This is the first of a series of emails that I will be sending out over the next few days. A number of enhancements will be placed into our MEDITECH EHR in the next week. The target date for this is Monday, January 13th.
The most anticipated of these additions is "Favorite" Order Sets. This functionality allows us to make modifications to the Covenant Health "base" Order Sets. On the following pages, this process is outlined. There are some limitations to what we can do within the Order Sets. Some of these are related to required fields within the Order Sets (Code Status, VTE prophylaxis), known as "hard checks" that cannot be removed. Others are due to the architecture of the current state of the build. This is outlined in more detail below.
Important limitations of the pending "Favorites" include:
- Existing orders may be checked or unchecked (unless they are "hard checked")
- Edits to the second (CDS) screen cannot be saved for Labs/Imaging/IV Fluids or Medication orders
- Medications can be added, however the dosage and schedule will need to be entered on subsequent uses of the saved "Favorite" set
When working within Favorites, if the "Add Favorite" dims, you have made a change that cannot be saved in the current Favorite iteration.
- If the "Add Favorite" button dims, the set cannot be saved, and we must start over.
- "PCS" and "RC" orders are not yet available to enter (or Modify), they can only be checked or unchecked. They cannot be edited or added.
- Orders cannot be removed from the approved sets. Most can be unchecked (except, again, if they are "hard checks").
Tips and Tricks
- In order to add a Lab, imaging procedure, medication or IV fluid a new order must be entered, as outlined below.
- Your Favorite Order Sets can be renamed; however we can only use numbers and letters in this field, no "special characters".
- You must exit "Orders" for your changes to take effect. This requires a few minutes to take effect, but once your changes have been saved, they will be available for future use.
- If you make additional changes to an Order Set and save the under the same name, this becomes "your" set. The previous set with that name is overwritten.
- A base order set can be modified in different ways, but each version must be saved under a different name.
Order Set Favorites -
From the Order Entry screen choose your order set and click "View"
From here you can select or unselect most of the Orders.
*** There are some hard checks in the order sets, as mentioned above.***
A "hard check" is an order that is required and must be addressed as part of the set. These cannot be unchecked.
Functional edits that can be used to modify the Order Sets. These "PCS" orders can be checked or unchecked.
View Set Screen:
- Check Boxes: Any fields can be checked or unchecked (unless it is a "hard check" as noted above).
- Add Procedure: New procedures (Lab and Imaging) can be added to a set and then be saved as part of the favorite. They will appear under the Additional Orders header on the set.*
- *The "second" (CDS) screen does not save currently as part of the favorite set for some orders.
- Add Medication/IV: New medications can be added to a set and then be saved as part of the favorites. They will also appear under the Additional Orders header on the set
- The dosage cannot yet be saved as part of our "Favorite" Set.**
- Add Additional Order Set: Additional order sets can be "stacked" on the base set.
*/** Both of these issues are being worked on, and we hope to add these functions as enhancements in the future.
Procedure Edit Screen
CDS/Query information: Queries within a CDS on a procedure can be defined or edited and then be retained within the favorite order set.
***Priority, Quantity, Date, Time and Series information can't be edited in the base
set. This will cause the Add Favorite button to be dimmed ***
Nursing Order edit screen
CDS/Query information: Queries within the second (CDS) screen defined on the Care Procedures can be edited or defined and then retained within the order set
***Priority, Quantity, Date, Time and Series information can't be edited. This will cause the Add Favorite button the be removed ***
Medication Edit Screen *** Any edits or changes made to this screen in the
base set will cause the Add Favorite button to be removed***
You can re-name your favorite order set use only letters and numbers – NO SPECIAL characters
The Physician Liaisons and our on-site support are available to help you with this process beginning the week of January 13th.