Go-Live Wednesday October 13, 2021.
Protocols for oxygen de-escalation pathways for COVID-19 have been developed and added to the COVID-19 General Plan. The new order, COVID-19 Oxygen Weaning Protocol is under the Respiratory heading and is prechecked on the powerplan.
When you hover over the “paper” icon a hyperlink appears. Click the hyperlink and the protocol will open.
If your patient needs to withdraw from ImmTrac, please follow the below workflow.
The patient has to fill out a Withdrawal of Consent and Confirmation Form. The patient can print the form themselves from the Texas Department State Health Services website and then mail it back in.
For Powerchart, one would have to navigate to Immunization Schedule and switch the answer on ImmTrac2 General Consent from OK to Share to Do Not Share and enter a reason from the dropdown & Save.
This will prevent immunizations from going to ImmTrac except for COVID vaccines and antivirals, which will always be sent by law.
Effective immediately, as a provider, you will notice changes to the relationship box. The list of relationships has been updated, and below are your new options. We have included information regarding each relationship and what it means.
Primary Care Physician – You are this patient's primary care provider, and this is your patient across all encounters. You will not see this pop-up message again, and you will receive notifications intended for PCPs.
Review Chart – You are not establishing a long-term relationship, just for this encounter. You will see this pop-up message for this patient once for each individual encounter. Useful for hospitalists or anyone managing an inpatient encounter.
Specialist – Provider – You are this patient's specialist provider, and this is your patient across all encounters. You will not see this pop-up message again, and you will receive notifications intended for specialists.
Visit Provider – Ambulatory – This is your patient for this specific clinic visit. Useful for one-time visits such as walk-ins, urgent care, etc. You will see this pop-up message for this patient on every individual encounter.
Please select the appropriate relationship as a provider for your patient.
During this time, Cerner will be available. There will NOT be a downtime; however, there will be brief interruptions in service during the following time periods:
8:00pm – 9:00pm
Pyxis
No new or transferred patients or orders will show
Pyxis machines will be placed on override during this time
Radiology Imaging
No new or modified radiology orders will cross to McKesson PACS
No new reports will be available in PowerChart
OnRad reports will be faxed
A radiologist will be onsite for any STAT requests
RapidComm blood gas and RALS/Sofia results will not populate in PowerChart
Quest results will not populate into PowerChart and orders will not send to Quest.
Orchard Orders and Results will not post for TTU Student Health.
South Plains Rehab-Encompass, Lubbock Heart Hospital and Montford orders will not populate into Cerner and results will not pass to the vendors.
Telemetry strips will not show in Clinical Notes
Kronos will not show new or transferred patients
ePrescribing
Prescriptions will queue up and be sent once the interfaces are back up
If a prescription needs to be sent immediately, please print or call in the prescription
Teletracking will not show new, updated or transferred patients
EasyID will not show new, updated or transferred patients
IDX will not show new, updated or transferred patients
Hill-Rom Dashboard will not show new or transferred patients and beds cannot be associated in Cerner.
** By 9:00pm, all patients and orders will be released and the above systems will be updated. Radiology systems will receive the updates and the reports will cross over once the orders are reconciled. **
Scheduled reports will need to be printed manually (ex. Dietary reports)
Batch label printing (Meds/Labs) will be ran early, but any new orders during that time will need to be ran manually
** At 9:00pm, all scheduled reports and batches for label printing will resume as scheduled **
You will be prompted to log out at least once during this event. If you receive this notice, then please log out. You will be able to log right back in without issue.
With the system being available during the maintenance event, there is a potential for odd issues to occur. If you experience any issues, then please call the IT Helpdesk at 59109.
Effective October 4th, 2021 the below changes will be made available to patients with MyTeamCare (patient portal) access:
Inpatient provider documentation will now be released
History and Physical notes
Progress Notes
Consult Notes
Discharge Summaries
Emergency Center Documentation
All providers notes, clinic and inpatient, will be viewable to the patient with the below criteria
All note statuses, including “In-progress”, “Saved”, and “Auth Verified” will be viewable
Immediately (no delay)
Sensitive Lab Results (HIV, STDs, etc.) will now be released
Immediately once resulted from the lab
This change is a result from the ONC Cures Act, requiring by law to make a core set of clinical data available to patients in a timely fashion to encourage interoperability and portability of health data.
Changes effective 9/15/21: Replacement orders should only be used in patients with a serum creatinine less than 2 mg/dL, and urinary output greater than 0.5 mL/kg/hr.
Starting September 13th instead of placing an individual order for a POC COVID-19 (SARS-CoV-2) test, a powerplan named POC COVID-19 (SARS-CoV-2) Plan will need to be placed.
The powerplan will ensure that the correct order is automatically placed based on the patient’s location.
Ex. If the patient is on 5 East, the order COVID-19 Sofia Ag – Lab will be automatically be placed.
If the patient is in the Emergency Center the order for POC COVID-19 SARS Ag Sofia will automatically be placed.
The individual COVID-19 Sofia orders for inpatient testing will no longer be available and testing must be ordered through this plan after Sept. 13th.
When: 8/25/2021
What: The Adhoc charting button from the Immunization Schedule tab in PowerChart is being deactivated and will be dithered. This form of documentation is no longer appropriate. Instead, please continue to order immunizations from caresets and document administration on the tasklist. Continue to use the Registry Import process to properly document the administration of vaccinations outside this organization. If the vaccine is not available via registry import, please document the vaccine using the History button.
Why: Using this functionality does not incorporate charging for medication or the administration. It also does not properly capture all necessary information when administering vaccines causing failures when sending information to ImmTrac.
Please see below for DKA Insulin Infusion Protocol changes that will change the Diabetic Ketoacidosis (DKA) Plan:
Please click the DKA Insulin Infusion Protocol button below to access and print detailed information about these important changes.
Starting Wednesday, August 11, 2021, the Discharge Patient (Outpatient) order will no longer have the required ‘Discharge Diagnosis’ field.
It will now look like this:
The plans that use this order are shown below. This change will not affect your favorited plans. The field will simply not be there anymore.
During this time, Cerner will be available. There will NOT be a downtime; however, there will be brief interruptions in service during the following time periods:
8:00pm – 10:00pm
Document Viewing
o Document viewing via Clinical Notes, PowerNotes, DynDoc, PowerForms, etc. may be affected
o You will continue to be able to create/document PowerNotes, DynDoc, PowerForms, etc. as normal
o Camera Capture and e-Signature will be impacted
Document Scanning
o Single document scanning will not be available
o Batch scanning will not be available
o Camera Capture, e-Signature, Report Request, Manual Expedites, Multimedia Manager, and Images for Access Management Office will not available
You may be prompted to log out at least once during this event. If you receive this notice, then please log out. You will be able to log right back in without issue.
With the system being available during the maintenance event, there is a potential for issues to occur.
If you experience any issues, please call the IT Helpdesk at 59109.
A request has been made to change the verbiage on the Referral Ambulatory order. The verbiage for a high-priority referral will be changed on this order from Urgent to Stat on the highlighted field:
The functionality in Referral Management details will still show as High Priority
The indicator will still show as red and high priority
Starting August 5, 2021, the Adult and Pediatric Discharge Plans will expire 45 days from the date they are planned, if not initiated.
S - Discharge Plans from prior admissions are inadvertently being activated on a patient’s current encounter. Patients can be sent home with inaccurate discharge information.
B – Discharge Plans are placed on admission by the provider or nurse.
A - Patient is discharged and discharge plan is not initiated. This leaves the plan in a “planned” state for 365 days from the date it was originally ordered. If the patient readmits to the hospital within this time frame, the “old” discharge plan is active on the chart. This can lead to staff documenting on and initiating the discharge plan from the previous encounter instead of the new encounter’s discharge plan.
R – Technical Suggestion, shorten the plans expiration criteria from 365 days to 45 days. After the 45 days have passed the EHR system will automatically void the old discharge plan. The only identified risk associated with this recommendation is for patients who stay longer than 45 days. Their discharge plan will be discontinued by the system prior to their discharge, at which time the nurse/provider will need to re-order the discharge plan.
Cerner CAMM 7 Prod Storage Database Upgrade / Downtime
Cerner CAMM 7 Team will be upgrading the Oracle database, which will result in a ~4-hour downtime event.
Cerner CAMM 7 Archive
All Radiology End Users, Physicians, EC Staff
CHG0038291
On 7/14/2021 at 1AM CDT Cerner will be upgrading the Oracle database in a downtime event. Event is expected to last 4 hours and end 7/14/2021 at 5AM CDT.
The solution will be unavailable for the duration of the event. Studies ingested during the event will be re-directed to a non-prod storage location.
Studies ingested during the downtime event, and priors up to 3 days, will be viewable via the SkyVue Downtime Viewer, which has been installed on marked workstations throughout the hospital.
Once the database is back up, then studies will be sent from the non-prod storage location to CAMM 7 for verification.
Currently, MAR Summary defaults are set as:
Hours Forward: 8
Hours Back: 48
Based on a request from residents & approved by PIC on 6.15.21, we are updating these defaults.
Future MAR Summary Defaults:
Hours Forward: 8
Hours Back: 168 (7 days)
Current View: 48 hours back by default
Future View: 168 hours back by default
When completing a Discharge Med Rec for patients with chemotherapy orders, you will receive this Discontinue Protocol Order pop up box if you choose “Do Not Continue Remaining Orders”:
When you see this, you should choose Continue to keep the protocol order active.
If you choose Confirm, you will be discontinuing all future scheduled chemo orders for that patient, and the oncologist will have to re-enter the protocol.
New Orders:
CT TEVAR Protocol
- Dynamic Aortic Evaluation in planning Thoracic endovascular aortic repair (TEVAR) is important to provide optimal stent graft sizing for aneurysm repair in chest
- For any questions, contact the Cat Scan department (775-8715)
CT EVAR Protocol
- Dynamic aortic evaluation in planning endovascular aortic repair (EVAR) is important to provide optimal stent graft sizing for aneurysm repair in the abdominal aorta.
- For any questions, contact the Cat Scan department (775-8715)
CT Bone Biopsy/Aspiration
- Bone marrow aspiration and bone marrow biopsy can show whether your bone marrow is healthy and makes the normal amount of blood cells. Interventional Radiology performs these procedures.
- For any questions, contact Interventional Radiology (775-8770)
CT Guided Cyst Aspiration
- When Fluid abnormally fills a cyst or collects in the body it may be removed with a very thin needle guided by a computer tomography (CT).
- For any questions, contact Interventional Radiology (775-8770)
SP Biliary Drain Removal
SP Cholangioscopy with Biopsy
SP Cholangioscopy with Stone Removal
SP Diagnostic Cholangioscopy
SP Sclerotherapy Single Vein (varicose vein treatment)
SP Sclerotherapy Multiple Vein (varicose vein treatment)
- To reflect new procedures performed in Interventional Radiology
- For any questions, contact Interventional Radiology (775-8770)
DX EOS Full Spine 2 views
DX EOS Full Spine 4 views
DX EOS Lower Limb
DX EOS Full Body
- To clarify the new orders for the new EOS machine. ALL these "EOS orders" can only be done with the new "EOS machine."
- For any questions, contact Amanda or Rachel in the diagnostic radiology department (775-8415)
Order Changes:
DX UGI (Contrast, Air) >> DX UGI Double (contrast/air)
DX UGI (w/o Contrast, Air) >> DX UGI Single (contrast)
DX UGI w/ SBFT (w/ Contrast, Air) >> DX UGI w/SBFT Double (contrast/air)
DX UGI w/ SBFT (2/o Contrast, Air) >> DX UGI w/SBFT Single (contrast)
- Improving clarification on the terminology for the exam because some have barium contrast and some have contrast with "fizzy" AKA air
- Contact Amanda or Tim if you have any questions (775-8415)
CT Guided Cryo Ablation Bone >> CT Guided Cryo/Microwave Ablation Bone
CT Guided Cryo Ablation Liver >> CT Guided Cryo/Microwave Ablation Liver
CT Guided Cryo Ablation Lung >> CT Guided Cryo/Microwave Ablation Lung
CT Guided Cryo Ablation Renal >> CT Guided Cryo/Microwave Ablation Renal
- To reflect which body part and the option to perform cryo or microwave based on IR provider assessment and discussion with ordering provider
- For any questions, contact Interventional Radiology (775-8770)
DX Thoracolumbar 2vw >> DX Thoracolumbar Junction
- To clarify the procedure that is being completed by the diagnostic department
- For any questions, contact Diagnostic Radiology (775-8415)
NM Gastric Emptying Study (4 hr study) >> NM Gastric Emptying Solid (4 hr study)
- This is to clarify for ordering providers the difference between similar exams
- For any questions, contact Nuclear Medicine (775-8768)
NM WBC SPECT/CT Local >> NM WBC Whole Body/SPECT/CT
- This is to clarify the procedure that is being completed in Nuclear Medicine
- For any questions, contact Nuclear Medicine (775-8768)
Order Removal:
NM Renal Scan (Pedi)
- For greater clarity among ordering physicians and offices the Nuclear Medicine Cerner orders now have:
NM Renal Flow/Scan MAG 3 (Pedi) & NM Renal Scan with Lasix (Pedi)
- This clarifies if a physician requests a with or without Lasix Renal scan for pediatric patients.
- For any questions, contact the Nuclear Medicine Department (775-8768)
Currently, the Procedures tab within the Histories component of Provider View Workflow MPage is set to default to Reconciliation Mode if an outside record is available.
Records that normally appear under "Surgical Records" do not show when the component is in Reconciliation Mode. These Surgical Records will only show in Review Mode.
To reduce the risk of procedures being overlooked by providers, we are updating this tab to default to Review Mode.
If there are outside records, clicking on Reconcile will change the tab to Reconciliation Mode.
Example: EGD done on 5/24/21
Reconciliation Mode: current default.
Review Mode: future default.
On May 1, 2020, the Center for Medicare & Medicaid Services (CMS) published the Interoperability & Patient Access Final Rule in the Federal Register. The Interoperability Final Rule contained a new Condition of Participation (CoP) requirement, effective May 1, 2021. CMS’s Interoperability and Patient Access Final Rule was published in conjunction with The Office of National Coordinator for Health Information Technology (ONC) Cures Act in furtherance of federal efforts to increase interoperability and eliminate information blocking practices.
The Admission, Discharge, and Transfer Event Notifications requirement of the CMS Interoperability and Patient Access final rule requires health IT systems capable of sending / receiving ADT messages provide the ability to send ADT event notifications to patient-designated providers and organizations. The compliance date, May 1st, 2021, for requirements is based on the hospital’s compliance plan. Each hospital must have a plan to be fully compliant by this date.
What notifications are required?
Events Notifications for a patient’s admission, discharge, or transfer.
· Inpatient admissions
· Emergency department
o Presented
o Discharged
· Observation admission/registration
· Transfer
o From outpatient to inpatient
o Unit Transfers are not required.
· Discharge
Failure to comply with the CMS Rule by the May 1, 2021 deadline can result in loss of certifications and reimbursements.
Who will receive notifications when initially enabled?
· Primary Care Physician (PCP)
Who potentially could receive notifications based off the ruling in the future?
· Primary Care Physician (PCP)
· Admitting
· Attending
· Consulting
· Referring
· Informed Provider or Organization (i.e. Case worker, Skilled nursing facility, Social worker, Informed PCP)
Opt-out Notifications
Providers or informed providers can opt-out of ADT event notifications. Opting out of ADT event notifications disables notifications for all patients where the provider is the PCP or associated to the patient with the specific relationships mentioned in the ruling.
The provider will no longer receive a notification for any patient that is admitted, discharged, or transferred when opting out notifications.
How to opt-out notifications?
Providers or informed providers must submit a request to UMC IT or TTP Clinical Transformation department with the following required information:
· Provider’s Name
· Provider’s NPI
