Emr basics
- 1. Kelsey’s Intern Guide: tech stuff + EPIC (aka preventing date night with the EMR) aka what you really need to know for intern year
- 2. New Innovations • https://www.new-innov.com/login/Login.aspx • Youtube tutorial: https://youtu.be/cEk6GHakjoY
- 3. E source • ohesource.ohiohealth.com • Consult directory • submit UOR
- 4. Email • www.Outlook.office.com • Accessing webex invite https://youtu.be/CcmtAHdfKm4 •
- 5. Call schedule • Www.amion.com or app • Login: gmcfm or grant • How to get on your phone: https://youtu.be/oe08Yj3ETew
- 6. Important numbers • IT: 614-566-EDOC • Operator: 614-566-9000 • Vocera: 614-533-9200 • Office: 614-788-5400 • Central scheduling: 566-1111 • Transfer center 614-566-5127 • Martii – 855-837-8685 • Gen Surg 566-7444 • 393 566-9108 • Save pagers/r1/r2/ob etc into your phone Green 788-5401 Blue 788-5404 Gray 788-5403 Yellow 788-5402 And all other numbers from intern book
- 7. Haiku/Canto • Download – you have to register device and it takes ~24h • http://news.ohiohealth.com/pdf/haikucantosetupti psheet.pdf
- 8. Zoom • Zoom cloud meeting
- 9. Remote access – VM ware • Follow instructions given • News.ohiohealth.com • 2 factor verification via app instead of phone call: Microsoft authenticator • From a PC: go to Mfa.ohiohealth.com, login with opid
- 10. Doximity • You can set “outgoing phone number” to office number • It can connect to epic so when you click on a patient number in haiku it will open in doximity app • You can also get a personal fax number
- 11. How to train your Dragon • How to sign up • esource > IS Support > make a request > search for “dragon” • How to access: now there’s a button within epic • Switching mics • Logout from dragon if logged in • How to use with mic • How to use with phone • Power mic mobile app • http://news.ohiohealth.com/PMM.htm
- 12. Playground • PLY2 • Opid login • Then • login: prov** (where ** is any number between 01 and 19) • password: train
- 13. Badge Tap in! • Saves you time and keystrokes and fingerprints that sometimes don’t work
- 14. Typing skills • We can help you if you need help!
- 15. Contexts • OPG GMCGME FM TOWN • OPG GMCGME OUTRCH TOWN • GMC MED SURG • GMC EMERGENCY DEPARTMENT • GMC ONCOLOGY SURGERY • GMC LABOR & DELIVERY
- 16. Overall Personalize • Personalize left tabs, top overview • Orders pick and click (personalize > preference list composer) • Dot phrases – how to steal • Shared lists – how to add self and other • Wrenching in https://youtu.be/yqQulAGHaeA • Spend 5 min personalizing / reordering at the start of each rotation
- 17. Inpatient Overview • Top bar, personalize button • Second bar – printing/editing handoff, right service, arrow to open handoff in chart, printing list, form reprints • Left, patient lists, how to find floors/ED • Adding self/others to list membership, adding patients to lists • Result/note flags and time marks • Admit order status • Treatment team / sign in
- 18. Handoff • Make sure you are in the correct context • Use arrow to open chart with handoff still on the side
- 19. Inpatient Chart • Summary - Overview, handy tabs, MAR • Chart Review – labs in process, cardio/MUSE, procedures • Synopsis • Flowsheets • Admit / transfer / discharge buttons • Orders – home meds, signed and held • Notes • https://youtu.be/hsvrxTt0QBQ
- 20. Chart review • Filters • https://youtu.be/N6MKy2hMvMw
- 21. Overview tabs to favorite • Delivery, Pregnancy, Labor, L&D Timeline • Peds Flowsheet • Micro • Glucose • Blood transfusion • Fever • Weight • Snapshot
- 22. Flowsheets to favorite • Labor, Mag • Ballard, Finnegan, Screenings • Orthostatic vitals • CIWA • PHQ9, GAD7 • Stop bang questionnaire • Chads2vasc score • Edinburgh post depress • MOCA, Mini Cog, MMS, SAGE • Menstrual and sexual hx • Opioid risk tool
- 23. Order sets to favorite • Adult blood components • CIWA • CCTA • Critical Care Delirium • Electrolyte replacement • DKA/HHS • General Adult Admission • Insulin Adult • Opiate withdrawal • Pain management • VTE Prophylaxis
- 24. Order sets
- 25. Order Sets – OB • c/s admission pre-procedure • Intrapartum glycemic • Labor and vaginal • Labor and delivery triage • Labor and delivery triage – ROL protocol • Labor induction focused • Labor induction admission • OB GBS focused • PROM admission • Preterm labor admission • Vaginal bleeding admission <23w • Vaginal delivery PP orders • Then newborn LPI and term, newborn prophylaxis, newborn circ
- 26. Discharge • Favorite follow up locations • Favorite outpatient orders • Dot phrases for discharge edu
- 27. Lexicomp • Can access link directly when ordering meds
- 28. Accessing Surgery Schedule • “Grant” • Sort by room • Can save to favorite bar
- 29. Accessing L&D board / tracings • Change context to L&D • ***Snapboard scheduling • Tracings via periwatch
- 30. Dot Phrases - Inpatient • .sfm*** • .gfp/.gfm*** (office) • Rat call, sepsis notes • Procedure notes • https://youtu.be/iLuFQf9NyhE inpt/outpt notes personalization
- 31. Dot Phrases - OB • See OB handout • .pregnancy • .obtriage or .gfpobtriage • .oblabs • .obhandoff and .obhandofflabs • .obdcsum • .session1 -- .session10 for centering
- 32. Dot Phrases - Newborn • .gfpboy or .gfpgirl • .gfpnewbornprogress • .gfpnewborndischarge • .gfpcirc • .newborn (Assessment and plan summary statement) • .newbornhandoff
- 33. Dot Phrases - Surgery • Get from your senior on service – h&p, postop check, progress notes, consult notes
- 34. Dot phrases - Peds • Use the smart text box or smart sets • I think .all has some .wcc ones
- 35. Dot phrases - Outpatient • .gfpmednote • .gfmphonevisit • .gfmvideovisit • For problem list to pull in: .probap (assess & plan) .probdiag (just diagnoses) .probov
- 36. Note Contexts • Newborn note in “newborn” • ICU notes in “critical care” • Otherwise typically in FM or GYN context
- 37. User Dictionary autocorrect • https://youtu.be/OeDZU8px9Rc
- 38. Outpatient Chart • Demographics • Treatment team • Rooming • History • Flowsheets • Note • Problem list • Plan • Wrap up • Billing/charges https://youtu.be/Bkj5DJuHUI8
- 39. Viewing your schedule • FM TOWN • View open slots • Customize your schedule template • https://youtu.be/xuoGMuPwsls
- 40. Pick and click orders
- 41. Pick and click orders https://youtu.be/8Qwx3wz0oEk
- 42. Pick and click orders
- 43. Copy user’s favorite orders https://youtu.be/fde3dXc_xzk
- 44. Meds
- 46. Sticky notes • Self – yellow – only for you. I use for personal reminders – how many kids, what they do for work, labs I need to follow up on etc • Blue sticky – specialty comments – general info, good especially if you won’t be seeing them next • Pink – pregnancy only. Continuity person, important info
- 47. Health Maintenance • Good tab to update • Can change modifiers for patient to reflect their status or what schedule they are on
- 48. a/p • Update problem lists • Overview • A/P • Visit diagnoses – wrench in, favorites, past dx • Associate diagnoses
- 49. Maybe you like 3 column view?
- 50. Notes – create macros for ROS and PE https://youtu.be/8Ch9gUP_SJc
- 52. Charge for procedures • More > “charge” • For meds and also for procedure itself
- 53. Tips with your MA • They can do a lot! • Schedule patient for next appt • Add pt edu • Work/school excuses • Coordinate care
- 54. Communications FYI you can fax from right within Epic! https://youtu.be/pu2yVZRlN-Q
- 55. Wrap up • Patient instructions – defaults/speed buttons • Follow up time – quick picks • “Remind me to …” • Send chart on closing to PCP (last thing you do) • also can route any note to PCP under chart review > notes > route button • https://youtu.be/9L_iByK9m-M • https://youtu.be/wogOPytA6Tc speed buttons ***
- 56. MyChart • Sign patient up • More > MyChart utilities > administration • Text / email signup • Super easy: https://youtu.be/Pi1SL7oc3jU
- 57. Refill and or telephone note • Orders only entry • Rx request – approve, deny, open to route to someone else • Phone call/telephone note • Route to your pod MA team • Can sign meds but not encounter if you need something else or need MA to call and make appointment for pt • “indirect supervision” and your advisor as cosigner • Can always call R2, office and talk to preceptor, GFP attending if need advice after hours
- 58. Result notes • Mychart – sends to patient • Call patient – route but don’t close note, tell MA exactly what to say • If abnormal call pt yourself • Always an option to call patient yourself • Can also send letter if unreachable • Result note – “Pt called or mychart message sent” • Some people write whole note there
- 59. Inbox tutorials • Inbox 1 results https://youtu.be/E-wEfXwaJNU • Inbox 2 prescriptions https://youtu.be/FaCoDD7doOg • Inbox 3 telephone https://youtu.be/oVMMGOtIg9I
- 60. Routing 393 Pool: OPG GMCGME TOWN CLINCIAL
- 61. 485 – homecare • Review diagnoses, meds, allergies • Make sure patient has been seen within ~1 year • Initial meds etc and sign OUTSIDE/very edge of of main signature box • Place in 485 bin • More to come in orientation that will be the most up to date
- 62. Staff message • More > send message > staff • Can also send to self! Options tab future date
- 63. Route to PCP! • Please please please • Send on closing chart • Also make sure follow up scheduled with PCP if possible • Also – how to add yourself to treatment team / care team as PCP!
- 64. Visit diagnoses to remember • Need for vaccination • Preventative care visit
- 65. Getting patients! • Give them your business card and/or Grant FP flyer • Tell them about the walk-in clinic • Remind office patients seen in the hospital about walk in clinic • Ask patients on other rotations if they have a PCP – you can be their hospital follow up!
- 66. Must have Apps (Kelsey’s)
- 67. Other apps • Whatsapp – that’s our group text would recommend switching y’all to that app so we can all be on the same one • Evernote • Photos • Take photo of all procedure cards, important documents • Contacts • Save numbers in there • Can save operator, vocera, pager numbers, etc • Also can save ID numbers such as your clock # etc on the notecard of important stuff • Can save passcodes for floors etc
- 70. Kelsey’s Intern Tips https://twitter.com/uts_australia/status/1014796553548992514?s=12 << VIDEO
- 71. Other tips • Have backup pair of scrubs, pair of dress clothes, and pair of underwear/bra/socks in car/locker • Portable snacks • You’ll do great!