Epic Tips: August 19, 2022

Additional August 4^th Upgrade Resources and Communication

• Ambulatory: View In Basket enhancements in this 26 minute Ambulatory In Basket Overview Video
• Ambulatory: Hyperspace Stops Responding When Acting on a Refill Request In Basket Message with Duplicate Medications
• Ambulatory: Prescription Refills Are Signed After a Non-Authorizing Clinician Clicks Refuse All in a Specific Scenario
• AllProviders: If you need to request a Cosigner: Click the icon pictured right, then indicate the name of the co-signer.
• All Providers: Broken Image links appear in Notes and may cause data loss under certain conditions
  • This issue will be resolved between 8/15/22-8/21/22
• All Providers: Quick Communications Automatically Send at Sign Encounter & May Not Have Up-to-Date SmartLink Information if They are Edited Prior to Being Sent
• All Users: Since the upgrade, several Epic workflows are experiencing slowness, sometimes significantly. Several contributing factors have been identified and work continues to improve the situation.

Inpatient & Ambulatory: QuickAction Issue

• Since the Epic upgrade on 8/4/22, In Basket QuickActions meant to refuse or deny prescription renewal requests were incorrectly approving those requests. This error occurred only with QuickActions.
  • Refusals entered through the “Refuse and Route” button () work correctly.
• If you have used a QuickAction to refuse any Rx Requests since 8/4/22, please check for and correct any unintended approvals by going to the button at the bottom of the list of messages on the left side of your In Basket.
• The problem was fixed as of 8/12/22 and the providers impacted have been contacted. The solution is temporary, and required adding a few extra buttons to the toolbar in the Rx Request folder. We hope to restore the previous list of buttons soon.
• You may still rearrange your buttons (click and drag) without causing any problems.

Inpatient: Eloped Added to Discharge Disposition List

• “Eloped” is an option under the magnifying glass in the Patient Ready for Discharge order.
• For guidance on when to use Eloped vs. Left Against Medical Advice, see the educational flier at AMA and Elopement Policy: Key Points for Staff
• Review the blog post here.

Ambulatory: Outpatient Imaging Orders Priority Level Protocol

• Enter a testing priority to ensure patient care needs are met
• The Priority field guidelines are below:
  • STAT: For testing with potential critical results resulting in harm within hours or days if not treated.  Provide your cell phone number on the order, so that radiologists can communicate critical results after hours.
  • ASAP: For tests that are required in less than 5 days for decision making.
  • Routine: For tests that can wait for the next available appointment.
• Clinicians will only be called for critical findings.

Ambulatory: Verbal Order Modes for Non-Oncology Therapy Plans

• This change affects verbal order modes ONLY. Providers entering their own therapy plans are not affected.
• Ambulatory Non-Oncology Therapy Plans only include the following verbal ordering modes:
  • Ordered during downtime
  • Transcribed
• Beacon-Owned Therapy Plans only include the following verbal ordering modes:
  • Ordered during downtime
  • Per protocol: no cosign required
  • Transcribed
• To ensure the entire plan is routed to an authorizing provider select Send Plan (under Actions). See screenshot here.
• Review the blog post here.

Ambulatory: CPT II Codes Autogenerate in Encounters for Blood Pressure and HgA1c Values

• To promote efficient communication with payors, CPT II Codes (supplemental tracking for quality care gap performance measurement with zero billable charges) automatically drop for all face to face, lab, and video encounters based on Blood Pressure [BP] and HgA1c values.
  • BP CPT II codes drop based on BP readings documented on the current encounter, including both documented during a visit and patient reported BP values.
  • HgA1C Codes drop based on HgA1C value that was collected & resulted on the day of the encounter.
• Review the blog post here.

Ambulatory: Influenza 2022/2023 Vaccine Season

• The Influenza Health Maintenance topic is active. The BPA launches on September 1^st for JHCP and September 21^st for the remainder of the health system.
• For more information review the blog post here.

Ambulatory: Telemedicine Hot Topics – States of Emergency Telehealth Services Updates [Data as of 8/10/2022]

• The Office of Telemedicine launches new training portal for quick access to training videos, tip sheets, and other resources to assist providers and patients.
• Update – Direct link to the most recent Telemedicine Regional Waiver Grid
• 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.

-Juliet Allen, MSN, RN, Business Solutions Analyst, Health IT Optimization & User Wellbeing

COVID-19 Epic Training Portal link

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