User Guide — Data Reconciliation

 

When you receive or import a summary of care record or Patient Portal document into a patient chart, athenaOne provides visual prompts to reconcile data in the relevant chart sections. An orange alert bar appears on the left side of the history tab if data is available to reconcile.

The orange alert bar also appears next to the specific history section and next to the link to the data reconciliation tool.

 

For imported summary of care records, athenaOne provides visual prompts to reconcile data in the Allergies, Medications, Problems, and Vaccines sections. To view information in other sections, open the document itself.

1. Display the patient chart and locate the sections marked with an orange bar.
   Note: You can also access the Data Reconciliation item in the Intake checklist.
2. Click a chart tab — for example, Meds or Vaccines — and click the reconcile link at the top of the tab.
   
   The Data Reconciliation tab opens.
3. Expand the sections and review the items.
   Note: You do not need to reconcile items from an incoming document that match corresponding items already in the chart or items that are only in the chart (these items appear in the data reconciliation document for your information only). For more information, see Items that appear in the data reconciliation document.
4. Resolve the Conflict items. Items marked with Conflict indicate that the item exists in both the chart and the incoming document, but the information is different.
   • To keep the chart information, click the item on the left.
   • To update the chart to reflect the information in the incoming document, click the item on the right.
5. Resolve the Incoming Only items. Items marked with Incoming Only indicate that the item exists in the incoming document but not in the chart.
   • To discard the item in the incoming document, click the item on the left.
   • To add the item to the chart, click the item on the right.

Note: The Last Edited date indicates when the data element (allergy, medication, hospital discharge medication, or problem) in the incoming transition of care or referral summary was last updated.

6. Resolve the Related Items. Items marked with Related Items exist in both the chart and the incoming document. They appear related, but they may or may not refer to the same event (for example, a vaccine "administered in 2019" and the same vaccine "administered on January 1, 2019"). You may need to reconcile these items.
   • To keep the item in the chart and discard the item in the incoming document, click the item on the left.
   • To overwrite the item in the chart with the item in the incoming document, click the item on the right.
   • To keep the item in the chart and add the item in the incoming document to the chart, click both items.
7. As you work through the items that need reconciliation, periodically click Save Progress at the top of the page. This action saves the selections that you have made up to that point, allowing you to navigate away from the Reconciliation tab without losing your work.
   Note: Items that have a note field in athenaOne also have an editable note field on the Data Reconciliation tab. Edit the note only in the item that you select to keep (the chart data or the incoming document, not both). If you edit the note in the item that you then discard, the edited note is discarded as well.
8. (Optional) After you complete one section, you can update the chart to reflect your selections in just that section. To do this, click Update Chart for that section. In the Chart Confirmation dialog box that appears, review the items that appear in that section, and click Confirm to update the chart.
   Note: If you do not want to work through the other sections of the reconciliation document at this time, you can archive the reconciliation document and return to it later (see To dismiss a reconciliation task).
9. After you complete all sections, click Update Chart at the top of the page.
   Note: You can click this button only after you make a selection for all items.
10. Review the items and click Confirm.
    athenaOne updates the patient's chart based on your selections.
    
    

1. Display the patient chart and locate a section marked with an orange bar.
   Note: During the Intake stage of the encounter, you can click the Data Reconciliation item in the Intake checklist.
   
   
2. On the Data Reconciliation tab, click the show documents to reconcile link at the top of the page.
   The list of documents that require reconciliation appears. If you are currently reconciling a document, it is labeled "Active."
3. To reconcile a different document, click its reconcile link.
4. To examine the contents of a document, click the {document name} link.
5. When you are done examining the list of documents, you can click the hide documents to reconcile link to provide you with more working space.

1. Display the patient chart and locate a section marked with an orange bar.
   Note: During the Intake stage of the encounter, you can click the Data Reconciliation item in the Intake checklist.
   
2. On the Data Reconciliation tab, click the show reconciliation history link at the top of the page.
3. To view the log of selections made for the items, click the review link.
4. To view the contents of the imported document used in the reconciliation, click the {document name} link.
5. When you are done examining the history, you can click the hide reconciliation history link to provide you with more working space.

 

You can dismiss an active reconciliation task and move it to the Reconciliation History section, and you can reconcile dismissed tasks later.

Note: You can reconcile some items on the Reconciliation tab and dismiss the rest of the task.

 

 

 

 

For more information about immunization registries, see Immunization Registry Interfaces.

 

If your state immunization registry matches the patient record, it sends a document that you can find in the patient chart.

• If the record matched the vaccination record for your patient exactly, you do not need to reconcile vaccine information. To see the registry document, you can use the Find tab in the chart.
• If the record did not exactly match the vaccination record for your patient, you can reconcile the vaccine information from the Vaccines tab in the chart.

Best practice: Reconcile the vaccine information sent by the registry during the patient encounter so that patients can verify that they received the vaccines listed in the document.

1. Display the patient chart.
2. Click the Vaccines tab. An orange vertical bar indicates that a reconciliation document is available.
   
   
3. Click Vaccines to reconcile at the top of the Vaccines tab. The Data Reconciliation document opens.
   For instructions on reconciling the registry vaccine information with the patient chart, see To reconcile and integrate data from external documents.

If no orange vertical bar appears next to the Vaccines tab, you do not need to reconcile vaccine data. You can display the document sent by the vaccine registry as follows.

1. Click the Find tab at the top of the patient chart.
2. Enter "medical record document" to find the vaccination record from the registry.
   
   
3. Click the vaccination document to open it. The document is in a CLOSED status.
   Note: If no vaccination document is found in the patient chart, it may indicate that the patient had no immunizations in the state vaccine registry or that you need to map this patient's record with a record from the registry (see To map an immunization record to a patient in your practice).

 

As defined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), medication reconciliation is:

"... a process of identifying the most accurate list of all medications a patient is taking — including name, dosage, frequency, and route — and using this list to provide correct medications for patients anywhere within the healthcare system. Reconciliation involves comparing the patient's current list of medications against the physician's admission, transfer, and/or discharge orders."

With respect to EMRs and EHRs, the Office of the National Coordinator (ONC) interim final rule (IFR) describes this process as follows:

"... electronically complete medication reconciliation of two or more medication lists by comparing and merging into a single medication list that can be electronically displayed in real time."

 

For imported summary of care records, athenaOne provides visual prompts to reconcile data in the Allergies, Medications, Problems, and Vaccines chart sections (you cannot reconcile vitals data). To view information in other chart sections, open the data reconciliation document.

 

Items in the data reconciliation document are classified as follows.

• Chart Only — The item exists in the chart but not in the incoming record. No action is required for this type of item.
• Conflict — The item exists in both the chart and the incoming document, but they have different information. You need to reconcile these items.
• Incoming Only — The item exists in the incoming document but not in the chart. You need to reconcile these items.
• Match — The item exists in the chart and the incoming document, and both have the same information. No action is required for this type of item.
  Note: If an item has the same information in both the chart and the incoming document except for the Last Edited date, the item is considered a "Match."
• Related Items — The item exists in both the chart and the incoming document. They appear related, but they may or may not refer to the same event. For example, a vaccine "administered in 2019" and a vaccine "administered on January 1, 2019" may or may not refer to the same event. You need to reconcile these items.

Note: You do not need to reconcile items from an incoming document that match corresponding items already in the chart or items that are only in the chart (these items appear in the data reconciliation document for your information only).

 

In the following example, four items are included in the reconciliation document, but only two of them need to be reconciled.

 

 

If an incoming document includes a medication that has a start date prior to an earlier historical stop date for the existing, active medication in the patient chart, you see a warning on the Data Reconciliation tab.

• Select the chart medication (on the left side of the Data Reconciliation tab) to keep the medication active in the patient chart.
• Select the incoming medication (on the right side of the Data Reconciliation tab) to include the medication in the historical (not active) medication list.

 

During data reconciliation, athenaOne displays a warning message when the following information appears in the patient chart or in the incoming document and that information conflicts with the chart or the incoming document. You must resolve the conflict to reconcile the incoming document information with the patient chart.

 

No known problems

• Patient chart says "no known problems" but an incoming document specifies an active problem.
• Patient chart lists an active problem but an incoming document specifies "no known problems."

No medications reported

• Patient chart says "no medications reported" but an incoming document specifies a current medication.
• Patient chart lists a current medication but an incoming document specifies "no medications reported."

No known allergies

• Patient chart says "no known allergies" but an incoming document specifies an existing allergy.
• Patient chart lists an existing allergy but an incoming document specifies "no known allergies."

No known drug allergies

• Patient chart says "no known drug allergies" but an incoming document specifies an existing drug allergy.
• Patient chart lists an existing drug allergy but an incoming document specifies "no known drug allergies."

athenaOne flags the potential conflict and does not allow you to select both the data in the patient chart and the data in the incoming document. Following is an example of a warning message when athenaOne detects this conflict in the Allergies section:

 

Following is an example of a warning message at the Medications section level of the Data Reconciliation tab.

 

You must select only one of the options — the data in the chart or the data in the incoming document — to reconcile the incoming data with the existing data in the patient chart.