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Kareo Help Center

Clinical (EHR) Release Notes May 24, 2018

In May 2018, your Kareo Clinical account will be upgraded to the latest version. 

View Rx Eligibility

The new Rx Eligibility feature in the patient account tab will display the patient's medication coverage.

The Rx eligibility check will run for a patient when you prescribe a medication, perform a medication history check, or visit the Rx Eligibility tab in a patient's account.

  1. Search for and open the patient's chart.
  2. Click Account > Rx Eligibility.
    1. The plan name of the medication coverage.
    2. Pharmacy Benefit Manager (PMB) administers the prescription program for the plan.
    3. The Rx plan number associated to the name.
    4. The date of the last eligibility check.
    5. The Pharmacy Coverage displays what is covered under the plan. It will display Covered, Not Covered, or N/A based on the information provided by the PMB.
    6. Error messages will display if there is a discrepancy in the patient information.

Note: Retail, Mail Order, Specialty, and Long Term Care are different pharmacy types.

 

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Search and Display Patient Specific Medication Coverage and Cost

When a prescription is being populated, the system will search the patient's formulary plan, display the formulary status, and if the drug has any coverage factors.

  1. Search for and open the patient's chart.
  2. Click Medications > + Prescription. The Prescribe Medication window will open.
  3. Populate the Drug, Quantity and Pharmacy field.
    1. The system will verify if the drug is Non-Formulary, On-Formulary/Non-Preferred, On-Formulary/Preferred, Unknown Formulary (no coverage was found or the drug could not be found in the formulary database), or Non-reimbursable (no coverage).
    2. When available, the Coverage Factors will display any Quantity Limits, Age Limits, Gender Limits, General Information, Prior Authorization, and Step Therapy.
    3. Click on the drop-down to select a plan when multiple are available.
    4. Alternative medications that can be prescribed. Clicking on the alternative drug name will automatically update the prescribed medication. The list is sorted by highest coverage to least within the same therapeutic treatment family.
    5. The patient cost section will display the copay amount based on the Rx plan. If the exact cost is not displayed, the patient will need to check their plan information for more information.
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Notate Non-Administered Medication in a Patient's Chart

Providers can now track medications that were not administered to a patient due to medical contraindication, refusal of treatment by patient, or treatment not available.

Add a Not Administered medication without details:

  1. Search for and open the patient's chart.
  2. Click Medications.
  3. Click +Med List. The Add to Med List window opens.
  4. Select the Not Administered status.
  5. Add the Drug name.
  6. Click Save & Close.
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For Quality Measures, a specific reason is required as to why the medication is under Not Administered.

Add a Not Administered medication with details:

  1. Click +Med List. The Add to Med List window opens.
  2. Select the Not Administered status.
  3. Add the Drug name.
  4. Click Add more details....
  5. Select a Reason for non administration.
  6. Click Save & Close.
  7. The medication will now be under the Not Administered tab with a comment icon.
  8. Hover over the icon to view the comment.
     

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Reason for Rx Added to the Prescribed Medication Form

Providers can now send a pharmacy up to two ICD-10 diagnosis with the new Reason for Rx field.

  1. Search for and open the patient's chart
  2. Click Medications.
  3. Click +Prescription. The Prescribe Medication window will open.
  4. Enter an ICD-10 code into the Reason for Rx or click Browse for more options.
  5. If applicable, click Add Another Reason to enter a second diagnosis.
    1. Enter an ICD-10 code into the Reason for Rx or click Browse for more options.
  6. Click Preview and Send or Print Rx once the necessary fields have been populated.

Note: If a new diagnosis is selected, it will not be added to the patient's problem list.

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Medication History can now be Retrieved from Surescripts

This feature enhancement is required to meet 2015 edition certification requirements and addresses the need to establish Medication History & Reconciliation which is important for medication safety and medication planning.

The medication history data is pulled from Surescript from the past 12 months or the last 50 drugs filled using the patient's name, date of birth and address to match to the prescriptions with their consent.

The following steps can be performed every day, but new data is only available every 3 days.

 

  1. Search for and open the patient's chart.
  2. Click Medications. The Active Medication page displays.
  3. Scroll down to the Med History via Surescripts section.
  4. Select Yes > Save. The medication history will pull from Surescripts.
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  1. The medication will populate on the screen with the following:
    1. The filled drug name, strength and when it was last filled.
    2. Copy to Active Meds will add the selected drug(s) to the Active Medication list or Copy to Discontinued Meds will add the selected drug(s) to the Discontinued Medication list.
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Note: Clicking on the drug name will open the Medication History (from Surescripts) modal with additional details: med_history_info.png
  1. Check the checkbox next to the drug to select.
  2. Click Copy to Active Meds or Copy to Discontinued Meds.
  3. The medication will be added to the list showing the filled drug name, strength, when it was last filled, available refills, and prescriber with the source as Surescript.
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Filled Prescription

Providers can now see if a patient fills a medication that was prescribed electronically.

  1. Hover over the Clinical Icon.
  2. Click eRx Requests. The eRx Request page displays.
  3. Click Fill Responses.
    1. The status of the fill response will be shown as New or Closed.
    2. The Fill Status will show as Filled, Partially Filled or Not Filled.
    3. Click Mark as reviewed to close all New task.
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The fill status will also show in the patient's medication list.

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Change Rx Request

Providers can now respond to prescription change requests sent by the pharmacy.

  1. Hover over the Clinical Icon.
  2. Click eRx Requests. The eRx Request page displays.
  3. Click Change Requests.
  4. Click on the Change Request to view the details.
    1. The status of the change request will be shown as NEW or CLOSED.
    2. The patient's name and date of birth associated to the prescription.
    3. The original drug prescribed, pharmacy information, and the prescriber.
    4. The requested medication(s) change from the pharmacy including the change type.
    5. Options to process the change request.
  5. Click Submit to complete the change request.

Note: If a new medication is approved, the previously prescribed medication will be marked as discontinued.

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Cancel Rx Request

Providers can now initiate a cancel request of medication instead of calling the pharmacy directly.

Send the cancel request:

  1. Search for and open the patient's chart.
  2. Click Medications. The Active Medication page displays.
  3. Click on the medication that needs to be canceled. The ePrescription window opens.
  4. Click the drop-down arrow next to Discontinue > click Send Cancel Request. The Send Cancellation Request? window opens.
  5. Click Yes.
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A Cancellation Pending banner will show in the patient's medication list. The provider can click on the banner to go directly to the Cancel Rx task.

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View a cancel request:

  1. Hover over the Clinical Icon.
  2. Click eRx Requests. The eRx Request page displays.
  3. Click Cancel Requests.
    1. The status of the change request will be shown as NEW, PENDING, or CLOSED.
    2. Detailed status information will show as Approved by Pharmacy, Awaiting Response from Pharmacy, Denied by Pharmacy, No Response from Pharmacy, or blank.
      1. If the status is NEW, the details can be: Approved by Pharmacy, Denied by Pharmacy, or No Response from Pharmacy.
      2. If the status is PENDING, the details will be Awaiting Response from Pharmacy.
      3. If the status is CLOSED, the details will be blank.
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Closing a cancellation request:

  1. Click on a request with a NEW status.
  2. Select what to do with the medication.
  3. Click Submit.
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Add exception per patient on Quality Measure report

The enhanced Quality Measure report allows users to see which category patients fall under for a specific measure with the ability to add exception reasons for accurate reporting.

  1. Hover over the Clinical Icon.
  2. Click Quality Measures.
    1. If applicable, select the provider from the Provider drop-down.
    2. Select the date range.
    3. Click Run Report.
    4. Once the report is available, click on the report to view.

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  1. Click View Details to view the patients associated to the measure.
    1. Click View to filter the report.
    2. Patient and date of birth associated to the measure.
    3. If applicable, click Add Exception.
    4. Choose the Exception Reason for each visit date.
    5. Click Done.
    6. Click Download to export the report to Excel.
  2. Rerun the report to reflect the added exceptions.
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New bonus measure added to MIPS 2018 Advancing Care Dashboard

The MIPS eligible clinician who uses a 2015 Edition Certified EHR for reporting 2018 ACI measures will receive a one-time 10% bonus and can be added to the 2018 Advancing Care Dashboard.

To add the bonus:

  1. Hover over the Clinical Icon.
  2. Click MIPS 2018 Advancing Care Dashboard.
  3. Select Yes under Met Requirements for Used 2015 Edition Certified EHR

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Bug Fixes

  • Fixed an issue where the lab results status was not updated when results were available
  • Fixed an issue where several vaccinations VIS dates were outdated
  • Fixed an issue where providers were unable to prescribe controlled substances through EPCS
  • Fixed an issue where the Manage Controlled Prescribing link displayed an "Organization ID is not valid" error
  • Updated Gabapentin as a Schedule V Medication for the state of Kentucky
  • Updated CDC recommendation to the 2018 immunization schedule
  • Updated Zyrtec as a Schedule V Medication for the state of Louisiana
  • Fixed an issue where the MIPS dashboard would not load
  • Fixed an issue where encounter forms were printing with the wrong time zone
  • Fixed an issue where  was showing instead of $ in the patient's account page
  • Fixed an issue where users were unable to determine which insurance plan was being selected due to overlapping text
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