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What’s New with axiUm Ryan Brandon

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2 What’s New with axiUm Ryan Brandon
Ryan, director product, 18 years at Exan, 17 years working on axiUm My privilege to show you what we’ve been working on over the past year. Difficult to cut down to 1 hour material Thank 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 weather If you’re still listening to me, then you haven’t figured out that you could be checking or shopping on-line. Wifi: exan/axiumsummit2013 Don’t use until after I’m done!

3 Welcome Don’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 affinity Only call when problem or need something See each other once a year - awkward meeting handshake, hug, kiss - Roger don’t pretend like you don’t know what I’m talking about

4 WHAT’S NEW UPDATE ON axiUm CE and Meaningful Use Product Advancements
v5.11 and v5.20 HealthAccess PatientAccess FacultyAccess

5 Meaningful Use Update Last year we announced that axiUm was certified as a Complete EHR … no small feat. As it turns out, our work wasn’t finished Certification is not MU!

6 Meaningful Use Update axiUm CE certified in February 2012
Most State Medicaid programs are now up Many dentists have now registered and collected Year 1 funding with axiUm CE: $21,250 per provider All states except for DC and HI happy to hear how many have collected the Medicaid $$$ with the axiUm CE package We 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

7 axiUm MU Reporting Develop programs, scripts, reports and supporting documentation to configure axiUm CE Will meet MU requirements to qualify dentists for Year 2 incentives under Stage 1 rules Working 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

8 MU Summary Report Green is good Red is bad
Displays each objective/measure Numerator, denominator, percentage, exclusions 8

9 MU Detailed Report Detailed reports displays both Numerator and Denominator population details (i.e. patient name, chart) Green indicates record is in both denominator and numerator 9

10 axiUm MU Consulting For clients ready for Year 2 MU, Exan can provide expertise and additional services: State-specific eligibility requirements analysis Practice workflow and business process consulting Customizations to the MU package Compliance monitoring over the reporting period MU dashboard Once 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 guidelines Assist in attaining the Year Two Medicaid funding per Provider based upon government standards Provide an overview of Meaningful Use Criteria and help determine applicable exemptions and the appropriate Clinical Quality Measures required for attestation Provide Practice Workflow and Business Process Consulting during the initial phase to ensure compliance at the practice level Provide 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…

11 Stages & Medicaid Incentives
3 Stages in incentive program Different requirements for Certification and MU 6 Years of eligibility for each Provider 2 Years in each Stage Reporting requirements in Years 2 through 6 Can be non-consecutive 11

12 $63,750 axiUm CE $21,250 axiUm CE + MU Reporting $8,500
Incentives is per EP Ideally, 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 other Year 2014 will be a 90 day reporting period, no matter what stage/year Aside 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 Stages TBD $8,500 TBD $8,500 $63,750 12

13 axiUm Product Updates axiUm 5.11 September 2012 axiUm 5.20 July 2013

14 axiUm 5.11 Recertified axiUm CE v5.11 in August 2012
Released September 2012 Many of you have upgraded already Who has v5.11 installed?

15 axiUm 5.11 Status Bar Indicators Quick alerts shown in the status bar
Like current alerts, but customizable Alerts based on: User logged in Patient selected Quickly give the user information about the clinic, the current patient, etc. Calculate by database query. Defined by user; see different indicators The 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

16 Status Bar Indicators Formats: - image (bitmap)
- text (up to 3 chars returned by function) - color block Refresh manually or timer Embedded or pop-up Tooltip to view details.

17 axiUm 5.11 Date changes Replaced odd-formatted date/time fields
Custom Reporting is simplified DB stores 24-JUL-2011 instead of Support across time zones Operate clinics or admin from different time zone Multi time zone applies to Indiana who seems to have 3 different time zones going.

18 axiUm 5.11 List Sorting Sorting on lists throughout axiUm
Click on column header to sort Scan and find codes faster

19 axiUm 5.11 - SCHEDULER Rotation Scheduling
Student placed into rotation clinic Student can schedule in that clinic only and is blocked for taking a chair in any other clinic Schedule shows the rotation information like non-clinic time Can be used as to pre-block all schedules Non-clinic time to support rotation scheduling

20 axiUm 5.11 - SCHEDULER Display Additional Appointment info
Be able to view relevant details for a list of appointments Appt Display options (pop-up tooltip)

21 axiUm 5.11 Consents - Limitations Can’t specify which form is required
When modify planned tx, need to get re-consent Can’t get consent for future tx (i.e., for next year) Can’t setup required consents differently by provider type Can’t enforce multiple consents CURRENT FUNCTIONALITY: Consents are configured as required per: - Patient - Procedure - Provider Each 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.

22 axiUm 5.11 Required Consents - Enhanced
Prevent treatment without appropriate consent Conditionally require consent based on: Procedure: surgical, high-risk, cosmetic, date planned Patient: age, insurance, payment history, health condition Provider: student year, specialty enforce that a specific consent form is required for planned treatment that meet conditional (and customizable) factors. Procedure is not covered by insurance Procedure being performed on a child Procedure being performed on a patient with diabetes ACCEPTANCE 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.

23 axiUm 5.11 Required Consents
Specify which consent form(s) can be used to satisfy requirement Option to require multiple consents, including general and treatment-specific Display list of consents required prior to delivery Resolves all of the limitations

24 axiUm 5.20 New Treatment Planning Module Scheduling Operatory Monitor
Ready for JULY 2013

25 axiUm 5.20 – Tx Planning Simplified/All-in-one user interface
Support to view/update chart while Tx Planning Improved entry of terms with text matching Decision support for proper Dx and Tx selection In review now, ready for Summer 2013 New Functionality/Capabilities: match Tx to Dx Multiple Dx to Tx (0 to many) Multiple Problems to Dx (0 to many) Sets up for future development to associate: 25

26 axiUm Treatment Planning

27 Problem List 27

28 Diagnoses Entry 28

29 Planned 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

30 Tx Planning - Future Support new functionality
Merge plans to present to patient Make changes and re-approve Automate creation of Problems Findings/Conditions charted Form entries Evidence-based support for appropriate tx planning Sets up for future development to associate: Findings to Problems 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. 30

31 axiUm 5.20 Info Manager – Open in MS Excel
Requests to perform calculations, custom sorting, grouping in Info Manager Take any Info Manager list and open as an Excel spreadsheet No formatting required Allows complex data mining and review with spreadsheet functionality – Export to Excel

32 axiUm 5.20 EPR Form enhancements
“Don’t Know” answer for Yes/No questions Prompt for additional info when respond No to a Yes/No question There are times when you truly don’t know Cartwheels!

33 axiUm 5.20 Spell Checking for Clinical notes Medical dictionary
Ability to add terms and abbreviations

34 axiUm 5.20 Rolodex More columns added Up to 5 additional columns
Find the right patient sooner For resolutions > 800x600 Audience Participation Does anyone still use 800x600?

35 axiUm 5.20 Operatory Monitor
Monitor status of appointments in clinic Follow patients through visit Sign in, check-in, seated, checked-out Alert to providers needing: Start Check, Approval, Assistance Large screen display options Create a system to monitor the status of appointments and alert to providers in need of assistance View as a list of appointments or as a graphic representation of the clinic Summary of benefits: Keep providers with their patients (instead of leaving to go track down help) Reduce Faculty needed to monitor the clinic 35

36 Graphical Display Patient status colors displayed
Follow patients through visit Sign in, check-in, seated, checked-out

37 Text Display List shows appointment details and mini-chair map of clinic On the desktop, this can be used as the check-in list

38 Provider Notifications
Provider sets indicator to notify of need Needs are defined with level of urgency and color Quickly set through Status Bar Replaces call-light system Access to States are defined per Level State is set per chair that the provider is working Alert to provider needs Start Check, Approval, Assistance Communicates to FacultyAccess 38

39 Monitor Providers Chairs are colored with the background of the current notification state Visually alerted to the state

40 Monitor Providers and Patients - Graphical
Patient Status colors are shown on the chair

41 Monitor Providers - List
List may be sorted by urgency and time waiting Colors are still displayed List is sorted by urgency and time waiting for assistance

42 Monitor Providers and Patients - List

43 Operatory Monitor Mount it on the wall Runs unmanaged
Cycles through clinics and pages through lists Place in central location Providers see when patient has arrived Faculty can triage students requiring assistance When displayed on large screen, there are options to run “un-manned” and have the system cycle through clinics and page through lists. Refreshes automatically

44 Operatory Monitor Benefits
Keep providers in the chair with their patients Optimize Faculty time in clinic Reduce response time to critical issues Prevent non-urgent issues from jumping the queue Improve patient safety and quality of care Improve student satisfaction Track and Report out Critical issue response time Clinic efficiency with the transition of patients through a visit Provider requests for assistance Mounted

45 axiUm HealthAccess PatientAccess FacultyAccess 45

46 FacultyAccess Notification States
Communicates with Operatory Monitor system Instructors are notified when provider ready for start check, approval or need assistance List is prioritized based on the urgency of the request Clear the state when it has been addressed Chair Notification States New 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.

47 FacultyAccess Sessional Evaluations Edit Notes on Approval
Review, add, update, hold and resume evaluations Support for sessional and cumulative evaluations Edit Notes on Approval Just like in axiUm, notes can be edited during the approval process Sessional Evaluations Instructors can view, add, edit, hold, and resume evaluations. Cumulative-style evaluations are fully supported. Edit Notes on Approval Just like in axiUm, clinical notes can now be edited during the approval process.

48 PatientAccess Content Management System
Customize the appearance and content of PatientAccess using a WYSIWYG editor Manage application settings thru a GUI Install PA updates without losing content or formatting Content Management System Administrators 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.

49 PatientAccess Medical Summary Appointments Display
Problem List Medications Medical Conditions Allergies Meets MU requirements Appointments View and confirm upcoming appointments Medical Information Patients 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 Information Patients can view their upcoming appointments and appointment calendar. Patients can confirm their appointments online.

50 PatientAccess Insurance Information Update Personal Information
View policy details Indicate that information is incorrect to create a sticky note in axiUm Update Personal Information Patients update information to create a sticky note in axiUm Insurance Information Patients 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 Information Patients 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.

51 PatientAccess Password Reset
Patients can reset their passwords securely by Prevent the patient from having to contact the clinic if they forget their password Patient Self-Registration Securely self-register for a PatientAccess account No clinical interaction required Who can remember all of their passwords Password Reset Patients can reset their passwords and recover their usernames securely by . All s sent by the system are fully customizable by your institution. Self-Registration Add the ability for patients to securely self-register for a PatientAccess account, without involving clinical staff.

52 FUTURE PLANS Communicate and collaborate with
Customer Advisory Groups: COHRI, Financial, Clinical Suggest to form an IT/Technical CAG as well: Brad Lowry has volunteered to lead the nerd herd. Enhancement Triage process Improve existing systems: Odontogram, Payment Plans, Template Notes Add new systems

53 HealthAccess - Doctor DoctorAccess New product for Providers
Optimized for Smartphone devices Integrated to axiUm’s Messenger View schedules and reservations View patient information DoctorAccess A 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.

54 Questions? No time 54

55 THANK you Enjoy the meeting! Coffee Break 55

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