‘PowerNote, Transcription’ Pool asking a transcriptionist to forward the

document to another provider, please remember to give them the first and last name of the provider. This will

ensure the transcriptionist will know the specific provider to send the document to and expedite the process.

Transcription Contact Information:

Transcription Department: Cindy Parr, Supervisor

Phone: 402-354-1436 Phone: 402-354-1435

Fax: 402-354-1544 Email: Cindy.Parr@nmhs.org

Dragon Questions: Hand-Held Questions:

Contact MPC Support at 402-354-5420 Contact the IT Service Desk at 402-354-2280

MPC Release of Information (ROI) Clinic Visitations

Cindy Parr, Supervisor and Erin Miller, Lead for MPC Release of Information will be contacting all MPC clinic

managers to schedule a site visit. The purpose of the site visit will be to review the role of the Release of

Information Department and the services that they provide and answer any questions staff may have

regarding medical record requests.

Report Request (RR) Training for Clinic Staff Update:

Since the Medical Record Request (MRR) go-live we have found a number of clinics would benefit from having

the ability to print multiple encounters/documents at the same time. Report Request (RR) will allow appropriate

clinic staff to print multiple encounters/ documents at the same time. Report Request (RR) is not part of

PowerChart; instead it is a program that is accessed through Citrix XenApp.

We are working with Cindy Parr and Release of information on what they discover on their site visits, clinic

needs, etc. Once their visits have been completed we will contact clinic managers with a training plan.

Release of Information/Medical Record Requests

Please refer patients, facilities, lawyers, insurance, third party callers, etc. to the appropriate ROI

(Release of Information) Department below if they need patient records or if they are checking on a

submitted request. If the caller is requesting images/radiology, direct them to the Imaging Department,

not the ROI Department.

Please use the email(s) for questions, not medical record requests; instead forward those calls directly to

the appropriate ROI Department. As always, MPC Clinics will still handle their own immunization requests

and referral records. When in doubt as to when and what you should or should not print, contact your

ROI department for more information.

MPC ROI Department Methodist Hospital ROI Department

Phone: 402-354-1494 Phone: 402-354-4657 or 402-354-4658

Fax: 402-354-1350 Fax: 402-354-8790

Email: RESDLMPCReleaseOfInformation@nmhs.org

Methodist Imaging Department Jennie Edmundson Hospital ROI Department

Phone: 402-354-4383 Phone: 712-396-7248

Fax: 402-354-3595 Fax: 712-396-7773

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MPC Support - Electronic Medical Records (EMR)/PowerChart Training Schedule & Guidelines

Position Day of week Start Time

End Time

Training Contact – please contact

at least one week in advance. Misc. Information

Resident/Medical Student Tuesday 8:30a 9:30a Karen.Rau@nmhs.org or 354-3371 MPC Support management will request Cerner & Network sign-ons for Residents & NP and Medical Students

Physical Therapist Coders/Admin Secretary Tuesday 10:00a 12:00p Karen.Rau@nmhs.org or 354-3371 Time is approximate and not all positions will require the full 2 hours.

HealthCoach Tuesday 1:00p 5:00p Karen.Rau@nmhs.org or 354-3371 PowerChart training – Rhonda Rowley does additional training as well

Receptionist Wednesday 8:30a 11:00a Karen.Rau@nmhs.org or 354-3371 PowerChart training only – Revenue Cycle is separate training.

MA/Nurse Thursday 8:30a 3:30p Karen.Rau@nmhs.org or 354-3371

MA Student training sessions will vary depending on what duties they will be performing in the clinic. Please specify duties when requesting training. (1 hour break for lunch)

Provider Friday 8:30a 1:00p Karen.Rau@nmhs.org or 354-3371 PowerChart and PowerNote training

Provider Dragon Training See Misc. Information Karen.Rau@nmhs.org or 354-3371

Dragon Training for providers will be scheduled on an as-needed basis & taught within the Provider’s Clinic. Please allow at least three hours for Dragon Training (includes additional PowerNote training). The provider schedule will need to be blocked out once this time is confirmed with MPC Support.

NOTE: When requesting provider Cerner & Network sign-ons, check the Dragon section and add LAA/Computer # so IT will know to set up the provider for Dragon.

Medical Record Request (MRR) Trainings are done on site or in MPC training room depending

on staff and clinic requirements.

Cindy.Johanson@nmhs.org or 354-5636 Training on printing legal copies of patient information.

Medical Records and/or scanning Training Cindy.Johanson@nmhs.org or 354-5636 New employees or refresher scanning training.

General Training information for Clinic Managers:

Once a training date and time are arranged, a Microsoft Outlook meeting request will be e-mailed to you and each trainee, indicating the training time, location, training information, etc. The trainer assigned may be contacting you to obtain necessary information for training set up & materials.

Please request Cerner & Network sign-ons for new employees in advance. NOTE: It is extremely important that you do not give the Trainee this information prior to him/her being properly trained on how to navigate our patients’ medical records.

Reminder: Include the Pools and Proxy information under the appropriate sections of the Sign On request form so they have access to what they need in message center.

TRANSFER Employees: To make sure employees who transfer from one department to another are set up and/or trained properly be sure to fill out the ‘User Information Section’ and mark this area appropriately.

Example:

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MPC Support Newsletter Word Search

Fax completed puzzle to MPC Support at 402-354-6355 ‘Attention Cindy’.

Entries must be received by December 12thth to be entered into the drawing for next month’s gift cards!

The Winners and the answers will be posted in the next newsletter!

Name: ______________________________________

Facility/Dept: _________________________________

Phone/Contact #: ______________________________

1 All _____________________ associated with a clinic office visit should be attached to the appropriate encounter.

2 It is very important to choose the correct encounters for your facility/department so they count towards _____________ ______ numbers for the appropriate provider.

3 It is very important that all _______ tasks are being done by nursing staff. 4&5 When clinic staff are filling out ______________/injection MAR powerforms it is VERY

important to be sure these forms are filled out completed and accurately for _____________ , billing and documentation purposes.

6 The __________field is to be left blank or marked with a “0” if there was no medication wasted after the injection.

7 If a patient brings in their own __________________ it is important to document that in the comment field so the patient is ONLY charges for the injection fee...

8 When using the Date Range in MRR be sure to look at the ________ date. 9 CMR will help us with __________ tracking. 10 MPC __________Center has been updated and has all new computers. 11 Please advise your clinic staff to only place __________ orders as one-time orders. 12 If staff need access to a folder on the x:drive for MultiMedia Manager, clinic managers

need to fill out a section on the __________ eform on mhsintranet. 13 It is important when booking appointments that staff does not use ________________

marks when entering a Reason for Exam. 14 Over the last year there have been some changes with document types because of

_______ Maintenance requirements and Meaningful Use. 15 Outside _______________ reports should be scanned to the document type

“Mammography Note’ 16 Scanning documents like mammograms, colonoscopies and flu shots to

the appropriate _____ of the exam is also important to satisfy Health Maintenance requirements.

17 When providers send messages to the ‘PowerNote, Transcription’ pool it is important to include the ________and last name of the provider.

18 MA student training sessions will vary depending on what ______ they will be performing in the clinic.

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CONGRATULATIONS to the following winners of last month’s puzzle competition! The winners were drawn randomly by MPC Support:

1st Place: Cheryl Schenk - HealthWest IM $10 gift card to Starbucks 2nd Place: Jackie Olsasky - HealthWest Peds $ 5 gift card to Target 3rd Place: Emily Poore - CB Main, OB/Gyn $ 5 gift card to Bath & Body Last Month’s Puzzle Solution:

“Thank you!” to all clinic managers who encourage their employees to read our newsletter & enter the competition.

Last month we received entries from:

Council Bluffs Family Practice, Heart Care Center, OB/GYN & Administration, HealthWest Internal Medicine, Orthopedics, and Pediatrics,

Regency Pediatrics & Medical Records, Louisville Family Practice, Millard Family Practice, Northwest Family Practice, and the Renaissance

Health Clinic.

The Newsletter is a great resource for information and updates. By encouraging their employees to participate

in the competition they are ensuring their staff has access to important information, reminders and updates.