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As usual, there are a number of topics to discuss this week.

"Lock Out"

Although it happens infrequently, occasionally an alert will appear while we are using MEDITECH that a chart is locked. When this occurs, the EHR will not allow input into a patient's medical record. If this happens to you please call 725-5555 and tell the Help Desk that you have a patient record that is "Locked out." In order to resolve this, the SJH Enterprise Clinical Informatics (ECIS) team must go into the record and unlock it. The ECIS team can usually resolve the issue and unlock the patient's record. At times, ECIS is unable to unlock a patient's record and needs to involve MEDITECH in the process.

This is a separate issue than having more than one user session open on a workstation or a MEDITECH user being unable to access the EMR on a workstation.

Badges

Since the EHR implementation our CH ID badges have become necessary to our work. The badges allow us to log on using EasyPass and also function as our parking cards. Starting January 1st Texas State Law requires that anyone who provides patient care in a hospital wear a badge identifying who they are. The badge must be visible to the patients. Please be aware of this when you are caring for patients at Covenant Health.

Postop Notes

Many of you have discovered that there is a very useful Procedure Note in the MEDITECH EHR. This notes serves the same purpose that the Brief Postop note served in the paper world. The Procedure Note allows for a brief communication in the chart while the full Operative Note is being transcribed. It does not replace the full, dictated Operative Note. There is still a need to dictate the full note. In the event that you or CH is asked to provide an Operative Note to a payer, if the only documentation that is present is the brief Procedure Note, it may result in denial of payment.

Alerts

The EHR has a number of alert functions built into it to promote patient safety. These include Drug Allergies, Drug Interactions and Dose Ranges. These alerts are there for your patient's and you protection. Please pay attention to the alert boxes when they appear. One physician called me and complained "MEDITECH let me order morphine on a morphine allergic patient." When the order sequence was reviewed, it showed that the physician had "clicked through" the drug allergy alert. The Pharmacy noted this during medication verification, and after the physician was notified the order was cancelled.

"Alert Fatigue" is a real phenomenon. Please be aware of it and help us to provide safe and effective care to our patients.

As always, if you have any questions please feel free to call me at 725-0265.

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

Tel: 806.725.0265
Fax: 806.723.7346
lmartinelli@covhs.org