Coming Soon: Open Notes

The OpenNotes initiative encourages provider note availability to patients through means such as the patient portal. All patients have the right to read these notes already but must access this information through the health record request process which takes time, may cost the patient money, and many patients may not even know about.

OpenNotes encourages health systems and clinicians to make notes automatically available to patients in order to avoid these issues for the patient as well as improve things such as patient engagement in their own care, the efficiency of care and patient-physician communication. They call this "transparency".

Starting on August 1st, 2016 all “office/clinic” note types will be published to MyTeamCare (our patient portal). This decision was made after seeing success stories at many other major health systems across the country and our own desire to improve patient engagement and access to their health information. Input from multiple clinicians from multiple specialties and practice types was considered and the decision was approved by the EHR Use & Standards Committee and Med Executive Committees.

Here are some additional details to our OpenNotes plan:

  1. This will only apply to “office/clinic” notes. Not hospital notes, op notes, messages to nurses, etc.
  2.  This will be proactive only – NOT retroactive. Notes signed prior to August 1st will not be published to MyTeamCare. But be aware, a patient can request any of their medical records at anytime just by simply going to Medical Records department.
  3. The notes will be published to MyTeamCare 72 hours after the note is signed by a clinician – this includes resident notes that have yet to be cosigned by an attending. We have no way to limit this to attendings only.
  4. Any updates made to the note in the EHR after publishing will also be updated to MyTeamCare.
  5. Education and information for both clinicians and patients will be coming in the next weeks in preparation for the OpenNotes kickoff.

Many sites have benefitted from OpenNotes including MD Anderson, Geisinger, Kaiser Permanente, Ochnser and many more.

Please feel free to look at www.opennotes.org for more information

Also, here is a video from that site that presents OpenNotes from the view of both clinicians and patients.


UMC Endoscopy Center Conversion

The UMC Endoscopy Center will convert to electronic scheuduling and order entry this month.  Back scheduling of patients starts May 3, 2016.  A powerplan specifically for endoscopy has been built and is located in the applicable order folders for provider use. 

Training for schedulers and providers has been completed.  If you missed the opportunity for training and will be doing procedures in the Endoscopy Center, please call the UMC help desk, 775-9109, to set up your training.

Full conversion date is currently scheduled for May 17th, 2016.

 

Prescriptions: Brand Medically Necessary

Reminder to prescribing providers: per Texas law, to"prohibit the substitution of a generically equivalent drug or interchangeable biological product for a brand name drug product” the practitioner must write across the face of the written prescription, in the practitioner’s own handwriting, the phrase 'brand necessary' or 'brand medically necessary'." Part 15 Texas State Board of Pharmacy, Chapter 309.3

Text will be updated at the bottom of prescriptions relecting this law stating, "Texas law mandates that a generically equivalent drug product may be dispensed unless the practitioner hand-writes the words ‘Brand Necessary’ or ‘Brand Medically Necessary’ on the face of the prescription.”

Drug-Drug Alert Issues

It has been discovered that with our recent Cerner upgrade that Drug-Drug alerts have not been firing appropriately for all providers. To correct this, we will have to lower the threshold for severity of alerts that will fire. This means that we expect to see a rise in Drug-Drug alerts until new code is released to correct this. We will get this corrected as soon as possible.


Contraindications for VTE Prophylaxis

*Disregard filling this new section out if observed in an ambulatory note.  We are in the process of having those removed.  Please feel free to let us know which notes to assist with the process if you wish. 

d'neise.laverty@umchealthsystem.com     OR     steph.hoelscher@ttuhsc.edu

 

CMS will require UMC to electronically submit VTE-1 & VTE-2 quality measures starting in July 2016.

We have updated and standardized VTE prophylaxis contraindications within PowerPlans and are also building PowerNote sentences that will be able to be queried and submitted to CMS electronically.


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Duplicate Cdiff PCR Orders

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Duplicate C. difficile PCR orders: Auto Cancel


Due to overutilization of C. difficile PCR laboratory tests, UMC administration and the Clinical Decision Support Committee voted to implement a rule to auto-cancel duplicate C. difficile PCR tests.

 

Literature opposes repeat testing after a positive C. difficile PCR or testing for a cure. Furthermore, the C. difficile PCR has a high negative predictive value, so there is no indication to re-test a patient who has a negative result within the past 24 hours.

 

See link below for C. difficile Testing Guidance

 

The following interventions went into effect on April 11, 2016:

Click HERE for Guidance in CDIFF Testing