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PQRS Registries

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We have used DARTNet in the past for PQRS reporting. We recently saw a demo of the eCW product, as well. Does anyone have experience with other PQRS registries? We want to explore other options before we decide.

Thanks


Audit Queries

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Is anyone willing to share their sql audit queries for basic user tracking (i.e. appointment scheduling & deleting; scanning docs; etc)? I can’t believe its not already built into the system for basic user tracking and its vital for a new eCW implementer like us to identify users who need further training.

Release of Information - Medical Records

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Joseph

As part of a new process we want to implement to address the various Requests for Medical Information we receive we want to handle those requests centrally, rather than each clinic providing the requested documents individually. This will allow us to review all requests, keep a log of those requests and better control and monitor what is provided to third parties.  So to move forward I have the following questions and needs around eCW.


1. They will need to have the ability to make entries into patients files noting that records were provided on a certain date, to a certain third party, in furtherance of a written authorization.  How do we do this?

2. We will need compliance training around the limits and restrictions of accessing medical records

3. Does eCW have the capability, or does the tool exist within eCW, to create a log of: all requests for medical records, date of such request patient’s name, requesting party, what was provided, when it was provided, who provided the records, or why such was not provided?

4. Does eCW have the capability, or does the tool exist within eCW, to create for each patient’s file a separate and distinct patient Disclosure Tracking Log, that can be populated with information about a patient’s records as necessary and accessed as needed?

Thanks!

Patient Recalls

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I am curious how other users are handling patient recalls.  We are unable to use the Patient Recall area because eCW has identified a bug (10436) where the patient list that is returned does not always reflect our filter criteria (results include other protocols and/or providers).

Looking for advice/reviews on converting from self-hosted to cloud

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Good morning!

We are a large practice with over 40 providers and around 400 staff members, who are considering switching to cloud. We have asked eCW for a list of users who are currently on cloud, who converted from self-hosting, that would give us a review/recommendation, but they have not provided this to us yet. So, I am trying to come up with groups on my own.

We would love a few minutes of your time, preferably on a phone call, with our CEO, CMO, and our Application specialists, so we can hear what your experience has been like, and some of the details of what works, what doesn’t, etc.

If you would be willing to do so, please comment below smile

We are primarily looking for large practices, and we are a primary care practice ourselves, but we also have specialists, so that would be helpful, too.

Thank you!

can you run a report on how many pts are not up to date on vaccines?

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Is there a way to generate a report on how many patients have vaccines that are not up to date?  Since the imm module has forecasting now, has the reporting for it been updated?


We would love to generate a report of a particular Medicaid payer and how UTD those kids are.  The Indiana registry started just a few years ago and doesn’t have any back data, so a 12 yr old kid who has had all vaccines is “not current” on the registry.


Thanks,
Chris

RHC Flu Shots

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Hello I work at a Rural Health Clinic.  We have several scenarios for flu shots.  We cannot bill traditional Medicare for beneficiaries who receive the flu vaccine as we are reimbursed through our cost report for influenza and pneumonia vaccines. 

We do need to bill Medicare Advantage plans for these immunizations as they are not reimbursable on the cost report.

We have VFC which requires us to bill a penny for the vaccine and bill the administration fee but we are not paid for these.

We then have our “commercial” insurance that we will bill for vaccines.  We have fluzone and an under 3 vaccine.  How do you handle all of these different billing scenarios with one lot # (two lot #s for all the influenza we have in house).

We have templates setup for the flu vaccines that will automatically populate the correct CPT code.  But are there any other RHC’s out there and how do you keep track of who you can bill for and who you can’t or do you just do it on a claim by claim basis?

Assessment: All Encounters Not Showing under “Carrot” drop down- MD not happy.

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Today, my MD showed me an issue that he has with eCW. [Bare with me - the clinical/progress note portion of eCW is outside my normal use area, so I may explain this poorly. I normally enter Out of Office charges, run different EBO reports and design letter templates].

When he is seeing a patient who has a massive list of diagnosis and medications: He goes into the “Assessment” section of the progress note and hits the down arrow “carat”- which brings up a list of past appointments. Because the patient has many medications, this list tends to be flooded with telephone encounters requesting refills. All my MD wants is the last progress note - which is normally not visible, pushed out by the TEL.

He knows that he can technically click the “Assessment” word link, and find the Dx that way, but he claims that the Dx are then no longer linked to the medications, and he has to relink them in the new progress note.

What he has been doing in these instances, is printing the last progress note, and manually adding the Dx [and I presume, linking them to the appropriate medications, from the note].

Is there a more efficient way to do this? If his nurse creates a TEL encounter before he sees the patient and adds all the diagnosis to that, can they be linked to the medications there, and he can drag them into his progress note?

Is this an issue in later versions of eCW? (We have 10.0.80 SP1C-7)

Is there a way to see ALL the encounters when you click on the assessment drop down “carat”??? Or to block out the TEL encounters?

Any help would be appreciated - even if the help consists of “No - this is how the program was designed, and changing it would require changing the core code of the program.”  At least then, I can show it to my MD, show that I asked, and that there is really nothing that can be done about it at this time. Either way, any advice or information would be GREATLY appreciated.
Thanks!


eCW / OpenDental / Dexis Efficiency Tips

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As I mentioned in another post, I have been working on improving the efficiency of our EHR usage over the last two years I’ve worked at our FQHC. I just recently compiled all these tips into a presentation that I gave to all our sites. I previously posted teh pared down version with just the eCW tips. Now I am posting the full version that includes tips on eCW, Open Dental (alone and in conjunction with eCW), and Dexis.

The first half focuses on efficiency tips that dental assistants and providers can use. The later half focuses more on providers. I’ve also attached a handout. I’ll have to post them in a few different messages due to size limitations, and they are PDFs and a DOCXs in a ZIP because the forum is throwing an error for invalid “MIME type.”

eCW Dental

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Is anyone using eCW dental?  We have been using it along with Dexis for imaging since June and I’m looking for any tips/tricks, etc.

Thanks in Advance!

Charging for portal visits

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Hi all, long time no post.  I’m not sure it this has been addressed elsewhere, but I STF’d without any luck.

My portal messages are getting to be quite extensive.

Is anyone charging for these?  If so, how much and how are you doing it?  Sending a bill?

Thank in advance.

Major issues with IE 11

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Our IT pushed out IE 11 last week. Since that day, I have had nothing be major headaches.

issues with scanning
opening patient docs
send prescriptions
shutting people out
the log in screen pops up constantly
ink edit

I am going crazy.

I reverted back to IE10 on my computer and no problems at all. We have to move to IE 11 because the update for our hospital system requires it.

I need help!! Eclinicals is trying but no resolution to all issues yet.

Locking Progress Notes

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Is there anyone who’s providers are not Locking the Progress Notes, but actually someone else locks them for them? 

Our providers mark the Progress Note DONE,  the coders then review the notes for correctness and notify the Providers to lock them if everything is ok.  Well they don’t lock on a timely manner….....

Administration has requested that the Coders be able to lock them. 

I was wondering if anyone else is doing anything similar?

eClincical Touch Not loading documents

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Is any one having any issues uploading pictures, or accessing documents with eClinicalworks Touch?  We are currently on SP1C20.6 and I was told it would fix the issue of not being able to access documents with ecw touch.  I was wondering if anyone has been able to figure out a solution, or know of a work around?

Failed Fax Jelly Bean

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Hi,
In the distant past when an outgoing fax failed, the D jelly bean would turn red letting that person know they have a failed fax. It stopped when we upgraded our fax server which we host. eCW had no resolution.
Has anyone else had this problem?

Thanks
Ann Marie


2017 ICD Code Update PL Issue

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For the practices that already updated their ICD database to the 2017 version.

How are your providers handling the laterality and specificity updates for these newly implemented codes when all the old ICD-10 codes are already populated in the problem list, especially when the provider unknowingly pull over these codes to the PN causing the billers to fix them manually? Our providers are trained to carry forward problems from the problem list for a more efficient workflow, but the problem is: these are old codes will repeatedly be used until it’s manually deleted and updated from the assessments using the PL checkbox. The doctor will never know what codes needs to be updated, so in the end, the billers and coders have to manually update the old 2016 codes to the new 2017 ones.

I’ll be opening a ticket for ECW in hopes they have a better solution than having physicians manually delete and re-adding problems to the PL using the new 2017 version codes. Is anyone else running into this issue and have a better solution they can share? Thanks

2016 NUC conference ; new features coming?

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Hello,

Unfortunately I can’t make the conference this year.  But does anyone have any insight or ideas on what new features /tools will be announced at this year’s conference versus 2015.  The website doesn’t give away any teasers.  I hope the focus will be on building a more robust EMR based upon how doctors think and want to document, and not all the “futuristic” bells and whistles like healow, trackers and those gimmicky things.  I think ECW still can do a lot to resolve many of the long awaiting EMR improvements people have been requesting on ECW ideas and in this forum.

Using Scribe and the Examination

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Howdy,

I’ve just started using scribe and for the most part, I love it.  Saves a lot of time.  I’m currently using Dragon Medical 2nd edition.  I’m hoping that someone can help me get the wording down so that macros can be used to better place structured data in the proper places.  Right now when I dictate the HPI everything goes under one, and is always the same one, sub category.  It is the default subcategory that occurs when you open the HPI window.  For example, entering a rash under dermatology, or hypertension under cardiology.

The same goes with the physical exam.  Right now I can only enter structured data into one subcategory of the examination.I have tried using the format described on the YouTube demo videos but the majority of the information described over his entered as free text in the note section.

Thanks in advance

Chronic Care Management (CCM)

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Greeting,

I see no other thread on implementation of the new CMS CCM program…so here we go.

Has anyone tested a structured way to document all of the 20 minute, non-face-to-face services?

We are think about using a one-time-per-month virtual encounter to list what we’ve done (or a telephone encounter if better). We have the new code entered (as a procedure code) and can pull it under the Procedure section. Fo some reason to-date, this is not carrying forward to a claim…

Any thoughts, ideas or implementation on anything CCM would be helpful to many I am sure!

Thanks!

Medication dosage changing when refilling from right hand panel

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Has anyone else ever experienced medication dosages being changed simply by refilling a med from the right hand chart panel?  We have several instances if this complaint from staff and providers.  I’m opening a ticket but was curious if anyone else has experienced this as well.

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