***For RWJBH and Rutgers Providers Live on Epic***

May 18, 2023

Provider Top Stories

Attn: Physician Leaders and Practice Managers! Share these key items in your meetings:

Ambulatory and Inpatient Providers:

• This is your final semi-weekly Epic Provider Newsletter! Beginning next week, we return to the normal weekly, Wednesday cadence.
• Exciting Update! Once a performing provider signs their portion of an e-consent, they can push the consent to the patient's MyChart for the patient/designee signature.
• This is especially helpful when a provider needs to obtain patient consent via telehealth or over the telephone.
• Please promote MyChart to your patients.

Inpatient Providers:

• APPs placing blood Administration orders must enter an authorizing provider.
• Medication updates after Discharge Med Reconciliation may require re-reconciliation and re-printing the After Visit Summary.
• Discharge as Deceased refresher.
• Help with Outpatient in A Bed Patient Status Order and Level of Care

Today's Wave 4 Top Ten

Today's Wave 4 Top Ten

• Currently no open issues to report.

Wave 4 Epic Tip Sheets

We are providing links to tip sheets and change readiness talking points on key Epic workflows that are a focus for Wave 4 Providers.

Please click the links below to review these important Epic workflows.

Remember, all tip sheets are readily available by pressing F1 and accessing your Learning Home Dashboard.

APPs Placing Blood Administration Orders

APP-Placed Blood Administration Orders Require an Authorizing Provider

APPs placing blood administration orders will need to select an Authorizing Provider. Follow the steps below:

• Access Orders.
• Search "Blood" and select Adult Emergency Release Blood Transfusion Order Set.

• When APPs order the Adult Emergency Release Blood Transfusion order set, they are prompted to enter an Authorizing Provider.
• Update the Authorizing Providers field and click Accept to save your edits.

• Click here to review the APPs - How to enter Authorizing Provider for Emergency/MTP Blood Orders.

Discharge Medication Administration Updates

Updates to Medications After Discharge Medication Reconciliation Is Complete

• IMPORTANT! If you have completed discharge medication reconciliation and you prescribed a new medication(s) or changed the discharge medication order(s), you will need to repeat the discharge medication reconciliation process.
• Then, the provider needs to inform the nurse, so the correct After Visit Summary (AVS) can be provided to the patient. 

Discharge as Deceased Workflow

Discharge as Deceased Refresher

• When a patient expires during admission, it is appropriate to "Discharge as Deceased" in the Discharge Navigator.
• From the Discharge Navigator, select Discharge as Deceased.
• Enter the Date of Death and Time of Death to accurately reflect the patient's passing.
• In the Discharge Summary, select Create Note.

• This will generate the correct note template with preliminary cause of death included.

• If the discharge summary was already signed, but was not properly created with the death summary template, you can select the incorrect note > addend > then add the specific verbiage required by HIM compliance.
• Click here to review the Discharge Navigator Tip Sheet.

Outpatient in a Bed for Extended Recovery Time

Outpatient in a Bed Patient Status Order Clarification

• "Outpatient in a Bed" is the correct patient class for outpatient surgery or outpatient procedure patients who need extended recovery time before discharge.
• While "Observation" may seem correct, all charges for a patient's outpatient surgery are included in the surgery case. Therefore, Observation Patient Class, dropping hourly bed charges, is an incorrect Patient Status Order for extended recovery scenarios.
• When Outpatient Surgery/Outpatient Procedure patients require extended recovery time, please place an "Outpatient in a Bed" patient status order.

Click here to review the Patient Status Order Tip Sheet for more information.

Level of Care Defined

What is Level of Care?

Entered by the provider at the time a Patient Status Order, Transfer Order, or Patient Status Update Order is placed.

Level of Care is:

• Provider designated determination of the level of care the patient requires at the time.
• Drives inclusion/exclusion criteria for clinical decision support rules and alerts.
• Medicare and payor required fields that are tied to billing charges.
• Do not assume Level of Care automatically by patient location. For example, although most cases in the ICU have Intensive Care, we may encounter boarder patients with a lower acuity.

Referring Providers, Include Labs with IR Orders

Referring Providers must include required lab orders when ordering Interventional Radiology Procedures

• Referring Physicians need to remember to order the required labs that go with the procedure.
• The provider ordering the procedure best understands the indications for the procedure and should be defaulted to receive the results.

Referring Providers, Include Labs with IR Orders

IMPORTANT: Pre-Op orders must be entered for Case Requests to reserve Operating Room (OR) time

IMPORTANT: Failure to include the Pre-Op order may result in case delays and case cancellations.

• There are currently numerous scheduled cases missing Pre-Op orders.
• For surgeons that are entering Pre-Op orders for the cases that are already scheduled:
• To verify if a case is already scheduled review the orders in the Order Checklist
• You can also access Chart Review: The case will appear as Scheduled in the encounter.

• Please select the procedure via the Case Review Context pop up to attach the Pre-Op Orders.
• Please do NOT fill out a new Case Request if the case is already scheduled.

• Selecting the correct Phase of Care of Preprocedure is important.
• Selecting the wrong Phase of Care may contribute to the issue of missing Pre-Op orders.
• For questions about Phase of Care, please reach out to your CSI ATE Support for help.

Helpful Tip Sheets for Procedure/Pre-Op Workflows

Remember that all Epic Tip Sheets are available by pressing F1 to access your Learning Home Dashboard in Epic!

• Click the links below to review these helpful training tools on these important workflows!

• Click here to review Prep for Procedure Tip Sheet
• Click here to review Phases of Care Tip Sheet
• Click here to review Place a Case Request for an Admitted Patient Tip Sheet
• Click here to review Add PAT and Pre-Op Orders to an existing Case Tip Sheet
• Click here to review Surgical Post Op Workflow Tip Sheet

Wave 4 Dedicated Provider Support

Wave 4 Providers, Please Save these Important Numbers in your Phone:

• Dedicated Provider Help Desk: 855-453-1948
• Epic Training Provider Hotline: 732-658-4820

Help with Haiku/Canto, Dragon, Power Mic Mobile, and EPCS!

• Do you have questions about Epic's Mobile applications? Help is here!
• On site Mobile Application support is available Monday - Friday from 8:00 AM - 4:00 PM at all Wave 4 Hospital Locations in the Physician Lounge!
• Drop by your Physician Lounge for assistance with Epic's Mobile Apps.

For additional help, click to review the Haiku/Canto, Dragon, Power Mic Mobile Training Tools below:

• Haiku/Canto Help:
• Click to view a tip sheet on downloading the Haiku and Canto apps.
• Click to view a chart detailing distinctions between Android and iPhone Haiku functionality.
• Click to access Epic Web-Based Training - search "haiku" for short videos.
• Dragon/Power Mic Mobile Help:
• Click here for instructions on downloading Power Mic Mobile.
• Click here for common voice commands used in DMO.
• Click here to review a DMO Quick Reference Guide.

• Remember that all tip sheets are readily available on your Learning Home Dashboards!
• Press F1 to access training tools at your fingertips!

Wave 4 Go-Live Help Resources

To be viewed on your mobile device:

• Provider Go-Live Pocket Guide
• Nursing Go-Live Pocket Guide

To view the unit crosswalk documents, click the links below:

• Community Medical Center Unit Crosswalk
• Jersey City Medical Center Unit Crosswalk
• Monmouth Medical Center Unit Crosswalk
• Monmouth Medical center Southern Campus Unit Crosswalk
• RWJBH Behavioral Health Center Unit Crosswalk

To be printed and posted, click the links below:

• Wave 4 Go-Live Help at a Glance Flyer
• Epic: How to Get Help Flyer
• Wave 4: Where to Locate Heritage Data Flyer
• Wave 4 QR Code Flyer

Scan the QR codes above with your mobile device for ready Go-Live Help!

Scan the QR codes above with your mobile device for Unit Crosswalk documents!

Good Humor

Epic: How to Get Help

Review the Epic "Get Help at a Glance" Flyer!

The "Epic How to Get Help" Flyer includes instructions to:

• Open a Help Desk Ticket
• Check The Status of an Open Ticket
• Enter an Epic Enhancement Request

Click hereto view the updated "Epic: How to Get Help" flyer!

Live Site Epic Provider Print Edition!

• Click here for a printable PDF of last week's Live Site Epic Provider Newsletter.

• Click here for a printable PDF of this week's Live Site Epic Provider Newsletter.

Phone a friend:

Our cell numbers are available below.

Please call with any questions or concerns.

RWJBH-Rutgers Medical Leadership Team