Go-live is September 20, 2022.
Positions Affected:
Physician’s, Nurses, APP’s placing an MRI, CT, Nuclear Medicine or PET/CT order.
Summary:
Beginning the afternoon of Sept 20th , you will no longer have to address the CareSelect window. CMS has put a hold on the requirement to complete this consultation. Once a new date is released we will revisit putting this in place.
K e y P o i n t s
CareSelect window will no longer appear.
Problem: The order CXR Portable is currently defaulted to STAT. This is causing a high number of orders to be placed as STAT, when it is not necessary.
Solution: The CXR Portable Order will now default to the priority of Routine. This order will now be consistent with the primary order of Dx Chest Portable, or other diagnostic orders, which default to Routine.
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 run early, but any new orders during that time will need to be run 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.
The below will be available on August 29, 2022.
This new component will already appear in their components list, so they will not need to add it manually. They will be able to see all current outpatient referral orders and historical ones within the past 3 years. This component will provide them with easy access to referral information on the patient, which will ease their current workflow. The document attached outlines the application features and functionality. Please pass this along to all tech clinics.
During this time, Cerner applications (PowerChart, FirstNet, SurgiNet, etc.) will not be available for use. Please follow the appropriate downtime procedures for your department (reference unit-specific policies on the UMC Intranet).
There is a designated 724 computer on each unit. The 724 computer can be used during the downtime to view previous orders, labs, radiology, I&O, etc. If needed, don't hesitate to contact the Service Desk at 775-9109 for assistance with the functionality of these downtime computers.
Please utilize the education attached to help guide you through downtime procedures.
Former Careset with 5 items for deletion in red:
Updated Careset:
Items deleted:
Factor XIII Antigen
Mixing Study PT Based
Antiplatelet Antibody Direct
Von Willebrand Factor Activity
Von Willebrand Factor Antigen
Items added:
Protein S Activity
Plasminogen Activator Inhibitor Antigen
Phosphatidylserine Ab
Effective: 9.6.22
Positions Affected: All Positions who can currently complete discharge medication reconciliation
Summary:
As of Sept 6th, you will now be able to partially complete discharge medication reconciliation, which allows you to save current selections and complete later. This allows for you to go and assess results that may impact medication ordering, discussions with patients, or interruptions during the process of completing discharge medication reconciliation.
Key Points:
Once the change is in place, you will now be prompted with option to Reconcile and (Plan or Sign).
Choosing Sign will complete the process and it stands today, including the task to pharmacy for review.
Choosing Plan puts the med rec into a Partial Pending state
no task is sent to the pharmacy for review
prescriptions will not send and/or print
Places the planned med rec symbol (green arrows in a circle with a small P for planned orders) instead of the completed med rec symbol (green check).
Ensure you return and complete discharge medication reconciliation prior to placing the discharge patient order
Hovering over either icon will provide additional information.
In our Additional Assessments folder within the Ad Hoc Charting parent folder, you will notice a new powerform labeled Behavioral Health Patient Health Questionnaire.
This new powerform does not include the conditional logic for the PHQ9 questions like the Patient Health Questionnaire-2 form. This means if you prefer to complete the PHQ9, either by bypassing the PHQ2 or regardless of the result of the PHQ2, you can select either or. Please use the appropriate form that will meet your needs as a clinic or visit.
Patient Health Questionnaire-2
Behavioral Health Patient Health Questionnaire
All users that use the Pool radial button in the Message Center Address Book to communicate a General Message or Reminder in PowerChart, FirstNet, or SurgiNet will have to search for the pool name to find who they intend to send to. We are no longer able to immediately display Pools because we have a reach a limit that is allowed to show without searching in the “Type a name or select from list:” field.
General Steps most Users Follow to Communicate with a Pool
Click Communicate Button on the toolbar
Alternate options - Choose General Message or Reminder from the Communicate dropdown list
Click Binoculars icon next to the “To:” or “CC:” field
Address Book will open to display the Internal Address Book
Click the Pool radial button
The internal Pool address book will be blank which is an expected outcome
4. Type or Search for the specific clinic pool you want to communicate with
General terms to use to quickly find specific pools
o UMC
o UMCP
o TTU
o TTP
o SON
o EXT
o DERM
Users can input the asterisk symbol to display all possible clinic pools, if needed.
5. Once the desired clinic pool is displayed, the user can choose that pool to communicate with.
Positions Affected: Physician’s, Nurses, APP’s placing an MRI, CT, Nuclear Medicine or PET/CT order. NOTE: Will not pop-up for ED pts with a tracking acuity of 1 or 2.
Beginning July 26th, you will not be able to use the cancel button when the CareSelect window appears.
CMS requires consultation to be completed for advanced imaging orders or it will result in financial penalties. The program was updated on June 16th, which should allow for more appropriate indications, based on the type of exam chosen.
∙ If ordering an MRI, CT, NM, or PET order, you MUST address the CareSelect window as the “Close”
option will no longer be available.
Effective: 7.26.22
Positions Affected: All Providers using the Consolidated Problem List Component on an Inpatient Encounter
Summary:
Starting the evening of July 26th, you will now be able to set priorities at a user level versus a patient level on all inpatient encounters. This means that each user can choose those diagnosis that are applicable to their specialty. This will not cross to any other users, even if they are in the same specialty. Once the preference is applied all current priorities for inpatient encounters will be removed and will need to be re-addressed. This will only impact the Consolidated Problems Workflow MPage component and not the Problems and Diagnosis Control on the TOC/Dark-side. You can still leverage the control to see what the priorities were prior to this change.
Key Points:
∙ Each user can now set their own priorities in the Consolidated Problems List Workflow Component. If a priority is added, only those diagnosis with a priority will pull to the Assessment and Plan.
If no priorities are added, all diagnosis will pull into the Assessment and Plan, in alphabetical order, as it does currently.
NOTE: This is what all patient’s with an inpatient encounter will look like right after the change.
This will not impact the priorities set in the problems and diagnosis control, nor will any priorities from the consolidated problems list workflow component flow to the control, moving forward.
The date that you are wanting the surgery on now needs to be entered in the appointment attributes box that comes up after you select the order and is required, you will not be able to move past this point without a date.
**time is not as important as the date and will default to 00:00 if you do not enter a time.
The OR schedulers will no longer be able to see the dates in the ‘Request for Book’ box.
SPEECH THERAPY HAS NOT BEEN RECEIVING ALERTS/MESSAGES FOR PATIENTS WITH A LARYNGECTOMY.
Speech Therapy has not been receiving alerts/messages for laryngectomy patients when they are admitted or transferred in the hospital.
A rule has been created that will alert Speech Therapy, Nursing and Respiratory Users when a Laryngectomy Code is added as a Chronic Problem within the Consolidated Problem List in the Patient's Chart. Once this diagnosis is listed as chronic, the necessary teams will be notified each time the patient is admitted or transferred in the future.
ADD PROBLEM TO CONSOLIDATED PROBLEM LIST(REGARDLESS OF REASON FOR VISIT)
ENSURE PROBLEM IS LISTED AS CHRONIC.
SPEECH THERAPY WILL RECEIVE A MESSAGE IN MESSAGE CENTER AND A SMART ZONE ALERT WILL BE SENT TO NURSING AND RESPIRATORY USERS.
PROBLEMS THAT WILL TRIGGER RULE:
H/O laryngectomy
H/O partial laryngectomy
H/O radical laryngectomy
History of laryngectomy
History of parital laryngectomy
History of radical laryngectomy
Hx of larygectomy
Hx of parital laryngectomy
Hx of radical laryngectomy
S/P laryngectomy
Status post laryngectomy
Laryngectomy
Due to the nationwide shortage of iodinated contrast, restrictions on ordering imaging studies with contrast have been implemented.
Imaging orders that require contrast will be reviewed and prioritized according to availability and need
The following notification will come up when ordering contrast CTs to remind providers to consider alternative imaging studies (non-contrast CT, MRI with or without gadolinium or ultrasound)
If you have any questions, please contact Radiology at 806-775-8445.
Positions Affected: All Inpatient Provider Positions and their workflow MPages
Summary:
The Risk Indicators component (which contains the TOC recommendation) will be moved 'off view' in the inpatient provider MPages. There have been reports that the recommendation provided may not truly show the full patient picture. While this component is a recommendation only, we want to ensure providers don't feel that it's required to reference while we continue this investigation of the data that the recommendation is being qualified off of. If your patient population has not been having issues with the TOC Recommended and you wish to move it back on-view, it will be available for you. PT/OT will continue to make recommendations for therapy needs, as they do now, and will not make recommendations for disposition or placement. Please continue to use their documentation as you make your final discharge recommendations
Key Points:
∙ Risk Indicators component no longer face-up in your workflow MPage table of contents.
Can still add it back on, if you still want access to it. Components (upper right-hand corner of MPage) > Select Risk Indicators > Will populate at the top of your WF TOC > Can move it back to the bottom
1. Request from pharmacy:
-alteplase start time for both frequencies updated to T;N+2hours. Remove priority "NOW" as changing to q24h/q12h drops a now dose. the +2hr offset is to allow time for preparation & delivery of dose
-dornase start for both frequencies updated to T;N+4hours. Remove priority "NOW" as changing to q24h/q12h drops a now dose. the +4hr offset is to allow time for preparation & delivery of alteplase, then will time it for 2 hours AFTER alteplase task as the alteplase has to dwellx1hr, drainx1hr, then admin dornase.
ON the alteplase 10mg doses that are currently ordered as 2 x5mg syringes. We now have authorization to send instead 1 - 10mg/50mL syringe. so, the 10mg section only needs 2 orders total, 1 for leur lock and 1 for catheter tip syringe. Remove the red bars & duplicated order sentences. Change the verbiage on the 10 mg dose gray bar to "For a single 10 mg dose please select ONE of the following based on syringe type needed:" Reach out with any questions.
2. Also linked the current policy in Alteplase Intra-Pleural Policy to this plan for reference.
A new section has been added to the Pediatric Central IV Flush powerorder. You can now find PICC Lines under Medications if you need a flush.
Go-live May 9, 2022.
To provide discontinue orders for IV access after home health IV therapy is complete.
This order will allow the Home Health agency to either discontinue the PICC line themselves or to send the patient to UMC radiology to remove a tunneled line if appropriate. UMC radiology is able to see these patients M-F during normal business hours.
New field added to the Social Services for IV Therapy
Discontinue IV Access Once IV Therapy Complete: yes/no
