2017 Ambulatory Upgrade · This means that you will not be able to personalize anything until after the upgrade. Help During the Upgrade We will have a command center on July 23,

1 Revised on 7/11/17

2017 Ambulatory Upgrade Introduction ............................................................................................................................................................................ 3

Help During the Upgrade ........................................................................................................................................................ 3

Usability Changes .................................................................................................................................................................... 3

Personalization Tip: How do I Change My Theme? ................................................................................................................ 3

A Friendly Reminder: Chart Correction ................................................................................................................................... 3

Changes to the Schedule ......................................................................................................................................................... 5

Personalization Tip: Adjust your schedule .............................................................................................................................. 5

Snapshot and Chart Review .................................................................................................................................................... 8

Quickly Mark Key Info as Reviewed from SnapShot ............................................................................................................... 8

Chart Search ............................................................................................................................................................................ 8

Thrive Tip: Use Chart Search .................................................................................................................................................. 9

Personalization Tip: Creating Filters in Chart Review ........................................................................................................... 11

Personalize Chart Review Tabs with color and a different order ......................................................................................... 12

Chart Review: Change to the Notes Tab ............................................................................................................................... 12

Chart Review: Change to the Labs Tab ................................................................................................................................. 13

Chart Review: Change to the Orders Tab.............................................................................................................................. 14

Problem List: Calculator Added for Certain Specialties ........................................................................................................ 15

Problem Oriented Charting: Write your notes in fewer clicks .............................................................................................. 21

Personalization Tip: How to Document using Problem Oriented Charting .......................................................................... 22

Order Management .............................................................................................................................................................. 23

Simple Icons in the Meds & Orders Section .......................................................................................................................... 23

Personalization Tip: Keep Unsigned Orders in Sight ............................................................................................................ 24

Personalization Tip: Discontinue and Modify Meds Faster with Personal Speed Buttons ................................................... 25

Order Search Results Are Split into Logical Sections ............................................................................................................ 26

See a Referred to Provider’s Availability ............................................................................................................................... 27

Use Speed Buttons to Resolve Over-Dispenses .................................................................................................................... 28

Avoid Ordering Errors that could result in a critical overdose. ............................................................................................ 28

Critical Dose Warnings Help You Avoid Dangerous Errors ................................................................................................... 29

Easily Identify Pregnancy and Lactation Warnings Caused by Missing Documentation ...................................................... 29


Send Prescriptions to Multiple Pharmacies at once ............................................................................................................. 30

Health Maintenance and Immunizations .............................................................................................................................. 31

Quickly See when Care is performed elsewhere .................................................................................................................. 31

Immunizations Given Elsewhere Now Satisfy Health Maintenance ..................................................................................... 31

Deferred Immunizations from Admissions Now Appear ...................................................................................................... 32

Notes ..................................................................................................................................................................................... 32

Annotate the Plantar View of the Foot in Your Physical Exam Notes .................................................................................. 32

Use Notewriter and see the sidebar report at the same time.............................................................................................. 32

Quickly Add a Narrative to HPIs You Document in NoteWriter ............................................................................................ 34

Document Neurological Exams in the NoteWriter ............................................................................................................... 34

Wrap Up ................................................................................................................................................................................ 35

Quickly Send a Patient's Chart During Follow-up Documentation ....................................................................................... 35

AVS ........................................................................................................................................................................................ 35

Change the font size of the AVS when printing .................................................................................................................... 35

Thrive Tip: Delegate your In basket when you are on vacation ........................................................................................... 36

Attach to another’s In basket................................................................................................................................................ 37

Pre-charting........................................................................................................................................................................... 37

Haiku/Canto .......................................................................................................................................................................... 39

Growth Charts ....................................................................................................................................................................... 45

Clinicians Can Review Growth Percentiles for Pediatric Patients in SnapShot ..................................................................... 45

Use BMI Growth Chart for Premature Patients .................................................................................................................... 45

Use Extended BMI Growth Charts for Severely Obese Patients ........................................................................................... 45

Rooming Updates .................................................................................................................................................................. 46

Spot Differences Between Outside and Local Medications .................................................................................................. 46

MyChart Questionnaires ....................................................................................................................................................... 46

Current Functionality: Update a patient's history with data entered in MyChart through InBasket ............................... 47

A Cleaner Look for Flowsheets .............................................................................................................................................. 49

OB Changes ........................................................................................................................................................................... 50

Upgrade Resources ............................................................................................................................................................... 51


Introduction We will be upgrading to Epic 2017 on July 23, 2017. Starting July 17th, we will be on a transparent lockdown.

This means that you will not be able to personalize anything until after the upgrade.

Help During the Upgrade We will have a command center on July 23, 2017. The number is x3883.

Usability Changes Hyperspace themes affect the look of Hyperspace, including patient workspaces. After choosing a theme, you

can choose a decoration (new to Epic 2017). The decoration appears on the bottom left of workspaces. Deep

blue is the most eye pleasing theme for the training team.

Personalization Tip: How do I Change My Theme? Choose Epic button > Personalize > Themes or Decorations

To set it back to the default, follow the same path and choose Default.

A Friendly Reminder: Chart Correction You can send a message to the Chart Correction team when you are unsure of how correct an error in

documentation. For example, you notice that a note was recorded on the incorrect patient’s chart (ex: John

Smith’s note was entered on Jane Smith’s Chart) or incorrect documentation of an immunization.

To send a chart correction use the icon on the top right corner of the Epic Screen.

A pop up will appear that requires you to fill out the information needed to fix your documentation. It is imperative to

include detailed information about the problem and what needs occur to fix it.


Follow these steps to fill out a chart correction

1. Click the Magnifying glass to choose “Patient Information – Chart Correction”

2. Type a brief synopsis in the subject

3. Review this is the correct patient

4. Write detailed information about the problem and what needs to be fixed. Feel free to fill out any additional

information if pertinent

5. Click Send

Please note: If you send something to the correction team that you can fix yourself, they

will contact you to help you fix your documentation.


Changes to the Schedule A patient's preferred name now appears in quotation marks in the Patient column of the Schedule activity.

Personalization Tip: Adjust your schedule Customize your schedule to see the patient information you find most useful. Consider adding or removing

columns and changing the order in

which they appear to suit your

personal preferences.

To Adjust the columns:

1. Go to your schedule.

2. Select your name folder from

the My Schedule group

below the calendar. You

cannot make changes to any

other schedule but your own.

3. Click above the folder list

to customize your schedule.

4. To reorder your columns,

select one from the Selected

Columns list and click or

to move it.

5. To add a column, select it

from the Available Columns

list and click Add. For example, select the Meds Due column to see whether the patient has a

medication due, or select the Referring column to see the referring provider for the visit.

6. To remove a column, select it from the Selected Columns list and click Remove. For example,

remove the Provider column if your schedule lists only your visits.

7. Click Accept when you're finished.


Please note if a column doesn’t work that would be useful to you please submit a ticket for optimization.

To Make a New folder to see a different department schedule for your provider:

This is especially helpful if you your provider goes to multiple clinics. You can still log into your home

department and see everything that you need!

1. Go to your schedule

2. Click the Create button found under the Calendar 3. Name your new folder on the General tab 4. Click the Configuration tab 5. Search for the department you are looking for in the

department field 6. Click on the provider and click the add button to see the provider’s schedule for that department 7. Click Accept


Make a new folder to see a provider’s schedule regardless of department

1. Click the provider all departments. 2. Search the provider that you would like to add 3. Click Accept.


Snapshot and Chart Review

Quickly Mark Key Info as Reviewed from SnapShot To help save time and clicks, you can now mark allergies, medications, and the problem list as reviewed from SnapShot.

Note that the button marks medications as reviewed only when you click it within a specific patient encounter. If you’re

just reviewing the patient’s chart outside of an encounter, you can’t review medications with this button.

*** Make sure that your patient is checked in when you hit Mark as Reviewed in order to count for Meaninful Use and

MIPS/MACRA measures. If done outside of an encounter it will not count***

Chart Search A few updates for Chart Search:


• It shows only a

single row of filter

buttons.

• Matching results

appear bold in the

sidebar, not green.

• Year banners

appear on the left

side of the sidebar.

Thrive Tip: Use Chart Search If you're looking for something specific, or just want to see information that's relevant to a certain condition, save

clicks and search the chart. For example, search for "hypertension" to see problems, clinical notes, medications,

and other orders related to that condition.

Pro Tip: Use Chart Search to look through the media tab. It is able to search the document type and the

document description, but unable to look at the actual scanned document.

1. Within a patient's chart, enter a keyword in the Search field at the top right of Hyperspace and press

ENTER. Results appear organized by date in the Search tab of the sidebar, so you can get an idea of the

history.

Press CTRL + SPACEBAR to quickly move your cursor to the Search field.

2. Hover over a search result to see more info. For example, hover over a medication to see its history,

hover over a problem to see relevant meds and labs, and hover over a note to see relevant snippets.

• If necessary, click a search result to open a full report.

• If you get too many results, narrow them down using the filter buttons at the top.


Search tips:

• Enter a search term in quotation marks to find results that include only that exact phrase. If you

don't enter quotation marks, you also see results for common synonyms and related terms. For

example, if you search for arrhythmia, you see results related to arrhythmia, chest pain, and

fibrillation.

• Refine your search results by using the AND operator. For example, enter arrhythmia AND pain

to see only results related to both terms.

• Click at the top right of the Search sidebar to group results by encounter instead of by date.

o When organizing your results by encounter, click an encounter heading (indicated by )

to open the encounter report.

• Click in the Search sidebar to see more tips on searching effectively, including a list of all the

items that are included in a search.


Personalization Tip: Creating Filters in Chart Review You can find specific patient data faster in Chart Review by creating Quick Filters. For example, you can create a Quick

Filter that shows only encounters for which you were the provider. You can also filter on specific medications, orders,

chief complaints, and more. Quick Filters appear for all your patients. Other clinicians can't see your Quick Filters.

The filter options you see are based on the information in the patient's chart, so they vary by patient. To Create the best Filter, choose a patient that has lots of data.

1. In Chart Review, choose a tab that you would like to create a filter. Click Filter to see the different options to filter under.

2. To save your current combination of criteria as a Quick Filter, click Save as New Filter. The Save Quick Filter window appears.

3. Enter a name for your Quick Filter and click Accept. The filter appears as a check box with the name you entered above the list of encounters.


Personalize Chart Review Tabs with color and a different order Choose your tab order, decide which tab you see first, and update tab colors all from one place.

1. To customize multiple tabs at once, click the

wrench and select Manage Tabs.

2. Change the order by using the arrows at the

bottom

3. Change the color of a tab by clicking on the

magnifying glass

4. Click the start will set the tab as default.

5. Choose the reset to defaults button to set

back to the original settings.

Chart Review: Change to the Notes Tab 1. Note statuses now appear as icons, like the yellow diamond for incomplete notes.

2. Hover over an icon or the simplified Author column to see more information.

3. Notes you wrote show "Me" in green.

4. ED Provider and Discharge Summary notes appear red.

5. Notes outside your specialty and login department appear gray.


Chart Review: Change to the Labs Tab Abbreviations for various types of abnormal lab test results have been replaced with icons in Chart Review.


Chart Review: Change to the Orders Tab

See updated order statuses on orders-based tabs in Chart Review, like Medications,

Labs, and Other Orders. These statuses better match what's in the patient's legal

medical record. For example, Standing and Future orders now appear as Active.


Problem List: Calculator Added for Certain Specialties When a clinician selects a diagnosis on the Browse tab that has available modifiers, such as anemia or broken arm, the

Problem List Calculator now appears so they can select the appropriate modifiers for that diagnosis.

In the Specific codes section the calculator will not appear. The calculator section will show the calculator to add more

specificity.

Here are the lists per department. These lists were created with the help of our CDI team and Dr. Moss.

***If you would like to try this functionality please see the trainer after class. We can’t test this with our current

user***

CV Surg


Heart Vasc Inst

Neurology



Neuro Surg Spec


OBGYN


PSYCH


Pulmonology

Problem Oriented Charting: Write your notes in fewer clicks When adding a new problem to the problem list, click the Continue to A&P button to jump into Assessment Plan Note.

Please note the order in which you document on the problems in the problem list will be the order that they will be

pulled in for your note. For example, if I document on Diabetes, then Asthma, then COPD, the A&P notes will pull into

my note in that order.


Personalization Tip: How to Document using Problem Oriented Charting Write a problem overview

Use an overview note to provide the summary of a problem. This note is not specific to a single visit. Any clinician can

add to or edit it over time.

In the Problem List navigator section, click the name of the problem you want to document.

Click Create Overview.

Document your overview using SmartTools and free text.

Click Accept when you've finished.

Write a Current Assessment & Plan Note

Use assessment and plan notes to track the progress and treatment of a patient's health conditions from initial onset to

the present day. Every time you see the patient and address a problem, you can write a new assessment and plan note

about the current state of the problem and your current plan for treatment. You can then use a SmartLink to pull this

note into the Assessment/Plan section of your progress note for the visit. All past assessment and plan notes for a

problem can be accessed from the Problem List. Other clinicians can view but not edit your past notes.

In the Problem List section,

click the name of the

problem you want to

document.

Click Create Current

Assessment & Plan Note.

Document your current

assessment and plan for

this problem using

SmartTools and/or free

text.

Click Accept when you've finished.


To view previous assessment and plan notes, click Last Assessment & Plan Note or View All Notes.

Use the smartphrase .proborient or .proborientnw (NW stands for Notewriter) to document your note using the

assessment and plan outline.

Order Management For these exercises, please use your 9am Fillipe patient.

Simple Icons in the Meds & Orders Section The Modify, Reorder, and Discontinue/Cancel buttons are now icons – the button labels have been removed to save

space and create a cleaner view of the med list.


Personalization Tip: Keep Unsigned Orders in Sight Clinicians see unsigned orders at the top of the medication list instead, an Unsigned Order on Top check box appears in

the section's personalization options. Clinicians who prefer seeing unsigned orders at the bottom of the medication list

can leave the box cleared.

1. Click the wrench in the medication and orders section.

2. Put a checkmark in the Unsigned order on top


Personalization Tip: Discontinue and Modify Meds Faster with Personal Speed

Buttons You can create up to four personal speed buttons to quickly enter common discontinue and modification reasons when

managing a patient's medications. Click the wrench in the Discontinue Prescription or the Medication List Maintenance

window to customize your buttons.

There are 4 customized buttons for you.

• Duplicate order

• Error

• Discontinued by another clinician

• Therapy Completed

If you would like to change these buttons, follow the

steps below.

1. Click the Discontinue button

2. Click on the wrench next to discontinue reason.

3. Choose the new discontinue reason

4. Click Accept.


Order Search Results Are Split into Logical Sections Different types of orders are separated more clearly in order search results. Click the heading of a section to collapse it.

Use the Red X to remove an order.


See a Referred to Provider’s Availability Try this out:

1. For this update order

any referral.

2. Click on the blue

summary sentence to

adjust the details of the

order.

3. Click on the magnifying

glass to choose the

provider

4. The provider finder box

appears

5. Scrolling to the

right you can see

the Avg Utilization

column which

shows how busy a

provider is each

day and the Avg

lead days column

which shows how

many days until

the patient can

schedule an appt

with that provider.

6. Remember if you

are having trouble

finding a provider

remove their

specialty.


Use Speed Buttons to Resolve Over-Dispenses If the total days supplied for a medication is greater than the specified duration, you can click new speed buttons in the

warning that appears to resolve the discrepancy

Try this out:

1. Edit the Hydrocholorthiazide 25mg medication by using the pencil

2. Change the Duration to 30 days

3. Look at the dispense section and notice the buttons above

Avoid Ordering Errors that could result in a critical overdose. Try this out:

1. Order Ativan

2. Change the dose to 30

3. Review the following error message


Critical Dose Warnings Help You Avoid Dangerous Errors If you try to administer an extremely high dose, a critical dose warning now appears. You'll see these warnings on the

MAR regardless of whether the ordering clinician previously overrode them.

Easily Identify Pregnancy and Lactation Warnings Caused by Missing Documentation Now it's easy to identify the medication warnings that appear because a patient's pregnancy or lactation status hasn't

been documented. Seeing this information up front can help you act on the warning more efficiently.


Send Prescriptions to Multiple Pharmacies at once Try this out:

1. Order 2 different medications

2. Click the blue link for the pharmacy

3. Click the Add pharmacy button

4. Add a new pharmacy in by searching by name and click the search button

5. Notice Patient’s and clinic’s nearby Zip codes are checked. Uncheck this for a broader search


6. Review the radio buttons under show

7. Click Accept when you have chosen an additional pharmacy

Health Maintenance and Immunizations Try this out:

1. Use your Filipe patient

2. Find the Health Maintenance Group in the sidebar report or on the snapshot report

3. Hoover over the Influenza topic to review the last time this was completed.

Quickly See when Care is performed elsewhere When a patient receives preventive care outside your organization, the Care Everywhere icon now appears next to the

date a Health Maintenance topic was satisfied. If the patient had a procedure, click the date for more information about

where the patient was seen.

Immunizations Given Elsewhere Now Satisfy Health Maintenance Immunizations from outside sources such as state registries now satisfy Health Maintenance before you reconcile them

into the chart. The Care Everywhere icon indicates an immunization hasn't been reconciled yet.


Deferred Immunizations from Admissions Now Appear You can now see immunizations that were ordered but not given during admissions. Review these immunizations in the

Recently Deferred section of the Immunizations Activity. Order them again if you want to administer them.

Notes

Annotate the Plantar View of the

Foot in Your Physical Exam Notes The plantar view of the foot is now available for

annotation on the Musculoskeletal section on

the Physical Exam tab in NoteWriter.

Use Notewriter and see the sidebar report at the same time When Using a note that that has Notewriter on it, you can now see the side bar report by doing the following:

Try this out

1. Open the Notes Activity

2. Move your notes to the sidebar by clicking the boxes in the upper right corner and select move to the

sidebar

3. Use the dropdown arrow next to Create Note and select the Standard Visit Note

4. Click on the any of the Notewriter buttons for example, HPI

5. Click on the and click if you would like the report to show on the left or on the right



Quickly Add a Narrative

to HPIs You Document

in NoteWriter When you need to include more

of a narrative in your HPI, you no

longer have to go to a separate

Comments tab or edit the note

text itself. The Comments tab has

been replaced with a Narrative

section that at the top of HPI

form.

Click the wrench to create speed

buttons that pull in your commonly used text. Use the divider below the field to resize the section or collapse it until you

need it.

Document Neurological Exams in the NoteWriter Use a fresh, uncluttered NoteWriter form to document your neurological exam findings. Additional options appear when

you document an abnormal finding.

Try this out:

Type .PENEUROEXAM in any note to open the form.


Wrap Up

Quickly Send a Patient's Chart During Follow-up Documentation Click Send Now to send someone a CC’d Charts In Basket message without closing the section or workspace.

AVS The AVS has changed dramatically to make it more eye appealing for the patients. It now has a dynamic sidebar that

may appear.

• The sidebar does not appear in the following situations:

• The content doesn't fit within the sidebar.

• The content next to the sidebar would overlap with the sidebar.

• The AVS report is in multiple languages.

• A small amount of content would appear in the body of the AVS, making the content and sidebar appear

unbalanced.

Change the font size of the AVS when printing Try this out:

1. Go to the Wrap Up Tab


2. Click the Print AVS Button

3. Look at the different printing options

Thrive Tip: Delegate your In basket when you are on vacation Instead of letting your In Basket messages accumulate while you're away from the office, use the Out of Contact

activity to ensure that your most urgent messages are followed up on in a timely manner. For example, if one of

your patients has abnormal results that need to be reviewed while you are out, another designated clinician can

access your In Basket, review the results, and take the appropriate follow-up actions.

To set up this feature:

1. From In Basket, click Out on the In Basket toolbar.

2. Use the Out of Contact table to see any of your existing Out of Contact occasions, along with the dates,

times, reasons, and delegates for each outage.

3. To add a new Out of Contact occasion, click New

4. Select the reason for your Out of Contact occasion. Optionally, add a comment.

5. Enter beginning and ending dates and times for your Out of Contact occasion.

6. Enter delegate users to cover for you while you're out. Your In Basket automatically appears under the

Attached In Baskets tab for your delegates while you're unavailable.

Tip

Your delegates do not receive any automatic notification that they will be covering for you. Although your In

Basket appears in the delegate users' In Baskets as soon as you're out, you should tell your delegate about the

outage in person.

7. Click Accept to close the Out of Contact window and save your Out of Contact occasion.

•To modify an existing Out of Contact occasion, select it and click Edit.

•To delete an existing Out of Contact occasion, select it and click Delete.

•To see updated information in the table after changes have been made, click Refresh All.


Attach to another’s In basket You can attach to another’s inbasket temporarily or permanently if you wish

1. From the In basket click

the attach button

2. To permanently attach,

place the user’s name in

persistent attachment

section. You can check

and uncheck the show

button to see their basket.

3. Temporary Attachment

work in the same manner

except the attachment is

only good for 1 log in

session. If you log out,

you will need to attach to

their in basket again.

Pre-charting Pend orders, enter diagnoses, and start writing your note before the patient arrives. If the patient never shows up, your

documentation is automatically deleted after 30 days.

If someone forgets to check in your patient, click the Start Visit button.

Question Epic Default

Who should be able to pre-chart? Providers and clinical staff

How many days prior to the visit should someone be allowed to pre-chart?

7 days

What information can be pre-charted? Problems including problem oriented charting, Visit Diagnosis, Notes, and pend Orders

What tools should be available in the pre-charting workspace?

In the activity tab menu:

• Chart Review

• SnapShot

• Synopsis


• Pre-Charting Navigator

• History

In the More Activities menu:

• Admin

• Allergies/Contraindications

• Calculator

• Care Teams

• Communications

• Demographics

• Document List

• Enter/Edit Results

• Episodes of Care

• FYI

• Graphs

• Growth Chart

• Health Maintenance

• Immunization

• Media Manager

• Medications

• MyChart Utilities

• Order Review

• Patient Labels

• Problem List

• Results Review

• Review Flowsheets

• Send Message

In the Sidebar:

• This Visit report

• Notes

Who can view pre-charted data? Only clinicians who have worked in the pre-charting encounter can view this

What information should be cleaned up if a patient no shows and when?

All pended orders and notes will be removed automatically after 30 days of the scheduled visit via a batch job

Try this out:

1. Open the visit for Fiona at 3pm

2. Pend orders, enter visit diagnoses, and write your note as you normally would.

3. If the patient arrives while you have the workspace open, click Start the Visit to get access to all of your

standard tools.


Haiku/Canto

Epic Haiku and Canto With Epic Haiku and Canto you will be able to access the complete patient record anywhere from your mobile phone or

IPad.

Search for your patient list, see your schedule, and review patient information such as admission information and

progress notes (inpatient or outpatient). View vitals and see a snapshot of medications, allergies and problem list. You

can have Lab and Imaging results at your fingertips.

1) Download Haiku from the app store for IPhone or Canto app for IPad

2) Click on Haiku/Canto Icon and agree to license agreement

3) 4) Email me your -IPhone or IPad Device ID

. To find the Apple Device ID


At the Haiku/Canto login screen, tap the banner ” No environment configured” -at the top

Next screen that appears

Click OK

Hit “Identifier “ near the bottom of screen


Choose EMAIL and send to [email protected] –let me know if this is an IPhone or IPad-Click Ok

mailto:[email protected]


5) Cancel out of App

6) Make sure that you are on OSLER network before next step

7) Open my return email on your device it will contain a .txt file> copy the blue link in email and paste file into your

internet browser on your apple device.

8) Configuration password is RiversideHaiku (must be typed exactly)for IPhone and RiversideCanto for IPad

9) Login using your Network credentials

10) To log out--bottom of screen MORE>OPTIONS>LOG OUT

Epic Haiku for Androids With Epic Haiku you will be able to access the complete patient record anywhere from your mobile device

Search for your patient list, see your schedule, and review patient information such as admission information and

progress notes (inpatient or outpatient). View vitals and see a snapshot of medications, allergies and problem list. You

can have Lab and Imaging results at your fingertips.

11) Download Haiku from the app store


12) Click on Haiku Icon and agree to license agreement

13)

14) If using Chrome as your browser you must download any other browser to complete this setup

15) Email me your –Android install ID

. To find the Install Device ID

a. Upper Right corner click on the 3 dots

b. Click on settings box


c. Click on About –information about Haiku

d. e. Click "Install ID”

f. g. Choose EMAIL and send to [email protected]

16) Cancel out of App

17) Make sure that you are on OSLER network before next step-

18) Open my return email which will contain a .txt file> copy and paste file into your internet browser (remember

must be something other than Chrome to complete setup)

19) Configuration password is RiversideHaiku (must be typed exactly)

20) Login using your Network credentials

mailto:[email protected]


Growth Charts

Clinicians Can Review Growth Percentiles for Pediatric Patients in SnapShot Pediatricians and other pediatric clinicians can now see growth and blood pressure percentiles right next to recorded

vital sign information in their SnapShot reports for patients under the age of 20 years old. A hyperlink to the Growth

Chart has been added to quickly move to that activity.

Try it out

1. Open the 3pm Fiona appt.

2. Open the sidebar

3. Click the Growth Chart

Use BMI Growth Chart for Premature Patients See your premature patients' BMI data points plotted on the new Olsen BMI chart.

Use Extended BMI Growth Charts for Severely Obese Patients The new extended BMI growth charts are based on source data from the American Academy of Pediatrics and provide

detail about data points that are beyond the 97th percentile.

Unchecking apply patient filter shows you all of the Growth Chart Options


Rooming Updates

Spot Differences Between Outside and Local Medications When reconciling outside medications with the patient’s chart, you now see both the outside and local names of the

medications. This helps ensure that you don't inadvertently add the wrong medication to a patient's med list in cases

where the outside organization uses the same NDC for a different medication.

MyChart Questionnaires A patient-reported icon appears next to any item in Surgical History and Medical History that was entered in a MyChart

patient questionnaire. By clicking on an individual patient-reported item, a clinician can either select the Approved by

Clinician option to indicate that it has been reviewed or remove the item if it is not valid. The icon disappears after an

item has been verified.


Current Functionality: Update a patient's history with data entered in MyChart through InBasket When a patient completes a history questionnaire in MyChart, you can review the answers and add the information to

the patient's chart with just a few clicks. This can be done before a visit through inbasket or during the rooming process

during the office visit. At this time, history questionnaires are generated for patients who are scheduled for a New

Patient visit.

To complete by using Inbasket outside an office visit:

1. Open your In Basket and go to the Pt Hx Questionnaires folder.

2. Select the message you want to review and click Update Hx. A MyChart encounter opens.

3. Open the Patient Hx navigator section and review the patient's responses. Select the check box for each response

you want to add to the patient's medical history. Do not add any history that the patient has selected No to unless it

is a pertinent negative.


4. Click File & Close at the bottom of the navigator section and then click Yes in the warning box pop up window. The

responses now appear alongside other history information documented for the patient.

In History, you can identify patient-entered responses by clicking the Audit Trail Report in the lower right corner of each

section. "Patient" appears in the Source column if the information came from a MyChart questionnaire.

5. When you're finished, open the Sign Encounter navigator section to close the encounter and return to your In

Basket.

6. Select the message from step 2 and click Done to remove it from your In Basket.

To Complete From the Rooming Navigator during an Office Visit:

1. Open the Patient Hx navigator section and review the patient's responses. Select the check box for each response

you want to add to the patient's medical history. Do not add any history that the patient has selected No to unless it

is a pertinent negative.


2. Click File & Close at the bottom of the navigator section and then click Yes in the warning box pop up window. The

responses now appear alongside other history information documented for the patient.

3. Click Mark as Reviewed

A Cleaner Look for Flowsheets We've removed most of the dark colors and shading from the Flowsheets activity, flowsheet navigator sections, and

flowsheet reports to make sure that flowsheet information is easy to spot.

For example, previously in navigator sections, group headings and rows featured background shading and dark lines, and

most buttons were shaded rectangles:

Now, headings use font color and a larger font size to stand out. Flowsheet rows within a group are set off by lighter grid

lines and more white space. Icon buttons and check boxes give the navigator a simpler, more attractive look.


OB Changes The Prenatal Notes and Vitals section is simpler to use. You can click View Report to launch a Sidebar report to see

older notes, which frees up space in the navigator

section for writing and editing your current note.

You can also click Go to Notes to open the Notes

activity to addend or delete previously written

notes.


Upgrade Resources Epic Updates on Rivernet has this packet under the Ambulatory section.

Documents

2017 Ambulatory Upgrade · This means that you will not be able to personalize anything until after the upgrade. Help During the Upgrade We will have a command center on July 23,