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 Planning26

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