News and New Features

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The Blackbird Content Framework is always being updated and improved. News of some of the most important changes can be found here:

Aug 02, 2017

An option is now available to support sorting of the problem list (by description, ICD-10, or date). Because this feature could result in the problems appearing in a different order than shown within the EMR (and new problems may not necessarily get added to the top of the list), it is not going to be activated for all practices by default. However, we will happy to turn the feature on for you by request.

Removing a medication or allergy from Blackbird now results in a confirmation dialog being shown, which provides an opportunity to document the reason for removal.

Jul 27, 2017

The Medicare HCC display has been a popular feature in the Blackbird framework and we have, per customer request, exposed that data to MEL so practices can leverage that data in their own reports and workflows.

Other additions made in the last few weeks include the ability to toggle whether users can add problem assessments or edit flowsheet data from within the framework.

Please let us know if you have any questions about these new options.

Aug 08, 2016

Our Progress Note “Assessment & Plan” form is mostly finished and is the hands of select beta-testers. The form features spell-checking, full text formatting (e.g. bold, italics, underline), and streamlines the documentation workflow in a problem-oriented way.

Please feel free to ask for a demo or to become an early user. We will make a general announcement once we get some experience supporting a few practices through the transition over to this form.

Jan 20, 2016

For practices that see Medicare Advantage patients, you can now display HCC (Hierarchical Condition Category) values in the problem list and receive feedback on the last time those problems have been assessed. This updated feature is called “HCC Display”.

Please contact us and we will enable this feature at no additional cost to you. Be sure to let us know what practice you are with.

When this feature is enabled, the provider will see the numeric HCC value next to the ICD-10 codes for any problems that have an associated HCC. This value is a relative number: The larger the value, the more important the problem is to the patient’s overall “risk” score. If the problem has not been assessed in the last 6 months, the HCC value appears in red with an alert icon. Hovering the mouse over the alert will convey a reminder to the provider that this problem is due to be assessed. If the problem has been assessed within the last 6 months, the HCC value appears in green with no alert.

The HCC values are based on CMS 2016 data, using version 22 of their HCC model.

This feature can be extended to work with the problem search dialog as well. If you wish, the application can show a subtle “H” icon in the search results for any problems that have an associated HCC value. The user can see the specific value by hovering over the icon. The HCC value also appears in the Find Problem dialog.

Let us know whether you would like the HCC codes to display in the search results (otherwise, by default, the HCC values will only appear in the problem list).

Please keep your ideas and feedback coming our way!

Dec 07, 2015

We have been hearing from some customers that users may occasionally still add problems to the Centricity EMR patient chart with ICD-10 codes that are too non-specific to be billable (through encounter forms or the ‘SmartList’). You can now have the Blackbird Content Framework highlight those non-specific codes for the provider so they can be easily identified, and edited to be given a fully specified code. This new feature is called “Non-specific ICD-10 warnings“.

To activate this feature, please contact Blackbird, let us know which practice you are with, and we will be happy to turn this feature on for you at no cost. We did not turn this feature on for you by default, as some practices prefer to provide some advanced notification to their providers when new features are going live.

In general, however, this feature should not be at all disruptive to provider workflow. When Blackbird is opened from a patient chart, the provider will notice a small warning icon next to any ICD-10 codes that are non-specific. If they hover over the warning, they will see the message, “The code is not specific enough for billing”. If they click the warning, the problem will come up in the Change Problem dialog ready for editing. Typically, clicking the “Search” button on that dialog will be enough to find the best replacement for the non-specific code.

Oct 28, 2015

ICD-10 is little inconsistent in places. There is a valid ICD-10 code that represents “otitis media, bilateral”, however, there isn’t one for “hip pain, bilateral”. We don’t think providers should have to know which concepts are valid, and which are not, so the Blackbird Content Framework now supports the ability to add compound problems to Centricity. Thus, if a provider selects a concept like “hip pain, bilateral” where there is not single ICD-10 code that represents the condition, Blackbird will add multiple codes to the patient chart (e.g., “hip pain, right”, and “hip pain, left”). This feature is active for all customers by default, with no configuration needed.

Oct 16, 2015

The Blackbird Content Framework has long supported automatic problem end-dates (where the end date of certain problems can be configured so they automatically drop off of the problem list after a certain duration). For customers interested in that feature, we have historically had you send us a spreadsheet of your preferences and we would import them into the system for you. Things are much less cumbersome now. We have just introduced our Framework Configuration Tool, which will allow each customer to build and edit their own problem durations. To get each practice started, there is a “Load Starter Set” button which populates your list with the most common settings shared across the user community. The tool can be accessed by opening the Framework and clicking on the “Open Config Tool…” menu which appears when you click on your name in the upper right hand corner of the app. Note: Each Blackbird account has a list of admin users who can access the tool. If you wish to be added to that admin list, please contact Blackbird, send us your EMR user name (e.g. “hwinston”), and we’ll gladly add you.

The Configuration Tool will be an important component for some of the new features coming to the Framework in the next few months.

In other news, there have been a number of other behind-the-scenes improvements made to the application over the last many weeks. We’ve restructured parts of the app to cut down on external dependencies, which has allowed the loading time of the app to speed up by another 200 ms, or so. We have also introduced major improvements to the fuzzy-logic that is used by the problem modifier menus and methods for getting around cases where the data payload from IMO is incomplete, which should all translate into a smoother user experience.

Aug 28, 2015

Some customers have reported that it can rarely take several seconds to open the framework, so we decided to incorporate timing metrics all throughout the application to help us tease out what the cause is. It’s probably no surprise that the cause can come from many places. Sometimes, the EMR seems to pause while the clinical lists are being read. Sometimes the client machine spuriously takes longer than average to spin up the HTML page. Sometimes the network seems to introduce some lag in transporting the application to the client. Fortunately, it only seems to be 1 to 2% of all activations that take longer than 3 seconds.

This investigation has led Blackbird to identify things we can be doing on the server to speed the initialization of the application. So far, we’ve squeezed out an 800 milliseconds improvement in load times, and have most activations ready in less than 1 second now. That may not sound like much of a speed increase, but for an average provider doing 200 searches per month, this translates to a 32 minutes of time savings per year!

We have also been creating even more “hooks” between Centricity and Blackbird to help practices ensure their providers always find the best problems for the patient record with the best billable codes. If, for any reason, you find yourself wanting more custom options for helping your users get to the terms they like and the codes you like, be sure to ask Blackbird for a demo of the latest tools.

July 04, 2015

Blackbird has added an option which allows the framework to post an “event” to MEL whenever a user adds or edits a problem in the framework. This allows a MEL function (that you write) to “catch” a notification whenever your providers use Blackbird to modify the problem list. Some customers are using this feature to add an extra layer of advanced logic as they move toward ICD-10 readiness. For example, your MEL function can look at the problem that was just edited, and modify the problem comments to provide feedback to the provider about other coding information that they may need to be aware of when that particular ICD-10 code is on the problem list.

For details on how to use this feature, or to discuss a range of other options you have for assisting your users to better manage their problem lists, please feel free to contact us at Blackbird.

June 18, 2015

We have received feedback from several customers now asking us to make the problem ‘Edit’ menu open the Blackbird Change Problem dialog instead of the Centricity Edit Problem, so that has change has finally been implemented. If users would still like to use the Centricity Edit Problem dialog, they can still get there by holding down the ‘Shift’ key and clicking the ‘Add’ button on the top of the problem list.

This change required some refactoring of how some problem related functions are handled within the app, but the net result is that this change should actually speed up the rendering of very long problem lists even further. Please keep the feedback coming!

We have continued to work on product infrastructure to support problem assessments and progress note documentation too, but that’s a longer term project. Stay tuned….

May 20, 2015

The IMO/Blackbird Problem Lookup feature now gives users even greater control over how many search results they want to see. Users can change this setting using the “gear” button in the upper-right corner of the Find Problem dialog window.

We’ve also added a simple, but powerful Web Lookup feature to the Problem and Medication lists. Each clinic can configure those clinical lists to render a “Web Lookup…” menu item which would then appear for all problems or meds. When a user selects that menu item, the system will then open any URL you wish related to that problem or medication. This feature could be used in a variety of powerful ways. Consider using it to open reference materials, patient education, or coding references related to the selected item.

Contact Blackbird for more info.

May 11, 2015

The IMO/Blackbird Problem Lookup feature now supports an “Automatic Problem Search” mode. This means that, from an encounter form or quick-text macro, you can launch the framework with a specific problem description already in context. For example, the user could select a problem description from a list-based, or “fee slip”-like encounter form. The Framework would then open, search on that problem, and pull in all related problem modifiers and codes automatically.

This should enable you to build encounter forms that can perform problem lookups with no typing required by the user. The user would just review any problem modifiers, and click “OK” to add the coded problem to the chart. Imagine building problem lookup workflows where all you need is a problem description. There is no longer any need to embed ICD codes in your forms. You can leave the ICD maintenance to the coding experts at IMO.

Contact Blackbird for more info.

May 05, 2015

The IMO/Blackbird Problem Lookup feature now supports “Automatic Problem Durations“. This means that certain “self-limited” problems can inherit an automatic “stop date” of your choosing. For example, if the user chooses to add “Common cold” to the problem list, the problem “stop date” could automatically be set to 14 days in the future. This should help the problem list from becoming cluttered with short term problems.

For practices interested in this feature, you can configure the list of problems (based on ICD-10 codes) and their durations. Contact Blackbird for more info.

May 04, 2015

The Blackbird and IMO teams had a great time participating in the vendor booth area of Centricity Live this past weekend. Interest was very high in our integrated IMO/Blackbird Problem Lookup feature, and the feedback from our existing users has been that our solution is making both coders and clinicians very happy.

We also started to demonstrate the current work that is underway for progress note documentation including our integrated spell-checking. Everybody seemed to enjoy that we are moving toward unprecedented end-user control of what gets included in the progress note and how the note appears.

We are actively recruiting a few more practices who are interested in using the early versions of our progress note documentation features. This will help us fine tune them quickly and help you by making sure they evolve to satisfy all your needs. Please contact Blackbird if interested.