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Sept. 30, 2021

In the Know with Your CMIO

HM’s “digital front door” is equally important. It consists of digital touchpoints throughout each patient’s health care journey that keep patients engaged and connected. Through initiatives such as easy-to-use MyChart features, improved virtual visit platforms, patient cost-transparency tools, MyMethodist Patient tablets, Alexa Dots in patient rooms, Care Sense text messaging, Care Everywhere patient records exchange, new Epic specialty integrations and more, we’re transforming and leveraging innovative, easily accessible technology to provide an exceptional patient experience.

Our digital front door continues to evolve, and we’re committed to providing digital platforms that are engaging, intuitive, easy to use for both patients and providers and enable more personalized digital encounters. For providers, a more digital, integrated and connected experience allows for more streamlined workflows, better clinical collaboration and communication and quicker and easier access to a patient’s full health care story, across many areas within our hospital system. These combined efforts mean more automation and fewer time-consuming manual processes, so you can focus on what you do best — caring for our patients.

Dr. Nicholas Desai
Chief Medical Information Officer

In This Issue

Good to Know

For All Providers
New Epic Visitation Restriction Workflow Enhancements

Earlier this month, new visitation guidelines were implemented to align with the new state law. Currently, we’ve identified:

To help make this process easier for you, we’ve made the following enhancements to your Epic visitation restriction workflow. You can now:

• See which patients have a visitation restriction order by adding a Visitation Restricted column to your Patient Lists.
• Quickly see a list of your patient’s restricted visitors and who’s receiving daily text/email updates by:
  • Adding the Visit Contact Info column to your Patient Lists.
  • Accessing visitor contact information via the following:
    • The Disaster Visitation Restriction (DVR) order BPA.
    • Your Admission navigator.
    • Your Daily Communication for Disaster Visitation Restriction navigator.
    • To see screenshots, review the tip sheet.
• Easily access the SmartForm to document daily communications to all the patient’s restricted visitors. Reminder: You must complete the SmartForm in Epic to facilitate daily communication. The SmartForm can now be accessed:
  • Directly through Storyboard in Epic.
  • By clicking the Daily Update for Visit Contact? column.

For more information:

• Read the View and Document on a Patient with Visitor Restrictions tip sheet.
• Review the Visitation Restriction Order FAQs.

Epic Update

For All Providers
Epic Update Sunday, Oct. 24 

The next Epic Update is Sunday, Oct. 24, showcasing useful new features and enhancements, such as:

To prepare, be sure to review your Update Companion. You can click the applicable links below or log in to Epic, and press F1 to go to the Epic Learning Home. Note: Your Update Companion will reflect an Aug. 15 date. That's the most current version.

Update Companion links by role:

• All Providers (Epic Mobile)
• Ambulatory
• Anesthesia
• Cardiology
• ED MD
• Inpatient Surgeon, MD, APP
• Obstetrics
• Oncology
• Radiology

For All Providers
Reminder: Haiku/Canto 9.7 Required
Before Oct. 24 Epic Update

For All Providers
Some Epic Functionality Unavailable
Wednesday, Oct. 20 at 5 a.m. to
Sunday, Oct. 24 at 4 a.m.

Some Epic functions will be unavailable, and no changes or enhancements will be made from Wednesday, Oct. 20 at 5 a.m. to Sunday, Oct. 24 at 4 a.m.

You’ll still be able to work in Epic as usual, but you won't be able to do the following:

• Apply filters in Chart Review.
• Create, edit and share NoteWriter macros, SmartPhrases and SmartLinks.
• Create and edit In Basket QuickActions.

For All Providers
Epic Downtime
Sunday, Oct. 24 from 2 to 4 a.m.

Note: Data in Epic Read-Only is current until the downtime begins. You can’t document or place orders in Epic Read-Only. For more details, review the Planned Downtime Instructions.

COVID-19

For All Providers
Immunization Clinic Only Displays Pfizer COVID-19 Vaccine Warning for Patients Under 12 Years

For All ED, Inpatient and Outpatient Providers
Clearer COVID-19 Vaccine Status on Storyboard
Effective Today

Starting today, your patient’s COVID-19 vaccine status will now be color-coded on Storyboard. This makes it easier for you to identify whether your patient has completed, started but not completed or not started a vaccine series, so you can provide vaccination guidance, if needed.

Key Updates

For All Providers
Patient ImmTrac2 Vaccination Records Now in Epic

You can now quickly view a patient’s Texas Immunization Registry (ImmTrac2) vaccination records in the patient’s chart in Epic. This includes patient-specific COVID-19 and non-COVID-19 vaccine information.

To access:

• Go to the Immunizations tab in Epic.
• Under Immunizations from Immunizations Registries, you’ll see the patient’s DSHS ImmTrac Registry information.
• For Inpatient:
  • This feature is automatic for any newly admitted patients.
• For SPG/PCG:
  • This feature is automatic at the time of appointment check-in.
  • If your clinic isn’t fully registered with ImmTrac2, you won’t be able to use this feature.
  • For SPG/PCG ImmTrac2 registration questions, contact HMPO Clinical Operations at POQuality@houstonmethodist.org.

Important Note:

• If the patient hasn’t consented to be part of the registry, only disaster-related immunizations (e.g., COVID-19 vaccines) will display.
• If the patient isn’t part of the registry and doesn’t have any disaster-related immunizations, you’ll see the following message:

For All Providers
New Reconciling Outside Immunizations Workflow

The Reconciling Outside Immunizations workflow has been updated to help ensure the most correct data is reconciled into the patient's chart.

• When an outside immunization is identified as Similar to an Existing Immunization documented in the chart, you can’t merge the details.
• If you identify the details of the external immunization are more clinically accurate, replace the existing historical immunization with the external information.
• To help you accurately review and reconcile immunizations, use the Expand All button to expand the rows and review details of external administrations.

Example:

• If the patient reports that they’ve received a tetanus immunization through another organization:
  • You’ll add a historical immunization administration on the patient's chart as a placeholder.
    • Include as much detail as possible, but you can't record an exact immunization date or lot number.
  • After querying Care Everywhere, you’ll receive a similar immunization administration from the organization that administered the tetanus immunization, including the administration date, dose, lot number, injection site and manufacturer.
  • Replace the historical administration with the external administration.

(1) To review details, expand the rows of similar external administrations. (2) Replace the historical administration with the similar external administration.

For All Providers
TPN Monitoring Report Enhanced

The TPN Monitoring report is now available to providers and has been enhanced. It includes information on electrolyte and lipid emulsions administration outside of TPN and laboratory trends, appropriate for daily monitoring.

You can find the TPN Monitoring report under Summary reports in Epic.

For All Providers and Residents
New BPA: Reconcile PTA Medications for
Discharge-Readmit

When discharging a patient who’ll be admitted at another HM hospital, SNF or LTAC, you’ll now receive a BPA reminding you to reconcile the patient’s PTA medications. The BPA will display the patient’s current PTA medications and any actions taken on them, so you can reconcile them before the next encounter. 

For All Providers
Dx Codes Updated to IMO Standard
Effective Friday, Oct. 1

All Providers Placing Outpatient/Discharge Orders
Associate Diagnosis Now Required for
Certain Prescriptions
Effective Monday, Oct. 4

If the medication you’re prescribing requires an associate diagnosis, you’ll now be prompted to enter the information.

To see screenshots reflecting this change, read the full article.

For All SPG/PCG Providers
Caregility Upgrade for MyChart Video Visits
Effective Monday, Oct. 4

On Monday, Oct. 4, Caregility for MyChart video visits will be updated to help you conduct more efficient video visits. There are no changes to your current workflows, but you’ll notice new features and a new look within your video visit. New features and enhancements include:

To find out more:

• Review this presentation.
• Watch this video.
• Read the Telemedicine Workflow tip sheet.
• Visit the Telemedicine Resources and Training website.

For All Inpatient Providers
Epic Deterioration Index Replacing Rothman for Early Detection of At-Risk Patients
Effective Sunday, Oct. 24

On Sunday, Oct. 24, the new Epic Deterioration Index (EDI) will be available through Epic for early detection and intervention of at-risk patients by inpatient providers and med/surg and ICU nurses. The EDI replaces the Rothman Index, providing clear, easy-to-understand and statistically equivalent deterioration scoring.

Early detection of patient deterioration can improve accuracy of at-risk patient identification and decision-making time, leading to improved patient outcomes. EDI continuously tracks 16 patient variables to yield a numerical score based on:

• Patient’s age
• Recent vital signs and lab results
• Supplemental oxygen use
• Glasgow Coma Scale results
• Clinician’s neurological assessment (WDL or X)

The color-coded EDI score appears on the Summary Report or you can add a Deterioration Index column on the Patient List. The score will also be available on the previous Rothman display boards.

Reminders

Ways to Reach IT

Houston Methodist IT Website for Physicians:

• it.houstonmethodist.org/physicians/