3.0.16 Release Notes

August 2020

In release 3.0.16 we are introducing the new Unified Sign Queue feature, which gives you the ability to sign all Labs, Imaging, Other Documents, and Orders in one queue by individual patient. Additionally, this release implements a number of fixes to improve stability.

Release Highlights

Application Area	Highlight Information
Worklist Queues	The new Unified Sign Queue feature allows you to sign all Labs, Imaging, Other Documents, and Orders in one queue by individual patient simply by scrolling through each item.
New Orders	The new orders date feature introduced in the 3.0.14 release is now available to all users. This update allows you to change how non-medication orders are dated. Instead of defaulting to a Prior to Next Visit date, you can switch to Require user to select, which will prompt users to choose a date for all new, non-medication orders.
Enhanced Password Security	We are taking steps to strengthen passwords in iKnowMed Generation 2, as well as enhancing and improving the user experience with new tools and interactive support while resetting a password. In the coming weeks your Account Manager will be reaching out to discuss the changes and how those changes affect users.
In-Product Alerts	We are introducing a new notification system that will alert you inside the product when there are issues or unplanned downtimes. The alert will appear in the upper right-hand corner of your screen and you can click the X to dismiss it.

Worklist Queues

Unified Sign Queue

The Unified Sign Queue gives you the ability to sign all Labs, Imaging, Other Documents, and Orders in one queue by individual patient. However, all Clinical Notes must still be reviewed in the Documents tab. Watch the video below for more information.

NOTE: Unified Sign Queue is permission-based and requires your user permissions are set to full for Unified Sign Queue

Check your permissions:

From the top navigation, select the ADMIN drop-down and choose Users.
Select your username in the user list and click the EDIT USER button.
In the next window, select Permission and locate the Worklist Queues section to check that your Unified Sign Queue option is set to Full.

Using Unified Sign Queue:

To get started, select the View option in the left panel on the page. This will open a window where you can set preferences around which items you want to view in the Unified Sign Queue:
1. The Viewing queue for provider search box allows you to view another provider’s queue by searching for that provider.
2. Automatically select items for sign/review as I scroll down the list is selected by default and configures the system to automatically check Reviewed for items as you scroll through the list.
3. Which items do you want to see in your focus queue? allows you to choose which items will display under the Focused and Other areas.
4. Do you want to focus on a specific time frame? allows you to see newer queue items first for a specific day range.
5. Do not focus on items received today allows you to hide review items until the next day, which may be preferable when a patient will have multiple labs and orders created throughout the day. This way, you only review that patient’s information once instead of multiple times.
6. How do you want your focus queue sorted? allows you to view the items in either Descending (Newest items shown first) or Ascending (Oldest items shown first) order.
After selecting your preferences, simply close the window by clicking the X in the corner. The feature will automatically populate with patients based on your preferences.
You can also use the Find icon in the left panel to search for a specific patient, or the Refresh icon to refresh the list of patients.

Once your patient list has been populated, the first thing you’ll notice is that this feature is divided into three panels:

Left Panel
- Contains the list of patients with items needing review.
- Any patient with abnormal labs of any type (low, high, critical low, critical high, or abnormal) will show at the top of the list with a red dog-eared tab.
- You can also choose which queue items will appear in the Focused or Other sections. The default setting is to have all items Focused, but you can move items into Other by unchecking the box next to each item.
Middle Panel
- Contains all the patient specific data that is found on the Patient Banner throughout the system.
Right Panel
- Contains individual Lab, Imaging, Other Document, and Order items requiring MD review and electronic signature.

Select a patient from the list in the left panel to view their information in the middle panel:

Patient Name: clicking the patient’s name brings you to your default starting patient chart tab.
Chart Alert Icons: clicking on any of the chart alert icons next to the patient’s name displays additional information about that alert.
MRN
DOB
Height
Weight
BSA
Next Visit: displays patient’s next physician visit.
Problems: lists all primary diagnoses.
Attending MD: lists all attending physicians.
Contact: displays patient’s primary phone number, if available.
Insurer: lists the patient’s primary insurance.
Focused and Other sections: display the name of the lab, imaging, other document, or order that needs to be signed.
- As you move through the review queue in the right panel, each item displayed will be highlighted in the middle panel, as shown both above and below.
- Red L, H, LL, HH, and AA symbols will show next to any lab marked as Low, High, Critical Low, Critical High, or Abnormal.

To sign off on any Focused or Other items in the middle panel, scroll through the right and final panel. This is where a full view of each item will display for your review. These items include:

Labs
- Lab data contains all the required CLIA documentation (ex: Source, Status, etc.) along with the provider Interpretation and Notes to patient.
- The screen will show that day’s lab values to be reviewed and up to 4 previous values for comparison.
Imaging
- The screen will show interfaced scanned PDF imaging that requires review.
Other Documents
- The screen will show Other Document PDF images that requires review.
- Remember, all Clinical Notes must still be reviewed in the Documents tab.

Orders
- The screen will show all orders done on behalf of the provider that requires a signature.

There are also 6 icons across the top of the right panel to help you throughout the review process:

Skip an item for a specific patient.
Go to the Next item for a specific patient.
Maximize the screen.
Transfer an item from one provider to another.
Create a Message in the chart.
Print a specific item in the queue.

Each item in need of review will automatically receive a check in the Review box as you scroll through the queue. When you get to the bottom of the right panel, there will be a View next patient button to move you forward.

There will also be a X items to review / sign button at the top of the right panel that counts the number of items with a check in the Review box. This button allows you to sign all the items it’s collected with one simple click.

If clicked, this button will prompt a verification box to appear where you must enter your PIN or password as your eSignature. Please note that if there are still items in your queue that need to be reviewed, the verification box will display an alert stating as such. You can choose to enter your PIN or password to sign those items or Go Back and view them in the queue before signing off.

Notes Review

Prior to this release, the patient list in the Notes Review queue was not updating appropriately after a note was edited and signed. This has been fixed, and now any note updated and signed in the queue will result in the patient row turning blue to indicate that the note has been reviewed.

Sign Orders

An issue has been corrected so that a prescription done on behalf of a provider now shows the user who entered the prescription in the Sign order update by field. It will no longer show Interface, eRX as the last updating user in the Sign Orders queue.

Orders I/F

An issue has been corrected so that STAT/ASAP and Add-On orders in red font will now be sorted to the top of the whole list in the left pane, instead of appearing on each page.

Flowsheet

An issue in the Outbound Lab Orders Interface (OLIF) has been resolved to allow you to fully remove lab results from an order. Prior to this release, the Close the Loop feature was creating a link between the order and the result, preventing you from removing the result from a patient’s chart. This has been corrected and you will no longer see these results with a status of Pending on hover or in the Display Details.

Flowsheet Management

When Printing an order from the flowsheet for a prescription, the Ordered by area will now list the ordering provider instead of the interface, eRx.

Regimen Management

A few practices reported they were not seeing the Clear Value Plus Decision Details when Edit Regimen Properties was opened from the flowsheet. This issue has been resolved and now the Clear Value Plus Decision Details will be visible for all regimens.

Orders

New Orders

Default New Order Date

Default New Order Date is now available to all users. The feature introduced in the 3.0.14 release that allows you to change how non-medication orders are dated using settings in Practice Preferences is now available to all users. Instead of having non-medication orders default to a Prior to Next Visit date, you can switch to Require user to select, which will prompt users to choose a date for all new, non-medication orders.

Checking the Allow Users to customize box will allow individuals to override this preference by displaying the new Default new Order date field appears in the User Preferences > Other tab.

Fixes

An issue with the Require user to select option has been corrected. Previously, choosing this option in Practice Preferences removed dates from orders with an already defined schedule. With this correction, these schedules will be preserved.

Order sets with both non-medication and medication orders, will now have all items added to the cart whereas previously only non-medication items were added. Furthermore, all prescriptions must have their dates adjusted to today to proceed with the order.

Medication Orders

Patient Demographics Display on Screen

In compliance with Surescripts certification requirements, the prescription order editor will now display patient demographics (such as first name, middle, last name, suffix, gender, and date of birth), as well as the patient’s height and weight in the upper-right corner of the screen.

Regimen Orders

You can now order regimens for patients with the diagnosis of Endocervical Carcinoma. The error message stating that Clear Value Plus^SM is improperly configured has been fixed and will no longer appear.

Documents: Clinical Notes

To keep the medical record’s history intact, only a note’s author can remove a note as of this release.

Sections set to Suppress Empty were still occasionally displaying in printed or faxed clinical notes because these sections contained a macro, even though the macro did not contain any content. This issue has been fixed, and now printed or faxed notes will no longer contain this section when the macro is empty.

You can suppress sections with empty macros by:

Navigating to Manage > Clinical Note Templates
Selecting the template Name from the list and clicking the Edit button
Clicking on the section from the clinical note template that you want to suppress
Checking the Suppress Empty box and clicking the Save button

Now, when you print or fax the note and those sections contain empty macros, they no longer appear in the document.

When sending a copy of a clinical note using the Send Direct Message feature, messages were failing because the file attached to the message did not include the .pdf extension. This has been corrected.

Nursing Care and MAR

The Zynopump interface will no longer add start and stop dates for Held drugs in the MAR.

Added Ability to Print Rx History

You now have the option to print a patient's Rx History when viewing it from their MEDICATION LIST if patient consent to access Rx History has been documented in Demographics > Patient Preferences.

Added Vaccine Information Statements Directly from CDC

In Administration Details, scroll down to the Immunization Details section and check the box for Vaccine Information Sheet (VIS) Provided.

You will now see a list of vaccine information sheets that are available from the Centers for Disease Control and Prevention. This list comes from a live feed to a data source with the most up-to-date CDC content. Select the sheet provided to the patient and click the OK button.

This update was made as part of a regulatory requirement that requires us to send the Immunization Registry the name and publication date of the CDC sheet provided to the patient.

Demographics

Patient Information

Added Help Text, Calendar Widget, and Notes Field for Hospice Patients

When changing a patient's status from Active to Hospice or from Hospice to Deceased there is now help text below the entry field to inform you that the date must be entered as MM/DD/YYYY. Clicking in the field to enter these dates will now display a calendar widget, making it easier for you to search for and select a date.

There is also a new Hospice Notes area where you can document and view hospice contact information for the patient quickly and easily. This box can contain up to 4,000 characters and the bottom right corner can be dragged to enlarge the box, enabling you to see all the information entered. Be sure to SAVE your changes so they can be viewed later. Hospice Notes are visible on hover from the Patient Status field once saved.

Preferred Pharmacy

Pharmacy Search Enhancements

The pharmacy search has been updated to include In House Dispensing (sometimes known as Medically Integrated Dispensing) as a new pharmacy type. Additionally, a new column for Script Version has been added to indicate the version of the NCPDP SCRIPT e-prescribing standard supported by the pharmacy (normally V106MU2 for the current version and 2017071 for the new version, which will be available in iKnowMed Generation 2 in the future).

Charge Capture

FIXED: After clicking the Release Drug Code button and refreshing the page, the charge capture report was reverting to its previous version, forcing users to try to complete the release again. This issue has been corrected and the Release Drug Code button is now working properly.

Added Prolonged Codes in E/M Codes for Telehealth Visits

When billing telehealth visits with the CPT Code 99443 Phone E/M Provider 21-30 min, you can now capture charges for more time using the new CPT code 99354 Prolonged physician in the office/other outpatient setting: first hour.

If even more time is needed beyond that first hour, then you can also select the new CPT code 99355 Prolonged physician in the office/other outpatient setting: each add'l 30 min.

This update was made to account for the rise in telehealth visits due to COVID-19. Now that you are spending more time treating patients in other settings, you should be able to properly capture that information.

NOTE: Additional services and modifiers can still be applied when using these codes.

General

In-Product Alerts

We are introducing a new notification system that will alert you inside the product when there are issues or unplanned downtimes. The alert will appear in the upper right-hand corner of your screen and you can click the X to dismiss it.

This is only the initial implementation of the notification system and will be used for truly critical occurrences, not routine maintenance.

Future enhancements will include a link inside the alert that will take you to a status page with more details on the situation.

Practice-level Logo/Letterhead Enhancements

NOTE: If your practice currently uses Admin > Locations to display your logo on notes, faxes, orders, or treatment plans, then no change is required. This feature is intended for practices for whom this functionality would not work. Please consult with your Account Manager prior to using this feature.

For practices that have logos stored in Practice Logo / Letterhead in Practice Preferences, you now have the option to switch to your logo of choice without the need for special permissions. This can be done in User Preferences under the new Logo tab.

After changing the logo, you are no longer required to log out and back in for the change to take effect. Just click the SAVE button and it will change over automatically.

If you change the logo while working in Documents, you will not see the new logo until you refresh the macros. Simply go to OTHER ACTIONS > Refresh Macros and the document will reload with the new logo.

There are also several new places where your logo of choice will appear: Outbound Fax Queue, print version of the Orders Queue, print version of the Orders I/F Queue, and Decision Tools - Treatment Plan.

Enhanced Password Security

Password security is a concern for anyone using technology in today’s digital world. With that said, our world is no exception, and therefore we are taking steps to strengthen passwords in iKnowMed Generation 2. This effort will help secure patient data and prevent cyberthreats.

While strengthening password requirements to protect patient data and ensure the ability of practices to secure other sensitive information is the key objective, we’ve also taken steps to enhance and improve the user experience with new tools and interactive support while resetting a password.

In the coming weeks your Account Manager will be reaching out to discuss the changes and how those changes affect users. This feature is being turned on practice by practice.

Understanding New Password Requirements

The table below shows a comparison of existing requirements.

Passwords will now need to meet a new level of complexity and may not be passwords that are commonly used or easy to guess. Failure to meet either requirement will result in the password being rejected by the system.

Complexity Check

Complexity requirements include:

At least 8 characters
One digit (0-9)
One special character [!@#$%^&*()]
One lowercase letter
One uppercase letter

The complexity check places a check mark next to each requirement as it is met and provides a status bar that indicates the strength level of the current entry. Passwords must meet the strength check for Strong or Very Strong before the system will accept the change.

Checking for Common Words or Previously Used Passwords

Once you’ve satisfied the complexity check and submit your new password, the system will make a final check for commonly used passwords or previously used passwords. If either condition is found, you will be required to make the appropriate changes before it can be saved.

Some examples of common words include: McKesson, Winter, Summer, Welcome, Password, 2020, etc.

To reset a password:

Pick a route to reset your password, either from the login page or from User Details in your profile.
Enter the new password following the enhanced password requirements into the New Password field.
Re-enter the new password in the Confirm New Password field.
Ensure your password meets the new requirements for a Strong or Very Strong password using the status bar in the Reset Password window, or the system will not accept it.
Click Save.

Using Passphrases for Increased Security

While you can certainly create passwords such as “d0ct0r3!” to meet the requirements, some industry security experts recommend the use of passphrases for an even higher level of security. A passphrase is more secure than many complex passwords because they are harder for a computer to guess, yet easier for a person to remember.

The more unrelated the words in the phrase, the better. Passphrases may include spaces or hyphens but should not start or end with a space. Examples of passphrases that meet the requirements include: “SunAndFun31!” or “Left-handed frog with 3 toes!”