Upgrade Education Packet for Providers

Transcription

1 Upgrade Education Packet for Providers Cerner Power Chart Upgrade June 2017 Orders Enhancements: Overview You can order recurring orders over a set time interval. (pg. 3) You can add a diagnosis to a future order without adding the diagnosis to the current visit. (pg. 5) Improved search function on Orders. (pg. 6) E & M order dates will default to the registration date for the Patient. (pg. 7) Available 6/26/17 by end of day Dynamic Doc Enhancements: Improved advanced auto-text functionality. (pg. 8-12) Change note type or date/time on a signed document. (pg. 12) Available 6/26/17 by end of day Author for documentation started by scribes will now be updated to the provider when signed or saved by the provider. (pg. 14) Available 6/26/17 by end of day Tagging enhancement in dynamic documentation. (pg. 18) Manage Workflow Mpage Enhancements: Implant device history now on Histories tab in TOC. (pg ) Improved Patient Education component on the Workflow Mpage. (pg. 15) Improved Home Medication component on the Workflow Mpage. (pg ) Improved Problem List on the Workflow Mpage. (pg ) Improved Health Maintenance (Recommendations) on Managed Workflow Mpage. (pg ) Create Note has quick links for Inpatient and Admit Manage Workflow. (pg. 23) Available 6/26/17 by end of day Ability to open documents in a separate window and interact with other windows while the document is open (i.e. two monitors you can review a document on one monitor while working in the chart on the other monitor. (pg. 23) Resolved issues with this Upgrade: ED Physician Workflow Mpage Patients with multiple weekly ED visits will no longer get error message: error retrieving results in Manage workflow components. RadNet: Digital dictation freeze should be resolved. FirstNet: Document management column should progress appropriately You can now discontinue Medications in the Med Rec if the patient has a med history done on an inactive encounter. (Currently requires a call to the Service Desk) Freezing in Draft Printing in Documents should be resolved Out of Memory error message in Patient Education should be resolved Incorrect special instructions on Prescriptions in erx should be resolved Freezing when searching in Consolidated Problems should be resolved

2 `Table of Contents Contents Pharmacy Enhancements... 3 Patient Preferred Pharmacy... 3 With No Preferred Pharmacy... 3 With Preferred Pharmacy... 3 PRN Prescription Enhancement... 3 Orders... 4 Future Orders... 4 Single Order... 4 Recurring Order... 5 Future Visit Diagnoses... 5 Quick Orders... 5 Order Details... 6 Search Sorting... 6 Evaluation and Management Order Date... 7 Documentation... 7 Advanced Auto Text... 8 Create Auto Text... 8 Add a Drop List... 9 Modify a Drop List Auto Text Notification Use an Auto Text with Drop List Change the Note Type or Date/Time on a Signed Document Implanted Device History Add Implant History Modify/Explant/Remove Implant History Perioperative Documentation Update Author on Save or Sign P a g e 1 25

3 Manage Workflow Patient Education Home Medications Problem List Enhanced Tagging Recommendations (Health Maintenance) from the Manage Workflow Overview Review Expectations Modify Expectations Satisfy Expectations Manage View and Settings Favorites Modeless Document Viewer Create Note Scales and Assessments P a g e 2 25

4 Pharmacy Enhancements Patient Preferred Pharmacy The Patient Pharmacy search will now detail the Last Review Date and Time. It also provides an option to mark No Preferred Pharmacy. When entering prescriptions to be sent to pharmacy, hover over the drop down for Send to to see when the pharmacy was last reviewed and if the patient has no preferred pharmacy. With No Preferred Pharmacy With Preferred Pharmacy PRN Prescription Enhancement When the frequency and duration are entered on a PRN medication, the system does not automatically calculate dispense amount. Instead the dispense amount is a required field for the Provider to enter the intended quantity. Dispense quantities defined in order sentences favorites will continue to be applied. P a g e 3 25

5 Orders Future Orders Order for future visit will now be a required detail when placing lab, POC, and in-office procedure orders. Choose Yes for orders that will be done at another visit or location, this includes same day but different location. Choose No for orders that will be done during the current visit. Clicking No will leave the collection date and time for today and now. If the order is not performed at the current visit, you will have to cancel and reorder as a future order to be able to perform later. Clicking Yes will open the Future Order Details window to assist with entering the projected start date. Single Order 1. Select Single Order. 2. Choose one of the following radio buttons: In Approximately will allow you to estimate the projected start date. Use either day, week, or months to calculate the start date. The grace period gives a window +/- days. The grace period can be adjusted as needed. Sometime Before will allow you to enter an end date the order needs to be completed by. On Exactly will allow you to enter an exact date. 3. The projected start date will be calculated by your choices. 4. Click OK. The collection date and time will be updated and the order sentence will reflect your choices. If all other required details are complete, you can sign the order. P a g e 4 25

6 Recurring Order 1. Select Recurring Order. Recurring order allows you to generate multiple occurrences of an order over a set time interval. 2. Enter the interval needed for EVERY and FOR. Adjust the grace period if needed. 3. The number of occurrences will be calculated based on your choices. 4. Enter the intended start date for the first occurrence. 5. The projected start date will be calculated based on the estimated start and grace period. 6. Click OK. The collection date and time will be updated and the order sentence will reflect your choices. If all other required details are complete, you can sign the order. Future Visit Diagnoses You are now able to add diagnoses to orders that will be used for a future visit without adding that diagnosis to the current visit. Quick Orders 1. When using quick orders, click modify to launch to the order details. P a g e 5 25

7 Order Details 1. IMPORTANT: Mark Yes for Future Order in the Details tab. Use the calendar icon to address the target date. 2. Select the Diagnoses tab in the order details. 3. Click the pencil and paper icon to clear all. This will remove the current this visit diagnoses from the order. 4. Search for the diagnosis to be used with your order for a future visit. Click the item to add. 5. The new diagnosis will appear check marked and default to Future Visit. Use the drop down to change to this visit if needed. Search Sorting When searching for orders, the results will now group orders together with order sentence sequencing and decimal value sorting. For example, left side is the current search results. The right side is after the improvements. P a g e 6 25

8 Evaluation and Management Order Date E&M order dates will default to the amb registration date for the patient. This will correspond to the visit date that can be found in the FIN. You will now be able to click sign in Quick Orders instead of modifying the date when placing orders after the day of service. P a g e 7 25

9 Documentation Advanced Auto Text From any documentation area, locate the icon for Manage Auto Text. 1. My Phrases is content created by you. Public Phrases is content available to everyone. 2. Use the + to create a new auto text. 3. Use the search box to locate already available content. 4. Use Next or Previous to move through the list. 5. Select an Auto text to see and manage its content. 6. With an auto text select use buttons to manage. 7. Preview the content of an auto text. 8. Toggle Auto Text notification. Uncheck to minimize pop up messages. Create Auto Text Click the + to create a new auto text phrase. P a g e 8 25

10 1. Enter an abbreviation and description for your text in the Abbreviation and Description boxes. 2. Enter the text that will appear when auto text is used. 3. Click Save. Add a Drop List Drop lists in auto text provide a method to choose response to be added from a list. Click the Create Drop List icon. 1. Click Add List Item. 2. Add text into the free text box and press ENTER. 3. Checking the Use Blank Default box inserts an underscore at the top of the item list. 4. Click Create to add the Drop List item into the Auto Text phrase. The newly created Drop List item will show blue with a downward facing arrow in the Auto Text phrase. P a g e 9 25

11 Modify a Drop List 1. Click a Drop List item in an Auto Text phrase to open the Modify Drop List window. 2. Edit the item(s) in the Drop List by clicking in the text box or boxes. 3. Click Save to save any changes. 4. The Remove Drop List button deletes everything in the Modify Drop List window and closes the window. Note: Any Drop List in the Auto Text phrase editor that has been removed using the Remove Drop List button turns from blue to black, and the downward facing arrow will be deleted. P a g e 10 25

12 Auto Text Notification Use the checkbox to turn off Auto Text Conversion Notifications Use an Auto Text with Drop List Insert auto text into note using the name of the auto text. Available drop lists with be indicated with blue text and arrows. Either click on the intended drop list or use F9 to jump to the next drop list. Choose an item from the drop list and the text will reflect the choice. P a g e 11 25

13 Change the Note Type or Date/Time on a Signed Document 1. Open the note for modification. 2. Scroll to the bottom of the note and click the blue Note Details at the bottom. 3. Make the needed changes in the Note Detail window 4. Click OK. 5. Type in the addendum note type or date/time change as applicable. 6. Click Sign/Submit. P a g e 12 25

14 Implanted Device History Add Implant History 1. Click Histories 2. Click Implants 3. Click + Add to document Implant History. Fill out all the available historical implant information. Click OK to submit. P a g e 13 25

15 Modify/Explant/Remove Implant History Right click on implant item. Choose the appropriate action. Perioperative Documentation Implant Log will flow to Implant History when case is finalized. Update Author on Save or Sign The author for documentation started by scribes will now be updated to the provider upon signature or save of the document by the provider. This will allow this type of documentation to appear under provider documents and be able to be sorted by the provider s name. P a g e 14 25

16 Manage Workflow Patient Education 1. Choose Education or Medication Leaflets 2. Use the Suggested list to meet the Meaningful Use Requirement. 3. Choose the Diagnosis or Problem you want education sheets for. 4. Select the education sheet. 5. Use Previous or Next to move through the list. 6. The stars can be used to mark favorite items. 7. Education added will appear under the Added Education section. 8. Star = favorite; pencil = view/modify; printer = print; x = remove. 9. Med Leaflets added with appear under the Added Medication Leaflet section. 10. Education and Leaflets will print automatically with the patient s visit summary, however if you want to print them all, use the blue link to Print All Education and Leaflets. Home Medications 1. Status: green check = complete. Any other icon the status is not complete. Click the words to launch the corresponding item. For example, click Outpatient to launch the outpatient med rec. 2. Review who completed the meds history and when. If not performed, complete to be able to access the Outpatient med rec. 3. Responsible provider is now viewable in the component. 4. Estimated supply is now viewable in the component. 5. Use the header for Home Medications to link to the Medication List to review non active meds. P a g e 15 25

17 1. To get credit for the med rec, you must do the med rec. However, if there is a need to manage home meds outside of the med rec click the medication to open the detail pane. 2. In the detail pane, choose renew, cancel, or complete. After you have chosen the action, you are prompted to verify where it is being sent (routing). You can also modify the refill and dispense quantity. Click apply when finished. 3. Click sign to submit the medications. Problem List This Visit = diagnosis (ICD10) being addressed this visit. Chronic = ongoing problem for a patient across visits. Inactive = problem not actively experiencing, but not resolved. Historical = resolved problem. 1. Choose dropdown to add new this visit diagnosis or chronic problem. Use search to find items. 2. Use buttons to mark items as this visit or chronic. Blue button indicates active status. Choose resolve to move item to historical list. 3. Use triangle dropdown to mark priority. 4. Use exclamation icon to address unspecific ICD10 codes. P a g e 16 25

18 5. Expand Historical to see prior problems and diagnoses. 6. Check box to toggle prior diagnoses in Historical list. 1. Click an item s name to open the details. Click again to close the details. 2. Use buttons to change status of the item. 3. Expand details via the triangle button. P a g e 17 25

19 Enhanced Tagging In the Manage Workflow you will now be able to drag and drop text from documents to the documentation sections. 1. Click and drag over the text to highlight selection. 2. Once text is highlighted, a block will appear at the end of the selection. 3. Click and hold block to drag and drop text to the documentation section you want the text to appear in. NOTE: This can only be done from the document preview. The same method can be used to drag and drop text from the tag bucket to documentation sections. P a g e 18 25

20 Recommendations (Health Maintenance) from the Manage Workflow Overview Asterisk = overdue items; green check = no overdue items. 1. Toggle between Pending and Not Due/Historical. Use Not Due/Historical to review completed, canceled, or upcoming expectations. 2. Mange the patient s communication preference. Use recycle icon to refresh. Use the menu to group items or manage time range settings. 3. Manage favorites and toggle between favorites and all items. 4. Use columns to review expectation information and to sort. Review Expectations 1. Click expectation to open the detail pane. 2. Use the (i) icon or view reference text link to open reference text about expectation. 3. Click the down arrow to expand task information and history. You can review associated results and history of the expectation in this detail pane. 4. Use modify to change due date and frequency. Use actions to satisfy expectation. 5. Use the x to close the action pane. P a g e 19 25

21 Modify Expectations Use modify from the side pane. 1. Use the pencil to modify the due date. 2. Enter how often the expectation is to recur. 3. Choose the reason for modification in the drop list. 4. Add any additional comments if needed. 5. Click save to submit. Satisfy Expectations 1. Click Actions 2. If an order is chosen, it will appear in the green orders for signature icon (shopping cart). You must go there to sign and complete the order. 3. If a power form is chosen, the form will open for you to document in the form. Choose the green check mark to sign. 4. To otherwise complete the expectation, choose items such as given with visit, completed elsewhere or manual satisfier. Complete the details and click Save. 5. Choose refusal, postpone or cancel permanently as appropriate. P a g e 20 25

22 Manage View and Settings View From the Menu on the header bar, you can choose to group expectations by category or show only favorites. Settings From the Menu on the header bar, choose Settings. General Settings allow you to pick the appropriate time range or enter a custom one for expectations. Click Submit. Favorites 1. Check box the items to be added to favorites. You can choose whole categories or individual expectations in a category. 2. Use the triangles to expand or collapse categories and expectations 3. When all of your items are checked, use the arrow point to the right to move them to the favorites box. 4. Choose Submit to save. 5. To clear favorites, choose revert. P a g e 21 25

23 REMINDER: When showing only favorites, non-favorite expectations will be hidden. There is an info bar at the bottom to remind how many are out of view. Use show hidden to review. P a g e 22 25

24 Modeless Document Viewer You are now able to open documents or reports in a separate window via the Manage Workflow mpages and interact with other windows while the document is open. For example, on two monitors you will be able to review a document one monitor while working in the chart on the other monitor. NOTE: This can only be done from the Manage Workflow Mpages. Create Note NOTE: Manage Workflow Inpatient and Admit Workflow ONLY. Under Create Note, there are quick links to documentation types. This will open directly to those note types and templates without prompting the user to do so. To open note types and templates that are not list, use Select other note or Documentation +Add. P a g e 23 25

25 Scales and Assessments You will now be able to quickly review past screening scores and information. 1. Click the triangle drop down to select an assessment powerform to document. Clicking the name of the powerform will launch the form. 2. Use the + to go to the full list of Adhoc powerforms. 3. Previously charted items will appear in component. Hover over the item to see the items details. Click the item to launch and review the entire powerform the item belongs to. 4. Manage your lookback time range. 5. Refresh the component to update the information in the component. P a g e 24 25