Auditing

The following table displays, from a high level perspective, the areas of Care360 Labs & Meds, ePrescribing, and EHR that are audited. The table also provides examples of audited actions a user may execute when using the Care360 Labs & Meds, ePrescribing, and EHR applications and whether or not you can view changed data for audited actions.

Audited Area	Examples of Actions	Can you view changed data?
Allergies/Adverse reactions	View, add, edit, or print allergies/adverse reactions.	Yes
Audit log	View or print an audit log report. Failed attempt to delete audit log report. Failed attempt to modify audit log report.	No
Billing	Exchange billing details for encounters with affiliated PMSs, save billing details as complete, or modify your organization’s billing template.	No
Care Recommendations	View, dismiss, hide, and restore care recommendations.	No
Chief complaint (CC) and history of present illness (HPI)	Add, edit, or copy the chief complaint and/or history of present illness in an encounter note.	Yes
Cognitive and Functional Status	Add, edit, or copy cognitive status or functional status in an encounter note.	Yes
Diagnosis	Add, edit, or copy a diagnosis in an encounter note. Copy a diagnosis to the problems list. Submit a reportable condition to the CDC.	Yes
Diagnostics	View, add or update a diagnostics report. Add, update, or remove an associated image, diagnostic description, or document type for a diagnostics report.	Yes
Document upload	Save an uploaded document to a patient’s summary.	No
Documented patient visits	Create a documented patient visit. Mark a documented patient visit as erroneous.	No
Drug Formulary	Successfully queried and returned during the prescription writing process.	No
Electronic Prescribing for Controlled Substances (EPCS)	Nominate a prescriber as a registrant. Remove a prescriber’s nomination. Assign Approver or Administrator roles. Remove Approver or Administrator roles. Agree to take on Administrator role. Give final approval of registrant. Failed entry of Care360 ePrescribing or EHR password or OTP when approving registrant. Temporarily suspend EPCS prescriber. Reinstate EPCS prescriber. Permanently revoke EPCS prescriber. Failed entry of Care360 ePrescribing or EHR password or OTP when permanently revoking EPCS prescriber. Enable/disable Allow controlled substances to be electronically prescribed organization preference. Write, edit, sign, deny, renew, electronically transmit, or print prescriptions for controlled substances. A prescription for a controlled substance is ready to be signed. Failed entry of Care360 ePrescribing or EHR password or OTP when signing a prescription for a controlled substance. Delete a renewal for a controlled substance. Delete a prescription pending approval for a controlled substance. Delete an approved prescription for a controlled substance. Failure of an electronic prescription or renewal transmission. View or print a failed electronic prescription. View or print a printed failed electronic prescription. Delete a failed electronic prescription. View or create a Controlled Substances Prescribed report. View a Monthly Controlled Substances Prescribed report. View a Controlled Substances Daily Event log.	No
Electronic Prior Authorization Requests	Click the link to submit a prior authorization request. Cancel a prior authorization request by deleting a medication.	No
Encounter Note	View, start, edit, copy, finalize, sign, mark erroneous, print, or add an addendum to an encounter note. View, copy, or edit the date of service, encounter type, location, template, authoring provider, or responsible provider. Select or clear the Urgent/Emergent Situation check box, Patient Declines Summary check box, Pregnancy Record, or the Pt. Education Material Provided check box. Click the Clinical Education link. Add, edit, or copy Subjective, Objective, Assessment, or Plan text. Add, edit or copy Assessments or Interventions. Add or edit the list of lab results in an encounter note.	Yes
Export Data	Export a CCD, CCR, or CCDA. Export a flowsheet.	No
Faxes	Send, print, view, delete, or remove a fax. Override patient consent when faxing clinical data.	No
History	View, manage, or print past medical, surgical, social, family, pregnancy, or menstrual history. Copy history into a new note.	Yes
Implantable Devices	Add or edit an implantable device.	Y
Import Data	Receive Claims History or Pharmacy History data from SureScripts.	No
Labs	Write, record, edit, finalize, place on hold, print, or cancel a lab order. Add, view, update, delete, print, annotate, or mark a lab report as reviewed. Lab result removed from New Results list (manually or automatically). Lab result added, updated, or removed from an encounter note.	Yes
Medications, Supplies and ePrescribing	View, add, edit (including activate and deactivate), reconcile, or print: • Reported medications • Administered medications • Vaccinations Write, edit (including active and deactivate), approve, deny, renew, save as pending, or print prescriptions for medications or supplies. Create, sign, or transmit prescriptions for a controlled substance. A prescription for a controlled substance is ready to be signed. Delete a renewal for a controlled substance. Delete an approved prescription for a controlled substance. Failure of an electronic prescription transmission Record or edit a documented medication.	Yes
Messages	View, send, update, delete, print a message or Direct message. Override patient consent when messaging clinical data. Save a message or Direct message to a patient chart. Accept or decline the End User Agreement for Direct messaging. Create an organization domain name for Direct Exchange. Submit the Direct Exchange enrollment form. Create a Direct Exchange address for sending/receiving Direct messages. Create a Direct Messaging address for sending/receiving Direct messages.	No
Patient Demographics	View, add, edit or remove patient information (name, birth date, sex, marital status, mother’s maiden name, and Social Security Number), ethnicity, race, language, and administrative details (primary provider, PID, health ID, retrieval of external medical history, consent, and payer type), patient’s preferred pharmacies, contact information (address, phone, email and contact preference), contacts, or care team information for a patient. Change a patient’s status (active, inactive, or deceased).	Yes
Patient (General)	Add a patient. Override a patient’s consent. Search for a patient. View a patient’s summary page. Merge patients.	No
Patient Portal	Send an invitation for a patient or authorized representative. Remove a Patient Portal link. Acknowledge the Minors Patient Portal Notification message for patients 18 years and older. Acknowledge the Minors Patient Portal Notification message for patients 13 to 17 years old.	No
Pregnancy Record	Add or edit pregnancy flowsheet details, OB lab tests, or OB patient education in an encounter note.	Yes
Physical Exam (PE)	Add, edit, or copy the physical exam information in an encounter note.	Yes
Plan of Care	Add, edit, or copy plan text, a goal or goal instruction, clinical instructions, future scheduled appointments, provided educational materials (decision aids), or patient health concerns in an encounter note.	Yes
Print	Print a face sheet, demographics, lab report, clinical document, fax, message, radiology order, patient note, diagnostic result, growth chart, audit log, informatics report, billing details, billing report, billing reconciliation report, OB data report, lab order, or public health report.	No
Problems	View, add, edit, or print problems. Submit a reportable condition to the CDC.	Yes
Procedures	Add, edit, or copy a procedure in an encounter note. Copy a procedure to the past medical or surgical history list.	Yes
Radiology	Write, record, edit, or finalize a radiology order. Add or update a radiology report. Add, update, or remove an associated image, diagnostic description, or document type for a radiology report.	Yes
Reason for Visit	Add, edit, or copy a reason for visit in an encounter note.	Yes
Referrals	Add, edit, or remove a reason for referral or referring provider/organization in an encounter note.	Yes
Review of Systems	Add, edit, or copy review of system information in an encounter note.	Yes
Risk Evaluation	Add or edit risk evaluation information in an encounter note.	Yes
Radiology	View, write, record, edit, finalize, print, and cancel a radiology order. View or print radiology results.	No
Reports	Search for lab results on the Find Lab Results page. Run an Informatics Query report. Run an Rx Transactions report. Run a Usage Metrics report. Request a Meaningful Use EHR Use Metrics report. Request a Meaningful Use Quality Measures report. Request Meaningful Use file export. Run a Billing Reconciliation report.	No
Tasks	View, add, or update a general, patient contact reminder, order, or amendment task.	No
Templates	Create, edit or delete section, encounter, or billing templates.	No
Textual Results and Transcribed Documents	Edit the document type of an electronically received textual result or transcribed document. Add or edit additional comments received on a transcribed encounter note.	No
User (General)	Care360 Labs & Meds, ePrescribing or EHR login (success or failure) and logout. Third-party application (SSO) login and logout. Access an organization. Session timeout. Reset or change password. Add or remove challenge answer. Account disabled for excessive login attempts.	No
User Management	Add, edit, deactivate, and reactivate a user. Add or remove a user role (Clinical Lab Staff, Clinical Office Staff, Clinician, Delegated Admin, Phlembotomist, Provider, and QAP ACO Admin). Reset or change a user’s password. Add or remove a user from an organization.	No Yes No No
Vitals	View, add, or edit length/height, weight, temperature, blood pressure, pulse, respiration, or 02 saturation.	Yes

Applicable FARS/DFARS Restrictions Apply to Government Use.