1. Presented by

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)

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

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.

5. ICD-10 Coding Methodologies Traditional coding

6. GE Digital Solutions Custom lists Smart lists Problems search

7. More Digital Solutions Phone apps Computer software Internet search

8. ONE Perspective… Custom Dynamic Forms

10. Added complexity of ICD-10 Most Ortho diagnosis are now side specific Bilateral condition = Double work Additional codes may be required

11. Additional Coding-Diabetes

12. Additional Coding-Neurology

14. Layout Tips Sections with visibility conditions used to dynamically display questions

15. Layout Tips Section groupings used to optimize space Visibility regions used to show individual questions

16. Layout Tips Dynamic labels utilized as warning mechanism

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

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

19. Coding Tips: If Statements Example:

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

21. Coding Tips: Case Statements Example:

22. CPOE

23. Traditional Order Entry

24. Current Functionality GE Orders Module Pre configuration Set up individual orders Build custom lists if desired

25. Setup Order GE Orders Module Pre configuration Set up individual orders Build custom lists if desired

26. Setup Custom List

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)

28. Order Entry

29. CPOE Optimization Custom forms streamline the ordering and documentation process Orders module only used to remove orders

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

31. CPOE Optimization Custom forms streamline the ordering and documentation process

32. Order Categories Service orders used for internal billing Casting DME’s Injections PQRS E&M Office Codes EMG/Nerve Conduction Study Xray’s UDS’ Test orders used for documentation/requisitions Work slips PT orders Lab orders Diagnostic orders Surgery orders Interventional procedure orders

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

34. Coding Tip: Automatic Flags MEL_SEND_FLAG() used to send automatic flag (Not present in older versions of EMR / CPS) Requires recipient’s login name Example: MEL_SEND_FLAG("Flag",, 'Normal', str(._todaysdate),,,'Update','')

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

36. Creating user-friendly layouts No scrolling Top to bottom Left to right Radio buttons vs dropdowns Navigation buttons Visibility fields Dynamic lists

37. Guiding the user Required fields Dynamic questions Regulations and Rule Enforcement Insurance Government Safety checks CDSR Osteoporosis LBP BMI Fall Risk Smoking

38. Guiding the user Training material Automatic Preferences Injections X-ray Therapy Surgery needs Filtering Family Dx Uncoded Dx

40. Layout Tip Enable conditions can lock a button or field until the proper action is taken

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}

42. Tips to meet MU measures Categorize your orders Configure CQM Data Mappings MU/CPOE user setup

43. Categorizing Orders

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

45. Data Mappings

47. MU / CPOE User Configuration

48. Thank You