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Ambulatory
Read of the Week of February 2nd, 2010 Medicine's Ethical
Responsibility for Health Care Reform — The Top Five List H Brody n engl j med 2010;362:283-285 ·
Eclipsys Issues Bulletin (updated
2/5/2010) –
Please refer to the most recent Eclipsys curriculum and the NYP teaching videos for
detailed learning. There are still several classes open, and for anyone who
wants to arrange personal individual session after the roll out classes
please email me Summary of the MD Task - See/exam pt →→ Write note→→
update/prescribe new Rx→→ enter order (PENDING RETURN for any
lab/vaccine/FOBT done after clinic discharge-inclds
same day labs) →→ Save note →→ present to PIC→→
update note and assign cosignature →→print
discharge med list 1. Error
Messages- there are 2 main recurring ones. The most painful one “SAVE
OPERATION FAILED” gets triggered when you forget to click med reconciliation
and then go back to click it. So please always click the med recon before you
save the note (if you forget and you get a “note will be saved as incompete” just click to save it as incomplete, do not
try to go back to click the med recon as that will cause the error). Once the message comes up, the note is
lost, so while it is still there copy and paste your 3 free text box content
to WORDPAD and reload a new note. Error message #2 is a new Rx writer message
“ELECTRONIC PATHWAY NOT DEFINED” this should be fixed 2/5/10. 2. Ordering
- Some of you are ordering everything under 1 set of PENDING RETURN order,
and then releasing the same day RTC/radiology/referral/vaccine orders. I
checked with IT,that is
fine. If you do it that way I would ask you to please release the same day
orders as soon as you enter the orders. This way your PFA can start to
work on orders/appts while you are still writing
notes or presenting to PIC. One of our goals is to use Eclipsys to decrease
pt wait time in AIM. If you wait to release it (or wait for your PFA to
release it) at the end of the visit, your pts’ d/c
processing time would be longer. 3. To
save an extra click, you can enter your Resident Notes as COMPLETED- Eclipsys
notes are modifiable after completion, I am okay with residents saving their
notes as COMPLETE before the PIC presentation. If there are changes after
discussion, you or the PIC can always go back and update or revise the note. 4. use F7 to import ambulatory BP/BMI, that is
prettier than the flow sheet. Also when listing labs, do not click the entire
date or column (that will make your note look like a data dump), just click
the individual result box and it will import only the numbers you want to
display. 5. Sorian issue
- during the Eclipsys transition with
attending template changes, the 1 day resource book view may not show all of your
scheduled pts. The “RESOURCE APPT” view is more accurate since it doesn’t
block out pts who don’t fit into the new template. 6. Useful
Lab set- there is a LAB OUTPATIENT order set available for
less commonly ordered tests that are not on the AIM common test order. To
search for the set just type LAB OP into the order box. 7. If the
patient is not registered yet, enter your pre-clinic draft or Rxs on a past DSC chart. Never work on a PRE chart,
the data may be accidentally erased when the pt is registered for the
visit. 8. When
ordering in between visit labs/Xrays/vaccines,
please order them as pending return on the last visit DSC chart. Then
generate a PHYSICIAN LETTER with the pt’s MRN and mail to pt to ask them to
go to the lab to have these labs released and activated. 9. Pt
message/Secure Health Message- Instead of getting email messages
about pt messages you will now
get SHM from nurses. The email to your CU mail is only a reminder to tell
you that you have a SHM. Please do not use the URL in the email to link to
your inbox as it DOES NOT work yet. To access the message, log into Eclipsys
inbox to retrieve the message. The SHM should link you to the RN’s telephone
triage note (blue letter link), click to open note. To confirm receipt and
note your action, you can add comments to the 3rd section of the
note, or click APPEND to add your comments. If you are away you can
assign proxy coverage to take your messages (this is for attendings). 10. PFAs will no longer be looking at your notes for d/c
instruction, use your RTC Order free text instruction box to remind them of
the things you want them and the pt to do.
“EKG today” “ortho hand clinic”. Think of
this direction box like the previous paper d/c directions we use to write to
sum up d/c instructions to the PFAs. 11. Inbox- Please
clear your inboxes weekly. If at first
logon you don’t see anything in it check on the interval filter on the top
bar to make sure you are bringing all result dates. Check the L hand filter
to make sure you are bringing in “all items” on “My View”. Overloaded inboxes
will slow down Eclipsys processing speed. 12. Structure
Note- there are
2 radiology boxes, this will go away soon. 13. Flow
sheet- It’s hard to see vital signs on the flow sheet,
use F7 to import a better ambulatory VS display on your notes. IT is helping
us construct IM specific flow sheets so BP will be visible. 14. Ordering
– Please input ICD just as you did before, some forms provide options
for codes already. 15. AIM
review page should show 9 tiles, sometimes it shows 7 based on
your local computer screen setting, in that case, click scroll box on R upper
corner to bring in all tiles. 16. For
those who write pre-clinic drafts- a pre-clinic draft it will retain
the date of the original draft, not the day you saw the pts and finalized the
note. Write your draft in the last DSC chart, be sure to identify it as a preclinic draft and not a visit note by using acronym
expansion “drf” (this is impt
since the draft will show up in WEBCIS). When seeing pts, open the active ADM
chart, start a new aim structure document, copy forward the content from the
incomplete draft, complete the visit note, and then delete the original draft
(this removes it from webcis). Somewhat clunky
relative to the hidden draft of Webcis. |
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