2What’s New with axiUm Ryan Brandon Ryan, director product, 18 years at Exan, 17 years working on axiUmMy privilege to show you what we’ve been working on over the past year.Difficult to cut down to 1 hour materialThank you to the great staff at Exan:Trainers and Support team - prepared sessions and setup systems for the week.Marketing team - for making us “paperless”, including wifi … and outfitting the team in the vests and ties!Also, thank you all for making it here thru weatherIf you’re still listening to me, then you haven’t figured out that you could be checking or shopping on-line.Wifi: exan/axiumsummit2013Don’t use until after I’m done!
3WelcomeDon’t think this is what the gov’t had in mind.a family (from Latin: familia) is a group of people affiliated by affinity.We’re like a family in a lot of ways:Share common affinityOnly call when problem or need somethingSee each other once a year- awkward meeting handshake, hug, kiss- Roger don’t pretend like you don’t know what I’m talking about
4WHAT’S NEW UPDATE ON axiUm CE and Meaningful Use Product Advancements v5.11 and v5.20HealthAccessPatientAccessFacultyAccess
5Meaningful Use UpdateLast year we announced that axiUm was certified as a Complete EHR … no small feat.As it turns out, our work wasn’t finishedCertification is not MU!
6Meaningful Use Update axiUm CE certified in February 2012 Most State Medicaid programs are now upMany dentists have now registered and collected Year 1 funding with axiUm CE:$21,250 per providerAll states except for DC and HIhappy to hear how many have collected the Medicaid $$$ with the axiUm CE packageWe had anticipated that you would be interested in CE, but we had not anticipated that so many would be early adopters. Based on the acceptance of the CE product, we have continued our commitment to this opportunity to provide a MU solution.6
7axiUm MU ReportingDevelop programs, scripts, reports and supporting documentation to configure axiUm CEWill meet MU requirements to qualify dentists for Year 2 incentives under Stage 1 rulesWorking with the Harvard School of Dental Medicine (HSDM) to implement MU to satisfy the requirements of Stage 1/Year 2 of the program.We expect that HSDM will qualify the first dentists for Year 2 funding in Spring 2013.Show samples of the reports…7
8MU Summary Report Green is good Red is bad Displays each objective/measureNumerator, denominator, percentage, exclusions8
9MU Detailed ReportDetailed reports displays both Numerator and Denominator population details (i.e. patient name, chart)Green indicates record is in both denominator and numerator9
10axiUm MU ConsultingFor clients ready for Year 2 MU, Exan can provide expertise and additional services:State-specific eligibility requirements analysisPractice workflow and business process consultingCustomizations to the MU packageCompliance monitoring over the reporting periodMU dashboardOnce the program with HSDM is successful, we will be providing access to the scripts, programs, reports and documentation to all customers with the CE product. This will be the axiUm MU standard solution.As HSDM can attest to, implementing MU is an enormous task and more onerous for the dental industry.Exan has gained significant understanding of the program and requirements, we are in a good position to offer services to complement the MU deliverable.We are packaging these services into the axiUm MU advanced solution with a web-based MU dashboard to be available in the late Spring 2013.For clients ready to attest to Year 2 Medicaid Meaningful Use, the axiUm MU advanced solution will include the following additional services:Determine Eligibility for Medicaid Incentive Programs based on your state’s Year Two MU guidelinesAssist in attaining the Year Two Medicaid funding per Provider based upon government standardsProvide an overview of Meaningful Use Criteria and help determine applicable exemptions and the appropriate Clinical Quality Measures required for attestationProvide Practice Workflow and Business Process Consulting during the initial phase to ensure compliance at the practice levelProvide compliance monitoring and consulting services during the selected 90 Day Meaningful Use period to the central office to ensure that Client’s practices are meeting the required standards necessary for achieving Meaningful Use for Year Two.If you are interested and looking to achieve Year 2 funding and MU in 2013 or even in 2014, please stop by the Sales desk to speak with Ted or Kuljit.Beyond Year 2, there is definitely more to this program. Year 3, starting in 2014, brings the new Stage 2 requirements into effect. This means another round of certification tests for axiUm and many more software changes to support the new regulations. Stay tuned for updates on our progress…
11Stages & Medicaid Incentives 3 Stages in incentive programDifferent requirements for Certification and MU6 Years of eligibility for each Provider2 Years in each StageReporting requirements in Years 2 through 6Can be non-consecutive11
12$63,750 axiUm CE $21,250 axiUm CE + MU Reporting $8,500 Incentives is per EPIdeally, Stages/Years should not be skipped (i.e. a Client shouldn’t go to Stage 2 if they haven’t done Stage 1)Years do not have to be subsequent to each otherYear 2014 will be a 90 day reporting period, no matter what stage/yearAside from Year 1 (Stage 1), CQMs are assumed to be submitted for each reporting year.CQM requirements vary between Stages.axiUm CE and MU vary between StagesTBD$8,500TBD$8,500$63,75012
14axiUm 5.11 Recertified axiUm CE v5.11 in August 2012 Released September 2012Many of you have upgraded alreadyWho has v5.11 installed?
15axiUm 5.11 Status Bar Indicators Quick alerts shown in the status bar Like current alerts, but customizableAlerts based on:User logged inPatient selectedQuickly give the user information about the clinic, the current patient, etc.Calculate by database query.Defined by user; see different indicatorsThe usage of this feature is limitless, as any data may be accessed. Examples:- Patient Last Medical History update/review: red flag if over 12 months, Yellow if over 6 months- Patient Caries Risk Category: Severe, High, Medium, Low- Patient Last Exam: Over 12 months, 6-12 months, within past 6 months- Patient has unapproved x-rays- Doctor has patient in waiting room (based on appt checked-in, but patient not seated)- Primary provider: Initials of DOR (tooltip displays full name)Number of patients in the clinic: Counts the number of appointments in the clinic that are checked-in but not yet checked-out.Patient updated Med History in PatientAccess
16Status Bar Indicators Formats: - image (bitmap) - text (up to 3 chars returned by function)- color blockRefresh manually or timerEmbedded or pop-upTooltip to view details.
17axiUm 5.11 Date changes Replaced odd-formatted date/time fields Custom Reporting is simplifiedDB stores 24-JUL-2011 instead ofSupport across time zonesOperate clinics or admin from different time zoneMulti time zone applies to Indiana who seems to have 3 different time zones going.
18axiUm 5.11 List Sorting Sorting on lists throughout axiUm Click on column header to sortScan and find codes faster
19axiUm 5.11 - SCHEDULER Rotation Scheduling Student placed into rotation clinicStudent can schedule in that clinic only and is blocked for taking a chair in any other clinicSchedule shows the rotation information like non-clinic timeCan be used as to pre-block all schedulesNon-clinic time to support rotation scheduling
20axiUm 5.11 - SCHEDULER Display Additional Appointment info Be able to view relevant details for a list of appointmentsAppt Display options (pop-up tooltip)
21axiUm 5.11 Consents - Limitations Can’t specify which form is required When modify planned tx, need to get re-consentCan’t get consent for future tx (i.e., for next year)Can’t setup required consents differently by provider typeCan’t enforce multiple consentsCURRENT FUNCTIONALITY:Consents are configured as required per:- Patient- Procedure- ProviderEach of the above can be set to require consent. When calculating if consent is required, all 3 must be true for the condition to "require consent".LIMITATIONS WITH CURRENT FUNCTIONALITY:- There is no way to indicate which consent form is required (per procedure, patient, provider). "Any" consent will satisfy the requirement and remove the "lock" on the planned treatment.- When a planned treatment is modified (that was previously consented), there may be a requirement to get a new consent form signed. This condition is based on hard-coded logic.- Cannot capture 1 consent that applies to future planned treatment for a period. There is an expiry date for each consent, but if you cannot apply a single consent to apply to any planned treatment for X months for example.- There is no way to configure required consents so that it will work in undergrad (all procedures require consent), post-grad (most procedures require consent) and faculty practice (limited procedures require consent).- There is no way to configure that multiple consent forms must be signed for a particular procedure, patient, provider combination.
22axiUm 5.11 Required Consents - Enhanced Prevent treatment without appropriate consentConditionally require consent based on:Procedure: surgical, high-risk, cosmetic, date plannedPatient: age, insurance, payment history, health conditionProvider: student year, specialtyenforce that a specific consent form is required for planned treatment that meet conditional (and customizable) factors.Procedure is not covered by insuranceProcedure being performed on a childProcedure being performed on a patient with diabetesACCEPTANCE CRITERIA:1. Be able to configure that any tx-based consent is required for specific treatment based on procedure, provider and patient information (including insurance coverage).2. Be able to configure that a specific tx-based consent is required for specific treatment based on procedure, provider and patient information (including insurance coverage).3. Be able to configure that a specific general consent is required for specific treatment based on procedure, provider and patient information (including insurance coverage). A non-expired general consent on the patient's account will satisfy the requirement.4. Be able to configure that a combination of tx-based consents (specific forms or a single unspecified form) and specific general consent forms are required for specific treatment based on procedure, provider and patient information (including insurance coverage).5. Planned treatment still requiring consent will display with the "requires consent" indicator (red circle with white line). This indicator is displayed in various areas within axiUm (as functionality in v5.1 in prior releases)6. Planned treatment requiring consent will warn the user if attempt to complete without the consent. This warning will be in Poweradmin.
23axiUm 5.11 Required Consents Specify which consent form(s) can be used to satisfy requirementOption to require multiple consents, including general and treatment-specificDisplay list of consents required prior to deliveryResolves all of the limitations
24axiUm 5.20 New Treatment Planning Module Scheduling Operatory Monitor Ready for JULY 2013
25axiUm 5.20 – Tx Planning Simplified/All-in-one user interface Support to view/update chart while Tx PlanningImproved entry of terms with text matchingDecision support for proper Dx and Tx selectionIn review now, ready for Summer 2013New Functionality/Capabilities:match Tx to DxMultiple Dx to Tx (0 to many)Multiple Problems to Dx (0 to many)Sets up for future development to associate:25
29Planned Treatment match Tx to Dx Multiple Dx to Tx (0 to many) Prognosis and Outcome assessment to each procedure/plan and provide Evidence-based data to be used for research and the creation of appropriate tx plans in the future.29
30Tx Planning - Future Support new functionality Merge plans to present to patientMake changes and re-approveAutomate creation of ProblemsFindings/Conditions chartedForm entriesEvidence-based support for appropriate tx planningSets up for future development to associate:Findings to ProblemsPrognosis and Outcome assessment to each procedure/plan and provide Evidence-based data to be used for research and the creation of appropriate tx plans in the future.30
31axiUm 5.20 Info Manager – Open in MS Excel Requests to perform calculations, custom sorting, grouping in Info ManagerTake any Info Manager list and open as an Excel spreadsheetNo formatting requiredAllows complex data mining and review with spreadsheet functionality– Export to Excel
32axiUm 5.20 EPR Form enhancements “Don’t Know” answer for Yes/No questionsPrompt for additional info when respond No to a Yes/No questionThere are times when you truly don’t knowCartwheels!
33axiUm 5.20 Spell Checking for Clinical notes Medical dictionary Ability to add terms and abbreviations
34axiUm 5.20 Rolodex More columns added Up to 5 additional columns Find the right patient soonerFor resolutions > 800x600Audience ParticipationDoes anyone still use 800x600?
35axiUm 5.20 Operatory Monitor Monitor status of appointments in clinicFollow patients through visitSign in, check-in, seated, checked-outAlert to providers needing:Start Check, Approval, AssistanceLarge screen display optionsCreate a system to monitor the status of appointments and alert to providers in need of assistanceView as a list of appointments or as a graphic representation of the clinicSummary of benefits:Keep providers with their patients (instead of leaving to go track down help)Reduce Faculty needed to monitor the clinic35
36Graphical Display Patient status colors displayed Follow patients through visitSign in, check-in, seated, checked-out
37Text DisplayList shows appointment details and mini-chair map of clinicOn the desktop, this can be used as the check-in list
38Provider Notifications Provider sets indicator to notify of needNeeds are defined with level of urgency and colorQuickly set through Status BarReplaces call-light systemAccess to States are defined per LevelState is set per chair that the provider is workingAlert to provider needsStart Check, Approval, AssistanceCommunicates to FacultyAccess38
39Monitor ProvidersChairs are colored with the background of the current notification stateVisually alerted to the state
40Monitor Providers and Patients - Graphical Patient Status colors are shown on the chair
41Monitor Providers - List List may be sorted by urgency and time waitingColors are still displayedList is sorted by urgency and time waiting for assistance
43Operatory Monitor Mount it on the wall Runs unmanaged Cycles through clinics and pages through listsPlace in central locationProviders see when patient has arrivedFaculty can triage students requiring assistanceWhen displayed on large screen, there are options to run “un-manned” and have the system cycle through clinics and page through lists.Refreshes automatically
44Operatory Monitor Benefits Keep providers in the chair with their patientsOptimize Faculty time in clinicReduce response time to critical issuesPrevent non-urgent issues from jumping the queueImprove patient safety and quality of careImprove student satisfactionTrack and Report outCritical issue response timeClinic efficiency with the transition of patients through a visitProvider requests for assistanceMounted
46FacultyAccess Notification States Communicates with Operatory Monitor systemInstructors are notified when provider ready for start check, approval or need assistanceList is prioritized based on the urgency of the requestClear the state when it has been addressedChair Notification StatesNew in axiUm 5.20, chair notification states are supported by FacultyAccess, allowing instructors to see at a glance which chairs are ready for start checks, approvals, or require assistance.Instructors can also clear chair states from FacultyAccess.
47FacultyAccess Sessional Evaluations Edit Notes on Approval Review, add, update, hold and resume evaluationsSupport for sessional and cumulative evaluationsEdit Notes on ApprovalJust like in axiUm, notes can be edited during the approval processSessional EvaluationsInstructors can view, add, edit, hold, and resume evaluations.Cumulative-style evaluations are fully supported.Edit Notes on ApprovalJust like in axiUm, clinical notes can now be edited during the approval process.
48PatientAccess Content Management System Customize the appearance and content of PatientAccess using a WYSIWYG editorManage application settings thru a GUIInstall PA updates without losing content or formattingContent Management SystemAdministrators can customize the appearance and content of PatientAccess using a WYSIWYG editor.Application settings can now be managed from a GUI interface rather than directly on the database.
49PatientAccess Medical Summary Appointments Display Problem ListMedicationsMedical ConditionsAllergiesMeets MU requirementsAppointmentsView and confirm upcoming appointmentsMedical InformationPatients may view a list of their problems, medications, medical alerts, and allergies.Supports both the legacy (EPR forms) and new (Medication tab) methods of medication entry in axiUm.Appointment InformationPatients can view their upcoming appointments and appointment calendar.Patients can confirm their appointments online.
50PatientAccess Insurance Information Update Personal Information View policy detailsIndicate that information is incorrect to create a sticky note in axiUmUpdate Personal InformationPatients update information to create a sticky note in axiUmInsurance InformationPatients can view detailed information about their insurance policies on file.The insurance information can be marked as incorrect for both policy holders and dependents.Update Personal InformationPatients can directly update their information such as contact phone numbers and address.Customizable sticky notes are added in axiUm when a patient updates their information online.
51PatientAccess Password Reset Patients can reset their passwords securely byPrevent the patient from having to contact the clinic if they forget their passwordPatient Self-RegistrationSecurely self-register for a PatientAccess accountNo clinical interaction requiredWho can remember all of their passwordsPassword ResetPatients can reset their passwords and recover their usernames securely by .All s sent by the system are fully customizable by your institution.Self-RegistrationAdd the ability for patients to securely self-register for a PatientAccess account, without involving clinical staff.
52FUTURE PLANS Communicate and collaborate with Customer Advisory Groups:COHRI, Financial, ClinicalSuggest to form an IT/Technical CAG as well: Brad Lowry has volunteered to lead the nerd herd.Enhancement Triage processImprove existing systems: Odontogram, Payment Plans, Template NotesAdd new systems
53HealthAccess - Doctor DoctorAccess New product for Providers Optimized for Smartphone devicesIntegrated to axiUm’s MessengerView schedules and reservationsView patient informationDoctorAccessA new product aimed at student and faculty providers.Features in the initial version will include:Integration with axiUm’s Messenger module.Ability to view provider schedules / reservations.Ability to view detailed patient information.Select information from axiUm’s Personal Planner module.Smartphones are a targeted environment for this product.