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					Medisoft Clinical & LytecMD Bridge                                                   5/25/2010



                            Medisoft and Lytec Bridge


Patient Records and Medisoft Clinical / LytecMD

There are four distinct components to Clinical and MD: the EHR, the HL7 interface for the EHR
(PPConnect), the PM, and the HL7 interface for the PM (Communications Manager).

Let’s start by discussing the EHR side of Clinical and MD, then we’ll discuss PPConnect,
Communications Manager and we’ll finish with Medisoft and Lytec.

The only difference in the EHR program functionality between Practice Partner Patient
Records, Medisoft Clinical and Lytec MD are the brand names and logos/icons.

Medisoft runs on a database called Advantage Database Server (ADS) and the Patient Records
install is always done on a Ctree Server Database (CTS). Lytec runs on SQL Server so the
Patient Records side of Lytec MD is always installed on a SQL server instance (separate from
the PM’s server instance).




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                      5/25/2010




The Bridge (HL7 Interface)




Purpose

Because Medisoft and Lytec use their own separate databases apart from Patient Records they
need to communicate with each other. The purpose of the HL7 interface is to push patient and
appointment data from the PM to the EHR and billing data from the EHR to the PM. The
diagram above demonstrates that there are two sides to every interface; a sending side and a
receiving side. Both sides of the interface must be running at all times for transactions to get
where they need to go.

Bridges can run in a file-based mode or a TCP/IP based mode. File-based interfaces are much
easier to troubleshoot. Clinical and MD use a file-based interface setup.

The bridge should always be ran from the server, ideally where PPart is located.




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                         5/25/2010



Setting up PPconnect for Clinical and MD

Although a PPConnect CD may have been shipped with early versions of Clinical and MD, the
disk didn’t need to be used because PPConnect is preinstalled when Clinical or MD is installed.
There are always two instances of PPConnect that must be running at all times – Inbound
“DemSched” and Outbound “BillCode”. Except for Medisoft Clinical 16, there is still some
painful manual setup needed in order for PPConnect to work. Those steps are outlined next and
then we’ll talk about what’s different in MCL 16.

Most Important First Step – Input Providers into the EHR (and hopefully give each provider
the same code as in Medisoft or Lytec) then complete the cross-reference files.

DemSch_Pvid.ref is located in P:ppart\Interface\BillingBridge\DemSch\CrossRef.

BillCode_Pvid.ref is located in P:ppart\Interface\BillingBridge\BillCode\CrossRef.

These files are blank after the initial install and must be completed. If these are forgotten,
patients and appointments will dump into the EHR and they won’t be associated with any
provider in the EHR nor will appointments appear in any dashboard.

The format of the files is always: CODE space PIPE space CODE

No space should follow the last code.

If provider codes are the same in Patient Records as Medisoft/Lytec, there is no need to
remember which order the codes are to be entered in the files and the contents of one file may be
copied into the other. If the provider codes are different, it’s critical to put the codes in the
correct order, based on the inbound or outbound direction:

Bill Code –

PR | PM

DemSched –

PM | PR




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge   5/25/2010




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                       5/25/2010



Once these are cross-reference files are setup and saved, we’re ready for the configuration files.

P:\ppart\Interface\BillingBridge\BillCode\BillCodeSnd.ini

P:\ppart\Interface\BillingBridge\DemSch\DemSchRcv.ini

DemSchRcv.ini should be opened in notepad first and modified.

The top of the file should look like this:

[Interface]
Type=inbound
OutDelay=00,00,00,00,00
InDelay=00,00,00,02,00

And should be changed to this:

[Interface]
Type=inbound
OutDelay=00,00,00,00,00
InDelay=00,00,00,00,00

Otherwise, a very large Medisoft or Lytec practice’s patient data could take weeks to transfer.

The desktop shortcuts for PPConnect need to be sent to the Server’s desktop and pointed to these
files by modifying the shortcuts’ properties.

This is a slightly complex process, but I’ll do my best to explain the easiest way:


Starting in P:\ppart\Interface\BillingBridge\DemSch\ find the Connect.exe application, right
click and Send To – Desktop (as shortcut)




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                               5/25/2010




Rename the shortcut “Inbound DemSched”. Then right-click on it and click Properties:




In the Target field, you’ll find:

P:\ppart\Interface\BillingBridge\DemSch\Connect.exe

You’ll need to change the target to this:

P:\ppart\Interface\BillingBridge\DemSch\Connect.exe P:\ppart\Interface\BillingBridge\DemSch\DemSchRcv.ini
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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                                    5/25/2010


That entire line needs to be in the target. There’s a space between the “…Connect.exe” and the
“P:\ppart..” that space is critical.

Now, go to P:\ppart\Interface\BillingBridge\BillCode\ and send that Connect.exe shortcut to the
desktop. Go into the shortcut properties and change its target from:

P:\ppart\Interface\BillingBridge\BillCode\Connect.exe

To:

P:\ppart\Interface\BillingBridge\BillCode\Connect.exe P:\ppart\Interface\BillingBridge\BillCode\BillCodeSnd.ini

Now PPConnect is all setup and ready to be launched.
Both BillCode and DemSched Connect applications need to be running at all times. This
means that a user must remain logged into the server at all times. The user can lock the
server but cannot log out.

Medisoft Clinical v16 maps the cross-reference and configuration files automatically during
installation. None of the above steps are necessary; however it is still best practice to check
these files before launching PPConnect, especially due to the next important caveat.

Important Caveat

Most long time Medisoft and Lytec users who have upgraded from previous versions will have
the same provider in Medisoft or Lytec twice or even multiple times. They set up their providers
this way so that they could bill various insurance companies differently. This is not necessary in
our latest versions, but that doesn’t mean that the providers won’t still be in there. Only one of
each provider should be mapped in the cross-reference files, otherwise it will be very confusing
to the practice and the provider will need to constantly switch providers and dashboard schedule
views.




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                       5/25/2010




Starting Communications Manager

Communications Manager is configured and works the same in Medisoft and Lytec, same
buttons and options, but they are launched from different places.

Once configured Communications Manager starts automatically on Windows startup and it
should always be left running. It usually runs minimized in the task bar and looks like this:




If you hover your mouse over the icon, it should say “Communications Messenger”.

If the icon isn’t running and you need to launch it, your user will need to log into Medisoft or
Lytec to do this.

In Medisoft, click Tools (from the Task Bar) , Communications Manager.




It will start up and look like this:
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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                       5/25/2010




In Lytec 2009, click Settings, Communications Manager.

In Lytec 2010, click Admin, Communications Manager.. it will look like this:




Click Connections to verify that Communications Manager has been setup properly and
registered for Clinical/MD. It should look just like this or it might say Medisoft Clinical:




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                     5/25/2010


To launch it, click on the Configuration button up top, then check the box that says “Enable
Communications Messenger on this machine”. You may notice that the box doesn’t check
immediately – that is typical but the program should launch then go to the taskbar.




Once launched and running in the taskbar, you can close the window above.



Configuring Communications Manager

If you launch Communications Manager, click Connections and it’s blank, you’ll need to
configure it for MD/Clinical. This is very simple.

Click Add…




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                         5/25/2010


The Connection Name can be anything, but it should be called LytecMD or Medisoft Clinical.




Type that in and then select either Lytec MD or Medisoft Clinical from the Connection Type
drop-down box. Then click OK.




Click the Enable button and if registration is required, a registration screen will appear. If the
customer needs assistance registering Communications Manager, they should contact support.




Once the status says Enabled, you’re ready to click on the Configuration button up top and
launch it.



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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                  5/25/2010




By default, Communications manager transmits every two minutes. It is not recommended to
modify this, but it can be modified by clicking Edit (see screen shot above).




Important Regarding Multiple Practices

The bridge setup described above is for a single practice. Communications Manager is currently
only able to manage one practice at a time. This makes multiple practice bridge setups very
complex, but you should know that it is possible.


DemSched into Patient Records

As soon as Communications Manager is initially launched and both PPconnects are running,
patient demographics and appointments should flow over to the EHR. Because patients only
flow from Medisoft or Lytec into Patient Records and never the other way, users should
never schedule appointments or add patients in Patient Records. You can maximize the
DemSched icon from the taskbar to confirm:




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                    5/25/2010




Nothing else is needed to view appointments except perhaps to refresh any dashboard that is up.


BillCode into Medisoft or Lytec

EEFs marked complete in Patient Records will flow through PPConnect BillCode into Lytec or
Medisoft.




Once transmitted, the charges will appear in Lytec in Billing/Pending Transactions or in
Medisoft in Activities/Unprocessed Transactions/Unprocessed EMR Charges where they can be
saved as new charges.

If the chart number, patient name, CPT or ICD9 is not in the Medisoft or Lytec database an error
will display.




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Rex Lloyd
McKesson Corp.
Medisoft Clinical & LytecMD Bridge                                                    5/25/2010


Appointment Statuses

With Medisoft 16 Clinical, additional appointment status messaging was introduced. This means
that users can right click on an appointment in Office Hours (the Medisoft scheduler) and check
in or out patients, and then the check-in status will update in Patient Records. The check-in
status in Patient records also writes back to Medisoft, so clicking the Timing button in Patient
Records will update Office-Hours.

Below is a graphical representation of what exists for Medisoft Clinical 16 and what is proposed
for Lytec 2011.




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Rex Lloyd
McKesson Corp.

				
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