www.orchardsoft.com
Volume 20, Number 1 • Winter 2019
See “Support Use of CPT II Codes”
on page 2.
Orchard Products Support Use of CPT II Codes
to Close Care Gaps
inside this issue...
Tech Tip: Viewing PDF Reports .........................5
Orchard Helps Raise Money for Athletes ............ 6
Where in the World is Orchy? .........................7
Holiday Decoration Contest ............................7
Spotlight On: Orchard Training ...................... 8
Orchard’s User Group & Symposium ............ 9
We Want to Hear from You ............................ 9
Technical Support Feedback Process ........... 10
Lab Week 2019 ............................................... 10
Compare LIS Usability Scores ........................11
U
sing CPT Category II (CPT II)
codes is one way to document
care gap closure for payers. CPT II
codes are a new version of Current
Procedural Terminology (CPT) codes
that are used to assess Healthcare
Eectiveness Data and Information
Set (HEDIS) and Star rating scores.
As always, Orchard Software is listening
to its customers’ needs and has added
functionality in its systems to support
the addition of CPT II codes.
HEDIS & Star Ratings
Inuence Reimbursements
HEDIS is a set of standardized
peformance measures developed by the National Committee
for Quality Assurance (NCQA) that is used to measure and
compare quality across health insurance plans. The Centers
for Medicare & Medicaid Services’ (CMS) Five-Star Quality
Rating System is used to measure the quality of care for
Medicare Advantage (MA) and Prescription Drug Plan
(Part D) beneciaries. Both HEDIS and Star ratings aect
healthcare organization reimbursements.
They are improved by:
• encouraging patients to have preventive health visits,
screenings, and tests
• educating patients about medication adherence and
side eects
• reaching out to patients who are non-compliant
CPT II Codes Provide Additional Information
About Quality of Care
CPT II codes are determined by insurance carriers and
are used to “grade” performance. As “follow-up” codes,
CPT II codes provide additional information to the insurance
provider that demonstrates the level of quality. For example,
the Comprehensive Diabetes Care HEDIS measure is for
diabetes patients age 18-75 years old. The measure includes
Hgb A1c control, a retinal eye exam, medical attention for
neuropathy, and blood pressure control. In tracking Hgb
A1c levels for diabetic patients, the CPT II codes correspond
to the Hgb A1c result (see Figure 1), showing the insurance
company where the patient stands regarding their diabetes.
Laboratory professionals need to be aware of these types
of reimbursement policies and determine where lab
data applies.
Laboratory Tests & CPT II Codes in the
Comprehensive Diabetes Care HEDIS Measure
Hgb A1c (83036, 83037)
CPT II 3044F Hgb A1c < 7.0
3045F Hgb A1c 7.0-9.0
3046F Hgb A1c > 9.0
Neuropathy Screening Codes (82042, 82043, 82044, 84156)
CPT II 3060F Positive microalbuminuria; result documented and reviewed
3061F Negative microalbuminuria; result documented and reviewed
4010F ACE Inhibitor or ARB therapy prescribed or being taken
Figure 1
www.orchardsoft.com
2
Support Use of CPT II Codes
Continued from page 1.
New CPT Code Rule Functionality for Multiple CPT II Rules
To help you manage your CPT II codes, Orchard’s laboratory systems have added functionality to CPT rules, allowing
for the creation of result evaluation test conditions. This means users can create a range with numeric results and
several text results in one rule. Figure 2 shows how the CPT II rule setup looks for Hgb A1c in Orchard
®
Harvest™.
Figure 2: CPT II rules for the Comprehensive Diabetes Care HEDIS measure in Harvest.
In Harvest, select Table Setup from the File menu, then click the Rules - CPT Codes button, followed by the New Rule
button. Enter the rule description and select the applicable conditions (see Figure 3) and actions (see Figure 4) under those
tabs. You can add multiple test result conditions instead of just one; to add each condition, click the Test Results button.
Figure 3: Adding a rule condition.
Technical Support: (800) 571-5835
3
In addition, CPT II codes will be available in the AdminCenter of Orchard
®
Copia
®
and Orchard
®
Trellis™ in the upcoming
release. You can set up CPT II rules in the CPT Rules table in Copia and Trellis as outlined in the following images:
Step 1: Click the Add CPT Rule button.
Figure 4: Adding a rule action to include a CPT II code.
news@orchard is published quarterly by:
Orchard Software Corporation
701 Congressional Boulevard, Suite 360
Carmel, Indiana 46032
If you are not on our mailing list and would like to be, please call us at
(800) 856-1948, fax us at (317) 573-2528, or email us at [email protected].
Contributing authors & editors: ___ ______________________________
Audrey Lorraine Kerry Foster Kim Futrell Christine Henderson
Megan Stanage Nancy Stoker Greg Lyons Megan Renn
Ashley Bland Sarah Goguen Kelly Haemmerle Gwenn Brode
If you have any questions or suggestions, please contact our publishers, Megan
Stanage and Sarah Goguen, or editor Kerry Foster, at (800) 856-1948.
View the newsletter online at: www.orchardsoft.com/newsletters.
Step 2: Select the order choice for the rule.
See “Support Use of CPT II Codes”
on page 4.
www.orchardsoft.com
4
Step 3: Congure a test condition.
Step 4: Add the CPT II code and save.
Step 5: Review saved rules.
Automate CPT II Code Documentation to Increase Reimbursements
Using this setup, Orchard’s systems can automate population of CPT II codes into the EHR so that the data can then
be sent to the payers. Depending on facility size, a small improvement in HEDIS or Star ratings can equate to a signicant
boost in reimbursements, while also demonstrating improved quality of care for patients.
Support Use of CPT II Codes
Continued from page 3.
Technical Support: (800) 571-5835
5
Tech Tip: Viewing PDF Reports Made Easier, More Seamless
R
ecent versions of Orchard
®
Harvest™, Orchard
®
Pathology,
and Orchard
®
Copia
®
include enhancements to the
PDF viewing experience that has been managed using the
versatile and universal PDF le type.
Copia Adds Universal PDF Viewer
Beginning in version 7.180907, Copia can display and
print all embedded PDF documents in the same universal
PDF viewer. This makes all PDF viewers in Copia consistent.
Recently, popular Internet browsers, such as Firefox and
Chrome, have moved to using their own specic in-browser
PDF viewer. Similarly, Copia’s use of the same PDF viewer
in all browsers eliminates confusion and potential problems
with one browser changing its PDF viewer settings, such as
when Firefox version 52 completely removed support for
the Adobe Acrobat plugin.
The new PDF viewer is enabled by default, but you can
disable it by selecting the “Use the browser’s native viewer
to display all PDFs” checkbox, found on the Result Delivery
tab of the System Defaults page. When you select this
checkbox, Copia displays the PDF as before this change,
relying on your browser’s native PDF capabilities. Note
that this new PDF viewer is not used for Internet Explorer
browsers.
Harvest & Orchard Pathology Leverage
Windows’ PDF Functionality
Harvest and Orchard Pathology also enhanced the PDF
viewing experience by taking advantage of the Windows
10 Print to PDF option in Harvest and Orchard Pathology
versions 11 and above, and the Windows XPS Document
Writer printer option for older workstations.
Like the previously required PDFCreator plugin, the
“Microsoft Print to PDF” option generates PDF les. To
use, navigate to the Printing tab on the Preferences window
and select “Microsoft Print to PDF” as your “Print to
le driver” setting. The Microsoft XPS Document Writer
printer option generates XPS-formatted les. This printer
has been available to all Windows users since Windows Vista.
If you want to generate PDF les using the “Microsoft
XPS Document Writer” printer option, you need to enable
an ACO to convert XPS formatted documents to PDF les.
Note that this will only work for automated printing jobs.
To set this up, you must have Ghostscript and GhostXPS
installed. You can place the ghostXPS.exe les in the same
folder as ghostScript (gswin64c.exe).
Copia’s embedded PDF viewer shows the same options in all Internet browsers.
See “
Tech Tip: PDF Reports Made Easier
”
on page 6.
www.orchardsoft.com
6
Tech Tip: PDF Reports Made Easier
Continued from page 5.
Once installed, you must add some ACO settings. The
rst is to let Harvest or Orchard Pathology know the path
to the GhostXPS application’s executable (gxpswin64.exe)
because the program needs access to the application to
convert XPS les into PDF les and to view a thumbnail
image of an XPS report.
[Ghostscript]
XPSFilePath=<directory path to ghostxps executable>
Harvest and Orchard Pathology include the XPS les on
reports and display thumbnail images of the XPS les on
the Links window. However, they only display the rst
page of the PDF les on the thumbnail image. This requires
adding “XPS” to the [Link]AllowedDocumentTypes ACO
for full implementation.
You also need to enable the function to convert XPS
documents to PDF les.
[Ghostscript]
ConvertXPSToPDF=<true or false>
The default is false. Set to true and select the “Microsoft XPS
Document Writer” option from the “Print to le driver” drop-
down list for XPS documents to be converted to PDF les.
Other Behavioral Changes
While these changes primarily aect report previews
in the program, they also alter the production of email
attachments, faxes, Orchard
®
Harvest™ Webstation or Orchard
®
Web AP PDFs, HL7-embedded reports, patient repository
reports, the acquisition of multiple images through TWAIN,
and the billing summary report. Note the following behavior
changes:
• Email attachments can be either PDF or XPS documents.
• Web PDFs can use the XPS printer, but must also use
the GhostXPS conversion so that the nal product is a
PDF report.
• Faxing cannot use the XPS printer with the conversion
setup. Only the PDFCreator and Microsoft Print-to-PDF
printer options work for a faxing workstation.
• The Patient Report Repository can include XPS reports
and preview them as a PDF report.
• XPS les can be encapsulated into HL7 messages or
included through a linked folder as a PDF report. Note
that XPS les can be included with the HL7 messages;
however, the end source may not be compliant. Orchard
Software’s recommendation is to use the conversion
methodology to convert the XPS to a PDF before being
linked to the HL7 message.
• When TWAIN is used to get multiple images, those images
can be put into either a PDF or XPS le.
For more information on Orchard’s support of PDF le
types in its applications, visit Orchard Resource Central or
call Technical Support at (800) 571-5835.
Orchard Employees Help Raise Money for Athletes Across Indiana
O
rchard Software sponsored and participated in
the 5th annual Strikes for Special Olympics
Indiana, presented by the Law Enforcement Torch
Run. Fifty teams, including four from Orchard, came
together to compete for a great cause. The event
raised $20,000 for more than 12,000 Special Olympics
athletes across Indiana. Although Orchard’s teams
did not bring home any trophies, they had a lot
of fun.
Orchard employee Christy Mutchman and
her son, Austin, snap a quick picture while
bowling for Special Olympics Indiana.
“Let me win. But if I cannot win,
let me be brave in the attempt.”
–Special Olympics Athlete Oath
Source: Special Olympics Indiana
T
he holiday season around the Orchard Software oce is always fun and exciting.
The main event of the 2018 holiday season was a decorating contest among multiple
departments. Each department collaborated and crafted their themes and presented
them to a panel of ve judges.
Administrative Coordinator (and head decoration judge) Christine Heater said, “The
Orchard holiday decoration competition was so much fun. The displays were entirely
dierent and so creative.”
The Support department created a replica of Dr. Seuss’s Whoville, the Accounting
department’s decor included Santa and his reindeer, and the Marketing department
had an impressive light and music display.
The competition was erce, but in a razor-thin 1.5-point victory, the Marketing department’s light display took home
the 2018 trophy. Departments are already brainstorming for the next holiday competition in hopes of taking home the
title in 2019!
Technical Support: (800) 571-5835
7
L
ast time we saw Orchard Software’s famous mascot, Orchy
®
*
, he was
celebrating everything pumpkin in Circleville, Ohio. At this small-town
festival, Orchy stued himself full of every pumpkin-avored food he
could nd, including donuts, pancakes, ice cream, and brownies. He also
watched parades, judged large pumpkins, and went ghost hunting at
an octagon-shaped home. He was glad he didn’t see any ghosts, and so
happy to meet new friends!
Congratulations, Chuck!
Chuck Kulla from Washington Hospital guessed Orchy’s location and
has won the drawing for the Orchy prize package.
Reections of Color
Orchy recently sent a postcard from this famous, ancient city that straddles two continents. He wrote about the old
sprawling markets that sell clothing, watches, handbags, scarves, and boxes of baby chicks and ducks. He was amazed and
taken in by all the glorious colors. Orchy followed an irresistible scent that took him to a booth selling his favorite dessert,
lokum. He purchased some and continued his walk along the reecting pool, dreaming of the Chronicles of Narnia while
eating this tasty treat. When Orchy woke from his dream, he was staring at a reection in the pool. He counted six minarets
surrounding a magnicent building, so of course this was his next stop. While touring the amazing building, he was in awe
of the colorful tiles owing throughout. The colors reminded Orchy of the sky on a clear day. We hope to hear more from
Orchy soon.
If you think you know where Orchy is, please send your answer to news
@orchardsoft.com by March 29, 2019, to be
eligible to win an Orchard prize package.
* Orchy is a trademark of Orchard Software Corporation for installation of laboratory software and technical support services, namely, troubleshooting of computer
software problems; maintenance of computer software.
Where in the World is Orchy?
Holiday Decoration Contest
www.orchardsoft.com
8
administrators the opportunity to learn how to utilize
the software prior to installation and opportunities to
build their skills through advanced classes.
• The Field Implementation Analyst (FIA) training provides
an opportunity for new Orchard FIAs to learn how to
plan, install, rene the database, and take a system live
in the mock laboratory.
• The online Technical Support training provides an avenue
for Technical Support employees to continuously learn
through online training while on the job.
• The Learning Management System (LMS) the team
administers provides an avenue to assign and track
completion of required online courses.
Department Goal
The Training department’s goal is to continue to develop
and improve its instructor-led classroom training while
expanding into eLearning, which will allow it to reach more
clients and employees.
Growing, Growing, Growing
Since 2015, the department has signicantly grown the
number of training oerings and increased productivity
through teamwork, project management, and learning how
to manage time, resources, and priorities. It has more than
doubled its on-site class oerings for client and employee
training. Additionally, there are a variety of eLearning
courses for Technical Support training.
Spotlight On: Orchard Training Department
T
he Orchard Software Training department utilizes
Orchard’s subject matter experts’ knowledge and skills
to develop training materials for clients and employees. The
move to the new Training Center with additional classrooms
has enabled the department to expand its course oerings.
During the past three years, it has developed several new
courses for clients and vendors, as well as enhanced the
courses for Orchard employees, including:
• Orchard
®
Copia
®
Advanced User Client Training
• Orchard
®
Trellis™ POCT Client Training
• Orchard
®
Trellis™ & Orchard
®
Sequoia™ Administrator
Client Training
• Orchard
®
Harvest™ FIA Training
• Orchard
®
Copia
®
FIA Training
• Orchard
®
Harvest™ Microbiology FIA Training
• Vendor Installation Training
• Onboarding/Harvest/HL7/Copia Technical Support
Training
These courses, along with existing Harvest, Orchard
®
Pathology, and Copia courses, provide a menu full of
oerings for various client and employee training needs.
What They Do
• The Training department assists both internal employees
and clients to gain the necessary knowledge and skills
to successfully perform their job function. The client-
focused classroom training classes oer new system
The team, from left to right: Shannon Bank, Training Specialist; Phil Friend, Harvest/Orchard Pathology Trainer;
Rachel Enlow, LMS Administrator; Nicole Carter, Training Specialist; Jacob Carlisle, LMS Administrator; Daphne
Davis, Senior Instructional Designer; Andy Gilmore, Associate Director of Training; Ed Roberts, Training Specialist;
Katie Walton, Administrative Assistant; Debbie Myers, Instructional Design Team Lead. Not pictured: Sarah Goodwin,
Training Specialist.
Technical Support: (800) 571-5835
9
Registration Now Open for Orchard’s
2019 User Group & Symposium on June 18-19
W
e are pleased to announce that registration is now open for our
2019 User Group & Symposium. The event will be held at the Hyatt
Regency in downtown Indianapolis, Indiana, on June 18 & 19.
Opportunities to Learn & Network
Attendees, including both current and prospective Orchard Software users,
have the chance to learn in-depth information about the lab industry,
Orchard Software, and Orchard’s various lab information system products.
It also provides the opportunity to network with Orchard employees and
other users of Orchard Software systems, as well as earn P.A.C.E
.®
credits
toward continuing education requirements.
Expanded Breakout Sessions
In response to your feedback, we have expanded the number of breakout sessions available on day two this year,
providing additional opportunities to learn about your Orchard products.
Cost & Additional Information
There is no cost to attend the symposium, and breakfast and lunch are provided each day. However, attendees are
responsible for travel, lodging, and other meals.
For more information on this event, including the agenda, registration, and hotel accommodations, visit
www.orchardsoft.com/symposiums, or contact your Orchard Account Executive at (800) 856-1948.
We look forward to seeing you there!
We Want to Hear from You
W
e want your feedback on how you read the Orchard Software newsletter.
Please visit www.orchardsoft.com/surveys to answer a few questions
about what you want to see in the newsletter. Do you prefer print or electronic
versions? More industry news? More Orchard product tips? Let us know!
Technical Support Feedback Process
www.orchardsoft.com
10
Mark Your Calendars: Lab Week 2019
I
n October 2018, Orchard Software implemented a new Technical Support feedback process, where clients are emailed
a survey link after closing a ticket with an Orchard Support Technician. This survey’s goal is to gather information about
client interaction with the Technical Support department.
We are pleased to share the survey results from Quarter 4, October 1, 2018–December 31, 2018. The possible answers
for each question are Very Satised, Satised, Dissatised, and Very Dissatised.
Question 1: In thinking about your most recent experience with Orchard Software Technical Support, how satised were
you with the quality of customer service?
Result: Out of 1,016 responses, 96% were Very Satised or Satised
(795 Very Satised, 179 Satised).
Question 2: The customer service representative was very courteous.
Result: Out of 1,008 responses, 99% were Very Satised or Satised
(880 Very Satised, 124 Satised).
Question 3: The customer service representative handled my call quickly.
Result: Out of 1,005 responses, 95% were Very Satised or Satised (766 Very Satised, 194 Satised).
Question 4: The customer service representative was very knowledgeable.
Result: Out of 1,005 responses, 96% were Very Satised or Satised (753 Very Satised, 214 Satised).
While we are pleased the top answer for each question was Very Satised, we will refer to all feedback to make
improvements in our customer service interactions. If you have contact with our Technical Support department, keep
your eyes on your email inbox for your survey link.
44
th
Annual Medical Laboratory
Professionals Week (MLPW)
Since 1975, the last week of April has
been recognized as a time for laboratory
professionals nationwide to increase
awareness of clinical laboratory
competency, to recognize the importance of the
laboratory’s role in healthcare, and to celebrate the hard
work and dedication each lab professional displays 365
days of the year.
Orchard’s Dedication to the Laboratory
For the past 25 years, Orchard Software has prided itself
on listening to and working with its clients to create the
best laboratory software on the market. It is with great
honor that we share in the excitement of Lab Week 2019.
How Are You Celebrating Lab Week 2019?
There are 17 national clinical laboratory organizations
that coordinate various activities to celebrate MLPW.
From hashtags to 5K runs, there are so many opportunities
to get involved in the celebration. Do you want to share
how your laboratory is celebrating
this year? Take this survey:
bit.ly/LabWeekSurvey
Win a Lab Week Lunch
This year, Orchard Account
Executives are sending clients two
newly designed Orchard lunch
bags with information about a
rae inside. Twenty lucky rae
participants will win a $50 gift card to use toward a
celebratory lunch. Register now:
bit.ly/LabWeekGiveaway
Question 3
Technical Support: (800) 571-5835
11
Compare LIS Usability Scores in Orchard’s New White Paper
T
he way humans think and logically process steps
inuences how they interact with computers and
other technologies. Particularly in healthcare, it is important
to design information systems that are user-friendly and
enhance workow. How specically can technology be
designed so that it is easy to use and the next steps are
intuitive? Usability includes ve quality components:
learnability, eciency, memorability, errors, and satisfaction.
From a healthcare perspective, a user-centered design
approach would focus on the usability, usefulness, and
t of a technology into daily workows for each type of
healthcare worker who uses the system. When end users
nd a system to be complicated and inecient, they
develop alternate ways to accomplish a task, which can
lead to errors and patient safety concerns.
Harvest Ranks Highest Among Competitors
A 2017 Journal of Pathology Informatics paper reports
the results of an LIS usability study determining that
overall, both LISs and EHRs have poor usability scores
when compared to benchmark System Usability Scale
(SUS) scores.
1
However, in the ranking of LIS usability
scores, Orchard
®
Harvest™ is the clear leader. All of Orchard
Software’s years spent actively listening to its customers
and making product changes has paid o, because Harvest
stood out signicantly in this peer-reviewed, non-biased
usability study, with an overall score of 78.7, which is well
above the benchmark mean SUS score of 68.
We Couldn’t Have Done It Without You –
Our Customers
By listening to customer requests and “learning the lab,”
Orchard has been able to make a product that lab users
intuitively and eectively use to make their jobs easier and
to increase the laboratory’s contribution to patient care.
At Orchard, we consider our customers as partners, and we
appreciate the ongoing support and input that has made
Harvest such a valuable tool for laboratories of all shapes
and sizes.
Download the White Paper for More Details
To learn more, download the full LIS usability white paper
at www.orchardsoft.com/whitepapers. Orchard regularly
publishes laboratory industry
information, news, ideas,
and recommendations
relevant to customers and
industry followers. We do
this via our website,
e-newsletters, blog posts,
webinars, and white papers.
Visit www.orchardsoft.com
for more information.
Notes
1. Mathews, A., & Marc, D. (2017). Usability evaluation of laboratory
information systems. Journal of Pathology Informatics, 2017(8), 40.
http://doi.org/10.4103/jpi.jpi_24_17
Harvest stands out signicantly, with an overall score of 78.7, well
above the benchmark of 68.
1
www.orchardsoft.com
701 Congressional Blvd., Suite 360
Carmel, Indiana 46032
Phone: (800) 856-1948
Fax: (317) 573-2528
Email: news@orchardsoft.com
Website: www.orchardsoft.com
2019 Orchard Software Event Calendar
Date Trade Show/Event Location
3/31-4/3 CLMA KnowledgeLab Grapevine, TX
4/1-4/4 Becker’s Hospital Review Annual Meeting Chicago, IL
4/3-4/6 CRI Symposium for Clinical Labs Las Vegas, NV
5/12-5/15 Netsmart CONNECTIONS2019 Washington, D.C.
6/3-6/6 APHL Annual Meeting St. Louis, MO
6/18-6/19 Orchard Software 2019 User Group & Symposium
Indianapolis, IN
8/4-8/8 AACC Annual Scietic Meeting & Clinical Lab Expo Anaheim, CA
9/21-9/25 CAP19 Orlando, FL
11/9-11/13 American College of Veterinary Pathologists Annual Meeting San Antonio, TX
Register Today for Orchard’s 2019 User Group & Symposium