Wolf Panel Clean-up. Initial Panel Clean-up Dashboard Active Pts. Set up Coded Problems in Problem List (Profile) Clean-up Patient Demographics

Transcription

1 Wolf Panel Clean-up Initial Panel Clean-up Dashboard Active Pts. Set up Coded Problems in Problem List (Profile) Clean-up Patient Demographics Case Finding by Name or ICD9 Code in Problem List Using Billing to Find Patients with Chr. Diseases Batch Processes to Apply Task to Multiple Pts. Practice Searches Actions for Practice Search Patient List Results Practice Search - Saving - Search Rules

2 Return to Menu WOLF (TELUS) Cheatsheet Objective Data Dashboard 1. To open the Objective Data Dashboard in Wolf, open the Wolf Medical Suite. From the homepage, click on the Dashboard tab. The following window will open: 2. Select the Primary Care Provider you would like to run this dashboard for, as well as the time period for (best practice is to select 12 months.) *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 1 of 4 Next

3 Return to Menu Viewing of details for a metric and improving on that metric: 3. Double click on the metric, and a screen will display a graph, target and table data for the metric 4. The right pane will display tips on how to improve the data for that metric. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 2 of 4 Next

4 Return to Menu 5. You can view the value from several places, as shown below: Main page Metricspecific page: below the graphic (in the lowerleft corner of the window) Metricspecific page: Hover the mouse over a data point. Metricspecific page: Data table (in the upperright corner of the Overview pane) *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 3 of 4 Next

5 Return to Menu To see which metrics do not meet the required values: 6. If the heading of the metric is in grey, it meets the criteria, and on the other hand, if it appears in pink, it doesn t. Metric status Color of the metric's horizontal bar Meets the required values Green Doesn't meet the required values Red Example To see which patients do not meet that criteria: On either the main page or the metric-specific page, click the magnifying glass to create a list of patients. A Practice Search window will be displayed, and you can perform the same kind of actions that are available for Practice Search patient list results, including: Add a problem code to selected patients (bulk add) Add patients to a follow-up list *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 4 of 4

6 Return to Menu WOLF (TELUS) EMR Cheatsheet Registry Creation For chronic disease and complex care recalls, use the following steps to create rules for a particular group of patients: 1. From within the Wolf Medical Suite, open Practice Search 2. To create a new rule, click on the White Page icon. 3. Enter a name for the rule e.g. Chronic Pain Patient. 4. Once all changes have been made, click the safe button. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 1 of 4 Next

7 Return to Menu 5. A Save Current Search As screen will come up: *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 2 of 4 Next

8 Return to Menu 6. Enter o o o o o the following information: The Search Name Select the Save Item as Rule check box Enter the Text to Display for Patients who Match this Rule Enter the Rule Priority. The range is between 1 and 9, with 1 being the highest priority and 9 being the lowest priority. 9 is usually reserved for populations. 7. To assign a role (for example, service provider, RN, or MOA) to the rule, from the Security Group drop-down list select a role. 8. You may select a time in the Scheduled to be run on box to run this rule automatically to regularly generate reminders. 9. If this rule is to be used for the whole clinic, select the Allow All Users to Use This Item (Office Share) check box. 10. When you have completed filling in this information, click Save as New. A pop-up is displayed confirming the Search was Saved Successfully. 11. Click OK. Now generate the rule engine: This can be done by either using the Practice Search or from within Rule Match results screen. A. Within Practice Search: 1. Open Wolf Practice Search. 2. Click on the Execute the Rule Engine button 3. The following message will appear: 4. Click Yes to continue and the Wolf EMR Rule Engine command window opens. 5. Do not close this window. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 3 of 4 Next

9 Return to Menu 6. Once the Rule Engine has finished running, the command window closes and your rules are up-to-date. The Rules run time and date when they were last run is shown at the bottom of the Rule Matches window. B. Within Rule Match Result screens: 1. When you are viewing your Rule Matches in the Rule Matches screen, click the Rules button. The rules refresh once completed. Reprocess all Viewing rule matches; The physician will see the following message displayed on their Workdesk under the Tasks tab: By double clicking on this message, the list and action of rule matches will be displayed. On the MOA Workdesk, rule matches will be displayed as follows: To access the list of which patients match which rules, double click on Rule Matches. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 4 of 4

10 Return to Menu Practice Search for Panel Identification From the Main Page, choose Practice Search On this screen: 1. Click the box beside Search All Patients in the upper right. 2. Choose Primary MD under Demographics. 19 Visit our website Contact us or Next

11 Return to Menu Useful Searches to Inform Panel 1) Identify the list of active patients attached to a physician. Click the Search All Patients box. Note the total number of patients identified in the search. This search will identify all the patients currently attached to Dr. Adams in the EMR. Click to Show Search Results as a Patient List Review the number of active patients that Dr. Adams currently has. Consider: Does this list really reflect his active patient population? When the list of patients is produced from this search, it shows the last visit date in the report. Scan the list of dates. How far back in time are the dates of last visit? This will inform panel decision making, as the physician could have last visit dates that were many years ago. 20 Visit our website Contact us top@topalbertadoctors.org or Next

12 Return to Menu 2) To start to define active patients, identify all active patients that have NOT had a visit to the clinic in a period of time nor a future scheduled appointment. Ask the physician how far back to go in time to define an active patient. If the answer is 4 years, use the following search to identify all the patients of Dr. Adams that have NOT had a visit of any type in the last 4 years and do NOT have a visit scheduled in the next 6 months (or a specific time forward; it is not common for a clinic to book more than 6 months forward). This may be a clinic-wide decision to look back between 3 and 5 years to define an active patient. Once the patient list is produced and reviewed by Dr. Adams (and perhaps the team, too), obtain Dr. Adam s consent to change the status of all these patients to Inactive or Lapsed (depending on clinic preference). He may choose to keep certain patients on the list active. 21 Visit our website Contact us top@topalbertadoctors.org or Next

13 Return to Menu Useful Tip: It is possible to customize the views in the Practice Search. See the Patient List Column Configuration help file mentioned below. Once a new status has been created you may wish to assign it in bulk to a list of patients. For example, if the prenatal or long term care patients are not distinguished in the EMR, using Practice Search you can identify a list of patients, and then you may update the patient status for the selected patients. See the Wolf help file called How to Update the Patient Status for the Selected Patients. 22 Visit our website Contact us top@topalbertadoctors.org or Next

14 Return to Menu For Additional Assistance on Practice Search: Visit the TOP ASaP Web site to access the Wolf How-To Videos: Visit the Wolf EMR Online Help (by clicking on the Help icon from the Wolf Main Page) Useful files: Practice Search Practice Search > How to Use Practice Search Parameters Practice Search > Save Current Practice Search Practice Search > Practice Search Results Patient Lists Practice Search > Practice Search Results Patient Lists > Patient List Column Configuration Practice Search > Practice Search Results Patient Lists > Actions for Practice Search Patient Lists Results > How to Update the Patient Status for the Selected Patients Wolf Video Tutorials: Practice Search Exam Findings Practice Search Separate observed dates for Labs and documents How to Use Bulk Add in Practice Search Note: To access Video Tutorials, the link to Available Video Tutorials will appear when a video tutorial matches a search term. 23 Visit our website Contact us top@topalbertadoctors.org or Next

15 Return to Menu The link to Video tutorials is always available in the help files; scroll down to the bottom right hand corner of the file to the link to Video tutorials. 24 Visit our website Contact us or

16 Return to Menu WOLF (TELUS) Problem Summary for Case Finding 1. To find a group of patients who would fit certain parameters, open Practice Search from the Wolf Medical Suite: 2. The following window will appear: 3. Expand the Demographics tab to select the Primary Care Provider if this step is omitted, all patients for the entire clinic will appear in lists. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 1 of 4 Next

17 Return to Menu 4. By expanding the History tab, you will find that you can search for groups of patients with specific problems on the Problem List (by ICD9 codes and/or where ICD 9 codes don t apply 5. To further narrow the search down, you can also add parameters e.g. specific age groups, or gender specific etc. by selecting the appropriate parameters from the Patient Demographic box. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 2 of 4 Next

18 Return to Menu 6. To select an item to be searched, e.g. Who are all my patients with Essential Hypertension, click on the item on the left side of the screen. You will find that it adds a box on the right side of the page. 7. Add the appropriate code e.g. 401, or other criteria e.g. if you are searching for a particular service fee code. Always still select from the dropdown arrow underneath the code. Alternatively, instead of the code, the description can be added. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 3 of 4 Next

19 Return to Menu 8. To access the list of patients who fit into those particular parameters, click on the magnifying glass. 9. You then have the option to either print the entire list, or select certain patients to appear on the printed list. The list can then be saved, however, it will be a static list based on the information pulled in that particular point in time. To include newly diagnosed patients, rather start the search every time you need to access this information. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 4 of 4

20 Return to Menu WOLF (TELUS) ICD9 Codes for Case Finding Cheatsheet 1. To find a group of patients who would fit certain parameters, open Practice Search from the Wolf Medical Suite: 2. The following window will appear: 3. Expand the Demographics tab to select the Primary Care Provider if this step is omitted, all patients for the entire clinic will appear in lists. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 1 of 3 Next

21 Return to Menu 4. By expanding the Billing tab, you will find that you can search for groups of patients with specific ICD9 codes 5. To further narrow the search down, you can also add parameters e.g. specific age groups, or gender specific etc. by selecting the appropriate parameters from the Patient Demographic box. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 2 of 3 Next

22 Return to Menu 6. Add the appropriate code e.g. 401, then select from the dropdown arrow underneath the code. Alternatively, instead of the code, the description can be added. (e.g. Essential Hypertension which will bring up the appropriate ICD9 code) 7. To access the list of patients who fit into those particular parameters, click on the magnifying glass. 8. You then have the option to either print the entire list, or select certain patients to appear on the printed list. The list can then be saved, however, it will be a static list based on the information pulled in that particular point in time. To include newly diagnosed patients, rather start the search every time you need to access this information. *Compatible with all versions of Wolf (Telus) May 2016 Renate Killoran Page 3 of 3

23 Return to Menu To change the status of a list of patients as a Bulk Group Example: to change a list of patients to Lapsed as a bulk group 1) Choose Selection > Select All This selects (checks off) all the patients on the list. Individuals can be deselected by checking the box beside the name. 14 Visit our website Contact us top@topalbertadoctors.org or Next

24 Return to Menu 2) Choose Selection > Update Patient Status 15 Visit our website Contact us or Next

25 Return to Menu 3) When the Change Patient Status screen appears, using the drop down menu, change the Status to Lapsed and put a Start date in the Admission Date field. You may wish to write a note, (e.g, had no visit in 4 years.) 4) Click OK when done. The list of patients that had not visited the practice in the past 4 years and did not have a future appointment booked has been changed to Lapsed and they are no longer Active in the physician s panel. 16 Visit our website Contact us top@topalbertadoctors.org or Next

26 Return to Menu At any time the clinic chooses to reactivate a patient, the patient status may be changed back to Office Patient or the default active patient for the clinic. Changing patient status of an individual back to active Open Patient Maintenance for the patient (F9 or click on Patient Maintenance). 1) Choose the Patient Status tab 2) Click New Status 3) Using the drop down menu, select a new status for the patient such as Office Patient. Today s date will appear in the *Start Date field. Click on the Start Date, if you wish to change the date the patient is active again. 17 Visit our website Contact us top@topalbertadoctors.org or Next

27 Return to Menu 4) Select Save Status when done. Note on searching to include Inactive patients: If it s new to have inactive patients in your clinic EMR, when Front Staff are using the Scheduler and using the Patient Search, the Include Inactive box needs to be checked. 18 Visit our website Contact us top@topalbertadoctors.org or

28 Practice Search Practice Search simplifies the management of patients with chronic diseases, resulting in better patient outcomes and more proactive scheduling of follow-up visits and tests for these patients. This is done by creating patient lists and rules to create letters or prompt for phone calls to patients who have missed recommended screenings, require medication monitoring or prescription refills, or just to call in at-risk patients for a follow-up appointment. Practice Search rules integrate into the Administrative Staff workflow to easily facilitate recall and follow-up tasks. You can use Practice Search to search for patients assigned to either you or the entire clinic; you can save search criteria for future use. You can also create Practice Search Rule Matches based on saved search criteria. Quickly and easily create complex queries and immediately find the answers in your practice. You can integrate results into the Wolf EMR follow-up system for patient recall, or save the results as Rules that trigger when the patient is in the office. You can use Practice Search as part of Wolf EMR CDM creating patient lists and rules. You can use the Rules shipped with the application or create your own based on your clinic's needs. Wolf EMR CDM with Practice Search simplifies the management of patients with chronic diseases, resulting in better patient outcomes and more proactive scheduling of follow-up visits and tests for these patients. Wolf EMR CDM makes it less burdensome to provide high-quality guideline-based care to patients by providing detailed disease specific templates and easy-to-use Practice Search capabilities to help you understand your patient base and focus on prevention in the monitoring of these patients. You can use Practice Search to define populations to be used in Run Charts, which are then used to determine changes in the practice s clinical processes and patient health outcomes over a period of time. Key functions of Practice Search Answers the question: How many patients have the following criteria? Flags patients' charts with specific reminders (threshold for reminders are user-defined) Flags physicians in-basket with reminders for patients who now match specified clinical criteria in the past 24 hours (threshold for reminders are userdefined) Defines populations for use on Run Chart trending reports How to open Practice Search 1. Open the Wolf EMR 2. Click the Practice Search button in the ribbon menu. View image.

29 Return to Menu How to search and use pre-loaded Practice Searches or Rules Practice Search has pre-loaded practice searches and rules. You can use these to get started on your search; you can also use these for your Run Charts. For demonstration purposes, let s say you want a list of all your Diabetes Mellitus Type 1 patients who have been diagnosed in the last 3 years with overdue or near overdue CDM items. You want this list to schedule a follow-up with these patients. 1. From the Practice Search screen, click the button to select from a list of pre-loaded Practice Search items. From our above example, scroll down to the Diabetes section to search for Diabetes patients. View image. 2. Select a pre-loaded practice search and fill in any other appropriate fields. Click the Open Selected button Basic search parameters open and patient information is loaded based on the pre-loaded practice search you selected. Next

30 From our example, you will see that your History section automatically fills in the problem as Diabetes, but you can select from the drop down that it is Diabetes Mellitus Type 1 Insulin Dependent. There are also some fields that you would like to fill in such as the Diagnosed field, which is not enabled. Select the check box next to the search fields you want to fill in, to enable them. 3. Fill in any further information based on a search you want.

31 4. You can further filter down your search by selecting and adding information from the Search Parameters frame. For information on the parameters, see Practice Search Parameters. From our example we want DM patients who have overdue or near overdue items, so we need to open the Care Plan section and select Overdue and Near Due parameters for your search.

32 5. Ensure the correct information is selected or filled in for any of these selected parameters. 6. Once all your search parameters are filled in, select one of the following options in the upper right hand corner of the screen: To do this: Display a list of patients who fit this criterion. Click this button: If you're searching on lab or exam results, the search results include a column with the latest lab or exam result (for example glucose). View image. Note (Show Search Results as a Patient List button) Display search results in a Pie Chart format to visually view data. View image. (Show Search Results in the Demographic Viewer button)

33 Run all items in Practice Search marked as Rules to execute. To learn more about Practice Search Rules, see Practice Search Rules. (Execute the Rule Engine button) Now that I have my list of patients, what can I do with it? For more information on the actions you may take on Practice Search Patient List Results, see Actions for Practice Search Patient List Results.

34 Actions for Practice Search Patient List Results Once you have your list of patients and you made your selection by clearing or selecting the check boxes beside the patient's names, you can perform a variety of functions by using the options in the Selection menu. How to review patient data on these patients Right-click a patient listed in the search results and select F7 for Medical Summary to view the patient's Medical Summary, or select F9 Patient Maintenance to view the patient's information in Patient Maintenance. How to add a Problem Code to the selected patients ("Bulk Add") You can easily add a problem code to selected patients. This feature is called "Bulk Add". This improves the quality of data in the EMR. For example, you can add the problem code for Diabetes to all patients who have been billed with a diagnostic code for Diabetes. The Bulk Add feature is accessed from the Add to Problem List item on the Selection menu in the Patient List screen. A video tutorial is available (How to use Bulk Add in Practice Search) How to add patients to a follow up list A primary use for CDM Practice Search is to schedule follow ups which enable better monitoring and better patient outcomes for patients with chronic diseases. 1. With your Practice Search Patient List Results screen open, click the Selection menu item in the Patient List screen and click Select All (or use the keyboard shortcut <Ctrl><A>) ( View image) Or You may also choose only certain patients from the list by selecting the box next to the individual patient s name 2. From the Selection menu, choose Add to Follow Up List (or press <Ctrl><F>) A New Follow Up for Selected Patients screen is displayed. View image.

35 3. Add any of the following information in the Follow Up Problem box if necessary: o Follow Up Problem: Enter the reason for the follow up. The default appear "Patient Selected for Follow-up in Practice Search". o In the Follow Up Type select one of the following: Physician Reminder: This sends a reminder to the physician on the WorkDesk under Current Follow Up Tasks on the Messages tab. Patient to Come in: This sends a reminder to the Front Office Staff WorkDesk under Patients to Notify in the Tasks tab. Note Both selections leave a note on the patient s Medical Summary stating there are Pending follow ups in red font at the top of the screen. Or click the Communications tab in the Medical Summary and the follow up is displayed in the Follow Up List. 4. Select the Urgency: Routine or Urgent 5. Select whom to assign the follow-up to: o o o Patient's Attending Physician You - Creates the follow up(s) for the user currently logged on Group - If you select Group, then select a group from the drop down below 6. Click OK when finished How to assign a Primary MD to the selected patient(s) 1. With your Practice Search Patient List Results screen open, click the Selection menu item in the Patient List screen and click Select All (or use the keyboard shortcut <Ctrl><A>) OR You may also choose only certain patients from the list by selecting the box next to the individual patient s name 2. From the Selection menu, select Assign Primary MD, or press <Ctrl><M> The Select a Provider screen is displayed. 3. Select which primary MD you would like to assign for the patient(s). View image.

36 4. Click the OK button when done. A popup confirming the change is displayed. 5. Click OK again How to assign an Alternate MD to the selected patient(s) 1. With your Practice Search Patient List Results screen open, click the Selection menu item in the Patient List screen and click Select All (or use the keyboard shortcut <Ctrl><A>) OR You may also choose only certain patients from the list by selecting the box next to the individual patient s name 2. From the Selection menu, select Assign Alternate MD The Select a Provider screen is displayed. 3. Select which Alternate MD you would like to assign for the patient(s). View image. 4. Click the OK button when done. A popup confirming the change is displayed.

37 5. Click OK again How to assign a Care Team to the selected patient(s) 1. With your Practice Search Patient List Results screen open, click the Selection menu item in the Patient List screen and click Select All (or use the keyboard shortcut <Ctrl><A>) OR You may also choose only certain patients from the list by selecting the box next to the individual patient s name 2. From the Selection menu, select Assign Care Team The Select a Care Team screen is displayed. 3. Select which Care Team you would like to assign for the patient(s). View image. 4. Click the OK button when done. A popup confirming the change is displayed. 5. Click OK again How to create a SMART Form for each of the selected patients The documents created in this procedure: Note Do not get added to the patients' chart. Are intended for bulk communication and cannot be edited; they are sent directly to the specified printer. 1. With your Practice Search Patient List Results screen open, click the Selection menu item in the Patient List screen and click Select All (or use the keyboard shortcut <Ctrl><A>) OR Choose only certain patients from the list by selecting the check box next to the patient s name 2. From the Selection menu select Send Selected to SMART Form.

38 The Send to SMART Form window is displayed. 3. Select the SMART form you want to use, as described (starting from step 2) in "Workflow for using Generic SMART Forms" in the topic "SMART Forms". This SMART form will be used for all the patients that you've specified. After you click, in the Send to SMART Form window, Send and Close, the following window is displayed: 4. Select the printer and click Proceed with Merge. 5. If the SMART Form contains the Signature bookmark and you have a signature image set up (as described in How to upload a signature for SMART Forms), you are prompted whether you want to add the signature. If you want to add the signature image to the SMART Form, click Yes. How to update the Default Location for the selected patient(s) 1. With your list of patients, select the patients you would like to update by selecting the check box next to their name OR To select all of the patients on the list, from the Selection menu select Select All 2. From the Selection menu select Update Default Location The "Select a location" window is displayed.

39 3. Click the drop-down arrow and select a location. 4. Click OK. How to update the Patient Status for the selected patient(s) 1. With your list of patients, select the patients you would like to update by selecting the check box next to their name OR To select all of the patients on the list, from the Selection menu select Select All 2. From the Selection menu select Update Patient Status The "Change Patient Status for Selected Patients" window is displayed. 3. From the Status drop-down list, select the new status. 4. Click OK. How to add patients to a user-defined patient list Add patient(s) to patient lists. For example, a waitlist. Choose from the following breakout menu: Add New List Selecting Add New List opens the Patient List Maintenance screen (found in Configuration - Patient Data Codes) and allows you to enter criteria for a new list.

40 1. Enter the List Type, Description and Source. 2. Click the button when done Add to Existing... Selecting Add to Existing opens the Select a Patient List window, allowing you to select a patient list and provider, then to add or update the behaviour for existing entries. Click OK. The patient list is now set up for your selected patients. How to deactivate the selected patients By deactivating the selected patients in the list, you are marking their status as 'Inactive' 1. With your list of patients, select the patients you would like to inactive by selecting the check box next to their name OR To select all of the patients on the list, from the Selection menu, select Select All 2. With the patients selected, click the Selection menu 3. Select Deactivate Selected A prompt is displayed stating: "Are you sure you want to mark selected patients as inactive?" 4. Click Yes How do I print my patient list or demographic information? Physicians and Front Office Staff may want to print practice search results as a reference to take further action. For example, if you are searching for certain CDM patients who have not been billed, then the Front Office Staff can print off the list and use the list as a reference of the patients they need to bill. To print the patient list: 1. Once you have completed your Practice Search and you have your list of patients, click the File menu and choose one of the following: o To print all the patients in the list, choose Print All o To print only the patients in the list who you selected with a check box, choose Print Selected

41 To print the demographic information: 1. Once you have the Demographic Viewer open, click the Print menu and select: Print: This opens up the print properties where you can choose your printer etc. Quick Print: This sends the file to the default printer

42 How to export all patients on the patient list to a CSV file (Excel file) Practice Search results displayed in a Patient List can be exported to a CSV file for further data analysis. The CSV includes the Patient Name or Patient ID, Sex, Date of Birth, Age at Export, Last Visit Date 1. In the Patient List screen, click the File menu 2. Click either: o Export All to CSV - Includes the patient name in the list. May be used for mail merges and other functions o Export All to CSV Anonymously - Includes the patient ID rather than the patient's name to keep anonymity. This is used for statistics and security.

43 The Save As menu is displayed. 3. Navigate to a location to save your CSV file and name the file. 4. Click the (Save) button. The CSV file is now saved to the selected location. How to schedule an appointment for a selected patient 1. With your patient list open, click the patient you would like to schedule an appointment for. A box should appear around the patient.

44 2. On your keyboard, press <Ctrl><T>. Scheduling opens, as well as the Available Time Slot Search screen.

45 Return to Menu Next

46 3. Adjust/fill in the required information as needed to find a time slot to schedule the patient: o Practitioner o Look in # of days o Start From o Minutes between time slots o Minimum Time Slot Length o Specific Time After this time Before this time 4. Click the Search button. A list of applicable appointments is shown in the box below. Select an appointment that works for the patient. 5. Click the Book button.

47 Return to Menu The appointment is added to Scheduling. Next

48 Options on the View menu Selection In New Window Displays selected patients in a new results screen using either the same view or Demographic List view. Results in Demographic Window Displays all patients in a new results screen using the Demographic List view. Roster Reconciliation You can: View differences between a provider's patient panel within the Wolf EMR and a list (CSV file) provided by a provincial body (for a specific service provider). Change patients' Primary Service Provider. Important To make sure you're comparing the CSV against the correct data in the Wolf EMR, check that you ran the Practice Search for the same service provider as the CSV file relates to. 1. From the View menu, select Roster Reconciliation to display the Open window. 2. In the Open window, browse to the CSV file and click Open. The Roster Reconciliation window is displayed ( view image). The window has two lists:

49 o o "Patients to Add to Roster" lists the patients that are in the CSV file but are not in the Practice Search results. "Patients to Remove from Roster" lists the patients that are in the Practice Search results but are not in the CSV file. Tip You do not have to compete all the steps below in one go. You can reopen the Roster Reconciliation window at your convenience and perform the desired tasks. 3. To add patients to the roster: a. Make sure the same physician is selected in the physician drop-down list (in the "Patients to Add to Roster" pane), as the physician that the CSV file is for.

50 b. Select the patients you want to add to the roster. Do one of the following: To select specific patients, select the check box next to the patient's name. To select all patients: I. If the button (below the list of patients) displays Deselect All, click it; the button changes to Select All. II. Click the Select All button. c. Click the Add button. 4. To remove patients from the roster: Note In the "Patients to Remove from Roster" pane, the Physician column shows the patient's Primary Service Provider according to the information in Wolf EMR (the value of Primary Service Provider in Patient Maintenance - Name / Addr / Phone tab). According to the CSV file, the patient has a different Primary Service Provider. Before you remove a patient from the roster/reassign a service provider, it's recommended that you verify who is the patient's service provider.. In the "Patients to Remove from Roster" pane, from the physician drop-down list, select the physician that you want to assign patients as their Primary Service Provider. a. Select the patients you want to assign to the selected physician. Do one of the following: To select specific patients, select the check box next to the patient's name. To select all patients: I. If the button (below the list of patients) displays Deselect All, click it; the button changes to Select All. II. b. Click the Reassign button. Click the Select All button. c. If you want to assign some patients to other physicians, repeat steps a through c. List Exempted Patients Displays another Patient List screen with patients recorded as exempt from the rule. For more information, see Practice Search Rule Exemptions. Column Options Displays the Practice Search Patient List Options screen where you can customize the columns displayed for the Patient List view for all users.

51 Saving The Current Practice Search Save Practice Search criteria for future searches or as a Practice Search Rule, which you can use to automatically flag patients who match the search criteria. 1. Follow the instructions to perform a Practice Search. 2. After a list of patients has been produced from the search results, click the button in the main Practice Search window to display the Save Current Search As screen. View image.

52 Fields Enter the following information: Search Name Enter a name to save the search criteria. Result View Select the view. A view defines columns, and their order, that are displayed in the Patient List view of the Practice Search results. For more information, see Patient List Column Configuration. Save Item as Rule Select this check box to save a Rule with the Search Criteria, causing any patient with matching criteria to automatically be flagged during their next office visit. Also enter the text that will display in the Practice Search Rule Matches for the patient, along with the date and time it is scheduled to run on. Text to Display for Patients who Match this Rule This field is greyed out unless Save Item as Rule (see above) is selected. This option allows you to enter a text message that is displayed anytime a patient matches this rule is encountered. Rule Priority Gives the ability to enter a rule priority. The range is between 1 and 9, with 1 being the highest priority and 9 being the lowest priority. 9 is usually reserved for populations. The default rule priority is 5. Default Action Click the drop-down list to select a default action from the list for when this rule is activated. Default Actions include: Follow-up, CDM Flowsheet, Refill Medication, Medical Summary, New Lab Requisition, New Problem, New Message, or New Allergy. Security Group To assign a role (for example, service provider, RN, or MOA) to a given rule match, from the Security Group drop-down list select a role. This enables the display of the role in the Rule Matches window. Scheduled to run on This field allows you to enter criteria for when a rule should be run. Active Select this check box to indicate that the rule is active. You can filter Active and Non-active rules in the list by using the check boxes at the top of the screen. Display Rule Match in Portal If Patient Portal is enabled for the clinic: To have the rule matches displayed in the Patient Portal, select the Display Rule Match in Portal check box.

53 Note For a rule match to be displayed in the Patient Portal, the rule must be active. Notification Settings If Patient Portal is enabled for the clinic: To enable notifications in Patient Portal and configure the notification settings, make sure the Display Rule Match in Portal check box is selected and click the Notification Settings button to display the Portal Notification Settings window. View image. In the Portal Notification Settings window you can type text and, using the ribbon bar (view image), format text that is to be displayed for this rule match on the Notifications tab of the Patient Portal. You can insert hyperlinks (for example, a link to your clinic's patient portal). To have an automatically sent to the Patient Portal when a rule match occurs, select the Send Alert check box. The informs the portal users (that have Rule Alerts enabled and for which the rule match applies) that information is available on the Notifications tab of the Patient Portal. Allow All Users to Use This Item (Office Share) Select this check box if you want the Rule to be shared by the entire clinic. Clear the check box if the Rule should apply only to patients assigned to you. 3. Do one of the following: o To save the current search criteria as a new search, click Save as New o To overwrite an existing search, select a Search Name and click Save Over Selected. 4. Click the Exit Menu button when finished.

54 Wolf EMR Pre-Defined Practice Search Rules Wolf EMR comes with a large set of pre-defined rules for Practice Search. These rules are used to manage a set of patients and govern the way that Practice Search works for a variety of conditions including CDM and Care Plan patients. Arthritis rules Code Name Rule Parameters Purpose ART1 Arthritis Register Rheumatoid Arthritis. Maintain a current register of all Rheumatoid Arthritis patients within the practice. Asthma rules Code Name Rule Parameters Purpose AST1 AST2 Asthma Register Asthma - No Action Plan Asthma patient with no Asthma Action Plan on file x 2 years. Asthma Asthma Exclude Match - Document where Keyword="Asthma Action Plan" in the past 2 years. Maintain a current register of all Asthma patients within the practice. Asthma patients should have a written asthma action plan updated regularly. Cardiac Risk rules Code Name Rule Parameters Purpose CR1 Cardiac Risk >10% Age <70 - no ASA. CR2 Cardiac Risk >10% - no Statin. Patient <70 yrs with >10% CHD Risk recommend ASA 81 mg OD. Patient with >10% CHD Risk recommend Statin. Examination Findings Cardiac Risk - Value >10% Exclude Match Drug Family = ASA Examination Findings Cardiac Risk - Value >10% Exclude Match Drug Family = HMGCoa ASA is recommended to those patients under 70 yrs with >10% risk CHD. Statins are recommended for patients with >10% risk CHD. CKD rules Code Name Rule Parameters Purpose

55 CKD1 CKD Register Renal Failure Maintain a current register of all Renal Failure patients within the practice. CKD2 CKD3 CKD Systolic BP > 130 CKD Systolic BP > 80 CKD patient suboptimal systolic BP >130 in past year. CKD patient suboptimal systolic BP >90 in past year. Renal Failure Examination Findings Systolic BP Greater than 130 in past year. Renal Failure Examination Findings Diastoilic BP Greater than 80 in past year. Recommended BP for CKD patients is < 130/80. Recommended BP for CKD patients is < 130/80. CHF rules Code Name Rule Parameters Purpose CHF1 CHF Register Congestive Heart Failure (CHF). CHF2 CHF No Echocardiogram CHF patient with no echocardiogram on file x 2 years. CHF3 CHF - No Ace/ARB CHF patient not currently on an ACE/ARB CHF4 CHF5 CHF6 CHF - No weight on file x 6 months. CHF no cardiac risk x 1 year CHF Suboptimal LDL CHF patient with no weight on file x 6 months. CHF patient with no cardiac risk on file x 1 year. CHF patient - suboptimal LDL > 2.0 Congestive Heart Failure (CHF) Exclude Match - Document where Keyword="Echocardiogram" in the past 2 years. Congestive Heart Failure (CHF) Exclude Match - Medication Type = Anti- Hypertensive: ACE or Medication Type = Anti-Hypertensive: ARB Congestive Heart Failure (CHF) Exclude Match Examination Findings Weight x 6 Months. Congestive Heart Failure (CHF) Exclude Match - Examination Findings Cardiac Risk in past year. Congestive Heart Failure (CHF) Last Lab of Type LDL > 2.0 Maintain a current register of all CHF patients within the practice. CHF patients are monitored with regular echocardiograms to assess cardiac function and guide medication management. Baseline weights and patient daily weights are an important part of CHF management. Aggressive management of CV risk factors is recommended to reduce the risk of ischemic heart disease. Current guidelines indicate that patients at high risk for Coronary Heart Disease (CHD) should have LDL cholesterol <2.0. CHF patients are by definition considered high risk for CHD.

56 COPD rules Code Name Rule Parameters Purpose COPD1 COPD Register COPD Maintain a current register of all COPD patients within the practice. CAD rules Code Name Rule Parameters Purpose CAD1 CAD Register Coronary Artery Disease. CAD2 CAD21 CAD23 CAD24 CAD Suboptimal LDL CAD Suboptimal HDL CAD Suboptimal Triglycerides CAD Suboptimal Lipid Ratio CAD patient - suboptimal LDL > 2.0 CAD patient - suboptimal HDL <1.0 CAD patient - suboptimal Triglycerides >2.0 CAD patient - suboptimal Lipid Ratio <4.0 CAD3 CAD not on ASA CAD patient not on ASA. CAD4 CAD Systolic BP >140 DM patient suboptimal systolic BP >140 in past Coronary Artery Disease Last Lab of Type LDL > 2.0 Coronary Artery Disease Last Lab of Type HDL < 1.0 Coronary Artery Disease Last Lab of Type Triglycerides >2.0 Coronary Artery Disease Last Lab of Type Lipid Ratio < 4.0 Coronary Artery Disease Exclude Match - Medication of Type ASA. Coronary Artery Disease Maintain a current register of all CAD patients within the practice. Current guidelines indicate that patients at high risk for CAD should have LDL cholesterol <2.0. Higher levels of HDL Cholesterol decrease cardiac risk. Low levels <1.0 increase cardiac risk. Higher levels of triglycerides (>2.0) increase cardiac risk. Higher Lipid Ratios (>4.0) increase cardiac risk. Recommended BP for CAD patients is < 140/90

57 CAD41 CAD Diastolic BP >90 year. DM patient suboptimal Diastolic BP >90 in past year. CAD5 CAD BMI > 27 CAD patient with BMI >27 past year. CAD51 CAD61 CAD7 CAD no BMI x past year. CAD no waist circumference x past year. CAD no cardiac risk x 1 year. CAD patient with no BMI on file x 1 year. CAD patient with no waist circumference x 1 year. CAD patient with no cardiac risk on file x 1 year. Examination Findings Systolic BP Greater than 140 in past year. Coronary Artery Disease Examination Findings Diastolic BP Greater than 90 in past year. Coronary Artery Disease Examination Findings BMI Greater than 27 in past year. Coronary Artery Disease Exclude Match - Examination Findings BMI in past year. Coronary Artery Disease Exclude Match - Examination Findings Waist Circ. in past year. Coronary Artery Disease Exclude Match - Examination Findings Cardiac Risk in past year. Recommended BP for CAD patients is < 140/90 BMI >27 indicates obesity. Obesity is a major risk of CAD. Obesity is a risk factor for CAD. BMI is a marker of obesity (>27). Waist circumference is an indicator of abdominal obesity which is a major risk for CAD. High risk >102 cm for non-asian men and > 88 cm for non-asian women. Increased risk cm in non-asian men and cm in non-asian women. High risk >90 cm for asian men and > 80 cm for asian women. Dementia rules Code Name Rule Parameters Purpose DEM1 Dementia Register Dementia Maintain a current register of all Dementia patients within the practice.

58 Depression rules Code Name Rule Parameters Purpose DEP1 Depression Register Depression Maintain a current register of all Depression patients within the practice. Diabetes rules Code Name Rule Parameters Purpose DM1 DM2 DM3 DM4 DM41 DM42 Diabetic Register Diabetic No HbA1c x 6 months Diabetic HbA1c > 8% Diabetic Suboptimal LDL Diabetic Suboptimal HDL Diabetic Suboptimal Triglycerides DM patient - no HbA1c x 6 months. DM patient - suboptimal control - last HbA1c > 8% DM patient - suboptimal LDL > 2.0 DM patient - suboptimal HDL <1.0 DM patient - suboptimal Triglycerides >2.0 Diabetes Mellitus Type I or Type II Diabetes Mellitus Type I or Type II Exclude Match - Any Lab Result of Type Hemoglobin A1c in last 6 months. Diabetes Mellitus Type I or Type II Last Lab of Type Hemoglobin A1c >8% Diabetes Mellitus Type I or Type II Last Lab of Type LDL > 2.0 Diabetes Mellitus Type I or Type II Last Lab of Type HDL < 1.0 Diabetes Mellitus Type I or Type II Last Lab of Type Maintain a current register of all diabetic patients within the practice. HbA1c (Hemoglobin A1C) provides an indication of the level of blood glucose control over the past 2-3 months. The closer the HbA1c to 5% the better the diabetic control. Patients that have not had a HbA1c in the past 6 months are not been followed adequately. ( Diabetic patients with HbA1c's >8% are by definition poorly controlled and require special follow-up. Current guidelines indicate that patients at high risk for Coronary Heart Disease (CHD) should have LDL cholesterol <2.0. Diabetic patients are by definition considered high risk for CHD. Higher levels of HDL Cholesterol decrease cardiac risk. Low levels <1.0 increase cardiac risk. Higher levels of triglycerides (>2.0) increase cardiac risk.

59 Triglycerides >2.0 DM43 Diabetic Suboptimal Lipid Ratio DM patient - suboptimal Lipid Ratio <4.0 Diabetes Mellitus Type I or Type II Last Lab of Type Lipid Ratio < 4.0 Higher Lipid Ratios (>4.0) increase cardiac risk. DM5 Diabetic Renal Failure DM patient - egfr <60 Diabetes Mellitus Type I or Type II Last Lab of Type Calculated GFR < 60 Renal failure is a serious complication of DM. DM6 Diabetic No Microalbumin x 1 year DM patient - no Microalbumin x 1 year Diabetes Mellitus Type I or Type II Exclude Match - Any Lab Result of Type Microalbumin in the last year. Microalbumin is a urine test that tests for the protein albumin. Normal kidneys do not excrete any protein in the urine. The presence of albumin in diabetics indicates microvascular damage to the kidneys. This damage can lead to Chronic Kidney Disease. It is also a marker for how the patient's diabetes is affecting other organs as well as nerves and extremities. DM7 Diabetic not on ACE/ARB DM patient not on ACE/ARB Diabetes Mellitus Type I or Type II Exclude Match - Medication of Type Anti-Hypertensive: ACE and Anti- Hypertensive: ARB ACE Inhibitors (ACE) and Angiotensin II Receptor Blockers (ARB) are indicated for all diabetics to prevent the progression of kidney disease. DM8 Diabetic Systolic BP >130 DM patient suboptimal systolic BP >130 in past year. Diabetes Mellitus Type I or Type II Examination Findings Systolic BP Greater than 130 in past year. Recommended BP for Diabetic patients is < 130/80 DM9 Diabetic Diastolic BP >80 DM patient suboptimal Diastolic BP >80 in past year. Diabetes Mellitus Type I or Type II Examination Findings Diastolic BP Greater than 80 in past year. Recommended BP for Diabetic patients is < 130/80

60 DM9 Diabetic BMI > 27 DM patient with BMI >27 past year. Diabetes Mellitus Type I or Type II Examination Findings BMI Greater than 27 in past year. Diabetes Mellitus Type I or Type II Exclude Match - Examination Findings BMI in past year. Diabetes Mellitus Type I or Type II Exclude Match - Examination Findings Waist Circ. in past year. Diabetes Mellitus Type I or Type II Exclude Match - Examination Findings 10g monofilament in past year. Diabetes Mellitus Type I or Type II Exclude Match - Examination Findings Cardiac Risk in past year. BMI >27 indicates obesity. Obesity is a major cause of DM. Lifestyle treatment of obesity results in better diabetic control. DM91 Diabetic no BMI x past year DM patient with no BMI on file x 1 year. Obesity is a major cause of DM. BMI is a marker of obesity (>27). Lifestyle treatment of obesity results in better diabetic control. DM92 Diabetic no waist circumference x past year DM patient with no waist circumference x 1 year. Waist circumference is the best predictor of Type II DM and is an indicator of abdominal obesity which is a major risk/cause for DM. High risk >102 cm for non-asian men and > 88 cm for non-asian women. Increased risk cm in non-asian men and cm in non-asian women. High risk >90 cm for asian men and > 80 cm for asian women. DM92 Diabetic no 10g monofilament x past year DM patient with no 10g monofilament x 1 year. Diabetic neuropathy is a major complication of DM and 10g monofilament test is a good diagnostic screening exam. DM93 Diabetic no cardiac risk x 1 year DM patient with no cardiac risk on file x 1 year. DM is a major risk factor for Coronary Heart Disease. Diabetics should have regular cardiac risk assessments with management of risk factors to reduce cardiac risk. Hepatitis rules Code Name Rule Parameters Purpose HEP1 Hepatitis B Register Hep B Maintain a current register of all Hep B