Steph Hoelscher

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Code Upgrade: Earliest Fill Date

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With the upgrade on November 16th, the ‘Earliest Fill Date’ field will be made available on all controlled prescriptions where previously it was only available on CII drugs. Using this field on a CIII-CV drug will cause the prescription to fail with a digital signature failure message sent back to the provider’s Message Center inbox or pool.

To mitigate the issue, we have added the note ‘(CII Only)’ to the field to help prompt providers that it should only be used on CII drugs.

After the NCPDP eRx uplift on December 9th, this field will become fully functional for all controlled prescriptions and the note will be removed.

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Radiology: MRI Breast Order Update

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Radiology: MRI Breast orders update

To make ordering MRI Breast studies more concise because it is always a bilateral scan, unilateral MRI Breast orders will be removed and the ‘bilateral’ description will be removed. Even if a patient has had a mastectomy, both sides are always scanned to evaluate residual tissue.

MRI Breast orders after changes:

MRI Breast Biopsy

MRI Breast w/wo with CAD

MRI Breast w/o

 

UMC Imaging Team

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Lab Orders with 2-Hour Frequency or Less

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PLACING LAB ORDERS FOR A FREQUENCY OF EVERY 2 HOURS OR LESS

What’s the problem?  Lab Orders that are entered with a Routine Priority and a Frequency of every 2 hours or less, Cerner will incorrectly combine every other specimen so that labels print with duplicate times and no labels print for missing times due to the specimen netting that occurs within Cerner. 

Solution: To avoid the confusion with orders for duplicate times as seen in the above example for the Urine Specific Gravity, place all Lab orders with a frequency of 2qh or 1qh with a Priority as Timed.

Example:

A Random Glucose ordered as Timed q2h for 2 days and a Urine Random Specific Gravity ordered Routine q2h for 2 days. Even though the frequency shows correct on the orders screen in PowerChart, Collections Inquiry shows incorrect times for the Glucose but correct times for the Specific Gravity.

Orders shown in Powerchart with the correct time frequency:

However, Collections Inquiry displays how the labels will print-Note the Urine Specific Gravity times are incorrect:



Click HERE for Printable Tutorial

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PowerChart Touch: Enabled Feature

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On November 11 there will be a feature enabled for all PowerChart Touch users. This new feature works to make the schedule in PowerChart Touch work like the ambulatory organizer. 

Impact - Users will have to have the schedule that they are trying view as an available resource on the ambulatory organizer.

Providers using PC Touch need to go to a PC and open Powerchart. Navigate to the ambulatory organizer and select the providers schedules that they want to view in PowerChart Touch.

Social Services for Placement Changes

This is what the order looks like today, “Placement” is the only required field.  All other fields and dropdowns are optional.

These are the changes that will take place. There are 2 required fields now.

The “Placement” field is the same. If “Other Placement Service” is chosen, address the “Other Placement Service” field.

The options of “No Preference” and “Other” were added under “Preferred Facility” in case you have no preference or would like to choose a different facility. The “Other Preferred Facility” field should be addressed if the “Other” option is chosen from the “Preferred Facility” field.

Please note, the addition of “South Plains Rehab Hospital (IPR)” and removal of “The Plaza” in this field.

Click HERE for Printable Tutorial

Ordering Restrictions for HIT Test

Ordering Restrictions for HIT test

Heparin-Induced Thrombocytopenia (HIT) testing and 4T score calculation will be restricted to providers ONLY, this cannot be a verbal or telephone order.  The calculation of the 4T score requires complex medical decision making and thus should only be carried out by those with advanced skills and knowledge.  The 4T score then determines if order the HIT lab studies are appropriate based on the patient data. 

 

For more information on the 4T score and HIT click here:

https://www.dynamed.com/condition/heparin-induced-thrombocytopenia-hit

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CareSelect Clinical Decision Support

CareSelect Clinical Decision Support for advanced imaging orders

This project began with a federal CMS mandate necessitating the program before January 1, 2020.

  • What?  This is ordering guidance on radiology exams to target the most appropriate use for the listed indication (based on expert panel guidelines from the American College of Radiology)
  • Why?  To prevent overutilization of high-value imaging exams
  • Who?  For all Ambulatory, Emergency, and Acute Care encounters
  • When?  Ordering for advanced imaging modalities only:  MRI, CT, Nuc Med, and PET scan – other radiology orders will be unaffected

This process is guidance only, it does NOT force or prevent decision making by the provider. 

The expected Go-Live will be 10/15/2019.

For more questions please call 775-8255.

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Double Numbers for Texas Tech Physicians

We have a new process in Double Number for Texas Tech Physicians.

*** Beginning September 23, 2019***

To help us facilitate combining numbers more quickly we now have a generic email that is being tended to daily.

When submitting a double number please submit the following information to doublenumberslubbock@ttuhsc.edu

  1. Patient name (last, middle, first):
  2. DOB:
  3. MRN #1:
  4. MRN#2:
  5. Address:
  6. Guarantor:
  7. Guarantor phone number:

 

Currently, we are experiencing issues where newborns are not showing in Centricity. They will appear in powerchart but not in Centricity. We are working to correct this issue, but until it is corrected, please go ahead and create the patient in Centricity and send us the above information. Please make sure you include all of the information above for faster processing. Please make sure this process is completed prior to creating any appointments.

For questions, call the TTP Help Desk - 743-4357

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Patient Status Order Changes

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When

Sunday August 4th, 2019

Why

  • We are transitioning to an order driven billing, based on status and level of care
  • Clinical classifications of  Inpatient, Observation, and Outpatient in a Bed will be defined by the admitting provider
  • The “Level of Care” defines what that hospital can bill
  • The goal is to decrease denials through clinical definition and accuracy of patient status and    level of care

Impact

NO PATIENT STATUS ORDER (PSO) = LOST HOSPITAL REVENUE

Order Changes

  1. Patient placement will NOT provide a room # unless the Admit/Observation Plan is placed
  2. The Admit/Observation Plan can be placed in the clinic or pre-admit encounter in a “Planned” state
  3. The Admit/Observation Plan cannot be initiated on a pre-admit encounter, so must be “Planned”
  4. Transfer patient order will be replaced by “Change Inpatient Level of Care” order
  5. Change Attending Physician order will directly update the attending on the banner bar

Click HERE for Tutorial Handout

HSV Culture Order Change

MEMORANDUM

DATE:                    April 30, 2019

TO:                        Physicians, Residents, Nursing, and Allied Health Staff

FROM:                   Alanna Emrick, MLS (ASCP)cm SMCM

                              Manager, Microbiology

 

SUBJECT:    HSV Culture discontinued – replaced with HSV PCR

In a continued effort to bring faster turnaround times, the laboratory will no longer perform HSV Culture.  The 7-day culture has been replaced with HSV PCR with a same day turnaround time. 

Beginning May 1, 2019, all HSV Culture will be unavailable and orders will be placed as HSV PCR.

If you have any questions, please feel free to contact me at 775-8361.