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Medicine Matters

Sharing successes, challenges and daily happenings in the Department of Medicine

Medicine Matters Home Patient Care Epic Tip of the Week: May 28, 2021

Epic Tip of the Week: May 28, 2021

Ambulatory: Release of Appointments/Visits to teen Proxies; How to Block when needed

  • The 21st Century Cures Act requires information to be shared with a Proxy of a teen patient (13yo-17yo).
  • The default displays upcoming and past encounters to proxies of teens in most situations.
    • The exception is when a teen may consent to care without a parent or guardian's involvement.
    • Access to a past encounter is necessary to see the After Visit Summary and any notes that were shared in MyChart.
  • Blocking an Encounter:
    • In rare cases, it is appropriate to prevent a proxy of a teen patient from viewing upcoming appointments and past encounters (including associated notes and the After Visits Summary).
    • Notes can be blocked on a case by case basis. To withhold sensitive information from proxies select the “Sensitive AVS.”
    • Note: Blocking an encounter or note does not prevent the sharing of test results.
    • For how to block an encounter from displaying to a proxy of a teen patient click Blocking an Encounter from a Proxy.

Ambulatory: Telemedicine Hot Topics – States of Emergency Telehealth Services Expiring [Data as of 5/25/21, 12 p.m.]

  • 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 5/25/21 [allows for 60 day grace period to wind down patient visits following waiver expiration date]
    • Pennsylvania: Approved for all licensed healthcare providers listed here, until the end of the Pennsylvania State of Emergency, which currently has no end date.
    • Florida: extended through 6/27/21
      • Providers are encouraged to obtain a Florida Telemedicine Registration to continue to see patients once the waiver expires. A tip sheet for this process can be found here.
      • This license is no cost to you; however, some states may require a fee to send Florida proof of your existing licenses. The typical turnaround time is 1-2 business days.
    • New Jersey: expires 6/30/21
    • New York: extended through 6/16/21
  • Refer to legal FAQs for information related to individual state waivers and licensing requirements
  • Direct general questions to JHM Telemedicine or legal-specific questions to Telemedicine Legal

Inpatient & Ambulatory: Add Media Attachments to Notes

  • Add up to five media files as attachments to specific note types
  • Add media from files that have been scanned into Chart Review in the Media tab, or from a Network or Department Shared Drive.
  • Click on “Attached Files” to view files that have already been attached.
  • Click on “Add” in the dialog box, to add additional attachments. A tip sheet is available here.

Inpatient: Sensitive AVS for Inpatients

  • Information is considered sensitive if it could potentially cause harm to the patient or someone else.
  • The "Sensitive AVS" section appears above the "Orders/Med Rec" section of the Discharge navigator.
  • Responses default to "yes." If "no" is selected, a reason and comment are required.
  • Complete the Sensitive AVS section before placing the discharge order set to be sure that the “patient-friendly reason for hospitalization” does not appear.

Screenshots of the above can be found here.

COVID-19 Epic Training Portal link

Epic Training Portal link

For more Epic Tips of the Week, click here.


Kelsey Bennett