Parking lot questions and answers - South Shore · PDF filePARKING LOT QUESTION S AND ANSWERS...

PARKING LOT QUESTIONS

AND ANSWERS Epic Training 2017

Training Team, South Shore Health System [email protected]

V1.8 - 2017-06-14

Latest Update: Wednesday, June 14, 2017

PARKING LOT QUESTIONS AND ANSWERS Epic Training 2017

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Contents Ambulatory ................................................................................................................................................... 3

Amb Nurse 100/200 .................................................................................................................................. 3

Amb Wound Provider ............................................................................................................................... 4

OP Therapy 100 ......................................................................................................................................... 4

OP Therapy 100/200 ................................................................................................................................. 5

Infusion Nurse ........................................................................................................................................... 5

ASAP .............................................................................................................................................................. 6

RN100 ........................................................................................................................................................ 6

RN200 ........................................................................................................................................................ 8

UC100 ........................................................................................................................................................ 9

Specialty Narrator ................................................................................................................................... 10

Provider ................................................................................................................................................... 10

STS ........................................................................................................................................................... 13

EMS ......................................................................................................................................................... 14

Beaker ......................................................................................................................................................... 14

Gross Assistant 150 ................................................................................................................................. 14

HD Phlebotomist 100 .............................................................................................................................. 15

SSHS Med Tech ....................................................................................................................................... 15

Cadence ....................................................................................................................................................... 15

Front Desk 100 ........................................................................................................................................ 15

Front Desk Radiant .................................................................................................................................. 16

Grand Central .............................................................................................................................................. 16

Admission Supervisor 101 ....................................................................................................................... 16

Admission Supervisor General ................................................................................................................ 17

Auth/ Cert 100 ........................................................................................................................................ 17

Bed Flow Facilitator 100 ......................................................................................................................... 17

HB ................................................................................................................................................................ 18

Customer Service and Self-Pay Follow up Manager 100 ........................................................................ 18

HB Biller - Account 100 ........................................................................................................................... 18

HB Biller-Claims ....................................................................................................................................... 18

HB Charging Expert ................................................................................................................................. 19

HB Biller Manager ................................................................................................................................... 19


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Payment Poster Manager ....................................................................................................................... 20

Self-Pay Follow-Up 200 ........................................................................................................................... 20

Working with Coverages & Guarantors .................................................................................................. 20

HomeHealth Hospice .................................................................................................................................. 20

HomeHealth Field User 100 .................................................................................................................... 20

HomeHealth Field User 200 .................................................................................................................... 23

Hospice Field 200 .................................................................................................................................... 27

Scheduling ............................................................................................................................................... 27

Quality Review ........................................................................................................................................ 29

HH Field User 100 ................................................................................................................................... 30

Op Time ....................................................................................................................................................... 31

Pre-Op ..................................................................................................................................................... 31

Intra-Op ................................................................................................................................................... 31

PSE ........................................................................................................................................................... 31

Surgery Scheduler ................................................................................................................................... 31

Professional Billing ...................................................................................................................................... 32

PB Insurance Follow Up 100 ................................................................................................................... 32

Radiant ........................................................................................................................................................ 33

Boarder Class .......................................................................................................................................... 33

Front Desk ............................................................................................................................................... 33

Manager .................................................................................................................................................. 34

IR RN ........................................................................................................................................................ 35

Rad .......................................................................................................................................................... 35

Tech ......................................................................................................................................................... 36

Stork ............................................................................................................................................................ 38

Stork Nurse ............................................................................................................................................. 38

Stork Nurse / Stork Unit Coordinator ..................................................................................................... 39

Stork Unit Coordinator ............................................................................................................................ 39

Stork NICU Nurse .................................................................................................................................... 39


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Ambulatory

Amb Nurse 100/200

1. Question How can flowsheet rows be updated if the department needs to add a row that is missing or needed?

Answer Place a ticket into the helpdesk with the information of what you need and where you need it.

2. Question If you open an encounter by accident, and then close it immediately, what happens? How bad is it? Will there be an open encounter in In Basket?

Answer Try to remember not to double click on the patient. To review a patient's chart, single click and click on chart on the toolbar. If a patient does not show up for a visit after an encounter has been opened, then you would need to enter the erroneous encounter smartset in order to close the encounter and prevent an inbasket message from coming to your inpatient.

3. Question What is the difference between the MRN, the CSN, and the HAR?

Answer MRN: Medical Record Number-specific to each patient, HAR: Hospital account-could be linked to a series of related visits, CSN: Contact Serial Number-specific to one visit. Be sure to select the correct HAR or create a new one if you are scheduling a patient.

4. Question Is there an easy way to find out more about the person who documented in the patient chart? For example, if Mark as Reviewed displays "Last reviewed by Karen Smith, RN on 5/1/17" how can I find out what department Karen Smith works in?

Answer Go to the encounters tab in chart review reference the reviewed date to the encounter dates.

5. Question Can we delete a flowsheet column (Vital Signs) if we make a mistake?

Answer If no values have been filed, you can click RESET in the top right to remove the extra column. Once values have been files in any rows you cannot delete the column, but you can delete the values in each row on a flowsheet if you make a mistake.

6. Question What information will be migrated from Meditech to Epic? (Medications, etc.)

Answer Labs, imaging, notes, problems, immunizations, allergies, (please refer to documents that have discussed specific conversion strategy). Managers of all outpatient areas have been involved in meetings. Please refer to your manager with specific questions.

7. Question For some procedures, it is very important to record when the patient took their last dose of a medication, particularly with blood thinners. How and where would a nurse reviewing medications record last dose taken at…?

Answer This can be done in the medication review activity in Rooming. Click on the medication to open the order composer, click Mark "Not Taking", and add a reason "other." Use the comment to document last dose and specific reason for variance

8. Question Cardiac Rehab Qtel orders where do they show up in the chart?

Answer Show up in the cardiology tab in chart review.


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9. Question When Care Everywhere queries another organization for information, is there a set limit as to how far back in the record the provider can see? For Hyperbaric treatment, the provider looks for Radiation treatment in the last 10 years.

Answer The clinical summary that is automatically downloaded covers the past 90 days. Information in specific encounters goes back as far as the organization has records. User double clicks on the encounter to download the detailed information.

Amb Wound Provider

10. Question How will we communicate with external VNA?

Answer Communication Management will have VNAs in its searchable directory. You can send faxes directly from Communication Management.

11. Question In Communication Management, how do we select/know how a communication is sent (Mail, fax, e-mail)? i.e. if a provider has a mailing address and a fax number, how do we select one over the other?

Answer After selecting the recipient, the communication will be sent by the preferred communication method in their record. There are icons to indicate whether the communication will be sent via In Basket, Fax, or Mail. Right-click on the recipient's name and select the desired communication method.

OP Therapy 100

12. Question How does a clinician view their schedule for the week all on one screen? (I know I saw this during a pilot training, but can't figure it out.)

Answer Epic Button > Scheduling > View Schedule From there choose your dept. and then provider. Click on a date on the small calendar in the left bottom corner. View needs to be set to "All Times, Multiple Dates." In the right hand corner, choose how many days you want to view (3, 5, 7, 10, 15, and 20).

13. Question Can you view your schedule for the day if it is split between 2 departments? i.e. OPR and PPK.

Answer Personalize your MPS view with the gears. Go to confgure and choose one dept. Then choose yourself. Pick another dept. and then pick yourself again. See pics on sheet 2 for details. They will need to personalize what columns show up in their MPS and add dept.

14. Question Speech Therapy-Will Modified barium swallow fluoroscopy video be viewable in Epic via the imaging tab of Chart Review?

Answer Yes.

15. Question How will the ITP flowsheet for Cardiac Rehab be documented if documentation occurs over three days?

Answer Each time the ITP flowsheet is documented, it should be done during a patient encounter. You do not have to wait until all ITP documentation is complete before closing the initial encounter. All patient encounters should be closed within 24 hours.


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OP Therapy 100/200

16. Question Where would we see in the chart if the patient is a VIP?

Answer We will no longer be using the VIP functionality in Epic. We will be using the FYI flags to flag patients. The FYI flag appears on the provider schedule and the patient header.

17. Question Can sidebar Cardview In Basket messages be configured to only show certain message types and not others? Currently does not show Patient Call Back messages.

Answer No, individual customization is not something that can be done. Results, patient calls, and refill requests will show by default.

18. Question How do you run a Care Everywhere query outside of an appointment encounter if you want to look at a patient chart in advance of the visit?

Answer You can't run a query outside of the appointment. The system will auto-query if a patient has an appointment to sites nearby the patients home and work address. (Keep in mind some sites also require consent - so we would highly recommend having the patient in front of you). Must be in an office visit, ED visit, or IP stay to be able to query via Care Everywhere.

19. Question Is there a way to access the time stamps for when a clinician began and ended an encounter? Would like to use this for recording Time In and Time Out on a patient visit.

Answer There is a Department Appointments Report (DAR) that can display this information. You can double click on the patient and see the Event Tracking Log. There are also crystal reports that can show you average times per provider based on events (check-in, rooming, etc.).

20. Question Where is PLY?

Answer If no values have been filed, you can click RESET in the top right to remove the extra column. Once values have been files in any rows you cannot delete the column, but you can delete the values in each row on a flowsheet if you make a mistake.

Infusion Nurse

21. Question For Scanned documents, what is the procedure policy for managing the paper original? Is there any SSHS policy or guideline? Should they be kept in the department for a period, shredded, sent to HIM?

Answer There will be official word coming from HIM leadership, but HIM will be asking the departments to interoffice all hardcopy documents to HIM. HIM has a Quality Check process verifying the hard copy document with the Epic System to ensure everything is scanned into the correct location, patient and quality of the image is good. HIM will report any issues to the Department Managers and maintain the hardcopy for a month in HIM.


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22. Question For the After Visit Summary (AVS), there is a current practice (policy?) to have the patient sign a copy to acknowledge unnderstanding and receipt of discharge orders/instructions. Will this practice be continued in Epic? How would the document get signed (on paper/e-sign)? If on paper, what should happen to the signed document? even though the AVS is in Epic, does the signed copy need to be scanned into Media Manager for every patient visit?

Answer The policy only applies to inpatient workflows. AMB practices do not have to follow this policy.

ASAP

RN100

23. Question Can the vital sign timer be adjusted to meet specific patient criteria? For example, psych patients often have vitals qshift not q2h?

Answer We *might* be able to make this happen, but not for Go Live. We will consider for optimization.

24. Question Can 'mypt' trackboard view have the lab status column that is on the all patients trackboard. (1,1,3)?

Answer Optimization.

25. Question Will there be a flag if the number of drinks per day is more than the normal daily amount per the SBIRT scale?

Answer No flag. We can build warnings (not sure if SSHS is using any from FS/built any custom) but this is probably optimization.

26. Question Can preferred pharmacy be a category by itself so you can F8 to it and not miss it.

Answer We will review in optimization.

27. Question Will there be a flag as a reminder for restraint documentation?

Answer There are reminders for restraint documentation already (TB columns and narrator alerts).

28. Question Where can child life specialists document?

Answer Child Life Specialist use ClinDoc tools not ASAP. Their workflows will resemble inpatient.

29. Question Add on lab process: Can phlebotomy see that there are rainbow labels in the lab? Will the nurse be able to "modify" an order by a physician that can be added on?

Answer Phlebotomy cannot see the held rainbow lab orders in lab. MDs are prompted to link lab order to available held bloods upon ordering. Nurse cannot link the order to a held rainbow after the order is placed. The MD or RN would need to cancel the order and reorder the lab with appropriate linking.

30. Question Can floor sitters do q15 minute checks in the ED. Will they have access to ASAP?

Answer Floor sitters will use inpatient clinical documentation as they do on the inpatient floors.

Question Can floor sitters do q15 minute checks in the ED. Will they have access to ASAP?


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31. Answer Floor sitters will use inpatient clinical documentation as they do on the inpatient floors.

32. Question Can a nurse sign a work/school form? Current state, this is our workflow.

Answer Validated workflow is the provider will enter data into this form. Nurse will print AVS form.

33. Question Dispo column contains the verbiage "place in hospital" in all pts or individual care areas but "admit" under my pts view. Why is there a difference?

Answer This can be evaluated during Optimization.

34. Question When documenting vitals can L/min always be open. If the nurse does not select Supplemental oxygen despite picking an oxygen delivery method of Nasal cannula or non-rebreather it does not allow you to choose how many liters of O2 a patient is on.


35. Question How long will patients populate into the recent patients tab?

Answer The tab lists the last 25 patients.

36. Question Can family history be collapsed with triage navigator?


37. Question Will serial EKG's show up on the task list as timed? If you order an EKG q3h x3, will they show up at say 1PM, 4PM and 7PM? In POC, we ordered all at the same time.

Answer Yes.

38. Question When documenting vitals, can L/min always be open? If the nurse does not select Supplemental oxygen, despite picking an oxygen delivery method of Nasal cannula or non-rebreather, it does not allow you to choose how many liters of O2 a patient is on.


39. Question Vital Sign timer does not reset once vital signs are completed. Do we need to select reset each time we want time to restart?

Answer If you don't do full vitals (RR, HR, SpO2, BP), then you need to click the button.

40. Question Can RNs delete Allergies?

Answer Yes.

41. Question Is there the ability to move patient to a test without putting them off the floor. For example, if someone is at xray, how will the CFC be aware? Or even the concierge?

Answer Back to bed functionality/workflow. For radiology: pt location will state which rad dept. patient is actually in.

42. Question Can xray or CT be completed without moving the patient to the department. Meaning if radiology has to check the patient in to their "appointment" but we are not "moving" the patient to that area, how will that happen?


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Answer Yes radiology will still be able to perform radiological procedures but it is best practice to ensure you update location changes - this functionality will not remove the patient from their bed assignment in the ED.

43. Question What kind of migration will happen from Meditech to Epic. For example, patients that come to SSHS and med rec's that have been done.

Answer Yes, data conversion will occur which will include patient master patient index information, demographics, and key clinical data elements.

44. Question When does the signed and held timer start ticking if the provider has orders placed at different times? Does it go off the last order or the first order?

Answer The timer starts when the first order is placed under the Sign and Hold option.

45. Question Can we use Sticky note functionality in Epic? "Comment" field in Meditech (the line below the patients name with a quick update.


46. Question Can ETP be a synonym for Emergency Triage Provider?

Answer No.

47. Question Does HAAS prompt nurse to place a Respiratory consult if abnormal?

Answer No.

48. Question Fetal Demise Pathology paperwork - Will this be within Epic or still on Paper?

Answer ED will remain on Paper.

49. Question Blood cultures: if held: rainbow or do you just hold them at desk?

Answer Blood Cultures are not included in a Rainbow draw so they cannot be sent to the lab.

RN200

50. Question Where do you see the overall total on the I/O flowsheet?

Answer Navigate to I/O Flowsheet, select More Activity, Select Intake and output, view 24h volume.

51. Question When bolusing fluids, rate changing to 999 dose automatically changes to the same number as the rate. For example, with a bolus of 500 ml you enter a rate of 999, then the bolus amount changes to 999 not 500.

Answer You must document volume within medication administration window so bolus will be documented within MAR flowsheet.

52. Question How will we know when blood is ready from the blood bank?

Answer You will see the Prepare Blood order is 'complete" within the "All Orders" tab.

53. Question Where on the flowsheet does blood fall/flow into? Even after documenting a volume amount blood intake is not on the flowsheet?

Answer Navigate to I/O Flowsheet, select the I/O tab. View Transfusions section at the bottom of the flowsheet.

Question Does blood show on the MAR flowsheet?


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54. Answer Blood is documented within your assessments and on the I/O flowsheet.

55. Question Procedures->Continuous Bladder Irrigation - only has urine, where do you document how much fluid has been instilled?

Answer Under Drain documentation add CBI, whenever changing irrigation bag or emptying urine go back to this documentation to enter volumes and it will go into flowsheets.

56. Question When you discharge a patient you are flagged a med is not given even if you've already documented that a patient refused it.

Answer Working now, there is a lag, but it falls off the list.

57. Question If you link more than one med to an IV and there is a known interaction with the other two meds, will you get an alert?

Answer Probably. (Explanation for project team: med alerts don't "come" from Epic, they come from the medication load we take from another company, but generally yes.).

58. Question Staff arrival does not document in the event log of a narrator unless you hit code start first. Is this correct?

Answer Yes.

59. Question After bolus of fluid, put in 500 cc volume, do you have to go back and document rate returned to prior rate? How is best to document this as the pumps will automatically decrease the rate, so to be careful of the time?

Answer Yes, you will need to document the rate change in Epic upon completion of the bolus.

UC100

60. Question In the Startup Activities tab, there is one for "my list" with consults. Is the consult column being removed from UC trackboard? Do they need the My list activity?

Answer Consult column has been removed in POC. The My List startup activity is necessary for Center 4 UC's.

61. Question How do we find a patient that has left the department (Home/Inpatient) quickly without entering the chart?

Answer Utilize the ED Chart function.

62. Question Currently UCs have access to transport screen to evaluate backlog of transport request - will this access be allowed in Epic?

Answer Transport column is available with a timer and can be sorted according to time.

63. Question Will the trackboard say "C CHG RN" anywhere? Or will the only flag on the trackboard be a status of Expired. How will the concierge see this?

Answer Patient status color of Navy Blue. Hover to discover.

64. Question Will labels print to Form Fast Printer as in current state?

Answer Form fast will not be necessary. Labels will be printed with Epic functionality.

Question Will we still have 'Summit' for downtime?


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65. Answer No. We will be utilizing Epic BCA.

Specialty Narrator

66. Question Pulses in secondary assessment: Can "WEAK" be a selection?


67. Question In trauma narrator: why do you have to choose trauma at all? Then cascades to Level 1 or 2, difficult to find.


68. Question Can we combine the airway and intubation assessment into one spot?


69. Question Can there be a similar button to a "one step med" but for a CBG order? So when you click the hyperlink you are both ordering and documenting the CBG result?

Answer No.

Provider

70. Question Share vs. sign: Why can't they have the pend option?

Answer Provider note edits are now restricted to original author only.

71. Question Everyone needs the observation navigator not just APC's

Answer This activity can be accessed through the more activity tab.

72. Question Children's discharge instructions are currently within Meditech. Will they be migrated into Epic for Pedi providers?

Answer We will be using Healthwise for all discharge instructions.

73. Question Please look at workflow of Procedure note. Providers are not used to signing multiple notes. Providers are saying if they do several procedures, they would have to create and sign many notes. For example, lac repair, reduction of hip, placing a central line —these require multiple "signs" and they feel it makes the chart "clunky.” In addition, there is some concern regarding if you were to transfer a patient some of these notes would/could be missed.


74. Question When a patient is discharged, do they stay on the providers "my list" and for how long?

Answer They won't be on the Trackboard but the provider can find them with ED Chart, patient list, or report.

75. Question If providers knew they were going to be out for an extended period, would they use the "out" function in the inbox to have their messages routed to someone else?

Answer Yes.

76. Question Care Everywhere: Will they have to obtain signatures from patients for Partners locations. Providers saying they do not do it now.


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Answer Yes. This is Partners requirement, not from SSHS.

77. Question Decision to admit, admitting provider it says "null.”

Answer It now states "clear" for generic hospitalist.

78. Question Do discharge medications with a stop date (i.e. antibiotics) follow patient as a current medication during next ED visit.

Answer They will be visible.

79. Question Current state requires MD/APC to re-enter password when placing orders - Epic does not. Is leadership aware of this practice change?

Answer Dr. J. Tracy confirms.

80. Question Is there a way to state "NO CHANGE" to Current Outpatient Medications during discharge med rec?

Answer Yes. Within discharge navigator go to medication review and select 'Mark All as No Change" on top of the eMedication review section.

81. Question Decision to admit. Can this be defaulted to "clear" provider (hospitalist unassigned service)?


82. Question In Chart review, can you customize which visits you see and what order?

Answer You can filter.

83. Question Can there be a column on the provider trackboard to indicate the provider clicked first provider time?

Answer Optimization (if this is not there already).

84. Question Can you pull in imaging results/lab results into your note? Does the note template/smart text pull in the results?

Answer Yes, there are dot phrases that do this.

85. Question If there is something you have not done such as signing your note, will you get a pop up saying "you have not signed your note?”

Answer Warnings at various points in workflows, need specific examples to answer further (which point in patient stay? Which activity? Which note?).

86. Question Do in basket messages get sent in real time? If you haven't signed a note, you will get an InBasket message that alerts you.

Answer Yes, real or near-real time. In basket messages also clear out in real time, so when you sign your note that IB message telling you to sign will disappear.

87. Question Can there be a MASSPAT link when trying to prescribe narcotics?

Answer Yes - already available.


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88. Question If you receive a message in your In basket that requires action such as chart completion, but you only work at SSHS once a month can there be an email generated to your SSHS email account or an assigned account to let you know there is something that needs an action? The thought process is that the chart would be automatically sent to Logix for billing within five days but if you do not return for several weeks, and you manually send to logix would that be too late? In addition, if you have a note from a provider letting you know something was incorrect in a chart or requesting someone to do something, they would not receive that message until they returned.

Answer You have the option to give another provider access to your inbasket.

89. Question APC's hoping to get more info on OBS templates and what is available. Asking specifically for Dr. Will Tollefson's templates. (Putting this here as a reminder. Karen Jeghers said Jess Kerensky is working on this but hoping they get to see them before go live!)

Answer Providers should bring their note templates to the personalization labs so we can help create the template smart phrases/macros and show you how to share them with specific providers. K. Klaes decided addition of system wide smart forms will be considered during optimization. Some providers may be worried that their “templates” are not going to be available but in fact, we have many really great templates available in the Note Writer functionality. They can also build custom macros, which allows a lot of the info they are commonly writing in their ROS and H&P’s can be customized an reloaded whenever they need it. There is a TON of great functionality in the Notewriter that they can definitely practice and customize in personalization.

90. Question Who can see "my data" report within ED MD Dashboard.

Answer You and Leadership.

91. Question Disposition Navigator - Dr. Ship noticed that the documentation is not what is required of them. There is a specific document within MEDITECH they use.

Answer All discharge documentation has been approved my ED Physician Leadership.

92. Question The Bridge Order Set in Training environments does not have a phase of care associated with it. If ED provider signs it as is, it will be active while the patient is still in the ED. Does it need to be or should it be signed and held for IP RNs to release?

Answer The Bridge Orders will not be sign and held.

93. Question Pedi Obs Workflow - PEDI ED MD's enter "Admit to OBS" order. This deviates from adult "Admit to OBS" workflow which is only allowed via Bridge orders and requires an inpatient MD to cosign.

Answer PEDI ED Bridge order set will be used.

94. Question Can providers change their assigned area via the ED Trackboard? This is possible via the ED Manager but not sure if this is the most efficient way to do this. APC can often float to support other areas within the ED throughout their shift


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Answer You would need to sign out and then sign back into you appropriate area - Signing into a specific care area is not required.

95. Question Can providers change their assigned area via the ED Trackboard? This is possible via the ED Manager but not sure if this is the most efficient way to do this. APC can often float to support other areas within the ED throughout their shift

Answer You would need to sign out and then sign back into you appropriate area - Signing into a specific care area is not required.

96. Question Is it possible to add a "intensivist" button like the hospitalist "clear" button with the decision to admit order?

Answer Will evaluate during optimization - will collaborate with orders team.

97. Question Can details within decision to admit (admitting provider etc.) be auto-populated into Bridge admit order?

Answer This can be evaluated during Optimization

98. Question (JM) I signed in and used the quick button for an 8 hour shift. Will the system auto-sign out at the end of my shift? If I stay longer, will I need to sign back in?

Answer The system will not perform auto sign out at the end of your shift.

99. Question I signed an order for imaging and the patient needs to go to Radiology. Must I verbally notify transport/nursing or are they notified electronically?

Answer The radiology order will appear on the "new orders to be acknowledged" tool box within the nursing narrator.

100. Question Will go live smarts sets includes patient instructions?

Answer There is a comprehensive database of Patient instructions that can be chosen from suggested instructions as well as from the whole database.

101. Question When providers sign out to the oncoming provider, where do the patients that are boarders go? The oncoming doc would not sign up they now go under "zzhosp". How will this work flow work in Epic?

Answer Boarders would be on the Hospitalist/inpatient provider patient list. They would not be assigned to an ED Provider.

102. Question What will be the electronic process for boarder patients who have been admitted and are stationed in the ED? Will they remain on the ED TrackBoard under My Patients?

Answer Yes, they would remain under your MY PATIENT list until you unassign yourself.

STS

103. Question Behavioral / Psych note / documentation template should be build in Epic (same as Meditech)

Answer These can be built in personalization labs by providers. Dragon (and dragon templates) will remain available in Epic.

Question Can we flag a patient once bridge orders have been placed?


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104. Answer Optimization.

105. Question How does pedi document a phone consult?


EMS

106. Question Can the Ambulance Company be the NAME for the anonymous patient? Especially the non-critical. Hull Fire, Scituate etc. as name, once they arrive? Pt Access can change the name to pt name.

Answer We will add a column within track board view to reflect EMS provider in optimization.

107. Question How will medics/transport staff know the transfer/EMTALA paperwork is complete? Today they look for the three yellow sheets and ensure they are signed and all the correct info is filled out. Will there be some kind of indication that they are completed?

Answer Chart review or RN / UC communication

108. Question How does pedi document a phone consult?


109. Question Will the EMS tablets interface with Epic? Or will they print their run sheet and give them to the UC to scan in?

Answer Current State will be Maintained. Interface will be continued.

Beaker

Gross Assistant 150

110. Question If Block A2 is deleted, and then I add another block, the next block will be A3. This is a problem as far as determining how many blocks are there, as well as finding "deleted" blocks if it is decided that they do want to use that block. How do we correct this?

Answer In Case Builder and Quick Results, lab users no longer see confusing gaps in block numbering when adding new blocks to the end of the list. For example, if a protocol automatically creates four blocks, but the prosector needs only two, she deletes the third and fourth blocks, A3 and A4.

If the pathologist later decides to use a third block, she can restore block A3 with its original tasks or create a new block A3 that overwrites the original. Additionally, because removing the last block is a common workflow, the Case Builder buttons to delete a block or delete a task have been changed to Delete Last Block and Delete Selected.

To restore deleted blocks, users can click Show Deleted in the Actions menu, select the deleted item, and click the Restore Selected button. The Restore Selected button replaces the Delete Selected button when a deleted item is selected.


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HD Phlebotomist 100

111. Question If a phlebotomist collects a BMP at 0800, but did not receive the specimen until 1600, is there a way for the system to catch that it is over 4 hours old when entering the collection information (lab currently has time of 4 hours to get into the lab)?

Answer There is logic for “Add ons” regarding specimen stability, but not for the described scenario. Meditech does not do this for them now either. This may be an optimization project.

SSHS Med Tech

112. Question If a sample is resulted and then they question the draw (i.e. contaminated) to get a new sample can they do "redraw" or does the new order have to come from the MD or can the lab place a new order?

Answer If the specimen is not final or preliminarily verified, the redraw functionality should be used. The lab should not place a new order.

Cadence

Front Desk 100

113. Question Is there a max number of characters in the appointment notes section on the Make Appointment Form?

Answer Not that we know of. We tested this and got up to about 2,200 characters and were able to keep entering.

114. Question Why would we use the 'Query to' field on the Coverage Wizard?

Answer The To date helps query for a future date of service. It is not required and typically left blank. Most payors do not accept queries for future dates of service, and even if you populate the field, the return will be for today, not the date entered.

115. Question When would you use 'Find Existing' in the Guarantor Account form?

Answer To search for an existing Guarantor account. Maybe they had an old TPL or Workmans Comp guarantor account that needed to be used. Just another useful tool that could help eliminate creating the same guarantor account.

116. Question Is there a max number of characters in the appointment notes section on the Make Appointment Form?

Answer Not that we know of. We tested this and got up to about 2,200 characters and were able to keep entering.

117. Question When or why would you use the 'Query to' field on the Coverage Wizard?

Answer The ‘to’ date is to query for a future date of service, it is not required, and typically left blank. Most payors do not accept queries for future dates of


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service, and even if you populate the field, the return will be for today, not the date entered.

118. Question When would you use 'Find Existing' in the Guarantor Account form.

Answer To search for an existing Guarantor account. Maybe they had an old TPL or Workmans Comp guarantor account that needed to be used. Just another useful tool that could help eliminate creating the same guarantor account.

Front Desk Radiant

119. Question What does the "Run all checks and complete registration" actually do? It doesn't update antying in the ACEs.

Answer The "Run all checks and complete registration" verifies checklist items where there are no warnings. If you had a warning free checklist and clicked on that button, it would verify everything in the checklist, leaving you to just then verify the encounter.

120. Question How can we print the schedule for the day?

Answer The best way to do it would be to run the DAR and then select printer icon on the top right.

121. Question How will the appointments from father's day to the time we go live get in the system?

Answer Post conversion weekend workflow: 1. During conversion weekend, all currently scheduled appointments that are after 7/1/2017 will be scheduled into Epic. 2. After conversion weekend, appointments that need to be scheduled before 7/1/2017 will continue to be scheduled in Meditech. Appointments that need to be scheduled after 7/1/17 will be scheduled in Epic. 3. Check-In will take place in Meditech up until 7/1/2017.

Grand Central

Admission Supervisor 101

122. Question Can I see a response history on a coverage that has been marked for deletion?

Answer "Yes! Within detailed view: Click Coverages in the form navigator Select the coverage to be deleted, and click Edit. Navigate down your Form Navigator on the left to see the coverage folder has opened up. You can see your Response History for the coverage here. "

123. Question Is there a report to show the average reg time/ average registrations per user for today?


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Answer There is not a report as-is to see this. You can use your dashboard to find the data. Click on Week to Date badge on your Patient Access Reporting dashboard, and click View Registrations. Click Options, and report settings. Click Go to Report Settings. Adjust the Date as needed (T- for today's). Click Run. By following these steps you'll be able to see who has done x# of registrations, and their average reg time for the day.

124. Question Is there a way for users to see their average stats (reg time/ number of reg's) in comparison to the other staff members?

Answer Currently there is not a way for the staff member to see a comparison, however, they can see their own metrics. Patient Access staff has access to a reporting dashboard, and the reports display metrics regarding the individual logged in.

125. Question Is there a way for users to see their average stats (reg time/ number of reg's) in comparison to the other staff members?

Answer Currently there is not a way for the staff member to see a comparison, however, they can see their own metrics. Patient Access staff has access to a reporting dashboard, and the reports display metrics regarding the individual logged in.

Admission Supervisor General

126. Question Regarding the Report Listing on Admission Supervisor dashboard- what is the definition of "recent results"/ how many recent reports will log here?

Answer There are no restriction on the total number of reports listed here, but the timeframes will vary depending on the report.

Auth/ Cert 100

127. Question Can I assign Workqueue encounters to myself, and then sort by insurance Type?

Answer Yes, select the encounters you wish, and click Assign to Myself. Then use your column headers to sort by insurance.

Bed Flow Facilitator 100

128. Question How do we recognize on the ED trackboard the difference between ED observation status and ED observation/tele status?

Answer There is not an ED Patient Status for ED Observation/Tele. There is an Observation Patient Status and this is denoted by dark purple in the first column of the Track Board. The best way to find out of it's obs vs/ obs tele is to look into the order placed on the patient.

129. Question How long do patients stay on the completed tab of bed planning?

Answer Patients will stay on the completed tab for 24 hours.


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HB

Customer Service and Self-Pay Follow up Manager 100

130. Question When looking at the HB self-pay follow-up dashboard (under the self-pay by agency-HB component), there are options in the agency field: All, Bad debt, external AR, outsourced, and pre-collect. How is SSH defining these? (pg 3 in EB).

Answer HCS and ROI = Bad Debt All other agencies = OUTSOURCED We are not using external AR and pre-collect.

131. Question When looking at the Statement Hold Reason Report and clicking On Account hyperlink, sometimes it takes you back to account maintenance workspace for that account and sometimes it doesn't? Why? (pg 10 in EB)

Answer From this report, you're taken to a stripped down version of account maintenance that provides all the tools to research statement hold reasons. You can still jump to the complete Account Maintenance screens from here. ( Hospital Account link is on the Guarantor Inquiry tab, the Hospital Account Listing tab, and the Enterprise Guarantor Summary tab)

132. Question How do you edit a Library report ( specifically after creating a new one from Reporting Workbench) once it's created?

Answer Once run, you can view the settings. You can edit the settings (hover over the report name to see the edit button) and re-run the report. (Works the same whether you created and saved a new report or just ran an existing one).

133. Question In reporting workbench (under my reports), what has the difference between recent results vs. saved results?

Answer Recent Results' displays the results of reports that were recently ran from the dashboard or from within reporting workbench. Saved Results shows results that you saved by clicking on Options (from the Report toolbar) > Save Results

HB Biller - Account 100

134. Question Account Note added by REG. Why does the note type = Coding / Billing?

Answer A generic note type has been created to be used with the communication workflows.

135. Question On Coverage Info form in Account Maintenance, is the employer info just pulling from REG since we said subscriber = self?

Answer Yes.

HB Biller-Claims

136. Question If two individuals access the same patient account from different WQs, will they receive a "locked account" message?

Answer If they were on a screen where they'd just be viewing information, no. If on a screen where you can edit information, yes.


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137. Question Is override ICN payor specific? What happens when payor doesn't provide ICN?

Answer The payor assigns the ICN, and the only time we’d send the ICN on a claim would be when replacing a claim for that payor. So in that sense, yes, the ICN is payor specific.

HB Charging Expert

138. Question Are we able to get into the Medical Record to view more details?

Answer Yes. When in a Charge Review WQ, with the patient/account highlighted, the bottom half of the screen includes a section called Charge Session Information. This section includes a link to jump to Account Maintenance. From Account Maintenance, you may have access to the Doc Review activity. You may also have access to an option called Encounter Review from the WQ toolbar. Both these options allow you to access clinical information in the encounter

139. Question Are we able to get into the Medical Record to view more details?

Answer Yes. When in a Charge Review WQ, with the patient/account highlighted, the bottom half of the screen includes a section called Charge Session Information. This section includes a link to jump to Account Maintenance. From Account Maintenance, you may have access to the Doc Review activity. You may also have access to an option called Encounter Review from the WQ toolbar. Both these options allow you to access clinical information in the encounter.

140. Question If charge is On Account in error, how would we delete it altogether.

Answer Hit Delete from WQ Activity Toolbar

141. Question Pending AR Component - negative WQ age? What does a negative number mean here?

Answer Some patients in training environment have a future service date for training purposes. These accounts with future dates show up on the WQ with a negative WQ age. This scenario will not happen in a live environment.

HB Biller Manager

142. Question Watch list section of dashboard - Why is it showing a blank gray row after each check/alert with numeric values to the right? Is that line showing the number of accounts?

Answer Yes.

143. Question If you pull the User Productivity report (after clicking view time log for all users), what does "by unique accounts" mean?


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Answer It shows how many different accounts that user worked on. There are ways to show how many activities were performed on each account if group by count instead.

Payment Poster Manager

144. Question Can you open and close a cash drawer multiple times throughout the day? E.g. someone who works in multiple locations throughout the day.

Answer Yes, drawers can be opened and closed multiple times each day. This is Epic's recommendation for users that work in multiple locations.

Self-Pay Follow-Up 200

145. Question When guarantor is changed on an account, it is taking a long time to reflect on the Enterprise Guarantor Summary screen. It reflects on the Account Summary screen almost immediately.

Answer HB TEAM SAYS: There may be system lag at times, please be patient and refresh your screen as needed.

146. Question What does the green dot(?) on the statement image icon in Enterprise Guarantor Summary mean?

Answer The green 'dot' is actually a leaf. It means the guarantor has signed up for paperless billing.

Working with Coverages & Guarantors

147. Question When adding the disputed balance billing indicator, the window has two radio buttons: Account or Guarantor. It defaults to Guarantor. We were only disputing the balance on one of the guarantor's account. Is it appropriate that it defaults to Guarantor? What's the difference between one over the other?

Answer When Guarantor is selected, the note will appear on all the guarantor's accounts. When Account is selected, the note will only appear on that account. When Guarantor is selected, even though the note appears on all the guarantor's accounts, the Billing Indicator will only appear on the selected account.

148. Question When creating a guarantor account and typing in the name in the order last name then first name, will the letter generate with the name in that order?

Answer When using @GNAME@ Smartlink, names appear as FIRST LAST (IE, John Smith)

HomeHealth Hospice

HomeHealth Field User 100

149. Question Seven day calendar in the schedule task

Answer Enhancement request

150. Question define expectation of communication, inbasket, email, alert, case commun

Answer Creating a tipsheet


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151. Question Recommendation - admin form drive time and end, move mileage to first

Answer This is an Epic owned form and cannot be changed. Enhancement request.

152. Question If disconnected will a message display not connected.

Answer Yes a message will display.

153. Question In My Patient list when syncing, what is the time it takes for sync

Answer Faster than Allscripts but it depends on the number of patients and when the last time that the synch was preformed.

154. Question Can anyone write an addendum - not the orginial author. Example, Nurse Jane created the contact. Can Nurse Mary add the addendum?

Answer Only PIE and your manager-not clinician for another clinician.

155. Question Is it possible to view the contact in a full view before syncing

Answer Go to chart review, encounter

156. Question Schedule task moving a timeslot - to 11a won't let us

Cannot move timeslot once the contact has been created.

157. Question Will the supplies table be used in the future

Answer No.

158. Question Can there be a quick sync option added just for orders

Answer No, there is no quick synch in Epic you can sync just one. patient, the whole caseload, or uset the synch options but orders is not one of the options

159. Question Erroneous contact - type of service, can we add visit date wrong, etc.

Answer Not at this time.

160. Question Discipline discharge - what type of service do we select - direct care doesn’t flow

Answer Teaching.

161. Question When discharged it wipes out all visits will it do same for LPN or PTA if the visit is canc

Answer The discipline is Skilled nursing or Physical therapy, the License is RN, LPN, PT and PTA, so it removes the visit for the discipline. A canceled it has been canceled.

162. Question In Basket, can you forward inbasket when clinician

Answer In hyperspace yes, in the remote client no.

163. Question Thumbnail report do we use patient flags for Home Health

Answer You cannot set a flag on the remote client. The hospital has a list of approved flag, things like MRSA, Violent patient metc.

164. Question Will admin info be viewable to scheduling

Answer Only if the clinician has synchronized the visit.


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165. Question Actions Narrative vs Additional, when would you use the additional section

Answer The is a HCD Policy question. I tried to remove Additional and could not.

166. Question How long will Allscripts be accessible for us for looking up patient history on a frequent flyer, etc.

Answer Until the end of September 2017.

167. Question Do wounds need a start time

Answer No.

168. Question How do we document an "Unmade" visit

Answer Missed Visit.

169. Question If I am in Admin and add a Team Meeting, can my schedule manager see it?

Answer After you synch and you can only add those today, not in the future. They will have to do that for you=sorry.

170. Question Will fields on forms section change color when completed

Answer No.

171. Question Will Lexicomp be available if in a disconnected state

Answer No.

172. Question Can we get clarity on when to use a pool vs class message

Answer Pool for when the first person to get the message and responds no one else needs to see the message. Class when everyone should get their own message and it should not disappear if someone else deletes it.

173. Question We are not really adding tasks for bday and anniversary’s in real life. Can you give an example of when we would manually enter tasks?

Answer Alerts, I don't have any good examples.

174. Question Define how and when and why we should use communication? It seems like its hard to find what other people have written and where can we find the info to see all the other clinicians notes in a simple view

Answer Encounter review in the disconnected or connected state to ready everyone else documentation. Communication is for telephone calls in the visit, Case conference will make you choose a person to send an in basket message to your own Clinical staff or an MD.

175. Question Do we have to inbox the insurance liasons still?

Answer You don't need it any more the contact type creates the message.

176. Question Can we have a smarttext template that has all the necessary info needed for a PT/INR order and all the results that come back in?

Answer This has already been created.

177. Question Is pool messages clear that it’s a pool message? How to identify?

Answer


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178. Question Will we have a "Read only" of Epic Hospitals (window view or snapshot)

Answer Information can be found in Chart Review.

HomeHealth Field User 200

179. Question What is the M number at the top of the Remote Client screen

Answer The medical record number.

180. Question Will the service address be in the Place of Service form from Intake?

Answer Yes.

181. Question MOO18 Provider is usually filled in by Intake. How about if the provider listed is incorrect and the correct provider is not listed in the database. Who can add the new provider to the database?

Answer There is the ability to change the provider when completing the SOC. Also there is System, Provider Not in (similar to New MD). Enter this in the address book and add the address, phone number and we will attach to the patient once it has been entered and make sure the orders go to this new MD.

182. Question M0080 - should be defaulted to clinician, pt depending on the type of contact, ie SN

Answer It does default to the Clinician Discipline completing the assessment.

183. Question UAF is a separate cont.

Answer True, this way you don't have to send an inbox message too only complete the form.

184. Question Will the UAF flow to workqueue for insurance liasion

Answer Once it is closed and sent, yes.

185. Question We can’t add free text / unable to add brand name drugs, but what if an allergy is not listed ie Keflex. Can this be updated?

Answer Keflex is Cephalexin (generic) Must use generic form of the drug.

186. Question DME, list has supplies

Answer It is a combination of both hospice and VNA, Each should choose their own_ Catheter for VNA, BED for Hospice.

187. Question Don't need to select verbal order for dme's

Answer Training note.

188. Question Are DME's shared across organization

Answer No, only Hospice and VNA. The rest of the organization does not use DME they are a DME for themselves.

189. Question Non Epic Provider verbal orders will go to the VO team to send out?

Answer Medical Records will receive these daily and fax to the non epic provider. We can print mail too.


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190. Question Patient taking differently, do we need to select active box to see in Active.

Answer Yes.

191. Question Taking differently, does it

Answer A. All medications entered from the Epic MD will be blue from SSH or SSMC. B. Any non epic referral will have to be entered by the clinician and will always be in Black. Even after the MD signs the order.B. Any non epic referral will have to be entered by the clinician and will always be in Black. Even after the MD signs the order.C.. If an Epic MD makes a change it will be in Blue, If you are calling an MD about a med, you don't enter it before it is confirmed, The MD will enter the med, no phone call will be made, it will appear on your med list as the new date and in blue. If the MD needs us to fill a med box or teach a patient new med that they do not understand, then a call is made from the MD to our call center. D. If you enter a medication in blue (only can for blue one not the black ones) the Epic md will get the message and can decide to change the order-it will come back or just acknowledge that they know about it. (I am not sure how this will look.) E. All patient documentation of any kind meds and care plans included are entered on the remote Client. All is visible in Hyperspace in chart review.

192. Question Will the prn show up on med list. Needs to say as needed, not prn for the patient

Answer You have to enter the frequency as the order + PRN, Daily and PRN,twice daily PRN then the PRN reason is required.

193. Question Insurance co are having them that the need to let them know that they reviewed interractions, where is this documented?

Answer It's on the med screen, first icon at the top of the med screen and everyone would just read the screen they would see that. Once checked it puts their name on the screen at the bottom. If the medications are not new you don't have to review the interaction every time. If there is an interaction you can type the necessary follow up at the bottom of the screen as we do now.

194. Question Selected Visits in Intervention Frequency, can that be grayed out in the future.

Answer WHY?

195. Question If a nurse is sick and has 4 visits for the day, can schedulers cancel visits and reschedule to another nurse

Answer Yes.

196. Question Will OASIS M1011 & M1017 be pre-populated to the contact?

Answer Which questions are these

197. Question Can we have a smarttext built for SOC Note, routine visit note, Insurance Authorization, etc.?


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Answer They have already been built. Use HH for home Health and HSPC for hospice template notes.

198. Question UAF red banner: * Where will user see the red banner? * How many days in advance we will get the warning? * Can users bypass the warning and can continue doing the contact?

Answer The banner will be at the top of the Thumbnail. Warning will be 5 days out and you can bypass the warning.

199. Question Does the system (SSH&VNA&SSMC) share the same Interactions database?

Answer For medications, Yes, the interactions automatically run for any physician and then they have to make a comment about the interaction.

200. Question Scenario: a field user cannot synch, because someone in the office (e.g. Pam) has it open in the hyperspace. Can the field user get a pop-up displaying Pam's ph extension to call?

Answer No.

201. Question New Laptop: Need to make a poster to show how to turn on: Fn Lock (F2)

Answer If you press FN Key and the esc Key, it will automatically turn on all the function keys forever F2 and F3 which are the ones you use the most

202. Question Is estimated length of service available for MC Recent in Visit Frequency?

Answer It will automatically appear for all Medicare patients upon recert and will require a response

203. Question Drug interaction - How do we know if Interactions are checked, every time a new med is entered (Audit Trail).

Answer Enter a note.

204. Question If meds are not in by name they are in home, we either need to add to dictionary or change our process?

Answer If the name is on the bottle it should be in the database. The medispan update will happen more often than currently.

205. Question If black text med gets updated by field user using Update Sig button. Will the med display in blue, once the MD did med reconciliation in the hyperspace.

Answer For all inbasket Physicians, when they add the new med it will come over and be added in blue to your medication record. If you have already added it, then you will have a duplicate med. Enter a note and wait for the MD to add the MD. How will you know the MD is on our system, SSMC 781-878-5200 or ask when you call the new medication in.

206. Question For non-epic provider: If patient taking med differently, should the clinician select generate verbal order to generate an order?


26

Answer You will select verbal order and the system will know that a fax needs to be generated.

207. Question Can each individual med "marked as reviewed"?

Answer No.

208. Question Define Active vs Current Med. Active Med appears in Plan of Care, why not Current Med?

Answer Active meds are those that are being taken and will flow to the 485. Current may have more meds but the patient is not taking them. Example, I take Atenolol but I am now pregnant and have to take Labetolol instead but once the pregnancy is finished I will go back to the Atenolol.

209. Question Workflow: User did SOC contact and close contact, then create Ca?e Plan. Question: Why user needs to go back to the SOC contact to document Intervention (Care plan charting in Allscript).

Answer We have been talking about a policy change for SOC so that they don't have to do this.

210. Question Care Plan: Should we teach users to enter General Admission as a template, then add Joint replacement template?

Answer General Admission is for all VNA patient 0nly once no matter how many disciplines!, Hospice for all Hospice patients, then add anything else that is needed-Wound, Ostomy, PT Ot ETC. Everyone will docuemant against the General Problem.

211. Question 2 Smarttext HH Wound (Same name) with different content.

Answer This may change as a result of the interaction with the wound care clinic- both foundation build.

212. Question General Admission Care Plan template & HHA Personal Care Problem: answered all required field (***) and smartlists, but still shows red banner. It happened to multiple users. What caused it?

Answer You have to go out and back in for the banner to disappear especially if you picked a Problem and then decided once in the intervention, that it is inappropriate.

213. Question Contact > Intervention: What is the different between checkboxes. After we put Variance Code, it shows stop sign, what else needs to be documented?

Answer It might be a comment, or you just need to click in and out of the form again. Not sure what checkboxes you are referring to.

Question What is the for with number headings in the New problem screen?


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214. Answer You can schedule interventions on specific visits if necessary. Right now the Intervention that you have selected is scheduled to be done at each visit. However, if you only need an intervention done on specific days, the frequency can be changed and selected visits can be chosen. Just click on the clock icon--it will schedule the intervention for that visit number.

Hospice Field 200

215. Question Care Plan > Visit Set / Schedule Link > Discipline/Provider drop down list has options for LPN and Skilled Nursing. Question: Does the visit set needs to have separate LPN and Skilled Nursing?

Answer We can customize that box to remove LPN if needed. Just depends on how users are built.

216. Question Medication Discontinue Reason: need to add "Unable to take / swallow" for Hospice patient.

Answer Tell Lisse and Jen. This category list may be owned by another application, so we would need to review with them.

217. Question Verbal order: After modifying order, is there away to find out what changes/updates have been made (Audit Trail).

Answer In Hyperspace, this is available in the detail report below. In the remote client, I believe it can be found in the order task.

Scheduling

218. Question Will the Owning Area column and Service Area stay as it reads now.

Answer Yes.

219. Question Where are the hospice workqueues

Answer You need to log in with HSPC. Training isn't set up for this.

220. Question What does Unlsd mean in the scanner

Answer Templates not available.

221. Question Can you book a clinician that reads 100% in scanner

Answer Yes.

222. Question Where will the Notes display in RC

Answer On the schedule task on Remote Client.

223. Question What is there is more than one episode at the Appt Info screen. How will it read.

Answer It will say Resolved.

224. Question Will hospice see that the patient had a vna episode in the past?

Answer Yes.

225. Question HHA do not use TBD, they are scheduling time

Answer Yes.

Question If I have a patient open, can the Clinician sync that patient


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226. Answer No.

227. Question Nurse did admission and decide they need PT, will it fall to discipline scheduling

Answer No, falls into VNA unscheduled Report.

228. Question Show more options when scheduling multiple

Answer Training Note.

229. Question Can you schedule a clinician that has an unavailable template

Answer Not without the appropriate security. That is a bigger decision than I can answer. The real question is SHOULD they even be doing that?

230. Question Recurring visits - if clinician template is unavailable will these visits be able to be booked.

Answer The recur would then suggest the next available time for the overlapping visit.

231. Question Visit Set for example 1-3 times / week. Clinician sent an Inbasket to Scheduler to set up 1 visit/week only. Question: Will the patient name still appear on the VNA Has Unscheduled Visits in a Visit Set or VNA Has Visit Sets Without Completed or scheduled Visits report?

Answer Yes, if there is a range and only a minimum is scheduled then they would show up on the report.

232. Question In the Workqueue, where will schedulers see what team the patient belongs to? For example, how can they know the patients belongs to Oncology or PCH versus Team 1 (geographic team)?

Answer Team is in HCD Department column.

233. Question In the Recurring Appts, how do schedulers know the end of Certification Date?

Answer

234. Question Recurring Visits (on Recurr Recommended Solutions screen). For example: Primary nurse is off next month for couple days only. Question: When scheduler set up recurring visits for the primary nurse, will the scheduler receive a warning on the Recurr Recommended Solutions screen that this primary nurse is unavailable? or, will it bump out of the whole process and have to start over selecting different provider?

Answer It should warn that one of the visits is unavailable so long as the nurse’s template is up to date.

235. Question How to run care plan for multiple patients for HHA?

Answer This functionality is not possible at this time.

236. Question On the snapboard, can we see multiple date (right now, only shows as single date entry)?

Answer Yes, on bottom left of screen, there is a place to pick more than one day.


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237. Question On the snapboard, can we select Team instead, and show all providers from that team?

Answer Subgroups will have teams listed.

238. Question On the snapboard and DAR, can we have a save button? So, if schedulers have to rerun the snapboard or DAR, they do not need to re-enter all previous data?

Answer

239. Question Will HCD Resource be broken down based on Team, like HCD Resource Team 1, HCD Resource team 2, etc).

Answer No; HCD Resource SN, HCD Resource PT.

240. Question On provider Schedule screen, what is "restrictions" and "skip full day" field mean?

Answer Does pertain to Home Health.

241. Question On the Intake screen >> Care Team Information >> What is the start date mean? Does it mean patient SOC date or when the scheduler added the clinician to the Care Team screen?

Answer Start date should be the date that the provider begins their assignment to that patient.

Quality Review

242. Question What is the tickler used for.

Answer It is a reminder that will pop up to remind you to look at a given patient at a later time.

243. Question Diag Review how do you sequence - place in order.

Answer It is a reminder that will pop up to remind you to look at a given patient at a later time.

244. Question What is difference between Encounter Oasis info link and OASIS summary.

Answer OASIS summary only shows OASIS info, no other documentation.

245. Question Quality Review - M1400 short of breath - How do we see whole assessment.

Answer Needs Clarification.

246. Question When sending Edit back to clinician and they fix, where do we see message that they fixed.

Answer You don't. The patient falls back into the review needed workqueue automatically.

247. Question How do we know which episode to choose.

Answer You don't choose episodes, it will automatically open when in WQ

Question How to verify Oasis completed with no error.


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248. Answer There wouldn't be any more validation errors. Outside of that, it is up to the PIE staff to know.

HH Field User 100

249. Question How long will Allscripts be accessible for us for looking up patient history on a frequent flyer, etc.

Answer Until the end of September 2017.

250. Question Do wounds need a start time

Answer No.

251. Question How do we document an "Unmade" visit

Answer Missed Visit.

252. Question If I am in Admin and add a Team Meeting, can my schedule manager see it?

Answer After you synch and you can only add those today, not in the future. They will have to do that for you=sorry.

253. Question Will fields on forms section change color when completed

Answer No.

254. Question Will Lexicomp be available if in a disconnected state

Answer No.

255. Question Can we get clarity on when to use a pool vs class message

Answer Pool for when the first person to get the message and responds no one else needs to see the message. Class when everyone should get their own message and it should not disappear if someone else deletes it.

256. Question We are not really adding tasks for bday and anniversary’s in real life. Can you give an example of when we would manually enter tasks?

Answer Alerts, I don't have any good examples.

257. Question Define how and when and why we should use communication? It seems like its hard to find what other people have written and where can we find the info to see all the other clinicians notes in a simple view

Answer Encounter review in the disconnected or connected state to ready everyone else documentation. Communication is for telephone calls in the visit, Case conference will make you choose a person to send an in basket message to your own Clinical staff or an MD.

258. Question Do we have to inbox the insurance liasons still?

Answer You don't need it any more the contact type creates the message.

259. Question Can we have a smarttext template that has all the necessary info needed for a PT/INR order and all the results that come back in?

Answer This has already been created.

Question Is pool messages clear that it’s a pool message? How to identify?


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260. Answer

261. Question Will we have a "Read only" of Epic Hospitals (window view or snapshot)

Answer Information can be found in Chart Review.

Op Time

Pre-Op

262. Question Can we have nursing staff assigned to the case appear on the status board? (have this now in Meditech)

Answer Yes.

263. Question What will the workflow be for the pregnancy waiver?

Answer Every female patient of child rearing age will get two Tasks: pregnancy test complete and pregnancy waiver complete. If the patient opts for the waiver, the nurse marks the waiver task as complete, and the test task as not needed. If a test is ordered, the test task will auto-complete when the test is resulted, and the nurse will mark that the waiver is not needed.

Intra-Op

264. Question Will nursing complete the Anesthesia Safety checklist? As part of the Timeout?

Answer Yes. This was incorporated into the hospital-wide Timeout and has been vetted by leadership. Nursing will document and should defer to the anesthesia provider in the room.

PSE

265. Question Will the nurse have to enter a diagnosis code when ordering?

Answer We are working on removing this from the system.

266. Question Appointments and orders are not appearing as expected in the Tasks section.

Answer This was not working in training, but will work properly in our live environment.

267. Question Is there a way to view orders placed for the patient?

Answer Yes. This did not appear correctly in training, but the ordering workspace will be more robust, and you will be able to review all active, signed, and held orders.

Surgery Scheduler

268. Question Can we double book a room / surgeon during set up / teardown time?

Answer Yes. We updated the system so that schedulers will have access to overlap procedures during set up / teardown time.

Question How will we add free text to a procedure during booking?


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269. Answer There is a free text comment box (white paper icon) to the far right of the screen when selecting the procedure during case entry.

270. Question Where should we include surgeon notes? Where will they flow?

Answer There are different areas to document depending on who the information is for.

The Special Needs field on the Questionnaire form and Scheduling Instructions on the Instructions form are available for other schedulers to see during booking. Pre-proc Instructions and Nursing Instructions on the Instructions form are available for nursing to see on the day of surgery.

271. Question How will we book organ harvests?

Answer The workflow will not change in Epic. You will book an organ harvest procedure with Dr. Harvest for the deceased patient.

272. Question Will we always have to enter a "Shuffle Reason" every time we rearrange cases?

Answer No. We removed this rule so schedulers can shuffle cases without entering a reason.

273. Question How can we access the booking information for canceled cases?

Answer You can view this information by searching for the patient in Open Cases. All of the booking information is saved for the case and it shows as Canceled.

Professional Billing

PB Insurance Follow Up 100

274. Question Is there a link from Inquiry that will allow coders to access 3M?

Answer No. 3M will continue to be accessed outside Epic.

275.

Question In Inquiry, can an end user change the order in which Visits are displayed?

Answer No. At this time, there are no settings available for end users to change the order visits appear in Inquiry.

276. Question When you add a Follow activity, where can you view this information?

Answer A follow up activity will appear in the Follow Up Activity section of the Follow Up record within the workqueue as well as on the Account Note tab within Guarantor Snapshot. If you want to report on the follow up activities performed on an account, or sort the follow up activities, you would utilize the Account Note tab.

277. Question When you correct a charge while following up on a claim, should you demand a claim?

Answer No. Once you correct a charge, the original charge will be voided and a new charge will be created. The new charge will go through the charge


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router. If no errors are found, the new charge will be posted to the guarantor account.

278. Question When would it be appropriate to demand a claim?

Answer You may need to demand a claim if you determine that the payor did not receive the claim that was sent. Demanding a claim prints a paper claim, so you would only use this function if a specific payor does not accept electronic claims.

Radiant

Boarder Class

279. Question Can we delete a column if documenting on the wrong patient's flowsheet?

Answer No. You would need to delete each erroneous entry.

Front Desk

280. Question If Medicare is incomplete can the check in be completed?

Answer Only for Inpatients. Not outpatients.

281. Question Will there be an alert if patient arrives for service and last registration is >6 months?

Answer The end user will not see this.

282. Question How can we determine which office to send results to when the provider has several office locations?

Answer Choose location.

283. Question Will front desk users add a picture of the patient upon registration?

Answer Yes, there will be cameras.

284. Question How does the front desk Pre-reg patients for the next day?

Answer Snapboard next day, Appt. Desk registration from there.

285. Question Provider wanted the RN to pend orders. Jewel said this was not in scope and RN didn't have the security to pend. It is something that is not taught in RN class, just wanted to confirm.

Answer Direct that question towards Orders since this is a system-wide decision. Update 5/24: This is out of scope for RNs.

286. Question Peer review: the entire department needs 100 per month. Dr. Lynch said it would be ideal if each provider received 1-2 per week. Also, would like to see Q&A going to the correct provider since it would be inappropriate for someone to review something they themselves do not perform.

Answer Lisa: The majority of rules are already setup to filter out certain radiologists from needing to peer review studies they don't do. However,


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there are still certain studies they'll need to manually decline. Marie is looking into updating the specific number of reviews per month (5/10). 5/24: Marie has adjusted the number to 5 peer reviews per month which will appear every 100 studies.

287. Question What if the patient refuses having their picture taken at registration?

Answer 5/22 - Marie Picture taking at registration is optional from what I understand.

288. Question In demographics no choice for a Veteran.

Answer Wrote to Cadence, choices come from the State.

289. Question Can there be an ABN for a chiropractor ordering XRs? Under Medicare will not pay for XRs if ordered by chiropractor.

Answer Marie 5/25 The Finance Office decided upon the scope of ABNs at go-live to only include select MRI and CT exams. Post-live, this may be expanded to more modalities and more applications.

290. Question When orders are combined, would reg check in both appointments so the tech knows the patient is here (because the rec won't print until the patient has arrived). This is for unlike catagories that are not necessarily located in the same area.

Answer Marie 5/25 The front desk can check-in both appointments so the requisition prints. However, by checking in the second appointment, you are scewing wait time statistics. My recommendation would be to only check-in the first appointment and have the 2nd appointment's technologist check-in the second appointment. There would need to be verbal communication between the two technologists alerting the 2nd technologist that the patient is ready for their 2nd appointment, which I would assume occurs today.

291. Question Please build an electronic form for quick disclosure. If the patient signs electronically we won't have to keep the paper.

Answer Marie 5/25 The paper form for Quick Disclosure was not a Radiant decision. The paper form is used across the organization and that decision was made by HIM.

Manager

292. Question Post Bx mammo, can we bring the exam to final at end exam since a report isn't generated?

Answer Marie 5/25 Yes, Marie has built this in POC and it will be available in other environments mid-next week.


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293. Question Will offices that currently have Meditech link have a similar link to epic to view reports?

Answer Marie 5/25 EpicCare Link is a view-only version of Epic, with the ability to place orders. All reports will be visible for the outside providers with this access.

294. Question Turn around time by procedure? Can there be different reports? Screening mammo goal is 24 hours. Dx goal 1 hour

Answer Marie 5/25 At go-live, we are delivering a standard turnaround time report encompassing all modalities. However, reports allow you to sort per modality, per procedure, per department, etc. You also have the ability to change the criteria of the report and save yourself a private copy so that the report is only focusing on information that is relevant to you.

295. Question How are results routing errors handled?

Answer There are three Reporting Workbench reports that were validated by Maureen to handle results routing errors.

296. Question How should managers handle revenue reconciliation and charge errors?

Answer There are two Reporting Workbench reports that were validated by Maureen regarding charging.

297. Question What reports should managers be running to find incomplete work and how often?

Answer Below are a list of Reporting Workbench reports that were validated by Maureen to use for finding incomplete work. I wouldn’t expect the “how often” piece to change from current-state workflow, but they can determine that internally. They’ll just want to keep in mind each report’s time range when determining the “how often”.

IR RN

298. Question How can you tell if the pharmacy has confirmed allergies?

Answer If the pharmacy has reviewed the patient's allergies, you would be able to see that in the audit trail by clicking on the history link.

299. Question Is there a way to see my patients only on the status board?

Answer No.

Rad

300. Question Can rads be launched to recent studies (iconnect) when protocolling studies rather than going into chart review

Answer No, They can still look at priors in PACS. Otherwise they'll need to go to Study Review (5/10).


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301. Question "Contrast" didn't come up when provider was entering allergies. They thought it was best to have the name of the actual contrast but should have a list to choose from when contrast is searched.

Answer It is a national database for allergies. Epic can't control what is in this database. Some specific contrasts show up, but "iodinated contrast agent" should be used for all others [AC].

302. Question Peer review: the entire department needs 100 per month. Dr. Lynch said it would be ideal if each provider received 1-2 per week. Also, would like to see Q&A going to the correct provider since it would be inappropriate for someone to review something they themselves do not perform.

Answer Lisa: The majority of rules are already setup to filter out certain radiologists from needing to peer review studies they don't do. However, there are still certain studies they'll need to manually decline. Marie is looking into updating the specific number of reviews per month (5/10). 5/24: Marie has adjusted the number to 5 peer reviews per month which will appear every 100 studies

Tech

303. Question Will the radiologists name default in at end exam when a radiologist has been assigned to an IR procedure?

Answer does not default in

304. Question Will transport arrive the patient?

Answer Transport only updates the patient location.

305. Question Rads sign the time out form. The managers/supervisors felt this workflow wouldn't change.

Answer 5/22 - Marie An organization-wide decision was made that all timeouts will be documented within Epic. The radiologist is associated to procedure's timeout, but nurses and technologists will be completing the documentation within their narrators and navigators. If they do not document the timeouts within Epic, statistics will be skewed on reports that Maureen will be monitoring.

306. Question On a trauma- we do a "pan scan" i.e. head, csp, chest abd/pelvis. Is there an order with all the exams that we do for a trauma protocol? One with contrast, one without contrast.

Answer Order sets have been created and were vetted.

307. Question What should the radiology staff do when the patient is sent over from a providers office without a script? This happens all the time. Currently, the exam is performed and the script will be entered in the morning when the office sends over the script.

Answer This is not an Epic issue. This is a compliance issue that they will need to address with their manager and/or Maureen. Procedures should be performed without either a paper script or an electronically signed order.


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From an Epic perspective, there are no restrictions in place, but I would suspect from a compliance perspective, this wouldn't be approved.

308. Question How will a patient get scanned if the provider sends them over without a script and the office is closed?

Answer 5/22 - Marie This is not an Epic issue. This is a compliance issue that they will need to address with their manager and/or Maureen. Procedures should be performed without either a paper script or an electronically signed order. From an Epic perspective, there are no restrictions in place, but I would suspect from a compliance perspective, this wouldn't be approved.

309. Question MRI: what if the patient isn't able to sign the screening form. The nurse usually gets the signature. Can they still do this before the tech reviews and documents "proceed."

Answer 5/22 - Marie Moving forward, the nurse will not be obtaining the patient's signature. When the patient present in MRI, the technologist will print out the screening form and obtain the signature within the MRI department. What do they do today if the patient isn't able to sign the screening form? They can make note of that on the printed copy when they scan it into PACS.

310. Question We never give the entire dose of contrast. It will always be different. Charting requires a reason whole dose wasn't given. Can a choice be weight-based protocol?

Answer 5/22 - Marie This was corrected by the Willow team last week for all contrasts and radiopharmaceuticals. I'm not sure if the change was migrated to MST, but they will not see this override reason in production.

311. Question No eovist or godavist on list of contrast. Only Dotarem. What if we need to change the dotarem to above or below?

Answer 5/22 - Marie If a radiologist orders a contrast through protocolling, since they signed that order, it cannot be changed. If the technologist needs to use a different contrast, they can place the new contrast order from the order set, administer the new contrast, and not act upon the contrast order previously placed by the radiologist.

312. Question Should the Tech review scripts before the FD scans for accuracy? Often times the script is incorrect.

Answer 5/22 - Marie This is an operational workflow decision that the department would need to make. Regarding Epic functionality, the new order does not need to be scanned into Epic prior to the procedure being performed.

313. Question MRI leaves an IV line in for PET who are not on epic. Who documents the removal of the line?


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Answer 5/22 - Marie No one would remove the line in Epic. Within the LDA Assessment section, the technologist could indicate why the line is remaining in. The line is set to d/c after two hours

314. Question Please add Per Patient weigh when a full dose is not used for CT. Remaining dose will be wasted.

Answer 5/22 - Marie This was corrected by the Willow team last week for all contrasts and radiopharmaceuticals. I'm not sure if the change was migrated to MST, but they will not see this override reason in production.

315. Question Where can I find inpatient hospitalist orders for labs requested on fluid and Bx specimens ie different for each patient. Will the order appear in the tech details report? Will the tech order it or will it need to be released?

Answer Marie 5/25 A decision was made with the Beaker team that if an outpatient or inpatient provider wants specific labs collected during a radiology procedure, they are to free text those labs within the comments section at the time of placing the IR consult order. This information will appear in the tech details report. During end-exam, the technologist will place/collect those specimens via the Specimen section within the Navigator. Within future releases of Epic, there is functionality to have providers pre-place orders for labs and have those be associated and visible to the technologist so this workflow has potential to change in the future.

316. Question How can other modalities see when there are multiple orders on a patient? Sometimes when there are several orders, techs coordinate the exams ie, you scan the patient first because I'm with a patient and will be ready in X amt of time.

Answer Marie 5/25 Other appointments/exams taking place on that day will appear within the control sheet and within the tech details report on the Tech Worklist screen.

317. Question Can you cancel an order after it has begun?

Answer Yes, but you will need to change it to the prior status.

Stork

Stork Nurse

318. Question Will the 24-hour calculation for I&O run 0700-0700 instead of the 0000-0000 as in current state?

Answer Yes, it will be now calculated as 0700-0700.


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319.

Question When drawing blood, when do we print labels and when do we scan patients?

Answer In current state, you scan your patient to get the label to print. In Epic, you will print your label and then when collecting your lab, you scan the patient and then the label.

320.

Question Can RN's delete an allergy?

Answer Yes

321.

Question Can RN's delete an allergy?

Answer Yes

Stork Nurse / Stork Unit Coordinator

322. Question When documenting a birth from outside the hospital, will the mother's and baby's chart still be linked?

Answer Yes, the baby will be admitted to the hospital through the delivery Summary marked as "External Birth." This will keep the charts linked.

Stork Unit Coordinator

323. Question Will UC have the ability to run the query for Care Everywhere?

Answer Yes, in some areas UC should have the ability to run the query.

Stork NICU Nurse

324. Question Will breastfeeding occurrence record on the I&O as unmeasured intake?

Answer Yes, there is a row built in flowsheet for unmeasured intake.

325. Question Will NICU Code Narrator be available in Birthing Unit as well?

Answer Yes, it will pull in on any baby with a Newborn Status.

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