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Presented by Slide 2 Presenters Krista Bennett, Clinical Supervisor, Ortho NorthEast (ONE) Mike Baeske, Software Applications Specialist, Team Leader, Ortho NorthEast (ONE) Tom Pawlik, Supervisor, Surgical Services / EMR Workflow & Design Specialist, Ortho NorthEast (ONE) Slide 3 Ortho NorthEast Orthopaedic Practice founded in 1962 11 locations throughout Northeast Indiana 35 Physicians including Anesthesiologists 35 Advanced Practitioners Part ownership of: Orthopaedic hospital Surgery center MRI PT Slide 4 Objectives Discover how we point providers and clinical staff to produce the correct ICD-10 code. Learn how to bypass the painful orders module through advanced custom forms functionality. Gather tips and tricks on how we comply with measures for MU, CPOE, PQRS, ICD-10 and insurance requirements. Slide 5 ICD-10 Coding Methodologies Traditional coding Slide 6 GE Digital Solutions Custom lists Smart lists Problems search Slide 7 More Digital Solutions Phone apps Computer software Internet search Slide 8 ONE Perspective Custom Dynamic Forms Slide 9 Slide 10 Added complexity of ICD-10 Most Ortho diagnosis are now side specific Bilateral condition = Double work Additional codes may be required Slide 11 Additional Coding-Diabetes Slide 12 Additional Coding-Neurology Slide 13 Slide 14 Layout Tips Sections with visibility conditions used to dynamically display questions Slide 15 Layout Tips Section groupings used to optimize space Visibility regions used to show individual questions Slide 16 Layout Tips Dynamic labels utilized as warning mechanism Slide 17 Coding Tips MEL_ADD_PROBLEM() function used to add ICD- 10 codes MEL_ADD_ASSESSMENT() denotes an assessment on a diagnosis PROB_AFTER("Delimited") used to retrieve detailed current diagnoses information MEL_REMOVE_PROBLEM() removes diagnoses utilizing the PRID Slide 18 Coding Tips: Control Structures If and Case statements are used to generate the appropriate ICD-10 code If statements evaluate one condition and reacts based on a true or false value Nested if statements can be utilized for more sophisticated coding Slide 19 Coding Tips: If Statements Example: Slide 20 Coding Tips: Case Statements Case statements evaluate multiple conditions, once one is met it will evaluate coding and then stop Else clause can be utilized to catch other scenarios not specified Slide 21 Coding Tips: Case Statements Example: Slide 22 CPOE Slide 23 Traditional Order Entry Slide 24 Current Functionality GE Orders Module Pre configuration Set up individual orders Build custom lists if desired Slide 25 Setup Order GE Orders Module Pre configuration Set up individual orders Build custom lists if desired Slide 26 Setup Custom List Slide 27 Current Functionality GE Orders Module Order entry during an office visit Enter order Attach diagnosis to order Add modifier (if needed) Document order instructions (if applicable) Slide 28 Order Entry Slide 29 CPOE Optimization Custom forms streamline the ordering and documentation process Orders module only used to remove orders Slide 30 CPOE Optimization Buttons perform multiple actions in form Bill for the order with specified provider attached Bill for medications/materials Attach diagnosis/modifiers to each order Create translation in office visit Send an auto flag Print patient handouts/instructions Save structured data Slide 31 CPOE Optimization Custom forms streamline the ordering and documentation process Slide 32 Order Categories Service orders used for internal billing Casting DMEs Injections PQRS E&M Office Codes EMG/Nerve Conduction Study Xrays UDS Test orders used for documentation/requisitions Work slips PT orders Lab orders Diagnostic orders Surgery orders Interventional procedure orders Slide 33 Coding Tips MEL_ADD_ORDER() function used to generate orders Must have orders configured in administration Need to know folder structure Description order needs to be identical to bill Slide 34 Coding Tip: Automatic Flags MEL_SEND_FLAG() used to send automatic flag (Not present in older versions of EMR / CPS) Requires recipients login name Example: MEL_SEND_FLAG("Flag",, 'Normal', str(._todaysdate),,,'Update','') Slide 35 Benefits Ability to re-create orders Reduces clicks Saves time, increases efficiency Ability to enforces rules Guides user to do the right thing Reduces training time Guarantees proper notification Slide 36 Creating user-friendly layouts No scrolling Top to bottom Left to right Radio buttons vs dropdowns Navigation buttons Visibility fields Dynamic lists Slide 37 Guiding the user Required fields Dynamic questions Regulations and Rule Enforcement Insurance Government Safety checks CDSR Osteoporosis LBP BMI Fall Risk Smoking Slide 38 Guiding the user Training material Automatic Preferences Injections X-ray Therapy Surgery needs Filtering Family Dx Uncoded Dx Slide 39 Slide 40 Layout Tip Enable conditions can lock a button or field until the proper action is taken Slide 41 Coding Tip: Watcher Statements Automated events can be triggered by watcher statements, which are control structures with an ! in front of it. Objects in the condition statement will trigger an evaluation every time the object is touched Example: {! if (DOCUMENT.DATE_ON_ORDER == "") then DOCUMENT.DATE_ON_ORDER = sub(str(DOCUMENT.CLINICALDATE),1,10) else "" endif} Slide 42 Tips to meet MU measures Categorize your orders Configure CQM Data Mappings MU/CPOE user setup Slide 43 Categorizing Orders Slide 44 Data Mappings Each Clinical Quality Measure is requiring different data to be met Example: CMS123 Diabetes Foot Exam requires visual inspection with either a sensory exam or pulse exam Slide 45 Data Mappings Slide 46 Slide 47 MU / CPOE User Configuration Slide 48 Thank You