Filing gastroenterology and other procedure suite notes

Different sites have different ways of filing their procedure documents outside of Cardiology. Some documents are directly entered into CareConnection, others are automatically routed through an interface and yet others are manually mapped to an appropriate folder.

• The group agreed to have all procedure suite notes except Cardiology route to Physician Documentation>Operative & Procedure Reports (renaming of the existing Operative Reports folder)
• Cardiology notes will continue to be filed under the Cardiology folder as all sites have this workflow. Although this represents variation in filing conventions, a change to how physicians file Cardiology notes will need to go through the Cardiology Service Line leadership (Vince Bufalino).

[] Anupam to notify the HIM Council.

Request to automatically populate the medication list in the Simple SOAP - AHC note template

Given the different variations of SmartTemplates that can pull in different versions of the medication list and the ability for end-users to customize their own version of the Simple SOAP-AHC note, the group decided against adding a medication list component at this time.

Displaying an alert for users when a patient is being discharged

• Patients being discharged right away (e.g., from the emergency department) The emergency department physicians would like a workflow that embeds the decision alert trigger (i.e., discharge order), within the existing discharge screens that they use rather than placing a separate order.
• Patients being discharged from the physician's perspective (e.g., discharge order placed in the morning, but patient leaving in the afternoon) The group agreed that the physician would appreciate an alert if the patient's temperature, heart rate, blood pressure or respiratory rate were outside the normal limits.

[] Determine if the alert could be broadened to include pain score and oxygen saturation
[] Provide the list of blood pressure values for kids as normal ranges for blood pressure depend on age, gender and height

• Patients being discharged from the nurse or patient care technician perspective (e.g., patient leaving several hours after the discharge order has been placed) A separate alert should be created to notify these users that a patient's vital signs are not normal. Ideally, the staff would then notify the physician prior to allowing the patient to leave.

[] Anupam to float idea by nursing leadership

Medication dosing weight on the banner bar

The group agreed to include the medication dosing weight on the banner bar. Although this addition may cause confusion, the confusion should prompt questions from the physician user to then lead to selecting the appropriate weight for a medication calculation.

[] Verify that the medication dosing weight and patient weight are side-by-side.
[] The label for the new weight should be medication dosing weight.
[] Obtain the method with how the medication dosing weight is calculated to share with end-users.

Workflow mPage instead of Physician Summary mPage

The group was amenable to switching to the workflow mPage if all of the components on the Summary mPage could be moved over to the workflow mPage. The load time will have to be faster to get higher adoption rates.

[] Anupam to work with CareConnection team to produce a mock-up of what this mPage might look like.

Users with pre-specified diagnoses and the ICD-10 transition

The group decided that we should notify all users multiple times (e.g., every couple of weeks for a few months) before October 1, but no special efforts should be made to save a user's diagnosis favorites or convert them from ICD-9 to ICD-10.

Push for real-time physician documentation

On April 13th, the Health Outcomes Council will review an SBAR that pushes to stop transcription for progress notes on July 1 and stop consults and in-house H&Ps (not pre-operative H&Ps) on September 1. Users will be encouraged to enter information directly into CareConnection or use voice recognition tools (Desktop Dragon, PC Touch) to facilitate this transition. There was some concern about the transition date for consults and H&Ps, but the group will defer to the Health Outcomes Council.

PC Touch challenges

• Users' default note filter is typically All PowerNotes, not All Physician Notes. The notes created in PC Touch do not file under All PowerNotes. This can lead some users to think those notes do not exist when they actually do.

[] Anupam to ask Cerner if they can combine the two filters into one.

• You can save a note and manipulate it on the desktop, but that functionality is not intuitive.

[] Anupam to update the PC Touch educational materials.

The next meeting is scheduled for May 14 at 0730 hours.

Minutes from other meetings