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21 Medflow Medication Manager Page: 1 of 33

Date: 10/141/2015 Software Requirements Specification Status: DRAFT

Medflow Medication Manager

Software Requirements Specification

Medflow, Inc., 6739-A Fairview Rd., Charlotte, NC 28210 Confidential

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Table of Contents

1. INTRODUCTION.................................................................................................................................4
1.1 PURPOSE..................................................................................................................................................4
1.2 SCOPE...................................................................................................................................................... 4
1.3 DEFINITIONS, ACRONYMS, AND ABBREVIATIONS...................................................................................4
1.4 REFERENCES............................................................................................................................................5
1.5 OVERVIEW...............................................................................................................................................6
2. OVERALL DESCRIPTION................................................................................................................7
2.1 PRODUCT PERSPECTIVE...........................................................................................................................7
2.2 PRODUCT FUNCTIONS..............................................................................................................................7
2.3 USER CHARACTERISTICS.........................................................................................................................7
2.3.1 Permissions shall change depending on EHR application...........................................................7
2.3.2 Logging.........................................................................................................................................7
2.4 CONSTRAINTS..........................................................................................................................................7
2.5 ASSUMPTIONS AND DEPENDENCIES.........................................................................................................7
2.6 NON-FUNCTIONAL REQUIREMENTS.........................................................................................................8
3. FUNCTIONAL REQUIREMENTS....................................................................................................9
3.1 CREATING MEDFLOW MEDICATION MANAGER USER INTERFACE..........................................................9
3.2 FUNCTIONALITY OF THE MEDICATIONS ENTRY AND MANAGEMENT WIDGET.....................................11
3.2.1 Access to the Medication Manager.............................................................................................11
3.2.2 Allow user to enter and manage current ophthalmic medications/systemic medications..........12
3.2.2.1 Workflow-adding current ophthalmic medications to active medication list ........................................12
3.2.2.2 Workflow-adding current systemic medications to active medication list ............................................12
3.2.2.3 Workflow- Updating the status of current medications on the active medication List ..........................13
3.2.3 Allow user to review medication list provided by sure scripts and add selected medication to
active medication list.................................................................................................................................13
3.2.3.1 Workflow-importing medications from sure scripts into patient active medication list (ophthalmic
medications)......................................................................................................................................................... 13
3.2.3.2 Workflow-importing medications from sure scripts into patient active medication list (systemic
medications)......................................................................................................................................................... 14
3.2.4 Allow user to add ophthalmic medications (topical, ointment & oral) to active medication list.
14
A. User shall have the ability to add a new medication order using the favorites or list or searching master
medication list......................................................................................................................................................14
3.2.4.1 Workflow for adding medications to active medication list..................................................................14
3.2.5 Allow user to manage ophthalmic medications (continue, discontinue, refill, update
instructions and remove medications........................................................................................................17
3.2.5.1 Workflow for managing medications...................................................................................................17
3.2.6 Allow user to enter and manage sample medications.................................................................18
3.2.6.1 Workflow-entering sample medications...............................................................................................19
3.2.7 Application performs Drug Formulary Check............................................................................19
3.2.7.1 Workflow-drug formulary....................................................................................................................20
3.2.8 Application performs Eligibility Check.......................................................................................21
3.2.8.1 Workflow-Eligibility Check.................................................................................................................21
3.2.9 Drug to Drug/Allergy/Disease Check.........................................................................................21
3.2.9.1 Workflow-Drug to Drug/Allergy/Disease Check..................................................................................21
3.2.10 Identify Controlled Substances...............................................................................................21
3.2.11 Allow user to search for Pharmacy and select patient’s preferred pharmacy.......................22
3.2.11.1 Workflow-Searching and selecting a pharmacy..............................................................................22
3.2.12 Active Medication List............................................................................................................22
3.2.13 Allow user to E-prescribe a medication.................................................................................23
3.2.13.1 Workflow-E-Prescribe medication(s)..............................................................................................23

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3.2.14 Allow user to print a prescribed medication..........................................................................23

3.2.14.1 Workflow-Print Medication Prescription........................................................................................23
3.2.15 Allow user to print medication instructions for patients........................................................24
3.2.15.1 Workflow-Print medication instructions..........................................................................................24
3.2.16 Allow user to enter medications administered at office.........................................................24
3.2.16.1 Workflow-entering Medication Administered at Office..................................................................24
3.2.16.2 Workflow-Viewing Medications administered................................................................................25
3.2.17 Access to Medline Plus...........................................................................................................25
3.2.17.1 Workflow-Access to Medline Plus..................................................................................................25
3.2.18 Provide the user the ability to meet CMS clinical quality measure NQF 0022 High Risk
Medication in the elderly...........................................................................................................................25
3.2.18.1 Workflow-High Risk Medication in the elderly..............................................................................25
4. IMPACTED FUNCTIONALITIES..................................................................................................26
4.1.1 Dependent Functionalities..........................................................................................................26
4.1.2 Bidirectional Functionalities......................................................................................................26
5. USER INTERFACE REQUIREMENTS..........................................................................................27
5.1.1 Mock-up of Medflow Medication Manager.................................................................................27
5.1.2 Pharmacy Mock Up.....................................................................................................................27
6. REVISION HISTORY.......................................................................................................................28
1. INTRODUCTION.................................................................................................................................4
1.1 PURPOSE..................................................................................................................................................4
1.2 SCOPE...................................................................................................................................................... 4
1.3 DEFINITIONS, ACRONYMS, AND ABBREVIATIONS...................................................................................4
1.4 REFERENCES............................................................................................................................................5
1.5 OVERVIEW...............................................................................................................................................6
2. OVERALL DESCRIPTION................................................................................................................8
2.1 PRODUCT PERSPECTIVE...........................................................................................................................8
2.2 PRODUCT FUNCTIONS..............................................................................................................................8
2.3 USER CHARACTERISTICS.........................................................................................................................8
2.3.1 Permissions shall change depending on EHR application...........................................................8
2.3.2 Logging.........................................................................................................................................8
2.4 CONSTRAINTS..........................................................................................................................................8
2.5 ASSUMPTIONS AND DEPENDENCIES.........................................................................................................9
3. FUNCTIONAL REQUIREMENTS..................................................................................................10
3.1 CREATING MEDFLOW MEDICATION MANAGER USER INTERFACE........................................................10
3.2 FUNCTIONALITY OF THE MEDICATIONS ENTRY AND MANAGEMENT WIDGET.....................................12
3.2.1 Allow user to enter and manage current ophthalmic medications/systemic medications..........12
3.2.1.1 Workflow-adding current ophthalmic medications to active medication list ........................................13
3.2.1.2 Workflow-adding current systemic medications to active medication list ............................................13
3.2.1.3 Workflow- Updating the status of current medications on the active medication List ..........................14
3.2.2 Allow user to review medication list provided by sure scripts and add selected medication to
active medication list.................................................................................................................................14
3.2.2.1 Workflow-importing medications from sure scripts into patient active medication list (ophthalmic
medications)......................................................................................................................................................... 14
3.2.2.2 Workflow-importing medications from sure scripts into patient active medication list (systemic
medications)......................................................................................................................................................... 15
3.2.3 Allow user to add ophthalmic medications (topical, ointment & oral) to active medication list.
15
A. User shall have the ability to add a new medication order using the favorites or list or searching master
medication list......................................................................................................................................................15
3.2.3.1 Workflow for adding medications to active medication list..................................................................15

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3.2.4 Allow user to manage ophthalmic medications (continue, discontinue, refill, update
instructions and remove medications........................................................................................................18
3.2.4.1 Workflow for managing medications...................................................................................................18
3.2.5 Allow user to enter and manage sample medications.................................................................19
3.2.5.1 Workflow-entering sample medications...............................................................................................20
3.2.6 Application performs Drug Formulary Check............................................................................20
3.2.6.1 Workflow-drug formulary....................................................................................................................21
3.2.7 Application performs Eligibility Check.......................................................................................22
3.2.7.1 Workflow-Eligibility Check.................................................................................................................22
3.2.8 Drug to Drug/Allergy/Disease Check.........................................................................................22
3.2.8.1 Workflow-Drug to Drug/Allergy/Disease Check..................................................................................22
3.2.9 Identify Controlled Substances...................................................................................................22
3.2.10 Allow user to search for Pharmacy and select patient’s preferred pharmacy.......................23
3.2.10.1 Workflow-Searching and selecting a pharmacy..............................................................................23
3.2.11 Active Medication List............................................................................................................23
3.2.12 Allow user to E-prescribe a medication.................................................................................24
3.2.12.1 Workflow-E-Prescribe medication(s)..............................................................................................24
3.2.13 Allow user to print a prescribed medication..........................................................................24
3.2.13.1 Workflow-Print Medication Prescription........................................................................................24
3.2.14 Allow user to print medication instructions for patients........................................................25
3.2.14.1 Workflow-Print medication instructions..........................................................................................25
3.2.15 Allow user to enter medications administered at office.........................................................25
3.2.15.1 Workflow-entering Medication Administered at Office..................................................................25
3.2.15.2 Workflow-Viewing Medications administered................................................................................26
3.2.16 Access to Medline Plus...........................................................................................................26
3.2.16.1 Workflow-Access to Medline Plus..................................................................................................26
3.2.17 Provide the user the ability to meet CMS clinical quality measure NQF 0022 High Risk
Medication in the elderly...........................................................................................................................26
3.2.17.1 Workflow-High Risk Medication in the elderly..............................................................................26
4. IMPACTED FUNCTIONALITIES..................................................................................................27
4.1.1 Dependent Functionalities..........................................................................................................27
4.1.2 Bidirectional Functionalities......................................................................................................27
5. USER INTERFACE REQUIREMENTS..........................................................................................28
5.1.1 Mock-up of Medflow Medication Manager.................................................................................28
5.1.2 Pharmacy Mock Up.....................................................................................................................28
6. REVISION HISTORY.......................................................................................................................29
1. INTRODUCTION.................................................................................................................................4
1.1 PURPOSE..................................................................................................................................................4
1.2 SCOPE...................................................................................................................................................... 4
1.3 DEFINITIONS, ACRONYMS, AND ABBREVIATIONS...................................................................................4
1.4 REFERENCES............................................................................................................................................5
1.5 OVERVIEW...............................................................................................................................................5
2. OVERALL DESCRIPTION................................................................................................................6
2.1 PRODUCT PERSPECTIVE...........................................................................................................................6
2.2 PRODUCT FUNCTIONS..............................................................................................................................6
2.3 USER CHARACTERISTICS.........................................................................................................................6
2.3.1 Permissions shall change depending on EHR system...................................................................6
2.3.2 Logging.........................................................................................................................................6
2.4 CONSTRAINTS..........................................................................................................................................6
2.5 ASSUMPTIONS AND DEPENDENCIES.........................................................................................................6
3. FUNCTIONAL REQUIREMENTS....................................................................................................8

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3.1 CREATING MEDFLOW MEDICATION MANAGER USER INTERFACE..........................................................8

3.2 FUNCTIONALITY OF THE MEDICATIONS ENTRY AND MANAGEMENT WIDGET.....................................10
3.2.1 Allow user to enter and manage current ophthalmic medications/systemic medications..........10
3.2.1.1 Workflow-adding current ophthalmic medications to active medication list ........................................11
3.2.1.2 Workflow-adding current systemic medications to active medication list ............................................11
3.2.1.3 Workflow- Updating the status of current medications on the active medication List ..........................12
3.2.2 Allow user to review medication list provided by sure scripts and add selected medication to
active medication list.................................................................................................................................12
3.2.2.1 Workflow-importing medications from sure scripts into patient active medication list (ophthalmic
medications)......................................................................................................................................................... 12
3.2.2.2 Workflow-importing medications from sure scripts into patient active medication list (systemic
medications)......................................................................................................................................................... 12
3.2.3 Allow user to add ophthalmic medications (topical, ointment & oral) to active medication list.
13
A. User shall have the ability to add a new medication order using the favorites or list or searching master
medication list......................................................................................................................................................13
3.2.3.1 Workflow for adding medications to active medication list..................................................................13
3.2.4 Allow user to manage ophthalmic medications (continue, discontinue, refill, update
instructions and remove medications........................................................................................................16
3.2.4.1 Workflow for managing medications...................................................................................................16
3.2.5 Allow user to enter and manage sample medications.................................................................17
3.2.5.1 Workflow-entering sample medications...............................................................................................18
3.2.6 Application performs Drug Formulary Check............................................................................18
3.2.6.1 Workflow-drug formulary....................................................................................................................19
3.2.7 Application performs Eligibility Check.......................................................................................20
3.2.7.1 Workflow-Eligibility Check.................................................................................................................20
3.2.8 Drug to Drug/Allergy/Disease Check.........................................................................................20
3.2.8.1 Workflow-Drug to Drug/Allergy/Disease Check..................................................................................20
3.2.9 Identify Controlled Substances...................................................................................................20
3.2.10 Allow user to search for Pharmacy and select patient’s preferred pharmacy.......................21
3.2.10.1 Workflow-Searching and selecting a pharmacy..............................................................................21
3.2.11 Active Medication List............................................................................................................21
3.2.12 Allow user to E-prescribe a medication.................................................................................21
3.2.12.1 Workflow-E-Prescribe medication(s)..............................................................................................22
3.2.13 Allow user to print a prescribed medication..........................................................................22
3.2.13.1 Workflow-Print Medication Prescription........................................................................................22
3.2.14 Allow user to print medication instructions for patients........................................................22
3.2.14.1 Workflow-Print medication instructions..........................................................................................23
3.2.15 Allow user to enter medications administered at office.........................................................23
3.2.15.1 Workflow-entering Medication Administered at Office..................................................................23
3.2.15.2 Workflow-Viewing Medications administered................................................................................23
3.2.16 Access to Medline Plus...........................................................................................................24
3.2.16.1 Workflow-Access to Medline Plus..................................................................................................24
3.2.17 Provide the user the ability to meet CMS clinical quality measure NQF 0022 High Risk
Medication in the elderly...........................................................................................................................24
3.2.17.1 Workflow-High Risk Medication in the elderly..............................................................................24
4. USER INTERFACE REQUIREMENTS..........................................................................................25
4.1.1 Mock-up of Medflow Medication Manager.................................................................................25

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4.1.2

25
5. REVISION HISTORY.......................................................................................................................26

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1. Introduction

1.1 Purpose
The purpose of this document is to create the Medflow Medication Manager. The
manager shall have the ability to be used with multiple EHR application(s). It shall allow
the user to manage prescriptions, enter current ophthalmic medication data and systemic
medications.

Develop the medication management screen as a stand-alone product with the ability to
interface with other electronic health medical record applicationssoftware.
.(should we refer EHR or EMREHR for maintaining consistency)

Broad Goals of SRS

 Create Medication Manager user interface
 Allow user to enter and manage current ophthalmic/systemic medications
 Allow user to review medication list provided by sure scripts and add
selected medication to active medication list.
 Allow user to add ophthalmic medications (topical, ointment & oral) to
active medication list
 Allow user to manage ophthalmic medications (continue, discontinue, refill,
update instructions and remove medications
 Allow user to enter and manage sample medications
 Application (i.ei.e. MMM) performs Drug Formulary Check
 Application performs Eligibility Check
 Drug to Drug/Allergy/Disease Check
 Identify Controlled substances
 Allow user to search for Pharmacy and select patient’s preferred pharmacy.
 Active Medication List
 Allow user to E-prescribe a medication
 Allow user to print a prescribed medication
 Allow user to print medication instructions for patients
 Allow user to enter medications administered at office
 Access to Medline Plus
 Provide the user the ability to meet CMS clinical quality measure NQF 0022
High Risk Medication in the elderly

1.2 Scope
The SRS will address the following:
• Functionality
• User Interface

1.3 Definitions, Acronyms, and Abbreviations

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 CPOE-Computerized Provider Order Entry

 eRx- Electronic prescribing
Generic Prescription-a drug defined as a product that is comparable to a drug
brand with similar dosage form, strength, quality, performance use and intended
use.
MMM-Medflow Medication Manager
CMS-Centers of Medicare & Medicaid Services
API-Application Program Interface- s a set of routines, protocols, and tools for
building software applications. An API expresses a software component in terms
of its operations, inputs, outputs, and underlying types. An API defines
functionalities that are independent of their respective implementations, which
allows definitions and implementations to vary without compromising the
interface.
Definitions, Acronyms, Details
and Abbreviations
CPOE Computerized Provider Order Entry
eRx Electronic prescribing
Generic Prescription A drug defined as a product that is comparable to
a drug brand with similar dosage form, strength,
quality, performance use and intended use.
MMM Medflow Medication Manager
CMS Centers of Medicare & Medicaid Services
API Application Program Interface- s a set of routines,
protocols, and tools for building software
applications. An API expresses a software
component in terms of its operations, inputs,
outputs, and underlying types. An API defines
functionalities that are independent of their
respective implementations, which allows
definitions and implementations to vary without
compromising the interface
User (to be mentioned as physician or technician)
EHR Electronic Health Record
LOT Number
widget
Medline Plus
E-CQM

1.4 References
 Medflow Medication Manager API Version 1.0 05/17/2015
 Medflow Medication Admin SRS Version 3 09/16/2015
 Formulary Widget (94) Version 1 06/12/2015
 Drug to Drug/Allergy/Disease Widget (96) Version 1 05/21/2015
 E-prescribing Log (98) Version 4 09/14/2015

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 CMS.gov-Meaningful Use
E-Prescribing- https://www.cms.gov/Regulations-and-
Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPCore_2_ePre
scribing.pdf
Computerized Provider Order Entry- https://www.cms.gov/Regulations-and-
Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPCore_1_CP
OE_MedicationOrders.pdf
CMS.gov (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-
Assessment-Instruments/PQRS/MeasuresCodes.html)
Medflow Medication Manager
API Version 1.0 05/17/2015
Medflow Medication Admin
SRS Version 3 09/16/2015
Formulary Widget (94) Version
1 06/12/2015
Drug to Drug/Allergy/Disease
Widget (96) Version 1
05/21/2015
E-prescribing Log (98) Version
4 09/14/2015
CMS.gov-Meaningful Use
E-Prescribing https://www.cms.gov/Regulations-and-
Guidance/Legislation/EHRIncentiveProgra
ms/downloads/Stage2_EPCore_2_ePrescrib
ing.pdf
Computerized Provider Order https://www.cms.gov/Regulations-and-
Entry Guidance/Legislation/EHRIncentiveProgra
ms/downloads/Stage2_EPCore_1_CPOE_M
edicationOrders.pdf
CMS.gov https://www.cms.gov/Medicare/Quality-
Initiatives-Patient-Assessment-
Instruments/PQRS/MeasuresCodes.html

1.5 Overview
 Section 2 provides a summary description of the requirements including
background information on the product and intended workflow.

 Section 3 contains the functional requirements. These specify the "business logic"
for the software. Individual requirements are marked in each section with a
number that includes the section number, followed by a dash, followed by a
requirement number, e.g. "3.1.1 - A".

 Section 4 contains the user interface requirements. These specify the "look and
feel" of the software.

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 Section 5 contains the document revision history.

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2. Overall Description

2.1 Product Perspective

The systemapplication (application?) shall allow user to enter medication orders. The
system(application application?) shall allow users to get CPOE credit, provide formulary
for selected medications and manage medications. Activity Diagrams are included
throughout document.

Items highlighted throughout the requirement document reflects new features that shall
be available in MMM application that was not available in Medflow 2.0 Medication
Manager.

2.2 Product Functions

1. Manage Medications
2. Formulary Checks
3. Eligibility checks
3. Drug to Drug Interactions
4. CPOE- Computerized provider order entry

2.3 User Characteristics

1.1.1 Permissions shall change depending on EHR systemapplication

Permissions shall be passed from the EHR Application to the MMM through the API

1.1.2 Logging
Type Action Description
Application Log Samples Given  Log Medications
provided as samples
 Log Medication Log
Lot Number
 Log Date and time
Medication sample
provided
 Log user entered
medication sample
Application Standard/Detailed Logging See Definitions (section 1.3)

2.4 Constraints

# Constraint Impact

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1 NA No immediate restrictions
Current MMM is restricted
to USA region
2 Application shall use DIT EHR application that use the MMM must
Database convert to DIT database for medications

2.5 Assumptions and Dependencies

Assumptions
# Assumptions Impact
1 EHR Application source of Single source for multiple EHR applications
managing medications to manage medications

Dependencies
# Dependencies Impact
1 MMM API user Permissions, import/export medications
to EHR, import of allergies MMM
application, export of Meaningful Use
measurement
2 Formulatory Check Sure Formulary Checks, Drug to Drug/Allergy
scripts checks, Eligibility checks
3 E-CQMMeaningful Uses If application fails to send back clinical
requirements quality measures and meaningful use
measures to electronic health record, it will
affect the physicians ability to attest to
Meaningful Use
4 Highriskmedications

2.6 Non-Functional Requirements

Application shall use web services to retrieve data from DIT. If web services fail, the
fail over shall be a Database. Backup Database shall be updated monthly.
MMM application shall work in the following browser: Microsoft Edge, Safari,
Chrome & Mozilla Firefox
Load time should be less than 2 seconds

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3. Functional Requirements
The functional requirements are creating the widget and setting functionality to allow
user to add new medication orders, refill medication order, manage medications, provide
patient instructions and e-prescribe a medication.

3.1 Creating Medflow Medication Manager User Interface

A. Upon accessing the Medflow Medication Manager, two radial dials shall
appear: Manage Prescriptions and Systemic Medications
B. Upon accessing the Medflow Medication Manger, the screen shall default to
Manage Prescriptions
i. The physicians favorites list shall default to Ophthalmic Medications
C. User shall have the ability to select the Systemic Medication tab.
i. The physicians favorites list shall default to systemic medications
D. User shall have the ability to view the active medication list. The list shall have
all active medications including systemic medications. The active medication list
shall have ophthalmic medications listed first followed by systemic medications
in chronological order.
E. The application shall provide the following fields
i. Search Field
1. Field shall have Search Medication within field
2. Allows user to search for medications from master medication
database
ii. Two Buttons
1. Medication History
2. Eligibility
iii. Medication Favorites List
1. Lists populates upon entering application
2. List shall include the physician favorite’s list configured in
MMM Admin-physician medication choices
iv. Medication with Instructions list
1. List populates upon selecting medication
v. 4 columns - Configured with MMM admin and free typing not allowed.
The columns list shall change based on medication selected.
1. Dosage-
2. Form Type
3. Frequency
4. Route
vi. Instruction field (required Field)
1. Populates upon selecting Dosage, Form type, frequency and
Route
2. Populates from selecting a most used instruction
vii. Dispense
1. Labeled Dispense (required field)

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2. 1st box shall be a free type section. Allows the user to enter the
number of units for medications
3. 2nd box shall allow the user to select unit from a drop down

viii. Days Supply field-Free Type Field and Numeric characters only

ix. Refill (required field)-Labeled Refill, Free type entry field-numeric

characters. User shall have the ability to select As needed dial in lieu of
entering a refill number
x. Check box-Sample Given
1. User selects Sample Given to open the lot number field
2. Lot Number shall be a required field if user sets the preference
xi. Check box Dispense as written
1. User shall select this option to alert the pharmacist generic
medications are not allowed for selected medication
xii. Pharmacist Message Field- Drop down field that shall allow user to free
type and configured in MMM admin
xiii. Additional Notes Field- Drop down field that shall allow user to free
type and configured in MMM admin
xiv. Buttons
1. Medication Administered-User selects to alert application a
medication was administered at the office and not prescribed
2. Order-User selects to order button to add medication to active
medication list that shall be prescribed.
The user shall receive validation when medication is added or
not added to list
Validation (Green) - Medication added to Medication List
Validation (Red) - Unable to add medication, missing a
required fields
Required fields shall have a red border around field
xv. Check boxes that shall show items within medication list
1. Show Medication Administered
List of Medications administered to patient shall populate list
Label shall change to Medication Administered
2. Show Discontinued
List of discontinued medication shall populate list
Label shall change to Discontinued Medications
xvi. Action Icons
1. Column labeled Actions
Info button
Continue
Current
Discontinue
Remove (standard red x) - only viewable if medication is entered
the current day

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2. User selects Show Discontinued, the only action button available

shall be continue and Info button page is not refreshing and
displaying ‘X’ for todays

xvii. Additional Action Buttons

1. Refill as Written
2. Update
3. Print Instructions
4. Print
5. E-Prescribe

xviii. Active Medication List

1. List of all active medications including systemic medications
Medications shall be listed in the following structure:
Ophthalmic Medications
Systemic Medications
Date prescribed
2. Check box column- allows user to multi select items to print
Rx, E-prescribe Rx, or print instructions
3. Date-Date medication was prescribed
User hovers over label date, a bubble shall appear
stating Date Prescribed
4. Medication
5. Instructions
6. Status
7. Compliance
xix. Discontinued list- User shall have the ability to see medications that have
been discontinued.
1. Structure of list: Ophthalmic Medications
Systemic Medications
Date prescribed
2. The compliance column shall change to Reason for discontinue
of medication if physicians sets option to enter a reason for
discontinued medication.

3.2 Functionality of the Medications Entry and Management Widget

Each section of this widget represents functionality to different workflows. The
functionality of this widget shall allow the user to manage medication with the least
amount of clicks.

3.2.1 Access to the Medication Manager

A. The user shall have an access point to MMM from electronic health record.

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B. At the time of access, MMM shall verify user permissions and import patient
demographicsthe following information. This information passes through the
MMM API.
i. Patient Demographics
ii. Patient Insurance
iii. Allergies
iv. Active Problem List (Diagnosis)
v. Preferred Pharmacy

3.2.2 Allow user to enter and manage current ophthalmic medications/systemic

medications
Current medications are medication the patient is currently using upon entering the clinic.
The medications on the active medication list represent current medications. User can
manually enter the medications or the medications maybe listed based in medications
prescribed by a physician at the clinic

A. User shall have the ability to add medication the patient is currently taking the
active medication list
B. User shall have the ability to add instructions associated to current medication.
C. User shall have the ability to select the date the patient starting taking the
medication.
D. User shall have the ability update the status of the medication current
E. User shall have the ability to note medication compliance
F. Application shall auto update status to current as today’s date if manually
entered into active medication list

3.2.2.1 Workflow-adding current

ophthalmic medications to active medication list
A. User access Mange Prescriptions tab
B. User selects Medication
i. Favorites List
ii. Searching Master List
C. User selects Instructions (required field)
i. User shall have the ability to enter instructions by selecting from the
dosage, form type, frequency and route
ii. User shall have the ability to select instructions from the medication with
instruction list
D. User selects Add to Current Medication List
E. Calendar shall appear allowing user to select a date
i. User shall have an option to select an alternative date
1. Default date populate date field (01/01/1900)
2. month/year-populate date field (03/01/2015)
3. year-populate date field (01/01/2015)
F. The date shall appear in the date field
G. The status shall appear current medication as of (current date)

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H. User shall have the ability to enter patients compliance to medication by selecting
compliance from drop down or free type compliance

3.2.2.2 Workflow-adding current

systemic medications to active medication list
A. User access Systemic Medication tab
B. User selects Medication
a. Favorites List
b. Searching Master List
C. User selects Instructions (required field)
a. User shall have the ability to enter instructions by selecting from the
dosage, form type, frequency and route
b. User shall have the ability to select instructions from the medication with
instruction list
D. User selects Add to Current Medication List
Calendar shall appear allowing user to select a date
User shall have an option to select an alternative date
a. Default date populate date field (01/01/1900)
b. month/year-populate date field (03/01/2015)
c. year-populate date field (01/01/2015)
E. The date shall appear representing the date entered.in the date field
F. The status shall appear current medication as of (current date)
G. User shall have the ability to enter patients compliance to medication by selecting
compliance from drop down or free type compliance

3.2.2.3 Workflow- Updating the status of

current medications on the active medication List
A. User highlights medication on the active medication list
B. User selects Current Medication
C. The selected medication status shall update to current medication as of (current
date)

3.2.3 Allow user to review medication list provided by sure scripts and add
selected medication to active medication list.
A. User shall have the ability to view a list of medications for each patient from sure
scripts.
B. User shall have the ability to select what medication to import from sure scripts
into the patient active medication list
C. User shall have the ability to tag a medication as ophthalmic or systemic
medication.
1. The medication shall be tagged based on where the user is during import
i. Manage Prescriptions or Systemic medications
D. User shall have the ability to add medication instructions to medications prior to
import
E. Application shall auto enter number 0 in the refill field.

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F. Application shall enter prescribed date from sure scripts into the prescribed date
field
G. Application shall enter a status: Current date as of (current date).

3.2.3.1 Workflow-importing medications

from sure scripts into patient active medication list (ophthalmic medications)
A. User enters the Manage Prescriptions tab
B. User selects Medication History
C. List of Medications assigned to patient shall appear.
D. User selects medication

E. User selects import

F. Medication shall appear in medication selection field
G. User adds instructions (dosage, form type, frequency and route), dispense and
refill- required fields.
H. User selects Add to Current Medication List
a. The prescribed date provided by sure scripts shall populate date field.
b. The status- Current date as of (current date).

3.2.3.2 Workflow-importing medications

from sure scripts into patient active medication list (systemic medications)
A. User enters the Systemic Medication tab
B. User selects Medication History
C. List of Medications assigned to patient shall appear.
D. User selects medication
E. User selects import
F. Medication shall appear in medication selection field
G. User adds instructions (dosage, form type, frequency and route), dispense and
refill- required fields.
H. User selects Add to Current Medication List
a. The prescribed date provided by sure scripts shall populate date field.
b. The status- Current date as of (current date).

3.2.4 Allow user to add ophthalmic medications (topical, ointment & oral) to
active medication list.

A. User shall have the ability to add a new medication order using the favorites or
list or searching master medication list
B. User shall have the ability to select instructions, dispense and refill prior to adding
medication to active medication list.
i. Instructions, dispense and refill are mandatory fields
C. User shall have the ability to add the following
i. Additional Instructions (optional)- Free type field that allows a user to
enter instructions that are added to the entered instructions of the selected
medication

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ii. Pharmacist Message (optional)- Provides the user the ability to enter a
message to the pharmacist that is not instructions for how the patient is to
take the medication
iii. Dispense as written- Selected when the prescriber does not want the
pharmacist to provide the patient with a generic form of the medication
prescribed.

3.2.4.1 Workflow for adding medications

to active medication list

A. User selects Medication

i. Highlight Medication on Favorites List
1. Medications on Favorites list will be classified by colored symbol (Ex.

)
a. Topical=Black Rx symbol
b. Oral=Yellow Rx symbol
c. Ointment=Purple Rx symbol
2. The instruction list for dosage, form type, frequency and route shall
display for selection
3. User selects instructions of medication (required)
4. User selects dispense and enters refill quantity (required)
5. User shall have the ability to enter a pharmacist message, additional
instructions or select dispense as written (optional fields)
6. User selects Order
a. Medication is added to Active Medication List
b. Validation appears: “Medication order saved successfully”
c. This is considered a CPOE order for medication
B. User enters medication using Medication Master List
i. Type Medication Name
1. Use Intellisense Method
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a. Start typing the 1st three letters

2. Medications shall populate
ii. Select Medication
1. Instruction fields shall change based on medication selected.
2. Configurations performed in Medflow Medication Manager Admin
under Medication Instructions
3. Table below is an example of what could be configured.

Dosage Form Type Frequency Route # Dispense

Topical 1 Ddrop QID Right Eye 1 Bottle
BID Left Eye 2
TID Both Eyes
QD
Oral 1 Capsule QID By Mouth 10 Capsule
Tablet BID 20 Each
Pill QD 30
Ointmen 1 Application QID As Directed 1 Tube
t BID Right Eye 2 mL
TID Left Eye
QHS Both Eyes

iii.User selects instructions

iv. User shall have the ability to select instructions by selecting (required
fields)
1. Dosage
2. Form Type
3. Frequency
4. Route
5. Dispense
i. Number and Units field
ii. Days Supply field ( User shall have the ability to enter in this field
in lieu of refills
iii. Refills
v. As an option a user shall have the ability to add
i. Pharmacist message
1. User shall have the ability to free type in the field or select
from a drop down
ii. Additional Instructions
1. User shall have the ability to free type in the field or select
from a drop down
vi. User has the ability to select Dispense as written
B. Use shall select Order
i. Required Fields are Dosage, Form Type, Frequency, Route, Dispense and
Refills
ii. Validation windows shall display

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1. Validation (Green)- Medication order saved successfully

2. Validation (Red)- Unable to add medication, missing a required fields
iii. This is considered a CPOE order for medication

C. Medication shall be added to the Active Medication List

D. All medication orders shall follow the process below.
i. All items entered current day shall appear in red font in Active
Medications
i. An indicator to user this medication needs to be E-prescribed or
printed
ii. Once e-prescribed or printed the medications shall appear in black
font
ii. If user enters a pharmacist message or additional instructions, a plus sign
shall appear in lower corner of instructions within the active medication
list
i. Select plus sign to view additional pharmacist message and
additional instruction
1. Label both within bubble.
2. The additional instruction shall appear 1st if there is both
additional instructions and the pharmacist message.
3. Label Additional Instructions and Label Pharmacist
Message
4. User shall see Additional Instructions and Pharmacist
message if medication is highlighted on Active patient List

3.2.5 Allow user to manage ophthalmic medications (continue, discontinue, refill,

update instructions and remove medications
A. User shall have the ability to manage medications within the active medication
list. The user shall use the following actions to manage a medication.
i. Continue
ii. Discontinue
iii. Refill a medication
iv. Update instructions
v. Remove Medication
1. The action to remove a medication shall only be permitted the same day a
medication was entered.

3.2.5.1 Workflow for managing

medications
A. User selects medication from active medication list
B. User selects one of the following: Continue, Discontinue, Refill as Written,
Remove Medication and Update Instructions
i. Continue
1. User highlights medication on active medication list
2. The medication shall populate the medication selected field and
instructions shall populate the instruction field

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3. Select C icon from actions column

a. Shall update status on Active Medication List Example:
Continue as of 07/23/2014
ii. Discontinue
1. User highlights medication from active medication list
2. The medication shall populate the medication selected field and
instructions shall populate the instruction field
3. Select D/C
a. Shall update status on Active Medication List Example:
Discontinued as of 07/23/2014
b. Medication will no longer appear on Active Medication List
c. User shall select show discontinued to view discontinued
medications
iii. Refill as Written
1. User highlights medication from active medication list
2. The medication shall populate the medication selected field and
instructions shall populate the instruction field
3. Select Refill as Written
a. Application shall update status on active medication list
Example: Prescription given-refill 07/23/2014
b. Medication shall appear in red font
i. An indicator to user this medication needs to be e-
prescribed or printed
ii. Once e-prescribed or printed, medication shall become
black font
c. This is considered a CPOE order
d. Validation shall appear “ Refills updated”
iv. Update instructions
1. User highlights medication from active medication list
2. The medication shall populate the medication selected field
and instructions shall populate the instruction field
3. User selects desired instructions to include refills and
dispense
4. Selects Update
5. Application shall update status on active medication list.
Example: Instructions updated as of 10/11/2015
6. Validation shall appear stating “Updated successfully”
v. Remove Medications
1. Select Medication from active medication list
2. The medication shall populate the medication selected field
and instructions shall populate the instruction field
3. If medication has an entry date of current date, a standard
red (x) shall appear.
4. User shall have the ability to select x to remove medication
5. Validation shall appear-“Medication order removed”

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3.2.6 Allow user to enter and manage sample medications

A. User shall have the ability to enter and manage sample medications
a. Add a sample medication as a medication order
b. Manage- Allow the user to change status as current, continue, discontinue,
update instructions, refill medication to send to pharmacy and remove
medication.
B. User shall have the ability to note the lot number associated with the sample
medication. This is a preference set in Medflow Medication Admin by physician.
C. The lot number shall not be a required field
D. Lot number field shall allow alpha and numeric characters

3.2.6.1 Workflow-entering sample

medications
A. User selects medication
B. User selects Instructions
i. Required field for samples
i. Dosage
ii. Form Type
iii. Frequency
iv. Route
v. Number
vi. Units
C. User places a check in front of Sample Given

D. Lot Number field shall appear.

i. Adding a lot number to the field is not a required field
ii. User free types lot number of sample
E. User selects Order
F. Medication added to Active Medication List
i. Status- Sample Given

3.2.7 Application performs Drug Formulary Check

A. The application shall auto perform drug formulary checks on all selected
medications.
B. Requirements for Drug Formulary checks are detailed within Formulary Widget
(94)
C. Formulary results shall not return if physician is not set up for e-prescribing
or sure scripts does not have insurance information available for selected
patient.
Will application or user notified with some message or smiley faces convey?
D. User shall have the ability to select an alternative medication to replace selected
medication

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3.2.7.1 Workflow-drug formulary

A. User selects medication

i. Upon selecting Medication a face icon shall appear indicating formulary
result
1. A green smiley face icon shall appear indicating medication is
within patients formulary
2. A red frown face icon shall appear indicating medication is outside
of formulary
3. A gray smiley face may appear if sure scripts does not have
updated insurance data on selected patient or physician is not set
up for e-prescribing.
How to depict if one is good and other is negative? How would
user know which is not setup?
B. User selects Formulary button
C. Formulary details shall appear
i. Drug Status
ii. Coverage Factors/Copay Details

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iii. Alternative Medications

iv. Therapeutic Medications
D. User selects alternative or therapeutic medication
E. User continues with entering medication instructions and adding order.

3.2.8 Application performs Eligibility Check

A. The systemapplication shall provide the user to perform eligibility check upon
demand (SRS document 102)

3.2.8.1 Workflow-Eligibility Check

A. User selects Medication
B. User selects Eligibility button
C. Eligibility results shall populate

3.2.9 Drug to Drug/Allergy/Disease Check

Patient allergy and active diagnosis lists shall be available to the MMM application. The
information shall update each time the medication manager accessed. Reference the drug
to drug/allergy and disease requirements document (96)

A. The application shall perform a drug/allergy and disease check automatically and
immediate to selecting a medication.
B. The application shall display drug to drug, drug to allergy and drug to disease
checks
C. The application shall display a table that alerts the user to type of reaction, name
of medication, interaction, interaction details and the ability to research
interaction by selecting info button
D. User shall have the ability to override the interaction and enter medication order.

3.2.9.1 Workflow-Drug to
Drug/Allergy/Disease Check
A. User selects medication
i. Upon selecting Medication the following shall appear
1. Drug-Drug interaction
2. Drug-Allergy interaction
3. Drug-Disease interaction
ii. The severity of the reaction shall be color-coded.
1. Red representing high severity
B. User shall select a different medication or override the alert.

3.2.10 Identify Controlled Substances

A. The application shall auto identified controlled substance upon selection of
medication
Will it talk to any API? If so we should mention that API as dependency.
B. User selects medication
C. The following icon shall appear within the medflow medication manager
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i.

3.2.11 Allow user to search for Pharmacy and select patient’s preferred pharmacy
A. User shall have the ability to select a pharmacy to send a medication order.
B. User shall have the ability to search for pharmacy based on type
i. Mail Order
ii. Retail
C. User shall have the ability to search by the following fields or combination of
fields
i. Pharmacy Name
ii. Pharmacy Phone number
iii. Zip code of Pharmacy
iv. State of Pharmacy
D. User shall have the ability to select up to two preferred pharmacies per patient.
i. Update the Preferred Pharmacy list for selected Patient in detailed
demographics
(assuming this is out of scope for MMM and options get displayed as per
patients demographics?)
ii. Patient Preferred Pharmacy list available in drop down in medflow
medication manager.

3.2.11.1 Workflow-Searching and

selecting a pharmacy
A. User selects medication to e-prescribe to pharmacy
B. Select Pharmacy Search button
C. Application provides search fields
D. User enters information within search fields
E. Select Search button
F. Search results return
G. User selects pharmacy
H. User selects E-Prescribe

3.2.12 Active Medication List

The active medication list contains the patient’s active medications. Medications
administered the current day, current ophthalmic and current systemic medications shall
populate the list.

A. The list shall follow the following structure

i. Ophthalmic
ii. Systemic
iii. Ordered by date

B. The active medication list is sent back to the EHR once the medication manager is
closed.
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3.2.13 Allow user to E-prescribe a medication

A. Physicians shall be set up in MMM Admin to prescribe medications. Reference
the MMM Admin SRS document.
B. Users shall have the correct permissions to E-prescribe
C. Users shall be set up in MMM Admin to prescribe medications on behalf of
selected physicians
D. The application shall allow users/physicians the ability to select a medication
from the active medication list, select a pharmacy and E-Prescribe
E. Eligible provider (it is physician or provider?) shall receive E-Prescribing
meaningful Use credit upon confirmation the medication was successfully
transmitted

3.2.13.1 Workflow-E-Prescribe
medication(s)
A. User selects medication(s) from active medication list by placing a check box in
front of medication
B. User selects preferred pharmacy from drop down or selects a pharmacy from
pharmacy search selection
C. User selects E-Prescribe
D. Medications shall transfer to selected pharmacy using the MMM API
Should we mention which API does this and can we mention this in dependency
section)
E. Validation shall appear stating “ E-Prescribed successfully”

3.2.14 Allow user to print a prescribed medication

Only users with permissions and set up in the MMM Admin shall have the ability to print
a medication prescriptions. The physician shall be required to sign the prescription once
printed.
A. Physicians shall be set up in MMM Admin to prescribe medications. Reference
the MMM Admin SRS document.
B. Users shall have the correct permissions to print medication
C. Users shall be set up in MMM Admin to prescribe medications on behalf of
selected physicians
D. The application shall allow users/physicians the ability to select a medication
from the active medication list and select print
E. The printed template shall be selected in MMM Admin

3.2.14.1 Workflow-Print Medication

Prescription

A. User selects medication(s) from active medication list by placing a check box in
front of medication
B. User selects Print
C. Medication prescription shall print on physician selected template
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D. Validation shall appear stating “ Medication prescription printed

successfully”

3.2.15 Allow user to print medication instructions for patients

A. User shall have the ability to select medications from active medication list
B. Medflow (MMM) shall create a document listing all selected medications with
patient instructions
C. Instructions shall be translated into terms the patient should understand.
i. Example: 1 drop BID Both Eyes translates to 1 drop twice a day in
both eyes
D. User shall have the ability to create translation for terms within MMM
Admin.
E. The translation of terms shall be available in different languages.

3.2.15.1 Workflow-Print medication

instructions
A. User selects Medication(s)
B. User selects Print Instructions
C. Patient Instructions shall print to selected printer.

3.2.16 Allow user to enter medications administered at office

A. User shall have the ability to note medications administered during an office visit
B. User shall have the ability to note each time the medication is administered.
C. User shall have the ability to prescribe the administered medication
D. User shall have the ability to remove a medication that was noted accidently
E. Medications administered will automatically be discontinued at end of day.
Appear in the Medication Administered section of MMM.

3.2.16.1 Workflow-entering Medication

Administered at Office
A. User enters Medication
B. User enters Dosage, Form Type and Route
C. Selects Medication Administered
i. Medication shall populate the active medication list for current day
only
ii. Status shall be medication administered
D. User wishes to add the same medication more than one time in current day, user
shall select (+) sign in the actions area
i. Each additional drop shall place the time administered next to
medication
ii. Medication Name, Dosage, Form Type and Route
E. User wishes to remove a medication from the active medication list entered in
error, select standard (X)

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F. The only options for Actions for a Medication administered shall be standard
(x) and (+)
G. The status for a medication administered at office shall medication administered
H. User shall have the ability to prescribe a medication that was administered the
current day by highlighting medications, enter a refill amount and selecting Order
a. Medication will be listed twice
i. Once as medication administered status
ii. Once as medication prescribed
1. The user shall have the ability to update instructions prior
to ordering medication.

3.2.16.2 Workflow-Viewing Medications

administered
A. The user shall have the ability to view all medications administered by selecting
show medications administered.

3.2.17 Access to Medline Plus

User shall have the ability to access Medline Plus to research or gather education data for
selected Medication

3.2.17.1 Workflow-Access to Medline Plus

A. User selects Medication from active medication list
B. User selects icon
C. User shall be directed to Medline website to view information specific to selected
medication

3.2.18 Provide the user the ability to meet CMS clinical quality measure NQF 0022
High Risk Medication in the elderly
A. The Medflow Medication Manager shall use the E-CQM specifications to update
the denominator and numerator of this clinical quality measure.

B. The information from the E-CQM shall be sent back to the EHR for reporting
each day.
C. Many EHR application may use a Clinical Decision Support Rule to assist with
meeting the measure. Workflow outlined below.

3.2.18.1 Workflow-High Risk Medication

in the elderly
A. User selects Medication within Medflow Medication Manager
B. A slide in alert shall appear within screen stating selected medication considered a
high-risk medication for this patient. Do you want to prescribe?
a. Yes-The application closes slide in alert, allowing user to place
medication order
b. No-The application closes slide in alert, removing selected medication,
allowing user to select another medication.

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C. The systemapplication shall identify high risk medications by the code listed
within high- risk value set. Value sets are available in Commons| MU 2015| Value
Sets| Highriskmedications

4. Impacted Functionalities

4.1.1 Dependent Functionalities

SRS Dependent Functionalities Impact

Ref
1 3.2.1 Access to MMMNA User permissions are not verified and no
patient data is available
22 3.2.17 Access to Medline No information on selected medication

4.1.2 Bidirectional Functionalities

SRS Bidirectional Impact

Ref Functionalities
1 3.2..8 Eligibility CheckNA No sure scripts insurance pull, no eligibility
provided to patient
2 3.2.13 E-Prescribing No update to the E-Prescribing Log;
3 3.2.9 Drug to No Interaction Check-Patient Safety
Drug/Allergy/Disease
4 3..2.7 Drug Formulary No output to Drug Formulary- Unable to
know if least expensive medication was
prescribed

5. User Interface Requirements

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5.1.1 Mock-up of Medflow Medication Manager

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5.1.2 Pharmacy Mock Up

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6. Revision History

Revision Author Date Description

1.0 Quentella 07/23/14 Initial Draft; This is the initial Draft for the Medication Manager Widget. Most of the
Middleton functionality will be the exact same as Medication Manager-109.
1.1 Quentella 10/11/201 Reorganiz
Middleton 5 ation of
the
requireme
nts
document
for easier
interpretat
ion.
Added
requireme
nts based
on review
10/07/201
5
1.2 Quentella 10/14/201 Requirements added-nonfunctional
Middleton 5 and dependencies; Corrected
Formatting , spelling and provided
consistency throughout document;
highlighted new features (2.0-MMM)
1.3 Quentella 10/16/2015 Update requirements based on review with MMM team:
Middleton

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