Renewal Orders - Message Center Inbox Update

All meds have a 30 day hard stop except for ketorolac, medications for antimicrobial therapy, and any other medication outlined in policy (SPP-#MM 20).  Orders that have a hard stop will show up in the ordering provider’s inbox for renewal in the folder named Renewal Orders two days prior to the medication reaching its stop date/time.  This means that on day 28 of a 30 day hard stop order, a message will go to the ordering provider.  An hourglass icon also appears on the order profile two days prior to the order’s stop date/time.

 

 

That message in the ordering provider’s inbox gives the provider three options:

                Approve - renews the order for another hard stop duration (additional 30 days

                                 for most meds, additional 14 days for antibiotics…)

                Dismiss - does nothing but remove the message from the inbox.  The order will

                                go into a Completed status once the hard stop date/time is reached.

                Discontinue - discontinues the order right now

 

***Orders that have a duration that has been entered or modified by a provider (physician, nurse, pharmacist, etc…) will NOT generate a message to the inbox.  That is a physician stop and the system assumes that the provider who entered the order knows that he/she entered a specified duration and does not want to be notified again.***

***The message will ONLY go to the inbox of the ordering provider.***

Renewal Orders

Smoking Status - Autopopulation of the Problem List

The Use and Standards Committee and Clinical Decision Support Committee discussed and decided upon a request that was brought to them. 

Soon there will be the automated capability, in any location or any encounter type, for smoking status to be documented on the problem list.

When the powerform field for Tobacco Use is used, any of the eight options will trigger a matching SNOMED code to be autopopulated upon the patient's Problem List (only, will not populate diagnosis list). 

It will have the classification of "patient stated" and confirmation of "confirmed".  It will update each time an intake form is filled out with new information (new visit) or altered (existing form modified).

C-Diff Alert PowerForm

 

This week, a new alert for your convenience will be turned on related to C-Diff.

This new alert will fire (present itself to you) when:

     C-Diff by PCR is positive

     Vancomycin PO/Rectal and/or Flagyl PO/IV is not ordered

     Patient is older than 3 years

     User is physician/midlevel

 

If you select the reason "Document Reason to Suppress Alert", you will receive the powerform below to fill out.  By doing this, this alert for will not represent to you again.

 

 

Radiology/Pathology Changes - Important

The following changes will take place February 10th, 2015

Orders:

CT of the Chest with and without will no longer be available order

     The individual orders will still be there.  This will help decrease the amount of

     duplicate orders.

Patient Portal:

Release of radiology and pathology reports will be...

     1. Radiology will be released 72 hours after results are finalized. 

         Addendums WILL show

     2. Pathology to be released after 7 days or 168 hours

This helps us take another step in keeping compliant with meaningful use objectives.  When the functionality is turned on, it will retroactively display results up to one year back (i.e. turned on 2/10/15...will display as far back as 2/10/14).

Inpatient Restraint Verbiage Changes

Due to revised requirements by CMS, DNVGL has identified that we need to change the verbiage of medical-surgical and behavioral restraints to non-violent and violent restraints.  This impacts all associated orders, tasks, and documentation.  Below is a listing of the changes that you will be seeing to meet these requirements.  Changes will go in to effect on January 28th.

1.)   Caresets, Individual Orders and any associated alerts will show the new verbiage

        – providers will notice the change when the orders go to their inbox for

           co-signature

2.)   We will also be adding a way to order if a secondary restraint type is being used

        AND what the location of both restraint types is.