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MEDITECH EHR update: December 30

Hopefully everyone had a wonderful Christmas, took some time off and is rested and relaxed heading into the New Year.

As always, there are a number of topics to cover this week.

Password Resets (eChallenge)

As part of the ongoing efforts to improve CH and SJH IT services and to make all of our work more efficient, CH and SJH will be introducing self-service password resets. This functions the same way as commercial sites that have you answer "challenge questions" in order to reset a forgotten or expired password. A second part of the process is to enter a Personal ID Number (PIN) to use with the Help Desk.

You will start seeing a new popup when you log in using EasyPass to remind you to complete the process.

In order to take advantage of this service, you must enroll and answer your challenge questions and enter a PIN. This can be done by going to echallenge.stjoe.org and working through the process, which takes 5 minutes or less. In order to log in, you must know your Network user name and password.

Beginning January 6th, we will be able to reset our passwords ourselves. Also beginning January 6th the Help Desk will start asking us for our PINs when we call in, in order to verify who they are talking to.

Once the new password reset system is live we will be able to call the Help Desk (725-5555), follow the voice prompts and reset our Network password. The Help Desk estimates that this process will take 60 seconds or less.

Medication Reconciliation- Part One: Continuing Medications on Formulary

Shortly before Christmas a number of enhancements were added to the medication reconciliation process. We now have the ability to edit a patient's medication list at the time of our initial medication reconciliation when we start the process through the "Continue from Ambulatory" function. This should resolve the frustration that occurred when we could not edit our patients' medication list at the time of admission.

To access this functionality, start by clicking on the "Orders" button in a patient's chart, as shown below:

This opens a one or two component screen. If the medications that your patient is on are all on the hospital formulary, you will see the following screen:

Once you have made any necessary corrections to your patient's medication list, click ok, answer any prompts as necessary, and click save when you are returned to the main order entry screen to confirm and finalize the medications.

Medication Reconciliation- Part Two: Non-Formulary Medications

If your patient is on a non-formulary medication(s), the following addition to the medication reconciliation process should simplify medication reconciliation. The process begins the same as that outlined above. If your patient is on a non-formulary medication then the following screen appears below the screen shown above:

Selecting Replace by Pharmacy for a medication brings up the following screen, where you confirm this action:

Site-Restricted Order Sets

CH provides adult inpatient care at both the Covenant Medical Center and Covenant Women and Children's campuses. We do not, however, offer all services at both campuses. For example, OB services are not offered at CMC. Adult Cardiac and Neurosurgical services are not offered at CWC. Because of this, not all Adult Order Sets are available at CWC. This is primarily due to the differences in the medications that Pharmacy stocks at the two campuses.

We are aware that there are occasions when a patient is initially seen at CWC and then transferred to CMC for a procedure that is not available at CWC. It would be helpful if the Order Set for this procedure were available at CWC. We are working on a solution for this, taking into account that some of the Adult Order Sets have medications on them that are not available at CWC. This is a complex process, since it involves evaluating each Adult Order Set, determining what medications may be on it that are not stocked in the CWC Pharmacy, if the Order Set is likely to be used at CWC and what changes (if any) need to be made.

This will not be a "quick fix", but if there is an Order Set that is being needed routinely at CWC that is not available, please let the Physician Liaisons (or me) know so that we can prioritize it.

Happy New Year to all.

Until next week,
Lawrence Martinelli, MD, FACP, FIDSA
Chief Medical Informatics Officer
Medical Director, Case Management/Utilization Review

Covenant Health
3615 19th Street
Lubbock, Texas 79410