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This is your new all-in-one roadmap for everything you need to prepare and implement the upcoming product upgrades. Your journey begins with planning followed by our NextGen 5.9 & KBM 8.4 upgrades, which are 2015 CEHRT ready.

This upgrade is required to fulfill various regulatory requirements. According to the Centers for Medicare and Medicaid Services (CMS), practices participating in Medicare MIPS must upgrade to the 2015 CEHRT (Certified EHR Technology) before the start of their 2019 reporting period. All clients, regardless of participation in CMS programs, must complete their upgrade before the end of 2019 to ensure HIPAA compliance.

Medicaid Meaningful Use Clients:
Must update by May 1, 2018

Medicare MIPS Clients:
It is highly recommended that you complete the upgrade process no later than July 1, 2019. Clients will be unable to begin the 2019 MIPS Reporting Period until the 5.9/8.4 Upgrade has been completed.

All Other Clients:

All clients not participating in CMS programs must complete the upgrade before the end of 2019 to ensure HIPAA compliance. It is highly recommended that you complete the initial steps (Test Database Overwrite Agreement, Super User Videos, and Setup Form) prior to August 6, 2019 to ensure adequate time to complete this upgrade.

Below we have outlined the steps necessary for the successful completion of your NextGen 5.9 & KBM 8.4 transition.
Please review each step carefully as the success of these projects depends heavily on your full understanding and
completion of each step.

Start Now. We look forward to guiding you through the journey!
Our Upgrade Central webpage will be updated regularly. Check back often for updates.

(Last Updated 7/15/2019)

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Step 1: Build A Team & Plan

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The transition to NextGen 5.9 & KBM 8.4 is expected to impact all practices participating in the CMS Quality Payment Program and Medicaid Meaningful Use. Clients should assemble key administrative, billing, and clinical team members within your practice to create a transition plan and guide the work.

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A First Look at NextGen® 5.9 & KBM 8.4: Recording | Slides

A First Look at NextGen® 5.9 & KBM 8.4 | Rheumatology: Recording| Slides

A First Look at NextGen® 5.9 & KBM 8.4 | Pulmonary & Sleep Medicine: Recording | Slides

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Step 2: Prepare for Your Upgrade

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In preparation for future updates and necessary testing, TSI Healthcare needs to make a fresh copy of your TEST database. This means that anything currently in TEST will be overwritten and erased (this will NOT affect your Prod (live) database at all).

To grant permission to overwrite your TEST database, please complete the electronic form below to agree to these terms.

Fields marked with an * are required.

[contact-form-7 id=”17234″ title=”TEST Database Overwrite”]

Step 3: Confirm Hardware Specifications

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TSI Healthcare has already updated our servers to meet Hardware Requirements for the NextGen 5.9 & KBM 8.4 upgrade. If you are hosted on TSI Healthcare’s Cloud ASP Servers, you do not need to complete this step.

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The NextGen 5.9 & KBM 8.4 Upgrade has minimum Hardware Requirements which must be met in order for the software to function properly. If you are not hosted on TSI Healthcare’s Cloud ASP Servers, it is extremely important that you review and/or share these requirements with your IT Staff to verify that all hardware requirements are met prior to TSI Healthcare installing NextGen 5.9 & KBM 8.4 in your Test Environment. You will be asked to indicate whether these minimum requirements are met on your Setup Form (under Step 4).

Database Server Requirements:

Window Server 2008 R2 SP1, 2012, 2012 R2
.Net Framework 4.6.2
SQP Server 2008 R2 SP1, 2012, 2014, 2016
Memory Requirements based on user accounts

Number of Users	SQL Server Memory Requirements
1-50 Users	24 GB RAM
50-100 Users	32 GB RAM
100-500 Users	64 GB RAM
500-1500 Users	128 GB RAM (Enterprise Edition Required)
1500-2500 Users	256 GB RAM (Enterprise Edition Required)
2500-5000 Users	512 GB RAM (Enterprise Edition Required)

SQL Server Raid Requirements Based on Users:

Number of Users	SQL Server RAID requirements
< 50 Users	RAID 5
50 Users or more	RAID 10

SQL Server CPU Requirements:

Number of Users	Operating CPU Requirements
< 26 Users	8 Core –server grade processor supported by Intel
26-200 Users	12 Core –server grade processor supported by Intel
200-500 Users	16 Core –server grade processor supported by Intel
500-1000 Users	24 Core –server grade processor supported by Intel
1000-2500 Users	40 Core –server grade processor supported by Intel

Workstation Requirements:

Windows 7 Pro SP1, Windows 8 Pro, Windows 8.1 Windows 10
.NET Framework 4.6.2
Intel Core i5 or great processor (x86 or x64)
4GB+ RAM
250 GB disk space free
Ethernet NIC
150 Kbps bandwidth per concurrent user on fat client with scanner

Interface Server Requirements:

Server 2008 R2 SP1, 2012, 2012 R2
.NET Framework 4.6.2
8GB RAM
200 GB disk space free
Supported Intel 2ghz or higher processor (x86 or x64)
Gigabit Ethernet

Terminal Server Requirements:

Windows Server 2008 R2 SP1 (64 bit only) Standard to Enterprise (Datacenter) Edition
Windows Server 2012 (64 bit only) Standard or Enterprise (Datacenter) Edition
Windows Server 2012 R2 (64 bit only) Standard or Enterprise (Datacenter) Edition
2 GB disk space for local client install
146gb RAID1 mirrored 15K drives or great recommended
Expected Ram Usage per Application:
- 130MB per EPM user
- 170MB per EHR user
- 140MB per ICS user

Average CPU Usage per Application (% of Single Core)
- 3.9% per EPM user
- 4.49% per EHR user
- 48% per ICS user

If you have any questions regarding the Hardware Requirements for 5.9 & KBM 8.4, please contact the TSI Help Desk at helpdesk@tsihealthcare.com or 1-800-354-4205.

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Step 4: Super User Training

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Each practice must designate at least one Super User to attend training on the new features and functionality available in NextGen 5.9 & KBM 8.4. (Typically, the Super Users are your Primary EHR and Primary EPM contacts, however, this may vary.) The Super User training sessions will cover a basic workflow overview and major changes related to the new updates.

Upon completion of Super User Training, please proceed to Step 5 to complete the Setup Form.

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Each practice must attend training on the new features and functionality available in NextGen 5.9. These sessions will provide a comprehensive workflow overview and changes related to the new updates.

Watch this first! ( If you are NOT on Version 5.8 UD3):

PM Gap Training – Overview of 5.8 UD2 and 5.8 UD3 – ( 1hr 1min )

REQUIRED FOR ALL CLIENTS:

Appointments, Recalls, Portal, and Demographics | PDF Slides – ( 41mins 30sec )

Charges and Transactions | PDF Slides – ( 15mins 5sec)

Billing and Claims | PDF Slides – ( 20mins 34sec )

Statements and Budget Plans | PDF Slides – ( 11mins 26sec )

Reports, Tasking, and BBP | PDF Slides – ( 17mins 39sec )

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Each practice must attend training on new features and functionality available in NextGen EHR 5.9 and KBM 8.4. Required EHR Training Videos must be viewed by the Client Team Lead and/or any designated staff members. Please note that some clients may have additional trainings based on specialty and services offered. Your TSI Healthcare Upgrade Specialist will provide guidance on which additional trainings may be needed for your practice.

Watch this first! (If you are NOT on Version 5.8 UD3):

EHR Gap Training – Overview of 5.8 UD2 and 5.8 UD3 – ( 23mins 38sec )

REQUIRED FOR ALL CLIENTS:

Patient Demographics – ( 4mins 27sec )

HQM Integration in EHR | PDF Slides – ( 5mins 56sec )

Medications Module | PDF Slides – ( 28mins 57sec )

Allergies Module, Procedures Module, & Problems Module – ( 5mins 2sec )

Electronic Nicotine Delivery System Documentation – ( 2mins 27sec )

Orders Module – ( 6mins 48sec )

Clinical Decision Support for Radiology Orders – ( 6mins 13sec )

Immunization Rules – ( 5mins 3sec )

Document Management – ( 4mins 21sec )

Patient Education – ( 7mins 1sec )

Patient Generated Health Data – ( 3mins 28sec )

Linking Scanned Documents to Orders – ( 6mins 41sec )

Clinical Reconciliation | PDF Slides – ( 20mins 53sec )

CCD Custom Viewer | PDF Slides – ( 8mins 54sec )

Enhancements Not Related to Specialty – ( 7mins 22sec )

Rheumatology MIPS Dashboard Training Video – Rheumatology Only ( 41mins 53sec )

OPTIONAL / SPECIALTY SPECIFIC:

Care Plan & Care Team Members – ( 11mins 46sec )

Transmission to Cancer Registries – ( 24mins 21sec )

Transmission to Public Health Agencies – ( 19mins 39sec )

HPI Template Updates – ( Document )

Dermatology – ( 21mins 48sec )

Ophthalmology – ( 24mins 24sec )

Cardiology – ( 23mins 29sec )

Women’s Health – ( 24mins 25sec )

Behavioral Health – ( 34mins 02sec )

Pediatrics – ( 60mins )

Histories Configuration – Admin/Super Users Only ( 14mins 37sec)

Future/Recurring Orders Training – ( 10mins 32sec )

Consent Module – ( 35mins 57sec )

Recommended for Pediatric/Family Practice clients:

Fenton Growth Chart – ( 10mins 19sec )

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If your practice utilizes Patient Portal, your Client Team Lead and/or an appropriate staff member will need to view the Patient Portal training(s) below.

REQUIRED FOR ALL CLIENTS:

5.9 Patient Portal Complete Training ( 1hr 57mins )

Patient Portal Enhancements | PDF Slides ( 20mins )

Sending Direct Messages | PDF Slides – ( 11mins 30sec )

Receiving Direct Messages | PDF Slides – ( 16mins 28sec )

[/spb_text_block] [/spb_accordion_tab] [spb_accordion_tab title=”Rheumatology Training” accordion_id=”” icon=””] [spb_text_block pb_margin_bottom=”no” pb_border_bottom=”no” width=”1/1″ el_position=”first last”]

Please read the TSI Healthcare 2018 Rheumatology Overview document to familiarize yourself with the changes and consult with your core team as needed before completing the Setup Form.

[sf_button colour=”accent” type=”standard” size=”standard” link=”https://tsihealthcare.com/wp-content/uploads/2014/05/2018-Rheumatology-Release-Content-Overview-.pdf” target=”_blank” icon=”” dropshadow=”no” extraclass=””]Overview: TSI Healthcare 2018 Rheumatology Release[/sf_button]

Rheumatology Provider Trainin g – ( 12mins 49sec)

Rheumatology Medication and Prior Authorization Template – ( 6mins 38sec )

Rheumatology Infusion Orders and Infusion Flowsheet Templates – ( 5mins 55sec )

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Coming soon!

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Step 5: Setup Form

After viewing the Super User training videos above, please complete the Setup Form(s) and return to TSI Healthcare via fax (888-808-6156) or email (helpdesk@tsihealthcare.com). The Setup Form(s) will allow TSI Healthcare to assist with your NextGen 5.9 & KBM 8.4 setup. The setup will be completed in your Test environment so that you can become comfortable with the changes and complete testing prior to scheduling your Production upgrade.

IMPORTANT NOTE: It is essential that you watch Super User training videos prior to completing the Setup Form as the questions require an understanding of new features in NextGen 5.9 & KBM 8.4.

Upon submission of your Setup Form(s), you can expect to hear from TSI Healthcare within 7-10 business days regarding the status of your Test Environment.

All TSI Healthcare Clients:

[sf_button colour=”accent” type=”standard” size=”standard” link=”https://tsihealthcare.com/wp-content/uploads/2014/05/5.9-8.4-Setup-Form-Rev1.29.2019.pdf” target=”_blank” icon=”” dropshadow=”no” extraclass=””]Setup Form[/sf_button]

Rheumatology Clients:

In addition to the standard Setup Form above, Rheumatology clients must also complete the Rheumatology Setup Form.

[sf_button colour=”accent” type=”standard” size=”standard” link=”https://tsihealthcare.com/wp-content/uploads/2014/05/2018-TSI-RHE-Setup-Form-GR.pdf” target=”_blank” icon=”” dropshadow=”no” extraclass=””]Rheumatology Setup Form[/sf_button]

Pulmonary & Sleep Medicine Clients:

In addition to the standard Setup Form above, Pulmonary & Sleep Medicine clients must also complete the Pulmonary & Sleep Medicine Setup Form.

Coming Soon

Step 6: Client Testing

To ensure a successful upgrade, testing of the NextGen 5.9 & KBM 8.4 update in your Test Environment is REQUIRED. This testing must be completed by your team in order to proceed with the upgrade. Once you have completed the necessary steps, your TSI Healthcare Upgrade Specialist(s) will provide you with a testing checklist to verify that the NextGen software is operating as expected, all data is intact, and your staff is comfortable with the changes in the new version.

Step 7: Checklist Submission & Review

Upon performing testing and completing the Client Testing Checklist (see Step 6), please submit the form via one of the following methods: email to helpdesk@tsihealthcare.com or fax to 888.808.6156.

After submitting your checklist, please allow a minimum of 7-10 business days for TSI Healthcare to contact you to provide an update on your checklist review. Once all issues/questions have been addressed, we ask that you retest all components of your system, as any changes completed by TSI Healthcare or members of your staff may have resulted in new errors.

Once your checklist has passed the review process, our team will work with you to schedule your Production Environment Upgrade.

Step 8: End User Training

It is up to each Client to conduct internal end-user training and determine a schedule that best meets their needs. All practice staff must be trained prior to Go-Live. Practices may use the documentation and recordings from the “Step 4: Training” tab above.

Step 9: Verification & Go-Live Approval

Upon completing the checklist review and end-user training, our team will assist you with confirming a date for your NextGen 5.9 & KBM 8.4 Go-Live. Dates are based on TSI Healthcare upgrade team availability and client preference.

When considering a date for the NextGen 5.9 & KBM 8.4 Go-Live, please note the following items:

All users must remain off the system while the upgrade is taking place.
All EHR encounters must be completed and documents generated prior to designated upgrade start time.
All pending eRx messages must be accepted/denied prior to designated upgrade start time.
All PAQ items must be approved/denied prior to designated upgrade start time.
All pending Portal forms must be accepted/denied prior to designated upgrade start time.

After selecting your Go-Live date from the options provided, you will be asked to complete a Go-Live Approval Form and submit it to TSI Healthcare. Once our team has received your signed Go-Live Approval Form and verified that all tasks have been completed in preparation for your NextGen 5.9 & KBM 8.4 Go-Live, you will receive an email confirmation that your practice has been approved for the NextGen 5.9 & KBM 8.4 Upgrade in your Production Environment.

Step 10: Production Environment (NGProd) Upgrade

TSI Healthcare will complete all technical aspects associated with the NextGen 5.9 & KBM 8.4 Upgrade in your Production Environment. At the time of the upgrade, all staff members must be logged out of NextGen by the agreed-upon time. You will be notified via email once our team has completed the upgrade in your Production Environment.

Your practice will be assigned a dedicated EHR and EPM Upgrade Specialist to provide support on your Go-Live date. If you experience any issues, please call or email the TSI Healthcare Helpdesk* (1-800-354-4205 or helpdesk@tsihealthcare.com) and reference that your issue is in regards to the upgrade. Our helpdesk will be aware of your Go-Live date and will ensure that your tickets are triaged accordingly.

*For urgent items before 8:00 AM ET or after 5:00 PM ET, please call our after-hours line (1-800-354-4205 ext 4000) and leave a message.

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For assistance, please email our helpdesk at helpdesk@tsihealthcare.com.

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5.9/8.4 Upgrade

Step 1: Build A Team & Plan

A First Look at NextGen® 5.9 & KBM 8.4: Recording | Slides

A First Look at NextGen® 5.9 & KBM 8.4 | Rheumatology: Recording| Slides

A First Look at NextGen® 5.9 & KBM 8.4 | Pulmonary & Sleep Medicine: Recording | Slides

Step 2: Prepare for Your Upgrade

In preparation for future updates and necessary testing, TSI Healthcare needs to make a fresh copy of your TEST database. This means that anything currently in TEST will be overwritten and erased (this will NOT affect your Prod (live) database at all).

To grant permission to overwrite your TEST database, please complete the electronic form below to agree to these terms.

Fields marked with an * are required.

Step 3: Confirm Hardware Specifications

Step 4: Super User Training

Upon completion of Super User Training, please proceed to Step 5 to complete the Setup Form.

Each practice must attend training on the new features and functionality available in NextGen 5.9. These sessions will provide a comprehensive workflow overview and changes related to the new updates.

Watch this first! ( If you are NOT on Version 5.8 UD3):

PM Gap Training – Overview of 5.8 UD2 and 5.8 UD3 – ( 1hr 1min )

REQUIRED FOR ALL CLIENTS:

Appointments, Recalls, Portal, and Demographics | PDF Slides – ( 41mins 30sec )

Charges and Transactions | PDF Slides – ( 15mins 5sec)

Billing and Claims | PDF Slides – ( 20mins 34sec )

Statements and Budget Plans | PDF Slides – ( 11mins 26sec )

Reports, Tasking, and BBP | PDF Slides – ( 17mins 39sec )

Watch this first! (If you are NOT on Version 5.8 UD3):

EHR Gap Training – Overview of 5.8 UD2 and 5.8 UD3 – ( 23mins 38sec )

REQUIRED FOR ALL CLIENTS:

Patient Demographics – ( 4mins 27sec )

HQM Integration in EHR | PDF Slides – ( 5mins 56sec )

Medications Module | PDF Slides – ( 28mins 57sec )

Allergies Module, Procedures Module, & Problems Module – ( 5mins 2sec )

Electronic Nicotine Delivery System Documentation – ( 2mins 27sec )

Orders Module – ( 6mins 48sec )

Clinical Decision Support for Radiology Orders – ( 6mins 13sec )

Immunization Rules – ( 5mins 3sec )

Document Management – ( 4mins 21sec )

Patient Education – ( 7mins 1sec )

Patient Generated Health Data – ( 3mins 28sec )

Linking Scanned Documents to Orders – ( 6mins 41sec )

Clinical Reconciliation | PDF Slides – ( 20mins 53sec )

CCD Custom Viewer | PDF Slides – ( 8mins 54sec )

Enhancements Not Related to Specialty – ( 7mins 22sec )

Rheumatology MIPS Dashboard Training Video – Rheumatology Only ( 41mins 53sec )

OPTIONAL / SPECIALTY SPECIFIC:

Care Plan & Care Team Members – ( 11mins 46sec )

Transmission to Cancer Registries – ( 24mins 21sec )

Transmission to Public Health Agencies – ( 19mins 39sec )

HPI Template Updates – ( Document )

Dermatology – ( 21mins 48sec )

Ophthalmology – ( 24mins 24sec )

Cardiology – ( 23mins 29sec )

Women’s Health – ( 24mins 25sec )

Behavioral Health – ( 34mins 02sec )

Pediatrics – ( 60mins )

Histories Configuration – Admin/Super Users Only ( 14mins 37sec)

Future/Recurring Orders Training – ( 10mins 32sec )

Consent Module – ( 35mins 57sec )

Recommended for Pediatric/Family Practice clients:

Fenton Growth Chart – ( 10mins 19sec )

If your practice utilizes Patient Portal, your Client Team Lead and/or an appropriate staff member will need to view the Patient Portal training(s) below.

REQUIRED FOR ALL CLIENTS:

5.9 Patient Portal Complete Training ( 1hr 57mins )

Patient Portal Enhancements | PDF Slides ( 20mins )

Sending Direct Messages | PDF Slides – ( 11mins 30sec )

Receiving Direct Messages | PDF Slides – ( 16mins 28sec )

Please read the TSI Healthcare 2018 Rheumatology Overview document to familiarize yourself with the changes and consult with your core team as needed before completing the Setup Form.

Rheumatology Provider Training – ( 12mins 49sec)

Rheumatology Medication and Prior Authorization Template – ( 6mins 38sec )

Rheumatology Infusion Orders and Infusion Flowsheet Templates – ( 5mins 55sec )

Step 5: Setup Form

IMPORTANT NOTE: It is essential that you watch Super User training videos prior to completing the Setup Form as the questions require an understanding of new features in NextGen 5.9 & KBM 8.4.

Upon submission of your Setup Form(s), you can expect to hear from TSI Healthcare within 7-10 business days regarding the status of your Test Environment.

All TSI Healthcare Clients:

[sf_button colour=”accent” type=”standard” size=”standard” link=”https://tsihealthcare.com/wp-content/uploads/2014/05/5.9-8.4-Setup-Form-Rev1.29.2019.pdf” target=”_blank” icon=”” dropshadow=”no” extraclass=””]Setup Form[/sf_button]

Rheumatology Clients:

In addition to the standard Setup Form above, Rheumatology clients must also complete the Rheumatology Setup Form.

[sf_button colour=”accent” type=”standard” size=”standard” link=”https://tsihealthcare.com/wp-content/uploads/2014/05/2018-TSI-RHE-Setup-Form-GR.pdf” target=”_blank” icon=”” dropshadow=”no” extraclass=””]Rheumatology Setup Form[/sf_button]

Pulmonary & Sleep Medicine Clients:

In addition to the standard Setup Form above, Pulmonary & Sleep Medicine clients must also complete the Pulmonary & Sleep Medicine Setup Form.

Step 6: Client Testing

Step 7: Checklist Submission & Review

Upon performing testing and completing the Client Testing Checklist (see Step 6), please submit the form via one of the following methods: email to helpdesk@tsihealthcare.com or fax to 888.808.6156.

Once your checklist has passed the review process, our team will work with you to schedule your Production Environment Upgrade.

Rheumatology Provider Trainin g – ( 12mins 49sec)