First Insight - Jay Henry Webinar

Dr. Jay Henry:  My name's Dr. Henry.  I am a private practitioner in a group practice in the Columbus, Ohio area.  I'm going to just talk to you guys a little bit about MaximEyes SQL and utilizing a certified EHR in your clinical practice. 

So, we're going to do a little bit of discussion of meaningful use.  We're going to talk just a little bit about what meaningful use means, how to get the incentive money.  And then we're going to really showcase MaximEyes SQL so that you guys can understand how a certified EHR can be used in your clinical office. 

All right.  So, this is kind of our overview.  We'll do a quick incentive program discussion, registration, attestation.  We'll just do a summary of meaningful use.  And then we're going to just showcase MaximEyes SQL. 

So, under the incentive programs, just so everybody's clear, the incentive programs were designed to give optometrists incentives for basically utilizing these EHR technology.  You have to use it in a positive way to impact patient care. 

There are very specific requirements out there that you have to meet to get the incentive money.  Okay.  You have to be meaningfully using a certified EHR system.  MaximEyes SQL is a certified system.  There are certain objectives that we'll talk about.  And they have to be met at a certain threshold level, too.  So, we'll discuss that a little bit.

So, the first thing we have to do is we have to select our certified EHR.  And so, today's lecture, obviously, it's on MaximEyes SQL.  How do you know if your EHR is certified?  Well, you can go to a Website down here at the bottom.  It's called the Chapel Website. 

And each EHR that's certified is certified by version number.  So, make sure that if you're using an EHR that you go to this Website and verify that the version that you're using is actually certified.

When you go here, you click on the ambulatory practice type.  And then you can search for your actual EHR that you're using.  And here's First Insight's MaximEyes SQL.  It gives you the version number, and it tells you that it's completely certified.

So, that's how you know if the EHR you're using is actually certified or not.

Next thing you have to do is determine if you're going to do the Medicare or the Medicaid EHR incentive program.  You have to pick one of those.  There are two programs.  The Medicare is not hospital-based Medicare.  And then the Medicaid side, you have to have at least 30 percent of your patient volume has to be Medicaid.  And if we have questions about this, we can certainly answer those as we go through.

Under Medicare, you guys have all heard this already.  You can get $44,000 over five years per each individual NPI.  So, that's per each doctor in your office.  Okay?

This is based on your submitted allowable Medicare charges.  So, basically, how they're going to do it is they're going to give you 75 percent of your allowable charges up to an annual cap.  So, each year, there's a specific amount that you kind of cap out at.

The way it works is, the first year, if you do it in 2011 or this year in 2012, you can get $18,000 is the maximum cap for that first year.  And then it goes to 12 and then eight and four and two.

So, if you start this year for meaningful use, under Medicare, you can get $44,000 still.  And that's per doctor.

If you wait 'til 2013, still do pretty good.  In the end, you're going to end up with $39,000.

If you wait 'til 2014, you end up with only $24,000.

And then if you wait 'til 2015 or later to start being a meaningful user of your EHR, you get no incentive money, and you'll actually start to be penalized on your Medicare claims.

So, you really--the earlier you start, the better off you're going to be.

Under Medicaid, it's just a little bit different.  It's $63,750.  And it's over six years.  And those years don't have to be consecutive like they do under Medicare.

You do have to have a Medicaid patient volume of 30 percent, and your state does have to have optometry approved under the Medicaid program for this to work.

This one's a little different.  Whether you start in 2011 or all the way out to 2016, you will still end up with the same amount of money, the $63,750.

So, under the Medicaid, you can start later, and there's no penalty as you go through, and you'll end up with the same amount as long as you start by 2016.  So, that one works just a little bit different.  It's a little bit easier.

You do have to register for either of these programs.  So, whichever one you decide to do, you need to go through the registration process.  There's a Website for that.  And that site is right up here.  It's in your handouts.

The registration does not mean you're going to start to participate today.  It's just getting you set up to start in one of these programs.  You can always cancel your registration.  You can go in and change your registration.

I do encourage you, though, if you're going to start this year, to register early on.  That way, you can make sure, if there's any problems with your registration, your NPI number's got a mistake, your PECOS registration is goofed up, or you have some issue with your tax ID, you have time to fix it before the end of the year.

So, I would certainly encourage you guys to start the registration process earlier than later.  Okay?

You obviously have to achieve meaningful use.  That's the goal.  That's the one thing we have to do.  Meaningful use has a lot of different objectives.  There's 15 core objectives.  You have to do all 15 of those.  There are some exclusions and exemptions.  And if you take one of those, you get credit for it.

But, you basically have to do the 15 cores.  And then there's 10 menu items.  And out of the 10 menu items, you get to pick five.  So, you get to select the five that you want to.  Okay.  There is a little catch to that, and I'll explain that in a minute.

This is the 15 core objectives.  I'm not going to read them to you.  They're in your handouts.  But, these are the ones that you all must do.  And I'll point these out as we go through the EHR and show you how we do that.  Okay?

Under the menu, you get to pick five.  But, one of them has to be a public health measure.  So, these top two are the two public health measures.  You have to do one of those two.  And then you get to pick four others.  So, you pick one of the top two.  And then you get to pick any of the other four that you want to do in your office.  And each doctor can pick which four they want to do outside of there.

All right.  You also--ultimately, you have to attest, which is basically you have to go into the site that Medicare has and tell them what you did.  So, you go back to the same site that you're registered on.  And you do your attestation.

And when you do your attestation, it's basically a legal statement telling them what you've done.  Have you met all the thresholds?  Have you met all the 15 core objectives?  Did you do the five menu objectives?  You will report out on each one of these.  And your software will produce a report for you to use.

So, you can get all this information directly out of your certified software.

All right.  How is optometry doing in general?  If we look at incentive payments by specialty for 2011, optometry's about number nine.  They did really well.  So, we're doing pretty good.  We've got about 614 as of the end of December 2011.  Those are the incentive payments that have already been paid.

And then if we look at how many people have actually attested by specialty, optometry's number seven.  So, we're higher here just because some people haven't reached that threshold yet.  So, they didn't get their incentive payment by year end, but optometry's doing really well as a profession with meaningful use.

All right.  We're going to talk now about MaximEyes SQL, their newest EHR.  Okay.  It is certified, completely certified.  Just going to point out a few features, and then we're going to show some videos of how it's actually used.

So, some of the new features that I think are probably really important to the SQL is it has patient alerts.  And they've designed this to really help us.  And I'll show those in a minute.

Medical history summary, that helps the doctor understand what the technician's probably already done.  We have a face sheet and a flow sheet.  And I'll show those in a little bit.

Data entry screens are kind of the core of this product.  It's how you get data into the EHR in a quick, efficient manner.  And then we have assessments and plans that are kind of pregenerated for us, which is really nice.  And then ultimately, we have this patient portal, which is just being released.  It's called iclinc.net.  And we'll show that at the very end of the lecture.

What's new with alerts?  You an now create alerts in your patient records.  In MaximEyes SQL, you can make these private, which is nice.  A lot of the software doesn't let you to make--mark things private.

What that means is that a patient won't see it.  So, if you have the screen up in front of the patient and it's marked private, you'll see a little P, meaning there's a private alert.  The patient will have no idea that there's anything on that screen that says something about them.

You can certainly mark the alerts to expire.  You can label them by certain types, whether it's an allergy, whether it's a generic alert, whether it's a diagnosis.

So, for example, here's how you make a patient alert.  So, you can just put in what the alert is, select the type, and then if you want to mark it private or expire, you can mark it to expire after a certain timeframe.

So, here would be an example of something you want to keep private.  This patient's HIV positive.  And we want to mark it private.  So, when you're in your EHR, if you have this screen up in front of your patient, there's just a little P up here.  That tells you there's a private alert.  Your patient sees nothing.

If you click on "manage", you actually have to tell it to show you the private alerts before that would show up.  So, when you first open that screen, this would be blank.  And then if you say, "Show me the private alerts," you can then see what's been marked private.

So, that's a nice way to keep patient information kind of hidden and certainly so that there's no HIPAA violations.

Medication history summaries, this is a great new feature.  It allows you to get a quick overview of kind of all the history summaries, so basically, what your technician would do or what maybe the patient would fill out online or how you'd get it off a welcome form.

If you tool-tip over kind of these things, it will show you the positives and negatives.  The positives all go to the top, which makes it real quick and easy to see.  It's just a great time-saving technique.  It gets all this information on one screen.

Let me just show you what we're talking about.  So, here's that one screen.  And basically, you have their past surgeries, their illnesses, their medication summary, their eye disease, their current eye symptoms, the review of systems, family history, and social history all on one screen.

And if you tool-tip over it, it will pop up and give you the positives and then the negatives or no responses below it.  Quickly, you can see what's going on with this patient when you walk in the room without flipping through multiple different sections in the EHR.

So, this is a great place to start as the doctor if your technician does history.  You walk in and look at this screen, and you know exactly what's going on with your patient already.

The face sheet, this allows you to basically see multiple key components over time before you start an exam.  So, this helps you quickly gain insight into what's happened with this patient in the past.

So, there's a number of different things on the face sheet.  But, basically, you can see we have a chief complaint.  You can see all their diagnoses.  And if you scroll up and down, you can see all the past diagnoses you've ever made.  You can see all the billing you've ever done, all the surgeries, all their CD ratios, their acuities.

And then on page two and three, there's more data.  So, you have IOPs and refraction and contact lenses.  And I'll show this when we show the actual EHR in use.

The flow sheet is very similar.  It just has a little different view to it.  And it's customizable.  But, essentially, you can also see detail over time and multiple exams at once when you look at the flow sheet.

So, in this example, each one of these little things opens up.  Here we have tonometry.  And you can see the dates of the exam across the top.  And you can just quickly compare multiple visits.  And you can open each one of these boxes up and see more and more information about it.

So, that's another great tool to kind of keep you in tune with what's been happening with this patient over time.

So, these are really good ways to look at data over time.  And there's another flow sheet with more boxes open so you can see more information.

So, this is, again, ways to gain information without going in and flipping through multiple records at once.

The data entry screens, this is a tool that is used inside of MaximEyes SQL.  So, basically, each area, whether it's visual acuities, glasses, anterior seg, posterior seg, whatever it is, it'll have a little box that you can click.  And it'll open up a data entry screen.

Those data entry screens allow you to very quickly just check off the things that apply and add it so you can have multiple chief complaints in there real quickly.  You can go through and do their glasses just real quickly by going, you know, minus 125, minus 125, axis 50.  And then you hit five, and it changes into 55.

You can put their add in there.  Their acuities go in there.  And very quickly, you can do right eye, left eye all the way across.  So, this saves a lot of time.  This is the way to get these information in and out.

Here's the posterior pole information, so the posterior seg.  So, you get your fovea, your macula, posterior pole, vessels, periphery.  You can go right across and do right eye and left eye real quickly instead of typing or dropping things down.  This is the way to get the information in quickly.

The assessment and plans, I'm going to show this in detail in a little bit, but MaximEyes basically has prebuilt assessments for each condition so that, at the end of the exam, the EHR can suggest to you, basically, what diagnoses might pertain.

And based off of those, it can tell you what assessments might be--it might be something simple like myopia or dry eye based off of those things.

Once you select an assessment, it'll actually give you plans that go with those diagnoses as well.

So, for example, on this one, here's myopia.  And it says for our plans, "Hey, do you want to update their contact lenses?  This is their first Rx, new contacts, new glasses, no Rx indicated."  These things obviously go with this assessment.

If you look at dry eye, artificial tears, Restasis, punctual plugs, so these go with that diagnosis.

So, real quickly, without having to type a lot for your plans, you can walk through assessment and plans very, very quickly and very simply.  So, again, a very powerful tool and a way to speed it up.

The patient portal, this is what's coming for them.  So, this is--has the ability for patients to go online and schedule appointments.  It allows them to go online and communicate directly with a doctor, secure messaging.

You can upload patient information for them.  They can go on there and see their clinical summaries, their medication history.  They can see past surgeries.  They can see your privacy policy.  And they can actually go on and upline their history so that the next time you do an exam with them, you can pull in their updated medical history.  It's a huge, huge timesaver.

As far as your office goes, your office can then look back and see what appointments are coming up.  They can give a yes or a no to online appointments.  They can answer messages.  They can broadcast messages out to all the patients or to just a select few.  You can upload educational material for the patient to view when they get home.

So, this is really cool.  This is iclinc.net.  This is coming.  And I'm going to show a video of this but at the very end.  So, we're going to jump in, just show a couple screenshots here.

So, on the patient view, if they wanted--it tells them when their next appointment is.  If they have messages or education out there, these are the things, kind of action items.  If they want to view their medical record, they can click over here.  And then over here, this is the practice side.

So, this side shows basically on--for the doctor, what's going on.  So, we can see that we have three new messages.  And we can see that we have no profile updates.  We could compose or broadcast messages to all our patients.  So, there's two sides to this, the doctor side and the patient side.

All right.  Let's jump in and just walk through a very generic patient coming in, who just basically needs glasses and contact lenses, and walk all the way through their exam from start to finish inside this certified EHR of MaximEyes SQL.

Okay.  So, we're going to load up a video and kind of walk through this.  This is the home screen of MaximEyes SQL.  This is where you start.  Once you log in, it knows who you are.  So, it says, "Welcome, Jay," tells you the date, tells you your task list up here.  If you had things that needed done, they would be listed out here with a due date or when the tasks need to be taken care of.

Down here, it gives your appointments.  I only had a few on this date, nice and easy day.  But, you can search by different doctors.  Up here, it gives you your quick links, things that need to be done.

So, for me, I could switch this to any other person in my office.  But, it shows me I have a pending e-prescribe prescription out there.  I have some encounters that need to be signed off.  I have documents that have been created but not sent yet.  And so, this is kind of your working list.

If you click on one of these links, it will take you to that task and allow you to complete it.  So, this just kind of is your home page as the doctor.

Down here, it will show you different Web links.  So, if I go to like First Insight, it shows me a bunch of Web links.  If I click on one of those, it will launch Internet Explorer and take me right to that Website.  So, this is nice for your staff.  They won't get lost in trying to find all the different Web pages.

When we're ready to do a patient, we just click "Find patient".  We type in a few things about them.  And it will pop up with their name here.  If you scroll across, it will give you more detail, date of birth, phone number.  If you keep going, it will give you drugs that they're on, medications they've been allergic to, those kinds of things.

If you select the patient, it brings up their patient record.  This is where basically the demographic information's housed.  So, on here, we can get their name, date of birth.  For meaningful use, we need to know their ethnicity, their race, their gender, their date of birth, and their preferred language.  So, we can see all of that gets recorded right in this area.

Down here, their appointments are listed.  Up here, you have their address.  And they can have a second address.  So, maybe they have a seasonal or a different address.  All their phone and contact information goes up there.  The physicians or provider of care and then their insurances are all listed on this page.

So, this is basically where all that information's housed.  They have a phone sheet.  And they also have a place to put electronic records for that patient, all right off of that patient record screen.  Okay?

This is at the point where you can come down here and open up--this is kind of your navigator toolbar on the side.  If we come down and open up encounters, we can see their face sheet, their flow sheet.  We can make a new encounter.  We can contribute and do different things.

So, over here, let's start out by looking at their face sheet and then their flow sheet.  And then we'll start an actual new encounter.

So, when we look at their face sheet, it shows us over time these are all the chief complaints this patient has ever had.  So, you can real quickly scroll through that and see every single chief complaint that that patient has ever had.

You can see every CPT code you've ever billed to that patient.  And this runs back through every exam that would be inside that certified EHR.  You can see all their CD ratios, all their visual acuities, again, their diagnoses, every diagnosis you've ever made.

This stuff is really useful to really quickly understand what's happened with this patient in the fast.  So, we can real fast do that.

Page two has IOPs, gonioscopy, pachymetry, auxiliary tests --this would be like visual fields, OCTs, those types of things.

And then the last page is refractive data, all their previous refractions, their spectacle Rxs.  And then at the bottom all of their contact lens information's there.  So, every trial, every final contact lens script you've ever used will be listed out here.

The flow sheet, as I showed you, it's just a different view of a lot of the same information.  You can customize this and list out whatever you want in here.  But, again, we can scroll through by date.  We can collapse all these boxes.  We can open just the one we want to see.

So, anterior seg, we only have information on 2-9 and 2-1.  So, we just had a couple of visits.  These other ones, we didn't do an anterior seg.

Over here, these boxes can be closed down so it shrinks down what's in them.  So, that makes it easier to compare different data.

So, again, this is just a different way to see multiple things over history.  It's a real good way, though, to get a good understanding of what you've done or not done with a patient in the past or how their CD ratio's changed over time or how their IOP or refractions have changed over time.

Okay.  So, let's go ahead and collapse all this out.  And we're going to go ahead and start with an actual encounter now for this patient.  So, let me close out of here.  And then we just go back over to our navigator.

And we'll say, okay, let's make a new encounter.  And it's going to come up and basically ask you what kind of an encounter you want to make.  So, when you drop down this list up here, you can pick any type of an encounter.  You can create all these different encounters and create an exam form to go with them.

So, if you wanted to have a cataract post-op that just has, you know, slit-lamp acuity, posterior seg, and a history, that would be fine, or something like a red-eye exam, a pediatric exam, or if you wanted to have a comprehensive exam with everything and contact lenses included, you can create these and lay out the exam forms how you want them to look.

We're going to start at the top.  This is basically where your technician would do these first bluish colored boxes are all the history.  So, that's usually where the technician does or where you'd pull that in online from a welcome form.

So, as you click on each one of these, these kind of link to spots on the page.  And as you open the next one, it goes to the next page.

So, this is your navigation toolbar over here on the left side.  That's how you find your way around.  If you need to know where something is, you can open up one of these boxes and click on it.

For chief complaint, we can just type in here if we want, or we can use this data entry screen.  And if we use the data entry screen, we can real quickly just check off what it is.

So, if they have burning and itching eyes, we can then go down and say which eyes, you know, what's going on, how severe is it, how often is it lasting, the duration, the timing, does something make it better or worse.

So, we can just check these things off.  And all of these lists down here are completely modifiable.  You can edit them and add anything you want to those.  So, you can customize this EHR exactly how you want it.  And when you add it, it will just add that right there as a chief complaint for you.  You could add two or three real quickly like that if you wanted to.

Your past surgeries will come out here automatically.  You can sort it.  So, here's just ocular.  Here's general and ocular.  Or, we can uncheck ocular.  There's just general or all other past surgeries.  And that's a flowing.  That will continue on.  Every time we add to that list, it will just keep going, unless we delete them.

You can see major illnesses.  We can see their allergy histories.  So, if they have no drug allergies, this is part of meaningful use.  That's why it's yellow.  If they have no drug allergies, we'd check that off.  Otherwise, we need to have something listed here.

And if we need to delete something or add to it, it's real quick.  So, we can just find the drug they're allergic to, mark if off.  What happens?  It makes them, you know, itchy skin.  It's active, and the patient reported it.  We add it.  We just added another allergy to cephalosporins just like that, so real quick.

Same thing for medication history, again, this is all their meds they're currently on.  You can mark off that they're on none for meaningful use if they have none.  But, again, you can add to it.

And then problem list is also part of meaningful use, so either no known problems, or we put things in here that are problems, so hypertension, diabetes, myopia, open-angle glaucoma.  Those are problem lists.

As we go through their history, usually, we bring this in online.  So, most of our patients will fill out an online history form.  All of this comes in automatically if you do that.  If you don't do that and you have a technician take a history, it's real easy for them to just clear them or set them to no and then just mark off the ones that are yeses.

So, we're just going to go through and mark a few of these as yeses and noes just so you can kind of see how quick and easy it is to do.  So, you know, this patient has some end-of-the-day dryness.  We'll just mark off whatever's going on with them.

And you can just type in here if you need to or change something to update it.  Okay?  So, we'll go ahead and say they have a sandy, gritty feeling also.

And then we're going to go back up, and we're going to go to the next area.  So, let's do the review of systems now.  So, as we do this, it brings up the review of systems.  They're already marked as having hypertension.  If we needed to say yes or no to that, we could change that.  If we want to mark something else, they have some seasonal allergies, we just check that and type in what we want to go with it.

And I'll show you on the summary how this all comes back to show up for us.

Family history, again, we can mark what's going on with the family.  Dad has blood pressure.  Mom's now got diabetes.  So, we check yes.  And who is it?  We can go down here and pick mother, so whoever the patient is in relationship to them.  Okay?

Social history, this is where their occupation goes, whether they wear contacts, glasses, you know, different--do they drive to work?  Do they have problem with glare?  Smoking status is another meaningful use objective.  So, we always have to record smoking status.  So, we want to do that.

Here is that summary page.  Now, remember, all of the positives go to the top so we can real quickly see, remember, they had dry eyes.  Remember, they had sandy or gritty feelings, allergic seasonal allergies.  Okay?  Mom, diabetes; dad, blood pressure.  So, all those yeses and noes, real quickly we can see them on one screen.  It's the beauty of these summary forms.

So, that's the way I start my exam is come in and usually look at this first, see what is going on with the patient.  You can also see the chief complaint at the top.  So, everything I need to know is right here.  Okay?

From there, we're going to start into the exam.  So, this is where we would start if they were a glasses wearer.  But, let's jump down to contact lenses because they have their contacts on right now.  So, they're actually wearing their contact lenses.

So, we're going to go down to the bottom of this.  And it's going to show us all their past contact lens information.  This top one is their last final.  So, it was from December.  Okay?  So, this is what they left wearing.

If we go down to the bottom, we can see a running history.  They came in February of 2011 wearing ACUVUE 2s.  They complained about them being dry and bothersome.  We switched them to the Oasis.  And we did a follow up with them.  And they liked that.

So, we then finalized that as their final Rx.  So, you get a running history here, so habitual, follow up, final.  Okay?

As you go up, you can kind of get to current time and see what has always happened with this patient.  So, here was, again, their final.  They came back in, in September.  They were wearing these.  And we did the same thing.  They did--nothing changed.  So, we finalized it again.  This was their last final.  September was their last final.

Oh, I'm sorry.  December was their last final.  And today, we're going to go ahead and say, "Let's start with this, copy it, and mark it as their habitual today," because that's the last thing they left our office wearing.  That was their last final contact lens Rx.

So, we can start with that and say this is their habitual.  This is what they're wearing today.  Tells us it already knows what it is.  And all we need to do now is take acuities, do some centration, movement, all the kind of things you guys want to do.

When you do acuities, if you click in the top box, you can put it in there.  And if you click on the little blue tab, it marks that for all, right, left, and both eyes.  So, it's a quick way to do it.

Same thing over here, you can click one, or you can use the data entry screen.  So, on the data entry screen, same thing goes.  There's no rotation.  Use this little equal signs, and it makes everything in the top row equal to bottom row.  So, these are just quick ways to get through the EHR.

So, we're going to make a little note, good fit, but the patient really wants to be in a monthly lens.  They're like, "You know what?  I'm tried of two weeks.  I really would prefer to be in a monthly lens.  Can we do that?"

So, we're going to make a little note.  Things were good, but the patient wants a monthly contact lens.  We're going to delete this part over here because that was from their last final and say, "Okay."

This is now showing us their habitual.  We're going to have them take their contacts out, go back and start kind of with their glasses stuff.  And we'll come back to contacts in a little bit.

So, spectacles, how do you get their previous spectacles in there, whatever they're currently wearing?  You could very easily copy it from their history.  And it will show you every spectacle Rx you've ever given to that patient.  And you could select the one that they're currently wearing.  So, you can grab it real quickly like that.

Or, if you don't want to do that, we'll go ahead and delete that.  We could go here and pull it in from our instrument, so our auto lensometer.  We can just real quickly grab this patient's Rx from the auto lensometer.  And it populates it right there for us.  Okay?

If we don't want to do that, we can also go in and use our data entry screen.  This is another way to get this information in there.  So, we could just say it's a general Rx.  They filled it.  Just go in.  Their Rx is 175 a quarter axis.  Go down, just grab 180.  Okay.  So, it puts it in here for us.

And let's go and just click on left eye.  Same thing, so, let's go, you know, whatever, 175, grab a sill of a half.  And this one, let's do 20, and then we'll mark off three.  So, it marks it 23.

You can go down here and do their acuities for their distance and their near, right eye, left eye.  And again, you can quickly add those in there.

So, this is another way just to get the information in.  So, you can either, you know, copy from past.  You can use an instrument, or you can use these quick data entry screens.  And then it just populates it all in there.

If you mark that they're currently wearing this, it will automatically populate the spectacle VAs into there because it knows that that's what you just took their acuities with.

On aided acuities, if we want to do a data entry screen on that, we can real quickly just check off, you know, 20/20, 20/25, minus or plus.  And we can--you can see how quickly we can do distance and near.

Again, if we use these bars, it goes down.  If we use the equal, it does them all the same.  Okay?  So, real quickly, we can get in unaided acuities.

I like the normal buttons.  These normal buttons you can set to prepopulate whatever you want into a given element.  So, when you're doing, you know, pupils, if you hit normal, it prepopulates all of that data.

Tonometry, you can very quickly just type in what their tonometry reading are, or you can go ahead and use an instrument or data entry.  So, I'll show you data entry here.  This is the data entry screen.  You can just select, okay, it was, you know, NCT or Goldman.  These are their pressures.

Or, we hook it up to our NCT, and we can just real quickly grab their reading and say, "Import their reading from the NCT directly."  And when we click on that one, it just populates in their reading for us.  So, that's a real quick way.

So, the more integrated you can have your equipment, the better off you're going to be.

Again, the normal buttons kind of speed up the process.  We like to use those just to get through these and prepopulate the data.

Cover test is kind of unique.  So, on the data entry screen here, if you grab like, you know, this, you can go ahead and say they have, whatever, four constant right, you know, esotropia.  Okay.  So, real quickly, you can do a cover test finding.

If you wanted to put multiple findings in there so it near, if they're also, you know, a hyper, you can do four right esotropia.  And then you can add to it a two constant right hypertropia.  And it just adds it right to it.  So, real quickly there, you can get multiple findings for your cover test, again, a nice, nice feature.

We'll use some more of our normal findings.  Amsler grid was normal.  We'll go ahead and take blood pressure because that's part of meaningful use.  And height and weight is also part of meaningful use.  So, we'll make sure we get all those things filled in.

Blood pressure, we usually just grab it.  So, you know, they're 124/94, right arm, adult.  Okay.  So, real quickly, we got blood pressure.  It's that fast to get information in.

So, that's kind of your preliminary tabs.  Now, we're going to move onto the refraction tab.  This is where you record your current refractions that you're doing.  Retinoscopy can go in there.  Autorefraction can go in there.

These top blue and white boxes are all past data.  So, they're scrollable.  They're not editable.  You can just see all the past refractions you've ever done.  There's six of them in there.  We've got 15 final spectacle Rxs in here for this patient.  If you need to see what's happened over time, you can always scroll through these and see them.

We do the instrument integration for our autorefractor.  So, we just really quickly grab it off our autorefractor.  It prepopulates that data for us.

Retinoscopy, you can grab it and say, "Copy from."  And you can grab it from their previous Rx.  You can grab it from the autorefractor, or you can use the data entry screen to enter it.

So, again, you get the concept.  These data entry screens are used over and over again.  It's a way to get data into the EHR in a quick, quick fashion.  So, we really like the data entry screens.

On the refraction, so, the quickest way to get information in the refraction is to copy data from somewhere.  So, if we copy it from their current glasses or their retinoscopy, it will prepopulate whatever was in there.  So, there, we just copied it.

And then if we just need to change something, we can just real quickly change it right here.  You just can just kind of click in a box and backspace and rechange it.  That's a fast way to do it.

So, here, if it's, you know, minus whatever, we just change it.  Or, if it's a sphere, we just delete it.  So, now, they're a 175 sphere in that eye.  So, that was real quick and easy.

Or, if you open the data entry screen, it will start with what's in there.  And if you want to change it, you just change it down here.  Okay?

So, if we want to change that to a two, change their sill by a little bit, their axis by a few degrees, and then if we need to change them to 20/20 plus a few more, real quickly, when we do that, it updates all this information out here for us.

So, you can see again the data entry screens can be used to manipulate data or to add new data.

Now, notice there's no final Rx yet for this patient.  When we mark this over here that this is now going to be a general final Rx, it populates this.  This is what your optical would see, or this would be what you would print.

If you don't mark something over here, it just keeps it as a refraction.  And it doesn't give you an actual final Rx.  So, you got to remember that's how you finalize your Rxs.

Now, we're going to go back to our contacts.  Remember, they wanted to switch to a monthly.  And they're currently wearing the Oasis.  So, we're going to come over here and say, "Okay.  Let's do a refit for this patient.  Let's refit them."

We're going to fit them now into a monthly.  So, when we do that, it brings in their current prescription refraction from today.  It brings in their K's because we took those with our auto keratometer.

I'm going to fit them today with Air Optix monthly lens.  We're going to see how it goes.  So, we're using a refit, Air Optix.  We're going to put them in an 8.6 base curve minus whatever, 175 and two and a quarter, whatever we need to do.

We can put that information in here, real quickly type it in.  We could use the data entry screen to get that information in.  There's a lot of different ways to get it in.  You guys kind of get that concept.

We could take acuities over here.  A lot of times, the quickest way is just to click in the box and drop them down what the acuities are.  Sometimes, it's faster to use the data entry screen.  So, you guys get to decide how you want to get the information in.

I'm going to do some centration here and just kind of use this little button that takes top to bottom to make them the same.  That's, again, a quick way to duplicate data.  We'll make a little note, good fit.  Let's bring him back in a week for a contact lens check.

Okay.  So, at this point, we would move on with our exam to, you know, anterior seg, posterior seg, whatever.  But, I'm going to finish this, and then I'm going to act like they came back in a week for their follow up so you can just kind of see the flow.  Okay?

We can put wearing time, solution information in here as well if you wanted to keep track of those.  It's nice to know what solution you told him to use, whether it was OPTI-FREE or Biotrue or Clear Care or whatever, how often they're supposed to be replacing their lenses.

This is a place to keep compliance.  So, you know, if they tell you, "Yeah, it's a two-week lens, but I change it once every three months," you can notate those things.

So, this is information that you can keep track of.  And it just goes right over here.  Okay?

So, when we hit okay, we have this refit here now.  Okay.  So, they leave.  We would save this encounter, close it.  They come back in a week.  We would open a new encounter.  We'd create a new encounter.  And we'd come back to this basically same area.  We'd copy the refit and say, "This is now a follow up."

Okay.  We'd change the date to the current date.  And we clear the fitting data.  And now, we can real quickly--we'll use our data entry screen this time.  Let's take their acuities with their new lenses after they're back for this one-week follow up.

We'll step through this real fast, kind of see how quickly it is to grab their acuities using the data entry screen.  And across the top, we can do other stuff.  So, now, we'll do their centration.  And then we'll do an over refraction.  We can do movement.  We can do staining.

You can see we're doing a bunch of different pieces of information all at once with this data entry screen.  And then when we close it, it will populate it all back in here.  So, their acuities go in.  Their centration goes in.  Their over refraction goes in.  All of that just pops back in, so again, just another way of getting data in.

We'll make a note that they like them, good fit, good vision, happy with them.  They're okay to order them.  We'll say, "Okay."

So, that was marked as a follow up.  What I always do then is I just copy that and mark it final just so that my staff and I know this is now their final contact lens Rx.  This is okay to order, okay to dispense, okay to give them a script.

And when you do that, it will create it up here in the final contact lens area.  This has now been finalized.  So, we have a running tab.  They were refit, came back for a follow up, finalized.

This is binocular vision for any of those BV gurus out there.  You can do cover tests in all positions and gauge.  You can do a Parks 3-step.  You can do foveas, vergences, accommodative facility, NPC, amplitudes of accommodation.  So, anybody who does this stuff, there's a lot of places to put that information now, which is nice.  Okay?

We're going to jump to anterior seg.  Quickest way to do this is copy it from their past exam.  So, I'm copying previous exam.  It says they have a little bit of mild blepharitis.  If we need to change that, we can always just backspace or delete it and grab whatever we wanted to put in there instead.

We could use the X to delete it completely.  We could just clear the right side or the left side.  We could open the data entry screen to put information in.  So, I'm just going to kind of walk you through some of these different scenarios.

Here, we're using the data entry screen.  So, we'll take mild off and make it severe.  So, you can see it changes it up here.  And then when you close it, it makes it severe over here.  Okay?

So, we want to just kind of clean this up.  Let's go ahead and copy it back from the previous, kind of start over here.

And we can clear one side.  So, there, we just cleared the left.  So, if we wanted to change just stuff on the left or if you want to copy the right over to the left, you can do that as well, so lots of ways to manipulate the data inside of here.

Again, we can copy from previous exam down here, or you can use normal buttons, which will put normal findings in there.  And those normals you set up.  So, they're however you want them to be.  Okay?

So, here, we're changing it to two-plus NS and leaving this one alone.  Okay?

Let's go over to the posterior seg.  We can put our drops.  We use the normal button.  We're just doing tropicamide.  Both eyes are dilated.  Again, posterior seg, we can copy previous.  We could use a normal, whatever you want to do to get that data in there quickly.

You can change it.  Real quickly, we can change their CD ratio just like that.  Okay?  We can mark if they have like, you know, some other finding.  We can change that.

We come down here.  We can open up the retina one and change something in here.  And let's say they have some AV nicking or something.  We want to notate that.  And let's see we see it in a posterior pole or if it was under vessels.  You could do it either place.

So, you just document what you see real quickly with the data entry screens.  And it puts that information in for you.

You can use a drawing tool here.  You open the drawing tool up.  You can see posterior pole.  You can see front of the eye.  You can see anterior seg.  Whatever you need to draw, if you draw it on here, when you close it, it brings it back into the EHR in text.

So, if I drew that CD ratio to be like 0.5, when I close this, it would bring in 0.5 for the CD ratio.  And I'm going to show you guys that in just a little bit in a different case.

Tests and miscellaneous, this is where you order your tests.  So, this guy had big CDs.  So, I'm going to go ahead and order a visual field and an OCT for this patient.  So, on here, we can just real quickly say I'm going to order an automated field, a 24-2 SITA fast.  Their diagnosis code is glaucoma.  So, we'd just use 365.11 or 01, OU.

I'm going to set this to be just my technicians to see this.  And it was ordered by me.  Okay?  And I'm going to say, "Add and continue."

I want to add another test.  I'm going to add an optic nerve or nerve fiber layer analysis, OCT, same diagnosis.  This one, I'm going to say, "Show it to all users."  And I'll show you why in just a minute.  Okay?

So, okay, we're done.  So, we're going to close that.  It creates these tests in here.  The findings aren't done yet because the tests haven't been done.  Once we do this, we can go back to the main screen.  Because I assigned that to all users and I'm logged in, it shows me that, "Hey, this patient's waiting for this test to be done."

If I logged in as a technician, it would show me that other test that I assigned to all technicians.  So, this is the way your technicians can kind of see what's going on.

Once the test is done, you can come back here and edit this.  And based on the test--so, this was an OCT.  So, these findings correlate to OCT, so no nerve fiber layer thinning.  No, it's stable, no change from previous eval or baseline exam.  And when do you--what do you want to do?  I want to repeat it in six months.

Okay.  And I make right and left the same with that equal sign.  I just did my--basically my interpretation and report for that OCT real quickly.

Do the same thing for the visual field.  When I hit edit, I can go down to that bottom section.  And these findings now correlate to what a visual field would be.  So, good fixation, no scotomas.  And you can obviously change these to be whatever you want, real quick way to do your interpretation reports.

Poor cooperation, poor fixation on this one.  Okay?  So, we change that just so you can see how quickly you can do right eye and left eye.  And then when you close it, it basically keeps this interpretation and report in there for you to see later.  Okay.  So, it's a quick way to do interpretations and reports.

Final findings, this is where your PQRS information comes in.  This is where you get to put in your diagnosis, your assessment, your plan, your follow ups, your billing.  Okay.  It's where you see documents that are created to send to the patients.

So, in here, it's going to list out a bunch of different things based on your findings or history that it thinks might apply to this patient currently.

So, we're going to just kind of say, "Okay.  Let's find it because we didn't see it in the list.  Let's search for myopia."  Description, myopia, there's what I wanted, 367.1.  I add that.

What else do we want to add?  You can grab them off the list.  Assessments, glaucoma, yep, and myopia, yes.  So, we came up with two assessments, glaucoma and myopia, real quickly.

Now, when we do the plans, we start with myopia.  Or, we can switch it and--I'm sorry, start with glaucoma.  And we go down here.  And we say, "Okay.  We ordered an OCT today.  We ordered a visual field today."

You know, we can mark off some modifiers over here, like they were good, they were stable, they were bad, we need to do them again.  So, we can make some notes.  And this just adds onto this, basically creates your plan without you typing a thing.

So, you can real quickly check off things.  So, it's stable.  I'm going to repeat it again.  Let's see.  What'd we say, six months?  So, go up and grab six.  And we just find months down here, six months.

So, ordered OCT today, ordered visual field today, stable, repeat six months.  So, it just builds that as you click on each one of those tabs.  Okay?

We can do glasses.  In this case, did we fit them with contacts or, you know, have them come back for glasses, prescribe new glasses?  We really refit them with contacts.  But, let's just say new contacts recommended.  Okay?

Let's recall him, bring him back in a year for an annual exam.  And let's say we wanted to also bring him back in a week for a contact lens check.  So, one year, annual eye exam.  Okay?

We actually want to add another recall.  And this time, we're going to say we're going to schedule him in, you know, couple weeks for a contact lens check.  And we add that, and that creates this down at the bottom.  So, recall one year, annual exam; two weeks, contact lens check.

The front desk would then see that when the patient checks out so they know to schedule the patient.  Okay?

We can change this if we wanted to modify it here.  We can just actually type in this.  So, you--this is always modifiable.  But, it's a quick way to get the data in there quickly.  Okay?

So, this patient was really just a glaucoma suspect.  So, I just changed that.

All right.  So, final procedures would be our next stop.  So, if we come down to final procedures, this is where we do our billing.  So, we can create our bills for what procedures we did.  We can link it to our diagnoses codes.  The nice thing here is you can create as many bills as you want.

So, I'm going to start with one for the myopia.  And I'm just going to do a, you know, general exam, one unit, link it to that diagnosis, and a refraction, one unit, link it to that diagnosis and add it.

I'm going to create a second bill.  So, I hit, "Add bill," make it a new bill.  I'm going to send this one to their medical insurance.

So, I grab glaucoma.  And now, maybe we just want to build the visual field.  And I don't know the code.  So, I'm going to just type, "Visual."  And there it is, 92083, one unit, one of those, add it.

And I need OCT also.  So, I'll type, "OCT."  It brings up our three OCT codes.  That was an optic nerve one, add it.

Just like that, we created two bills for this patient, one for their maybe routine vision, one maybe for their medical.  And that--all that billing information gets summarized right here.  And your front desk would then see that.

Down below--in the background, it automatically created these documents for us.  Remember, we did an OCT and a visual field.  It created an interpretation and report document for us.  We can automatically--it summarizes everything we did, what test we ordered.  It was a 24-2.  They had good fixation.  It was an OCT.  They had no NFL thinning, baseline scan, repeat it.  It's signed.  It's ready to either print, give to the patient, send off, or just keep in your records.

We also have a little patient education.  What is myopia, part of meaningful use.  We need to give patient education out.  It knows because I diagnosed them with myopia that that should be given to the patient.

I can sign this chart at this point.  I can sign off on it and say, "Okay.  I'm done."  I can up here, I can give the patient clinical summary.  This is part of meaningful use also.  And I can print this for the patient and hand it to him.  I can save it for him electronically.

Or, I could upload it to iclinc.net, which is the patient portal.  And I'm going to show that in just a little bit how quick and easy that is to do.

At this point, we're essentially done with this encounter.  We can save it.  And we're--we just went all the way through a glasses and a contact lens encounter.  So, you can kind of see how quick it is.

Let's look at meaningful use, though.  How did we do?  So, meaningful use requires 15 cores, 10 or five menus.  Let's just run the report.  I only saw this one patient today.  So, let's see how we did.

Just as I went through there and did my stuff, we got 100 percent.  We did every meaningful use thing we needed to do.  So, we're doing great with this one patient.  Now, granted, for meaningful use, your first year, you need to do it 90 days.  For your second year, you need to do it for the entire calendar year.

So, when you only get it on one patient, it's good to say, "Hey, I did really well."  But, you got to look at this report every day or every week or every month as you're going through the year to make sure you're doing well.

All right.  We're going to do another quick video.  I think we have enough time.  I'm just going to show you a video of a disease state just to kind of show you the drawing tool and a couple other features.  And then I'll show you the patient portal at the very end.

So, we're just going to kind of jump in.  This patient came in already complaining they had a bump on their eyelid.  Their eyelids were really itchy and red and bothersome as well.

So, we're going to go just right to the anterior seg.  And we're just going to go ahead and mark it normal.  And then we're going to use the drawing tool from here.  Okay?

So, we're going to open up our drawing tool.  And we're going to open it up to the anterior seg part where their eyelids are.  And their eyelids are itchy because they have a bunch of crud on their lid.  So, we're going to go ahead and just draw.  We can grab a stamp from over here and mark the crust all over where it's at on their eyelids.

So, this guy's really bad.  So, we're going to draw it all over the place, right eye, and then we'll draw it all over the left eye.  Okay.  And remember, they also had a bump on their eyelid.  So, we'll document that as well here in just a second.

So, we're drawing all the crust.  You can document where it's at.  Go over here, and you can grab any stamp over here.  And you can stamp it on the eye.

So, if we come down, let's find a sty or a hordeolum for this patient because they had that big bump on their eyelid, and we decided it was a sty.  So, we grab it, just click on right there.  It was on their upper lid, nice big sty.  We can make it bigger.  We can twist it or turn it, make it look however we want.  Okay?

So, you can make it look just like it looks on the patient.  It's a great tool.  It's a great way to show the patient what's going on.  And it's a great way for you to remember how it looked.

Okay.  When you close this and we exit, says, "Do you want to save this?"  Yep, I do.  When I come back in, look, it knows I drew crust and a sty on the right eye and crust on the left eye.  Based on my drawing, it documents for me.  Okay?

And now, when we get to the end of the exam, it's also going to know what to diagnose based on that.  This patient also, they forgot to tell us, "Hey, my eyes--I woke up, and I had a really sharp pain in my eye, just feels real scratchy and kind of hurts."

So, we're going to look at that.  We're going to throw some fluorescein dye in there and see what's going on with this patient.  And they have an abrasion.  Okay.  They also have a corneal abrasion, or it's a recurrent corneal erosion actually.

They've been seen a number of times in the past for this.  So, we can real quickly just label it as an abrasion, erosion.  Okay?

If there's anything else going on with the stroma, the tear film, you can label it here.  We're going to say, "Okay," come back here.  Abrasion, erosion, it's labeled here.  If we took a picture of it, we could actually tie it to this patient's record, and then we could see it by clicking on that little e-file button.  And there's their recurrent corneal erosion.

So, we can link these images through a couple of steps so that it stays with this patient's record.  So, you do have to import it or have a camera tied to your EHR to do that.  Okay?

So, we want to go ahead and jump off now to the final.  So, we're going over to the final.  And it's going to tell us, "Hey, let's e-prescribe."  This patient need some medication for the sty.  And they need some medication for their horrible blepharitis.

So, pick a pharmacy.  Right now, it's set to go to this pharmacy in Oregon.  Pick a drug.  I'm going to use bacitracin.  I want an ointment.  Okay?

You can label it however you want.  This is e-prescribing.  So, I'm going to say, "Put a small amount into both eyes or affected areas."  How often?  You can do it, you know, seven days, 14 days, three weeks, a month.  You just pick what you want to do.  Okay?

And I usually say, "As directed," over here.  Duration, so, let's go 14 days.  Quantity, we can just do one tube.  You can do grams, milliliters, bottles, whatever, how many refills.  Okay.  Continue.

We also want to prescribe one more thing for this patient.  This just shows you what that prescription looks like.  We say, "Yep, that's good."

Let's pick another drug.  Want to go ahead and give them Zithromax for their hordeolum because they need something to get that sty going.  So, this one's easy, by mouth.  I usually just say, "As directed," because it's in a Z pack.  So, it's--on the box, it says, "Take two on day one.  Take one each--the next four days," so by mouth as directed.

Quantity's simple.  It's one pack.  You want to give him a refill or not, you can.  And then continue to summarize.  It's what it looks like.  You sign off on it.  When you hit send, it sends it right to that pharmacy of choice.  Okay?

And then, what we do is, when we close this, we log out, and it tells you they were sent.  Inside our EHR, it brings that information back for us.  So, exactly what we prescribed is now in the EHR as well.  So, we don't have to double entry that.  So, that's nice.

We can use this in our assessment and plan also.  That's the other beauty part of the e-prescribing.  So, here's our final diagnosis.  Based on our drawing, it's saying, "Hey, they got blepharitis, and they got a hordeolum."  It knows that from what we drew and documented.  So, it knows our diagnoses.

So, we can real quickly just go ahead.  And if we didn't want to select it from here, we could search for recurrent corneal erosion because that one wasn't listed.  There it is, recurrent erosion of the cornea, left eye.  We'll add that.  They now have three diagnoses.

We can do our assessments real fast if we click on the assessment tab up here.  We can do assessment for each one of these if we wanted to.  So, we get to pick what we want for our assessment.  So, you know, we want to do sty.  We want to do recurrent erosion.  We want to do blepharitis.  So, sty's going to be first.  It's in the right upper lid.  Just add it.

So, assessment number one is sty.  We'll do assessment number two.  We want to do the recurrent corneal erosion next, so cornea, recurrent erosion.  It was in the left eye.  You can add it.  You can mark if it was, you know, worsening, stable, whatever's going on with it, small, big.  So, these are just modifiers you can use.  We'll say it was getting worse.

So, that's going to be our second assessment, goes down here.  Okay?  And then we can do a third assessment if we wanted.  We can do the blepharitis for number three, so blepharitis.

So, it knows based on what we've done what we should be thinking.  You can always add to this or take away from it.  But, it helps you because it prepopulates all this information.

Now, when we go to the plans, based off of our assessments, it's going to help us recommend plans, too.  So, it's going to know, okay, these are the common things that we should do.

So, if we start over here, we'll say hordeolum, hot compresses, lid scrubs.  Or, we can go over and click on the medication tab.  And it knows what we prescribed.  So, we can add that right to our plan.

So, for this patient, I want them to do hot compresses, lid scrubs.  Okay?  And then I'm going to grab medications.  And I prescribed, you know, Zithromax for that.  Okay?  So, that's their plan for the hordeolum.  Real quickly, it created the plan at the bottom.

Now, let's do a plan for the blepharitis next.  Or, we can do the plan for the recurrent corneal erosion.  That was our second one.  So, we'll do the recurrent corneal erosion.  Did we do a bandage contact lens, okay, in the left eye?  So, that's our plan.  That's all we did, bandage contact lens.

Let's go over to the blepharitis.  How quickly can we do blepharitis?  All right.  Well, we talked to him about lid hygiene.  You know, did we give him scrubs, hot compresses?  What did we do?  So, discussed, you know, chronic nature of the disease, educate him on proper lid hygiene.  And we prescribed him bacitracin.  So, we can click off bacitracin, add that to our plan.

Real quickly, we created our assessment and plan for that patient.

So, you can see how fast it is to get diagnoses in and out, get assessments done.  The plans are already pregenerated.  And it comes to you this way.  This EHR comes with all of this information already preset up so that you can real quickly use this.

We can do a recall if we want, schedule them back in a week or two weeks or a month.

Okay.  I'm going to just jump to the iclinc.net.  So, this is the patient portal.  I just want to show you this 'cause this is really cool.

So, this is the end of a patient exam.  We already did all the billing.  And remember, I told you, you could do a patient clinical summary.  So, usually, you would print this for your patient.  But, in this case, I want to upload it to iclinc.net so the patient can see this when they go home.

This will give the patient access to this on the Website.  So, I go ahead and upload it.  And it says, "Okay.  It was uploaded."  I'm going to close this.  And I'm going to go to the Internet now.

So, now, I'm on the Internet.  I'm at the patient's house.  The patient's at home.  And they have a way to log in.  So, they go to iclinc.net.  And they get their own user name and password.  And obviously, this gets set up.

So, patient user, we put in our e-mail and our password and log in.  And this will show the patient all their information.  Okay?  And it allows them to schedule appointments, allows them to send messages to the doctor, see their summaries.

So, if I go over here under "view medical history" and say, "Show me my health summary," I click on that.  It will show all of them.  In this case, they only have one, the one we just did, so that exam just done in February.

I want to view it.  Here it is.  So, what I would've handed them in a printed format, they can now see online at home.  They can print this at home if they want or see it.  And so, it tells them when it was updated and who updated it.

They can go back to the homepage.  And let's say they wanted to schedule an appointment or they wanted to update their medical history.  They can do all of that from right here.

So, if they want to make an appointment or update their history, they can just go right on here.  And let's say they come down to the health history and they want to change something.  They could change their address if they needed to.

I'm going to change down here their hypertension and that kind of stuff.  So, down here, they're marked as hypertension.  They realize up here they forgot.  They wanted to put yes in that box.  So, we'll go ahead and say yes.  They also have asthma.  So, we check off yes for that one.  Okay?

And it just says, "Thank you for submitting your changes."  So, just like that, the patient's updated their history.

When we create a new encounter for that patient in our exam, we will get that updated history to come in as part of that.  So, we'll then be able to see that.  On the doctor side, I'll show you in just a minute.

This is scheduling an appointment.  So, if they wanted to schedule an appointment for eyeglasses, you can real quickly type in a reason.  You know, "I need to--I need new glasses.  Mine are broken.  I can't see out of them, whatever."

And then they get to pick basically three or four times that they want to come in.  So, they can pick their top three.  So, I'd like to come in on March the 6th early in the morning.  Or, I'd like to come in on March the 7th in the afternoon.  Or, I'd like to come in on March whatever anytime.

So, they basically get to pick the times that are convenient for them.  And then that comes to your office.  And you get to actually schedule them.  So, they're not really scheduling.  They're just saying, "These are the appointments I would like to have."  Okay?  And then you get to schedule them.

They can also send a message to the doctor if they want.  So, here, we're going to just send a quick message about their contacts or whatever.  Just say, "Okay.  I want to send a message to Dr. Henry.  It's about my contacts."

So, we click contacts.  And then we can type something in here and just hit send.  And it sends it straight off to the doctor.  Okay?  So, it's secure messaging, though.  So, this is secure.  So, this is a nice feature as well.

And then, in a minute, I'm going to log out.  And I'm going to log in on the practice side so you can see what the doctor side sees.  Okay?

So, we'll go ahead and let this go through.  Does anybody have any questions while we're watching this video about this EHR at all, meaningful use, about this new patient portal?  Any questions?

Okay.  If you guys have any questions, I'll stay around and answer them afterwards.  But, I just want everyone to make sure they're comfortable with it.

I'm going to log out.  And I'm going to log in as a practice user now.  So, this would be one of my technicians at my office or maybe the doctor, myself, logging in.  I want you just to see what the practice side sees after a patient does some updates and asks for appointments and that kind of stuff.

So, you can see that you get to manage this on the doctor side.  So, here, we're just logging in as my office.  And we'll log in.  It looks similar.  But, it just gives me my action items.  I have one pending request for an appointment.  I have some profile updates.

Remember, Donald Duck requested these--this appointment for eyeglasses.  There's those three times he requested.  I get to go over here and say I want to accept or deny it.  And so, I'll pick one and say, "Yeah, we're going to accept this one on the 9th."  And it automatically says, "Okay.  On the 9th with Dr. Jay."  I get to pick the time as the office.

So, we're going to put in, you know, "You can come in at 8:45 or 9:45, whatever."  And we'll put a little note in here to the patient, like, "Hey, we look forward to seeing you," send it.

That patient now has an appointment confirmed.  And they will get an e-mail and an alert that their appointment has been confirmed.  Okay?

Here, we can see profile updates.  Remember, Donald Duck updated a couple of things.  He'd updated his hypertension.  And he updated his--I believe it was an allergy or asthma or something.

So, when we click on this, the highlighted blue areas have updates.  So, if we go down to health history and click on it, we can see exactly what's been changed.

So, the blue ones have been changed, high blood pressure.  If you hover over this, it'll tell you what their old answer was.  So, that one would've been blank, and that one would've been no if I hovered over it.  It's currently yes.

Okay.  You as a doctor get to say, "I'll accept this," or, "I'm not going to change it right now.  I want to talk to the patient about this first."  So, you get control over that as well.

You can broadcast messages to your patient, compose messages, find patients, do all kinds of different things.  This is new.  This is the iclinc.net.  It's the patient portal.  It actually hasn't been released yet.  It's going to be out here in the next number of months.

But, this is the way I think future of this is going to go.  Patients are going to be able to talk back and forth with the doctors, with the staff.  Patients are going to go home and see what was done during their exam.  They're going to get their patient educational material, their prescriptions.  All of that stuff is going to be done online.

Does anybody have any questions at all about MaximEyes SQL, their new certified EHR?  I will be happy to stay and answer questions.  I'll hang out in the back for a little bit.  And then certainly, you can go over to the First Insight booth.  And they'll do a one-on-one demo of MaximEyes SQL for you.

It's really a great new product, and been very happy with it.  So, thanks for attending, guys.  I appreciate it.