Referrals and Transitions of Care FAQs

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When reviewing the list of referrals for a patient, the Referrals/Trans tab will always display the date order from most recent to oldest. Below is instruction on how to change the order from the oldest to the most recent date.

1. From the patient chart, click the Referrals/Trans tab.
2. Click the Date column to change the sort order.

To view scanned documents attached to a referral and change the date order, follow the instruction below.

1. From the patient chart, click the Referrals/Trans tab.
2. Click the Scanned Records tab.
3. Click the Date column to change the sort order.

CDA stands for Clinical Document Architecture.  It is a standard electronic document in XML that defines the structure of certain medical records including summaries and encounter notes. 

The term C-CDA is often used interchangeably, which stands for Consolidated Clinical Document Architecture. The purpose of the C-CDA is to include all clinical documents and CDA templates within one C-CDA document template. 

CDAs can only be sent electronically to external contacts who have a Direct Email Address entered into the Address Book of OP.

A one-time job runs for the Export Date and Time specified by the user. For example: This Wednesday at 9:00 PM.

A recurring job runs every time the user indicates until the Job End Date. For example: Day 1 of the month, every month at 9:00 PM. 

Yes, the user will see a new line under the One-time tab of the CDA Export that was created from the DAR. In addition, the user can expand the job to view the current stage of the job itself.  

The Export Frequency field contains an ellipsis button that launches Cron Maker. After launching Cron Maker:

1. Choose whether they'd like the job to run Daily, Weekly, or Monthly. 
2. Complete the frequency information in the Generate Cron Expression section.
3. Click the Generate Cron Expression button. Cronmaker provides a Cron format within the Result box. 
4. Copy and paste the Cron format to the Export Frequency field. 

Cron Maker is a utility that helps to build a Cron Expression that is entered in the Export Frequency field of a Recurring CDA job. This will determine how frequently the recurring job will run. 

Daily

Weekly

Monthly

A user can select a Job End Date up until one year from the current date.

When exporting CDAs from the Demographic Analysis and Recall in bulk, the export job could take some time to run, depending on how large the export job is. OP offers a prompt for the user to schedule the job to run at a specific time in the background. The job can be scheduled for the same day, should the user need to receive the export quickly.

A Failed Job Stage means that something hindered the service from running the job successfully. There will be an error message to provide you with more information.

The Export Location differs between On-Premise clients and Cloud clients.

On-Premise

The location entered must be a folder that it is located on your gdb_common. We recommend that you create a folder on the gdb_common specifically for your CDA exports. Consequently, the path that you would enter in the Export Location field would be "C:\OP\gdb_common\[Folder Name you created]". Additional folders will be created for each run of the job. The name of the folder will include the Job Name and Date. The folder will contain all exported CDAs. 

In addition to the local file location, On-Premise users will use the Export Location to generate a location you want to save your exported files on S3 which is within your Cloud Storage. You can access these exported files by following the instructions here. 

If the Export Location is left blank, the CDA will not be saved locally. However, the job will create a folder with the JOBNAME_DATE in S3.

Cloud

The Export Location chosen is the location you wish to export your CDAs on your Cloud Storage (S3). You can access these exported files by following the instructions here. 

There are limitations with the API call that OP makes to build the C-CDA through Intelichart. This API call is dependent upon getting an Encounter by date or by date range. It cannot create one C-CDA for two different dates. Here are some options: 

• If the Encounters or Well Visits dates are consecutive you can use the date range fields at the top of the window to input the dates. Do not select anything within the grid, then click the CDA button. This will create one CDA for the encounters within the date range you selected. 
  • Example: You want to choose encounters from 3/15/19 and 4/1/19. There are no other Encounters or Well Visits within that time frame, so these dates can be entered as the date range within Medical Records to create a C-CDA with both visits.
• If the Encounters or Well Visits you want to select are not consecutive, then you will need to create separate C-CDAs. 
  • Example: A patient has a total of 4 encounters. The dates are 3/15/19, 4/1/19, 5/3/19, and 7/6/19. Only 3 of them are wanted for the C-CDA. To do this, one C-CDA can be created using the date range of: 3/15/19-4/1/19 and another C-CDA can be created for for 7/6/19. 

From Document Management, users can either search for and select the patient, or use the Search for Documents window to search for all CDA documents. Once the CDA is located:

1. Click to select the CDA that will be exported.
2. Click the Export drop-down menu located at the top of the window.
3. Select Export Document. 
4. Select the destination to which the CDA should be exported and click the Save button. 

OP takes PHI and security very seriously! That is why accessing your S3 (Cloud Storage) location will be done through a Secure File Transfer Protocol (SFTP). 

Please contact OP Support by emailing support@officepracticum.com for more information and to enable this feature. OP Support will get in touch with the correct team to expedite your request. 

Once credentials have been acquired, follow the directions below to download and use WinSCP to access your documents exported to S3:

1. Go to https://winscp.net.
2. Click the Download Now button.
3. Click the Download WinSCP button, or choose the Other Downloads if needed. This places an executable in your Downloads folder.
4. Click on the executable to proceed through the installation process. Once the installation process is completed, you will receive a Login window.

1. Complete the following fields:

• File Protocol: Leave the default of SFTP.
• Host name: Enter the URL Login provided in the email received from OP.
• User name and Password: Enter the user name and password provided in the email received from OP.

1. Click the Login button.

To learn more about WinSCP, please visit their Help Documentation.

In order to see external recipients listed in the To: field of the message, the logged in user must also have a valid DIRECT email address populated in the Address Book. 

All attachments are saved in Document Management with the Item Type :REFERRAL LETTER. The following attachment types open the Clinical Reconciliation window:

• CDAs (xml)

The following attachment types open the Document Management window:

• Text
• PDF
• HTML

External Messages are fetched from the Unread External tab of the Message Center. Simply click the Fetch External Messages button located in the bottom section of the window to retrieve External Messages.

When XDM (Zip) attachments are received, OP unzips the file so the CDA becomes available to the user. However, we do not remove the zip archive. Because of this, you see a blank document. Confirm you are selecting the CDA button in the message window.

If a Direct Message includes an attachment, it will be indicated in the message section of the Message Center window once a message is selected.

It is required that a patient’s clinical data is in the OP Patient Portal for a CDA to immediately generate. If the patient has not been issued a PIN, an appointment has not been scheduled, or a finalized patient note has not been created, then it is possible that the patient’s clinical data is not in the OP Patient Portal. 

When it is initiated by the user to create a CDA (either saving or sending) and the patient’s clinical data is not already on the OP Patient Portal, that will act as a trigger to send the patient’s clinical data to the OP Patient Portal. At that point, OP will notify the user that the CDA is not ready. Since more patients’ clinical data will be added to the OP Patient Portal as time goes on, you should find the workflow described below to occur less and less.

• When saving a CDA as an export, if the CDA is not ready, OP will notify the user. The user should continue to work in OP as needed. After about 3-5 minutes:

1. Check back in Document Management. 
2. Select the exported CDA. If for some reason it is still not ready, OP will notify the user when the user tries to click on the CDA to view. If it is ready, the CDA can be exported directly from Document Management and saved to a local secure location on the workstation. 

• When sending a CDA as an attachment on a Direct Message, if the CDA is not ready, OP will notify the user. The user should keep the external outgoing message window open by either keeping the window in the background or minimizing it in OP. After about 3-5 minutes:

1. Check back into the message, and try to click Send. If the attachment is ready, then the message will be sent successfully. If it is still not ready, OP will notify the user.