1. Avatar CWS 2015 New Features – Q2
John Robilotta - Netsmart

2. Agenda
Progress Notes
Treatment Plans
Meaningful Use
ICD-10
OrderConnect
General

3. Progress Notes

4. Avatar CWS 2015 Update 13
Ability to post appointments through all Ambulatory and Inpatient Progress Note forms has been added.
This is in addition to the existing functionality available in the Progress Note (Group & Individual) forms.

5. Avatar CWS 2015 Update 15
Avatar PM 2015 Update 13 and Avatar Cal-PM 2015 Update 27 has been modified to provide greater flexibility when Start and/or End Times are changed.
Registry Setting: Recalculate Service Duration When Service Start – End Times Updated
CWS has been updated to support these modifications.
Example:
If 1&2&3 is entered, the system will recalculate the service Duration when the Start or End Time changes AND will recalculate the End Time when Duration is modified.
If 1&2&4 is entered, the system will recalculate the service Duration when the Start or End Time changes AND will recalculate the Start Time when Duration is modified.

6. Avatar CWS 2015 Update 44 - Chart
Clicking the Add button from the chart will pass the current PATID and episode to the specific Progress Notes (Group & Individual) form that is being accessed from the Chart.
Clicking Edit from one of the Draft records will pass in the PATID, Episode and specific note information to the specific Progress Notes (Group & Individual) record that is being viewed from the Chart.
There was a question during the call regarding Widgets, and whether the parameters for PATID and Episode would pass through to the Progress Notes (Group & Individual) forms when launched. At this time the answer is no but there is additional work being done so I will check on this for future functionality.

7. Avatar CWS 2015 Update 44 – To Dos
The Action column will now have a hyperlink for the Progress Notes (G&I) form specified and will launch to that form when clicked from the My To Do’s widget.

8. Avatar CWS 2015 Update 44 - myCalendar
Requires Avatar Appointment Scheduling Update 17 and RADplus Middleware (expected to be released later this month)
Right click on an appointment in ‘My Calendar’ allows clinician to launch Progress Notes based on Forms defined in User Role or User Definition, as defined in the Appointment Scheduling section. The PATID, Episode, and Appointment data pass directly into the note.

9. Avatar CWS 2015 Update 47
Avatar CWS is updated to support web services for Progress Notes.
Can be associated to Inpatient, Ambulatory and Progress Notes (Group & Individual) forms
Draft/Final is supported
Allows for editing and deleting
New, Existing Service and Appointment supported

10. Treatment Plan

11. Avatar CWS 2015 Update 46
In the new Treatment Plan, reports using the CDR version of the old cw_tx tables, which were converted to views, dictionary values were showing as ‘Unknown’. This has been corrected by converting these back to SQL tables. RADplus 2015 Update 50 is also required to see this change.
Additional items included in Avatar CWS 2015 Update 46:
Line breaks entered into the Problem/Goal/Objective/Intervention description field are being lost.
Dictionary fields in the treatment plan work screen are not sorted alphabetically.
While not new features, the following updates for Avatar CWS 2015 impact the new Treatment Plan:
Update 10
Update 11
Update 34
Update 54
Update 56

12. Meaningful Use

13. Avatar CWS Update 12
The label '(2011 Edition)' has been added to the following forms: 'Medication Reconciliation', 'ARRA Measures Reporting', 'ARRA Measures Setup'.
The label ‘(2011 Edition)’ will also be added to ‘ARRA Eligible Provider Definition in a future update.
These forms are superseded by our MU 2014 Edition.
If you have not already done so, please contact your CAE for details regarding our MU 2014 Edition.

14. Avatar CWS Update 12
The MAXLEN of the 'dictionary_value' and 'field_description' fields in SYSTEM.cwdictionaries have been increased to 120 The length was increased to 120 to accommodate full SNOMED codes and descriptions.

15. Avatar CWS 2015 Update 16
Avatar CWS 2015 Update 16: The following modifications are made to the 'Client List/Reminder List' form: 1) 'Client List' report is modified to include immunizations and wellness information. 2) Search functionality is added to the 'Wellness Items' field.

16. Avatar CWS Update 64
The following forms are updated for the 'Event Log Report':
'Client Health Maintenance',
'Client Allergies And Hypersensitivities',
'Family Health History',
'View Results',
'Review Results',
'CWS Vital Signs' and
'Vitals Entry'.

17. Avatar CWS 2015 Update 64

18. ICD-10

19. Avatar CWS 2015 Update 6
‘Mental Status Assessment’ is now prepared to support ICD-10 Diagnosis Codes
The Diagnosis data that was previously allowed to be entered through the Mental Status Assessment has always been informational only. Any existing data is still available for reporting through the SQL tables.

20. Avatar CWS 2015 Update 6
‘Family Health History’ is now prepared to support ICD-10 Diagnosis Codes by utilizing the IMO search in the Health History grid.

21. Avatar CWS 2015 Update 26
Table Alias functionality in CWS updated to Support ICD-10
The 'Remarks' prompt is added to the Table Alias for the ICD-10 Diagnosis table. The controlling User Modeling table column type for the 'Remarks' prompt is Scrolling Text however users should be aware the Avatar PM Diagnosis table only accepts 4096 characters for 'Remarks'. To avoid cutting sentences in mid-word, or paragraphs in mid-sentence, the Table Alias processor passes as many complete paragraphs as possible. Note this means the first complete paragraph, even if there is only one paragraph, which pushes the total data length over the 4096 character limit and any paragraphs subsequent to that are not passed to the Avatar PM Diagnosis table. All data submits to the User Modeled form.

22. Avatar CWS 2015 Update 43
Associated Code search now points to IMO when ICD-10 is enabled.

23. OrderConnect

24. Avatar CWS 2015 Update 5
The following modifications are made: 1) The new field 'Reviewed With Client' is added to the 'Review Results' form. 2) The table 'SYSTEM.results_review' is updated by adding new fields: 'review_with_client_code', 'review_with_client_value', 'review_external_staff_id', 'review_staff_id', and 'review_staff_name'. 3) Support is added to the BackChannel process to populate the Avatar ‘SYSTEM.results_review’ table using “results review” data that are associated with lab results in OrderConnect.

25. Avatar CWS 2015 Update 7
The BackChannel data import process is enhanced to support real-time updates. *** It is highly recommended that any site using OrderConnect that installs this update (which is part of Avatar CWS 2015 Monthly Update ) that they also install Avatar CWS 2015 Update 53. ***

26. General

27. Avatar CWS 2015 Update 28
Credentialing information from the ‘Practitioner Enrollment’ form will be reflected based on Effective and End Date. This is available for Progress Notes and Treatment Plans in the Chart as well as in Document Routing.
Also requires RADplus 2015 Update 29 and either Avatar PM 2015 Update 63 or Avatar Cal-PM 2014 Update 80
For notes this is based on the Date of Service or Appointment. Independent notes will be based on Date of Entry.
For Treatment Plans it will be based on the Plan Date.

28. Avatar CWS 2015 Update 28 Document Routing
RADplus 2015 Update 29 is specifically for the Document Routing piece.
The credentials for each approver will be shown on the document image. This will follow the same rules detailed in the previous slide, regarding date comparisons.

29. Avatar CWS Update 42
The 'Reactions' and 'Reaction Severity' dictionaries that are used in the 'Allergies and Hypersensitivities' form are modified.
The 'Reaction Severity' dictionary has been updated to include ‘No Reaction’ and ‘Unknown’ selections.
Descriptions of 'Reactions' codes are simplified by removing the trailing parenthetic categories and by listing Reactions in alphabetical order by their descriptions, as opposed to in ascending order by code.

30. Avatar CWS 2015 Update 42 Expanded Reactions, sorted alphabetically by Description