PurpleTools RAF — Instructions

Getting Started

After installing PurpleTools RAF, click the Chrome puzzle-piece icon in the upper-right corner of Chrome and pin PurpleTools RAF so it is easy to find.

Click the PurpleTools RAF icon to open the Options page.

On first use, you will be asked to review the Data-Use Disclosure and Consent and agree before the extension becomes active.

New users can select:

• Start 30-Day Free Trial — begins the available 30-day trial.
• Subscribe — opens the subscription process.
• Already Paid? Log In — use this if you already have a PurpleTools RAF account.
• Refresh Access — rechecks your subscription or trial status.

After changing module settings, click Save & Close, then refresh eClinicalWorks:

Changes normally take effect on the next eClinicalWorks page load or refresh.

Diagnosis Sorter

Diagnosis Sorter helps organize the diagnoses in the eClinicalWorks Problem List according to their CMS-HCC V28 risk-adjustment values. When this module is enabled, PurpleTools places a purple Sort Dx button in the supported Problem List header.

Using Sort Dx

Open the patient's Problem List and click Sort Dx. PurpleTools examines the ICD-10 codes currently present in the Problem List and compares them with its local CMS-HCC V28 2026 data. Diagnoses with higher applicable CMS-HCC values are moved toward the top of the Problem List. Diagnoses without a CMS-HCC match remain in the list but generally fall below diagnoses with an applicable HCC value. After the order has been changed, PurpleTools uses the normal eClinicalWorks Save function to save the reordered Problem List. If the diagnoses are already in the intended order, PurpleTools reports that the list is already sorted rather than unnecessarily rearranging it.

HCC Hierarchy Suppression

CMS-HCC diagnoses can exist within clinical hierarchies. In some hierarchies, a more severe HCC supersedes a less severe HCC. When both diagnoses are present, the lower HCC may no longer contribute an additional value. Diagnosis Sorter checks the HCC hierarchy before calculating the displayed results. A diagnosis that has been completely superseded by another HCC is marked as Suppressed. The report also identifies the HCC responsible for the suppression. For example, the report may indicate that one HCC is suppressed by HCC [number]. This helps prevent simply adding together HCC values that should not both contribute under the hierarchy.

Diagnosis Sorter Report

After sorting, PurpleTools opens a Diagnosis Sorter Report. The report shows the diagnoses found in the Problem List and includes information such as: Diagnosis, ICD-10 code, HCC, Base value, Final value, Whether the HCC is suppressed, and The reason for suppression, when applicable.

At the top of the report you will also see:

• Surviving payment HCCs — the number of HCCs remaining after hierarchy suppression.
• Total local CMS score — the combined value calculated from the surviving HCCs in the PurpleTools local CMS-HCC table.

This displayed total is a coding-review aid. It is not the patient's complete official CMS RAF score, because a complete RAF calculation can involve additional demographic, eligibility, interaction, and other CMS model factors.

Report Buttons:

• Copy Report — copies the Diagnosis Sorter report to the clipboard.
• Print Report — opens a printable version of the report.
• Close — closes the report and returns to eClinicalWorks.

Always review the reordered diagnoses before relying on the final Problem List.

RAF Highlighter

RAF Highlighter automatically identifies ICD-10 diagnoses that are mapped to CMS-HCC V28 categories in the data used by PurpleTools RAF. When PurpleTools recognizes a supported RAF-relevant diagnosis, the diagnosis is highlighted with light purple shading. This makes potentially risk-adjustment-relevant diagnoses easier to identify while reviewing the chart. The highlighter works in supported eClinicalWorks diagnosis areas, including areas of the Assessment and Problem List.

Numerical RAF Value

In supported diagnosis locations, PurpleTools also displays a small numerical value beside the diagnosis. This number is the CMS-HCC V28 base coefficient contained in the PurpleTools data table for that diagnosis. For example, you may see a diagnosis highlighted in purple with a number displayed at the right side of the diagnosis row. Hovering over the number provides additional information including: The CMS-HCC V28 base value, The HCC number, and The HCC description. If an ICD-10 code maps to more than one HCC, PurpleTools displays the highest applicable mapped base coefficient in the badge. The RAF Highlighter is intended to draw attention to diagnoses that may deserve review. A purple highlight does not mean that the diagnosis should automatically be coded for the current encounter. The diagnosis should be clinically supported, appropriately documented, and applicable to the current reporting period.

CKD Diagnosis Finder

CKD Diagnosis Finder looks for supported eGFR laboratory results and identifies values that fall within CKD staging ranges. When PurpleTools detects an applicable eGFR result, a purple CKD button appears beside the result. The button blinks and may produce a short audible alert so that the result is less likely to be overlooked.

Depending on the eGFR value, the button is labeled:

• CKD-2
• CKD-3a
• CKD-3b
• CKD-4
• CKD-5

eGFR Ranges Used by PurpleTools:

• CKD-2: eGFR 60–89
• CKD-3a: eGFR 45–59
• CKD-3b: eGFR 30–44
• CKD-4: eGFR 15–29
• CKD-5: eGFR below 15

An eGFR displayed by the laboratory as >60 is not treated as an eGFR of exactly 60 and does not trigger the CKD-2 workflow.

CKD-3a, CKD-3b, CKD-4 and CKD-5

Click the displayed CKD button when you want to add the corresponding CKD diagnosis. PurpleTools then uses the normal eClinicalWorks workflow to navigate through the Patient Hub and Problem List, open Add ICD, locate the appropriate CKD diagnosis, and complete the supported Problem List workflow.

The corresponding ICD-10 stages used by the module include:

• CKD Stage 3a: N18.31
• CKD Stage 3b: N18.32
• CKD Stage 4: N18.4
• CKD Stage 5: N18.5

PurpleTools can perform this workflow from supported lab-result views, including the applicable View All Reports and signed lab-result workflows. Always confirm that the laboratory result and clinical history support chronic kidney disease before retaining the diagnosis. A single abnormal eGFR value by itself does not necessarily establish chronic kidney disease.

CKD-2 and Diabetes

The CKD-2 workflow is intentionally different. When PurpleTools detects an eGFR between 60 and 89 and you click CKD-2, PurpleTools asks: Does the patient have diabetes?

You then have two choices:

• No — Stop — PurpleTools stops the CKD-2 workflow and does not add a diagnosis.
• Yes — Insert Chronic Kidney Disease Due to Type 2 Diabetes Mellitus, E11.22 — PurpleTools opens the appropriate eClinicalWorks Add ICD workflow and searches for E11.22 — Type 2 diabetes mellitus with diabetic chronic kidney disease. For this CKD-2 pathway, PurpleTools pauses so that you can review the diagnosis selection yourself and complete the appropriate OK or Cancel action. This provides an additional manual confirmation before the diagnosis is entered.

BMI Diagnosis Finder

BMI Diagnosis Finder monitors supported BMI displays in eClinicalWorks. When PurpleTools detects a BMI in one of its supported high-BMI ranges, a purple BMI button appears beside the BMI. Clicking BMI opens the supported Patient Hub and Problem List workflow and adds the corresponding BMI ICD-10 diagnosis.

The current extension uses the following mappings:

• BMI 40.0–44.9: Z68.41 — Body mass index [BMI] 40.0–44.9, adult
• BMI 45.0–49.9: Z68.42 — Body mass index [BMI] 45.0–49.9, adult
• BMI 50.0 and above in this build: Z68.43 — Body mass index [BMI] 50.0–59.9, adult

PurpleTools opens Add ICD, searches for the appropriate code, selects the diagnosis, confirms it, saves the Problem List, and closes the Patient Hub when the supported sequence is completed. Always verify the BMI and selected ICD-10 diagnosis before accepting it into the medical record.

Add ICD Button

The Add ICD Button is designed primarily for the eClinicalWorks Review Documents workflow. Normally, adding a diagnosis while reviewing a document can require leaving the document, navigating through the Patient Hub and Problem List, adding the diagnosis, saving the Problem List, and then finding your way back to the document. PurpleTools shortens that process. When the module is enabled, a purple Add ICD button appears in the supported Document Review area.

Using Add ICD

While reviewing a document, click Add ICD. PurpleTools automatically navigates through: HUB → Problem List → Add ICD. The normal eClinicalWorks ICD search screen then opens. Search for and select the diagnosis you want to add. PurpleTools does not decide which diagnosis you should select. The diagnosis selection remains under your control.

Return to Documents

After entering the diagnosis, PurpleTools displays a Return to Documents button in the Add ICD workflow. Click Return to Documents after you have selected the desired diagnosis. PurpleTools then performs the supported eClinicalWorks return sequence: OK → Save → close Patient Hub and returns you to the document-review workflow. This allows you to add an ICD diagnosis without manually navigating through several screens and then retracing those steps back to the document. Review the diagnosis before clicking Return to Documents.

Enabling and Disabling Modules

Each PurpleTools RAF feature can be enabled or disabled independently.

To change your configuration:

1. Click the PurpleTools RAF Chrome icon.
2. Find the module you want to change.
3. Check or uncheck Enable this module.
4. Click Save & Close.
5. Refresh eClinicalWorks.

The available modules are:

• Diagnosis Sorter
• RAF Highlighter
• CKD Diagnosis Finder
• BMI Diagnosis Finder
• Add ICD Button

You do not need to use all five modules. Enable only the features that fit your workflow.

If a PurpleTools RAF Feature Does Not Appear

First refresh the eClinicalWorks page.

If the feature still does not appear:

1. Confirm that the module is enabled in PurpleTools RAF Options.
2. Confirm that PurpleTools RAF itself is enabled in Chrome.
3. Confirm that your PurpleTools trial or subscription is active.
4. Make sure you are on an eClinicalWorks screen supported by that particular module.
5. Close and reopen the affected eClinicalWorks window if necessary.
6. If eClinicalWorks has changed the layout of the screen, report the affected page and feature.

Some PurpleTools RAF controls only appear when the extension detects the corresponding eClinicalWorks information. For example, the CKD button will not appear unless PurpleTools recognizes a supported eGFR result, and the BMI button will not appear unless a BMI in a supported range is present.

Privacy and Data Use

PurpleTools RAF operates inside the browser on supported eClinicalWorks pages.

To provide its five RAF-related features, the extension may read information displayed in eClinicalWorks such as: Diagnoses, ICD-10 codes, BMI values, eGFR values, and Related page labels and controls.

This clinical chart information is processed locally in the browser.

PurpleTools RAF does not transmit patient chart content to PurpleTools, ExtensionPay, Stripe, advertisers, or data brokers.

PurpleTools RAF stores module preferences and related settings using Chrome extension storage.

After you consent to use the extension, PurpleTools communicates with ExtensionPay as necessary to verify items such as: Trial status, Account status, Subscription status, and License access.

Payment information is entered on ExtensionPay or Stripe pages. PurpleTools RAF does not receive or store complete payment-card information.

See the PurpleTools RAF Privacy Policy for the complete privacy and data-use disclosure.