Epic Tip of the Week: April 2, 2021

 All Jabber Users: New JHH Jabber Directory Group

• The new directory includes key numbers i.e. unit desks, charge nurses, key provider roles, JHH pharmacies, lab, etc.
• Follow this short video to download the new directory and easily create and save favorites.
• Your favorites are saved to your account and are available on your next login. Tip sheet is found here.
• To add a new contact to the Directory, send the role (prefix JHH…), the unit/specialty, and the number to jallen12@jhmi.edu
• Direct questions or concerns about directory information to jsmith31@jhmi.edu

Inpatient: Updated EPIC Heart Failure Orders & Resources [Armstrong Institute Suggested Guidance]

• Key Points:
  • Heart failure is the most common reason for hospitalization in older adults.
  • 25% of patients will be readmitted within 30 days.
  • Transitions of care and discharge planning are key. Implementing best practices can improve outcomes.
  • Incorporate the two helpful inpatient EPIC resources below into your practice when caring for heart failure patients:
• JHM IP ENTERPRISE GENERAL ADULT CHF DISCHARGE OrderSet and After Visit Summary [AVS]

1. • Includes prepopulated, standardized, patient friendly language specific to heart failure:
     • Reason for hospitalization, symptoms to monitor, who to call, when to follow up, diet and activity recommendations
   • After Visit Summary automatically attaches the Heart Failure Education “One-Pager” created by the CHF Clinical Community and Patient and Family Education Committee which includes discharge weight, potassium, and creatinine.
     • Click step 3 => New Discharge Orders in the Discharge Med Rec section of the Discharge navigator.
     • The orderset auto populates for patients with a heart failure diagnosis on the hospital problem list during the current admission.
     • Alternatively, search for the JHM General Adult CHF Discharge Orderset and add it to your preference list

• Diuresis Flow Sheet
  • Includes key patient information: I&O, weight, diuretic medications, electrolytes, and heart failure guideline directed medical therapies.
    • In the Summary tab (1), enter “Diuresis” in the search field on the top right (2).
    • Select the Diuresis (Flowsheet Only) report (3).
    • The report displays (4); click the wrench to add the report to your toolbar for easy access (5).

Inpatient: New Patient Status => Outpatient in a Bed [OIB]

• At the direction of Utilization Management, this new patient status order can be placed for patients requiring hospitalization who don’t meet standards for medical necessity [i.e. for patients awaiting placement, receiving chemotherapy or blood infusions who need a bed for logistic reasons, and other limited situations].
  • For hospitalized patients, with no admission order, the “Outpatient in a Bed” order is selectable in the General Admission Order sets.
• At the direction of Utilization Management, downgrade the level of care, from Observation or Inpatient status to “Outpatient in a Bed” by using order panels “JHM IP Update Patient Class from Observation to Outpatient in Bed” or “JHM IP Update Patient Class from Inpatient to Outpatient in Bed”.

Inpatient & Ambulatory: Meducation® Replacing Current Medication Education in Epic

• Meducation® is recognized by the National Academy of Sciences Health Literacy Roundtable as an exemplar in the application of the best practices of health literacy in medication education. Content has been approved by the multidisplinary, enterprise-wide Patient Education Committee.
• There is no change in clinician workflow.

Ambulatory: Telemedicine Hot Topics – States of Emergency Telehealth Services Expiring [Data as of 3/26/21, 5 PM]

• Emergency orders/states of emergency are starting to expire in many states. This impacts provider’s ability to perform telemedicine visits for out-of-state patients.
  • Delaware: unless you are a mental health professional (psychologists, mental health counselors, chemical dependency professionals and social workers) or currently hold a professional license issued by the State of Delaware, per the Division of Professional Regulation, telehealth visits with patients located in Delaware are no longer permitted.
  • Washington, D.C.: telehealth practice with established patients has been extended and is set to expire on 5/15/21
  • Pennsylvania: the licensure waiver for Pennsylvania telehealth practice is set to expire 5/20/21
  • Florida: expires 4/26/21
  • New Jersey: expires 6/30/21
  • New York: expires 4/16/21
• Refer to legal FAQs for information related to individual state waivers and licensing requirements
• Please direct any general questions to JHM Telemedicine or legal-specific questions to Telemedicine Legal will be coming in future weeks……

Screenshots of the above can be found here.

COVID-19 Epic Training Portal link

Epic Training Portal link

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