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

, ,

Patient Status Order Changes

, ,

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.

, , ,

Orders to Scheduling: NM and Cardio Stress PowerPlans

, , ,

ALL stress tests are now powerplans instead of caresets for single orders.  The “Why” for this is to ensure the correct type of imaging order is placed. 

Search for “stress” within the orders window or navigate to the Stress Folder

There is also a folder called “Stress Tests”

When you select the plan, the imaging/type options for stress are available.  If you do not choose an order, by clicking in the square, you are NOT placing any order.  Complete the needed fields as indicated by the blue circle with the X.  This means you need some additional information on the order

Complete the required fields, and sign the plan

If no order is selected, you will receive this message.  You will need to click “Cancel” and go back and chose the test you want to be completed on the patient

 

You cannot order from this screen; you must click cancel and order from the powerplan

Click HERE for Handout

, , ,

Orders to Scheduling: Mammogram PowerPlans

, , ,

ONE order will be REQUIRED

ALL Mammogram orders are now powerplans instead of a single order.  The “Why” for this is to ensure the correct mammo order is placed.  We have added an option for IMPLANT orders.  The radiologist read these in different views and the exam takes longer.

Search for Mammo orders using the “search” or navigate to the Mammo folder within the Radiology folder

When you select the plan, the two mammo options are available.  If you do not choose an order, by clicking in the square, you are NOT placing any order.  Complete the needed fields as indicated by the blue circle with the X.  This indicates you need some additional information on the order

Complete the required fields

If no order is selected, you will receive this message.  You will need to click “Cancel” and go back and chose the test you want completed on the patient.

You cannot order from this screen; you must click cancel and order from the powerplan

Click HERE for Handout

ACE Inhibitor Therapeutic Interchanges

ACE Inhibitor Therapeutic Interchange

Currently, when a medication is ordered that has an approved P&T Therapeutic Interchange, Pharmacy makes the change at verification. Cerner allows for the substitution to be visible to the provider before pharmacy verification.  UMC is trialing the functionality with the approved ACE Inhibitor Therapeutic Interchanges. Please see the attachment for the functionality and workflow.  This applies for inpatient medications only.

,

Health Maintenance Downtime

,

Health Maintenance will be down and not fully functional beginning at 9pm on 5/23/19. The QRIC Committee has approved for Cerner to take Health Maintenance offline and re-process all patients to resolve issues.

This refresh/reset will potentially take 1 to 2 weeks to re-process to appropriately qualify patients in Health Maintenance.

During this time, end-users may encounter a “yellow” banner in Health Maintenance indicating that the most current data is not displaying. This is expected behavior and will resolve when re-processing is complete.

, ,

Cerner Registration & Scheduling: New Radiology Order Process

, ,

Cerner Registration & Scheduling: New Radiology Orders Process

When: Past several weeks; addition of new folders (e.g., Stress Tests) and replacement of existing orders/caresets with the new PowerPlans

What: Updates of the existing radiology caresets (e.g., mammo, NM, MRI, etc.) to be usable with the new Cerner Reg/Sched process

*Note: This is the orders process, not the scheduling process that starts August 4th

You will notice right away that orders that were either single orders, or caresets, will now appear with the yellow “pizza.” This indicates they are now PowerPlans.

They will work much more straightforward than the larger PowerPlans.

 

You will locate and place the order for the desired exam as usual, and then find them in the PLANS section of the orders scratch pad to finish the required fields.

You MUST select an order prior to signing. Skipping the actual order will lead to no order processing through.

When you complete the entire order requirements, you will see the order in the “initiated” state.

, ,

Radiology: New Stress Test Orders

, ,

NEW STRESS TEST ORDERS

To clarify the ordering of stress tests, new orders have been created in Cerner to designate the type of stress and the type of imaging performed.  These orders can be found in a new “Stress Tests” folder and will also be available in the Cardiopulmonary Folder.

, ,

Radiology Order Catalog Redesign

, ,

UMC Radiology Order Catalog Revamp

New orders, more applicable choices, clean up of unused orders, etc – all to make ordering more streamlined to HRO.

 

Highlights to note:

Will now will have the ability to order Bilateral procedures for all extremity orders.

Combo order MRI Orbit/Face/Sinus order will now have individual orders to choose from.

“Brain” will replace “Head” for MRI procedures.

MRI Foot & Toes description to reflect more accurately with MRI “Forefoot” and MRI “Hindfoot.”

New SP orders for Pleurix Cath procedures.

 

Look for the option of Implant orders for Mammo procedures in specific PowerPlan.

 

When order placed, the option to choose Mammo with Implants:

 

*Note: Please see attached Excel spreadsheet for more details.

Changes will occur over the next few weeks.

Click HERE for Excel Spreadsheet

, ,

Antibiotic Time-Out

, ,

Attention Medical Staff:


Recently, it has been brought to the attention of the Antimicrobial Stewardship Committee that providers are uncertain of the utility for antibiotic time outs. We have made an effort to bring more meaning to these reminders.


The Centers for Disease Control and Prevention (CDC) recommends 5 core elements for a successful hospital antibiotic stewardship program one of which is “Action”.

An example of an “Action” is a systemic evaluation of ongoing treatment need after a set period of initial treatment also known as an “antibiotic time out”. At UMC these reminders or alerts fire for Level 1 and Level 2 restricted antimicrobials (see list below). There are two time outs, at 48-hours and 72-hours. The 48-hour antibiotic time out is a reminder through SmartZone (which is seen in a ribbon on the right hand side of PowerChart). However, if no modification is made to therapy at 48 hours then a 72-hour antibiotic time out will then fire on a close chart. This time out requires an action be taken by the provider before continuing. See below for examples of both.


48-Hour SmartZone Reminder:


Example: Carbapenem Alert

72-Hour PowerChart Actionable Alert:

Kind Regards-
The Antimicrobial Stewardship Program and Dr. Ragain, CMO

Orders: Change to Consult MD Order

There will be a change to the fields in the Consult MD order and how the Consult is completed.

New Workflow:

The Provider will place a Consult MD order.  Required fields are Reason for consult, Medical Service to Consult, and Assistance with Contact Number.

**NEW** If the provider needs a contact number, this will place a task for the HUC to provide you with the phone number.  

Provider will call consulting service.

Consulting service will assess patient and place orders if appropriate.

**NEW** Consulting service will Complete the Consult MD order.   This will be an indication to nursing and primary providers that the initial consult was completed.

Screenshot of New orders detail:

How to complete order: Find Consults/Referrals section and Right Click on Consult MD order.   Click on Complete.  Order Status will show as Complete.

VIZIO of Consult MD Orders Workflow