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Aug. 31, 2021

In the Know with Your CMIO

Several IT-related initiatives have helped us improve each patient’s experience across our system this year. Initiatives, such as changes made to align with 21st Century Cures Act requirements and Care Everywhere enhancements, have given our patients easier access to important health care data, improved their digital experience and kept them connected to their providers during a pandemic.

In the coming months, I’m focusing on five key factors influencing health care transformation and the overall patient experience, including methods to help you navigate through an ever-changing health care landscape. These factors — improving patient's ease of access to important patient data, reducing administrative burdens, staying connected with patients, enhancing physician hospital engagement and delivering health care while tackling COVID-19 — will facilitate methods to help you thrive and provide your patients with the best health care experience.

Dr. Nicholas Desai
Chief Medical Information Officer

In This Issue

All Providers
New Law Outlines Visitation Guidelines for Hospitalized Patients
Effective Wednesday, Sept. 1

Important Note: If the attending physician deems it unsafe, they can restrict a COVID-19 or other infectious hospitalized patient from having a visitor (e.g., the in-person visit could lead to infectious disease transmission, posing a serious community health risk). For these cases, use the following workflow:

1.    Write In-Person Visitation Restriction Order (Providers)

• ED providers: When a bed request for a COVID-19+/PUI patient is placed, you’ll be prompted to complete an in-person visitation restriction order (titled Disaster Visitation Restriction) on behalf of the admitting physician.
  • For further instruction, review the Disaster Visitation Restriction tip sheet for ED providers.
• For direct admissions: Admitting physicians will be prompted to complete the order. Note: APPs can place the order.
• The order restricting visitation expires on day five. On the fifth day, all care team providers will receive a Best Practice Advisory (BPA) to extend the no-visitation order. Note: APPs can extend the order.
• For more information on placing the Disaster Visitation order, watch this training video.
   

2.    Provide Daily Updates to Restricted Visitors (Providers)

• The new law requires us to provide a daily update on the patient’s condition to all restricted visitors who are:
  • Individuals authorized by the patient, or
  • The patient’s legally authorized representative (surrogate decision maker) if the patient is incompetent.
• To provide daily updates, use the SmartForm in the Navigator tab in Epic to trigger text messages to authorized individual(s) who are restricted visitors.
  • For more information, refer to the training video.
• Any of the patient’s care team providers can complete the SmartForm update.
• After it’s completed, authorized individual(s) will receive text messages about the patient’s status.
• Complete this form and/or provide a verbal update daily to all authorized individuals who are restricted visitors.
• Each care team provider will receive a BPA every day reminding them to provide an update.
   

3.    Send Daily Text Message Updates (Automatic)

• ED registration staff, IP nursing and UAAs/PCAs will complete the Visit Contacts field in Epic so the automatic, daily text messages can be sent to individuals authorized by the patient.

Good to Know

For All Providers
Epic System Pause
8 to 8:05 p.m., Wednesday, Sept. 1

At 8 p.m. on Wednesday, Sept. 1, Epic will experience a brief “system pause” for up to five minutes.

During the pause:

• Vitals and data will be stored and will flow into Epic after the pause.
• If you attempt to log in to Epic, you can enter your user ID and password, but Epic won’t fully open until the pause is complete.

If you have any issues, contact the IT Physician Help Desk, 832.667.5555.

For All Providers
Block One-On-One Secure Chat Messages When You’re Unavailable
Effective Thursday, Sept. 2

Starting Thursday, Sept. 2, you can change your Secure Chat status to Unavailable — preventing anyone from sending you one-on-one messages and preventing you from sending Secure Chat messages to recipients marked Unavailable. This change will help mitigate some liability concerns for when you’re unavailable and can’t respond to messages — they can’t be sent to you.

For All Outpatient Providers
Epic Hosts Efficiency Hour Sessions

Starting Tuesday, Sept. 21, Epic is offering four training sessions to help improve your Epic efficiency when caring for patients.

For more information, including how to register, read this flyer from Epic.

For All Providers
Epic Update – Sunday, Oct. 24 

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

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.

COVID-19

For All Providers
Admitted Patients Now Tested for
COVID-19 Antibodies

For more information regarding COVID-19 Serology Patient Surveillance, read this statement from Dr. David W. Bernard, PhD.

For All Providers
Prevention Monoclonal Injections for
COVID-19 Exposure

Monoclonal injections (REGEN-COV) are now available at Josie Roberts for high-risk people who’ve been exposed to COVID-19 but don’t have a positive test.

• Patients must have physician referral before injections can be ordered via Epic.
• Treatment is four injections plus one hour of observation.

Here are the details.

REGEN-COV may be used as post-exposure prophylaxis for adults and children (age 12 and older, weighing at least 40 kg) who meet all three criteria:

REGEN-COV may also be used for individuals at high risk of exposure to someone with SARS-CoV-2 due to living in an institutional setting with other infected people (e.g., nursing homes or prisons).

For All Inpatient Providers
New BPA for Patients Interested in COVID-19 Vaccine

When a patient expresses interest in receiving a COVID-19 vaccine, a new BPA will display in the patient’s chart, if the patient:

• Hasn’t started or completed any COVID-19 vaccine series and
• The patient hasn’t received any monoclonal antibody therapy in the last 90 days.

Acknowledge Reason selections will result in the following actions:

• I am not the appropriate provider: BPA locks out the provider for the encounter.
• Patient now refuses: BPA locks out all providers for this encounter.
• Not a candidate/has medical contraindication: BPA locks out all providers for this encounter.
• Remind in 72 hours: BPA locks out the provider for 72 hours for this encounter.

Key Updates

For All Providers
New IllumiCare Smart Ribbon Resources App

The IllumiCare Smart Ribbon Resources app is now available. The Resources app provides one-click access to clinical reference guides for the patient you’re viewing. It also includes links to the HM Pharmacy Blue Book and the pain pocket card.

For All Providers
Mechanical Ventilation Order Updated

The Mechanical Ventilation order has been updated to reflect the following:

For All Providers
New SmartPhrase for VTE Orders

There’s a new SmartPhrase (.VTEHM) available allowing you to pull VTE orders into your documentation.

Use this SmartPhrase for:

For Inpatient Providers and Radiologists
Electronic Approval for MRI Unconscious Patients

The MRI approval process for unconscious patients is now available electronically, facilitating more efficient approval documentation and communication.

For All Ordering Providers
Easier Process for Placing Lung Cancer
Screening Orders

There’s a new lung cancer screening scheduling process, making it easier for you to place Lung Cancer Screening (LCS) orders. You can now use your preferred format (e.g., paper, Epic or another EHR system) when placing these orders — you’re no longer required to use the HM-specific form.

For All Providers
View External Lab Results in Chart Review
Effective Friday, Sept. 3

Starting Friday, Sept. 3, when you receive a patient’s lab results from an outside source via Care Everywhere, you’ll now be able to review these results in Chart Review under the Labs tab.

Note: Orderables, molecular results, microbiology results and results received from organizations in other countries won’t appear alongside your local results. You can still find these in Care Everywhere documents sent from other organizations.

Reminders

Ways to Reach IT

Houston Methodist IT Website for Physicians:

• it.houstonmethodist.org/physicians/