Issue Identified: Inability to "Correct" PowerNotes

The recent code upgrade in PowerChart has introduced a bug into Powernotes. Once a note has already been signed, if you then later open the note in correct mode and re-sign it without making any changes, that note becomes locked into a read-only state. These easiest way to avoid this is, if you do open a note in Correct mode and decide you don't need to change any thing, at least add a period or a comma or something before signing.

If there is a note that is already locked into this "read-only" state, you then have two workarounds:

1.       Have the user copy the note forward and make the modifications needed.

          Then "in-error" the note that they could not edit. This is the preferred option.

2.      The second option is to have the user go to Clinical Notes and modify the note. 

         THIS OPTION WILL ONLY ALLOW ADDENDA ON THE NOTE.  The user will

         not be able correct the documentation.   

At this time, we recommended to not select the "correct" option until the fix can be installed.

Thank you for your patience and please call any of the HELP desks for questions or issues.

New Cancel MD Consult Order

If a provider cancels a consult that has not been called-in/charted by the HUC, the provider has the ability to right-click and ‘Cancel/DC’ that order.

 

If the HUC has already completed their documentation, that order becomes ‘Completed’ and you cannot ‘Cancel/DC’ it.  If the provider needs to cancel a consult that has already been completed they can place the ‘Cancel Consult MD’ order.  This will fire a task to the HUC to cancel the consult that was already called in.  This order must be placed by the provider or as a telephone order by nursing.

 

 

 

 

 

CORE MEASURES - Aspirin for AMI/STROKE

Core Measure:  Acute Myocardial Infarction (AMI)-1:  AMI patients receive aspirin within 24 hours before or after hospital arrival

Core Measure:  Stroke (STK)-5:  Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2 (e.g. aspirin, clopidogrel, dabigatran, enoxaparin, warfarin)

Due to fall outs regarding the above core measures, efforts are being made to heighten awareness when aspirin is ordered for AMI or Stroke.  If aspirin is ordered for one of these indications outside of a Powerplan, please select the following sentence:

 

 

When this sentence is chosen, extra attention will be given to the aspirin order on the MAR:

 

The following Powerplans will be updated with this sentence as well to help with consistency of how aspirin is ordered for these indications: 

Chest Pain Plan

Ischemic Stroke/TIA Plan

Rapid Response Plan

Admit Chest Pain Plan

Admit Ischemic Stroke/TIA Plan. 

In addition, an option to choose a contraindication to aspirin will be added to the Ischemic Stroke/TIA Plan and Admit Ischemic Stroke/TIA Plan.

Important Update: Problems & Diagnosis Blow Out

As discussed in previous news updates, the problems and diagnosis favorite folders were removed on March 28th.  Those users who called and wanted their favorite folders saved will actually have their folders deleted, but then rebuilt in the correct terminology.

After the downtime Friday night and Saturday morning, there will be a few changes that will be noticed on the Problems and Diagnosis tab. There is a new quick search field that will be displayed. You can enter the diagnosis or problem from this page without having to select add to get the search box, se the highlighted section on both problems and diagnosis.

Also after the downtime you will notice that rows that contain a problem or diagnosis will be highlighted in yellow, this means that this row did not map to the applicable target vocabulary.

 

Visibility of Patient Lab Results in Patient Portal

Due to the requirements of Stage 2 Meaningful Use, patient lab results will begin being released to the patient portal (MyTeamCare) 36 hours after results become available in PowerChart.  

This change took place March 28th.

Since patients with active portal accounts can view these labs at 36 hours, providers will need to review their results inbox in Message Center in a timely fashion. One helpful functionality for patients with portal accounts is the ability to send them a provider results note directly to the patient portal, as shown in screenshot below:


 

 

MyTeamCare is the shared patient portal of PNS, UMC, and Texas Tech Physicians of Lubbock and can be found at myteamcare.com.

 

Click HERE for full Consumer Message Tutorial

Correction - Prescription Compound vs Supply

When writing a prescription within PowerChart, the eRx Product Type field provides the choices compound, supply, or none.  'None' tells the system to look for an NDC number.  'Compound' and 'Supply' do not.  Based on recent issues presented by providers, the default setting for this for NEW prescriptions has been changed to 'Supply'.  A problem exists in renewals or cancel/reorders.  They are copies of old, previously used prescriptions.  Basically, anything that was already defaulted in as a 'compound' would still copy forward that way and be rejected by your pharmacy. 

As you are renewing existing prescriptions, be mindful of that field and make sure it is changed to 'Supply'.  An audit of this error showed the amount to be a very small percentage, but still worth mentioning to help improve provider understanding and satisfaction.  A true fix for all of this will be included in the code upgrade currently scheduled for March 22nd.  Thanks for your understanding.

New Feature - Problem Search Box

Another new feature coming soon is a great new way to search for your IMO problem diagnosis codes is coming soon, and it's amazing!  A code upgrade is going in during the weekend of March 22nd.  After that, this new tool should be visible.
    
Instead of using the button, you can now use a new function to develop your patient's problem list. 

    
Type in the diagnosis you are looking for and a list of quick-pick options will start lining up for you as you type.  Select the one you want and you are good to go.

Documentation Clarification Box

An additional function to help you with the Documentation Clarification box will be added soon.  When you select the document within this box, it will now take you to the Documentation Clarification PowerNote. 

 

 

Reminder:  this is an impatient function only.  You should be receiving a notification within your message center if you have a note needing clarification.  You then may proceed to the summary page.


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Adult Discharge PowerPlan

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Due to the 'Follow Up' area being commonly missed, we have moved the section higher up in the plan.  As of February 25th, 'Follow Up' was placed above the 'Line, Drain, and Wound Care' section.  Please make sure to order follow-up appointments for your patients, only one follow-up per order, and include the name of the provider and when they need the appointment by.  This lessens the confusion for the HUCs who are making these appointments on your behalf.

 

CMS 2 Midnight Workflow

Go-Live is February 3rd. 

Background
CMS (rule 1599-F) now requires that ALL admissions of patients requiring a LOS > 2 midnights be authorized/approved (co-signed) by the attending physician.  At a minimum, this co-signature must be done prior to the patient being discharged.

Workflow
Providers will continue to enter the Request Patient Bed order to admit a patient.  The options under ‘Patient Status’ will be expanded to accommodate the needs of the CMS rules.  For providers who do not have admitting privileges, the attending physician field will continue to be a required field that must be addressed.

Click the BLUE link below for the tutorial.


Click HERE for full Tutorial

Cerner SkyVue Outside Films

Outside studies splitting into several single image series

A few outside CT studies have been displaying incorrectly, splitting into several single image series. 

The following setting will resolve this issue.

1.       Launch the SkyVue viewer and open a CT exam

2.       Click on the Workspace Menu, then go to Manage Workspace…

    a.    Make sure you have a checkmark next to CT Layout

 

 3.       Then click on the Study Criteria tab then UNCHECK the box marked “Split mixed

           multi-frame series”