What are they?
They are IMO terms that have had the computer code behind them retired for regulatory purposes. This has nothing to do with the ICD codes. Allscripts is working to minimize the impact of this on the user. To help with this, they have created the Retired Problem script that the Upgrade Tech will run.
What do you need to do?
- Before the Test-upgrade (or Pre-prod if you are doing a parallel upgrade):
- Make sure you have the latest mapping files from Allscripts
- Rerun your frequencies
- Approve the Allscripts mappings by looking for the green star in the far right column.
- Make sure you have APPROVED all the mappings you have done (the conversion tool only looks at approved mappings)
- After the Test-upgrade (or Pre-prod), submit a ticket to have the Upgrade Tech to run the Retired Problem Script.
- The Upgrade Tech will give the IC an Excel Spreadsheet with the retired problems. The IC will review it and send it to the client. There are tabs to indicate what section of the PMT they were found in.
- Point the PMT to the test/pre-prod server by changing the server information. It is important that you change them there so that it will pull the available active terms from IMO via the ATP. This will also enable you to make and test changes to mappings in your test environment.
- Sort your spreadsheets.
- If you ran the frequencies before the files were taken from the PMT and put in the test environment, the frequencies on the spreadsheet and in the PMT will be the same. You can sort the sections that are not related to Charge by frequency and work your way down the list
- For the Charge section, sort that spreadsheet by ICD-9 codes. You will be able to fix most of the terms in the “ICD-9s Linked to All Charge Build Items” and they will flow down to the other sections.
- Go to the section of the PMT that corresponds to the tab in the Retired Problem spreadsheet.
- Find the problem in the list. Verify that you have the correct term by looking for the source code.
- Highlight the term.
- Right click and “clear map”.
- Search for a new term using the magnifying glass or right click “Search for a problem (map)’.
- Some of the terms may be worded exactly the same, but if you are pointed to test, they should have the new computer code behind them.
- You can also choose a term that is the same exact meaning, but worded slightly different (ie. RUQ pain was the old, you could use Pine in RUQ)
- Sometimes there will be no term that matches exactly. Clear the current mapping and leave it unmapped. The user on the front end can convert it to the term that fits the best for that particular patient or if it is a favorite, they can choose the term they desire. If this is the case in a CareGuide, Noteform or Flowsheet, keep track of those and add the terms you desire on the build side.
- As you go through the different sections, watch for the “SYNC” under the “User Name”. When you see this, it means that you mapped it somewhere else and is synchronizing this term with the other one. Just review the mapping and if you agree with it, approve it. When you work on the “Diagnosis Mapping” (aka Charge), you might want to sort by ICD-9 terms. That way, you will decrease the number of times you are searching for the same term.
- Ask the Upgrade Tech if they would rerun the Problem Mapping script to be sure everything is taken care of.
What happens if a problem isn’t mapped?
- If it’s in the Instance Data (what is on a patient’s chart), then it will show up on the chart as a Medcin term. If the provider wants to assess it, they will have to convert it to an IMO term.
- If it is a CareGuide, NoteForm or Flowsheet, the correct form will not pull when the unmapped term is selected. If you have taken and activate the latest CareGuide and NoteForm release from Allscripts, the term will most likely already be on there with the IMO version. You would only need to map the terms you added when you customized.
What if some of the terms were already converted when the problem is retired?
- Go into the Conversion tool in the TWEHR and fix it on the last tab. This will fix the already converted terms in the chart.
- Also, go into the PMT and do the mapping as described above. This will correct it for future conversions.