Provider Cerner Education Session 4 Eastern Maine Medical Center Provider Cerner Education Session 4 01.31.2019 Dr. Michael Ross

Blue Hill Training Web Page: http://ci.emhs.org/MIO_BlueHill Provider Cerner Education Session 2 01.17.2019

Curriculum Outline Week Topics Navigation, Personalization, Note Creation Overview Problems (Intro); Revenge of the Message Center, Centricity CCD Orders and Favorites Medications, Basic Mmodal Patient Letters, Autotext, Smart Templates Recommendations, Patient Care Advisor,Worklists Family & Soc History, Advanced Mmodal, Q&A Modify with Insert > Header & Footer mm.dd.yyyy

Test Patients for use: Go to Ambulatory organizer/Home Be sure to use MAY 1st Go to Ambulatory organizer/Home Search for me in calendar; you will see my calendar filled with test patients. Pick a test patient from the schedule for use today. We will use this as a source of Test patient’s with Ambulatory encounters for future sessions as well. Dr Z’s -> Modify with Insert > Header & Footer mm.dd.yyyy

Overview: Topics to be Addressed Today Medications and Prescriptions: Med compliance/Reconciliation Med changes during reconciliation Efficient refills during a visit New medications during a visit Freetext meds Pharmacy changes Refilling meds via the message Center Med Proposals in message center Medication Filters Medication Snapshot Mmodal Training: Feedback and Build: ServiceNow changes Survey results Provider Cerner Education Session 3 01.31.2019

Customizing View Customizing your view will allow you to select the columns you want to see in view. Right click anywhere in the med list or on the Column Headers Select Customize View Select columns from the left Click Add to move to the right Select Group/Sort orders Click Ok Provider Cerner Education Session 3 01.31.2019

Medication History and Filtering Options Click on Home Medications Click on the blue hyperlink Click the drop down arrow to reveal available filters To Create Your Own Filter: Click the New button Name your filter Select the options you would like included Click Save Provider Cerner Education Session 3 01.31.2019

Reviewing Prior Medication: Using the Medication History Snapshot Select Medication History Snapshot Select Expand All Select timeframe Select medication you want to look at history of Rx Provider Cerner Education Session 3 01.31.2019

Reviewing Prior Medication: EASTER EGG: using the Black Diamond Look for the “Black Diamonds” and expand them to show history of past prescription refills for same medication (thanks to Marianne Vandiver for this tip) Provider Cerner Education Session 3 01.31.2019

Real SOON™ now…. Timeline Provider Cerner Education Session 3 01.31.2019 This Photo by Unknown Author is licensed under CC BY-NC-ND

The Star of Today’s Class: 01.31.2019 The Star of Today’s Class: Provider Cerner Education Session 3

Different Roles for Medication Reconciliation: MA Role: -Remove vastly out of date medications (i.e. old antibiotics) -Check and document compliance of all chronic medications -Sign off and send to provider Note: It is not within the MAs scope of licensure to remove medications a patient has been prescribed and is not taking. Provider Role: -Review current medications -Decide the status of the medication: -continue -refille -stop -correct -acknowledge anything not directly continued/prescribed/discontinued. Provider Cerner Education Session 3 01.31.2019

Completing Medication Reconciliation From the workflow page, select Home Medications. Click Outpatient. Continue, D/C or Create new Rx as applicable for each med. Address compliance meds as applicable. Address any In-Office Meds by always selecting Continue. Click Sign. = Complete Med Rec = Partial Med Rec (Need to Continue In-Office Meds) 01.31.2019

Changing a medication dose during med reconciliation. Provider Cerner Education Session 3 01.31.2019

Prescription Refills During an Office Visit Same dose, instructions and dispense amount: Different dose, instructions and/or dispense amount: Provider Cerner Education Session 3 01.31.2019

Adding New Medications During an Office Visit From Med Rec screen: Click the +Add button Search for medication Use Order Sentences From Workflow Page: Home Medications component Click + sign Search for medication Use Order Sentences Provider Cerner Education Session 3 01.31.2019

Freetext Medications: Easter Egg! Check this box to disable the Order Info hyperlink popups if they are driving you crazy! Provider Cerner Education Session 3 01.31.2019

Pharmacy changes: From the Banner Bar or during prescription writing: Provider Cerner Education Session 3 01.31.2019

Prescribing/Refilling Medications from a Message Center Message Double click on Message Select Summary View to bring you to the Workflow page Navigate to Home Medications Click on Outpatient Add new meds using the +Add, button or refill existing med using then Create New Rx radio button Select Inbox View to return to message Provider Cerner Education Session 3 01.31.2019

Alternative: “Launch Orders” for Medications from a Message Center Message Launch Orders then click the Medication List tab Go to Documented Medication by Hx Right click the medication of interest- full menu available You can also get to Med Rec screen from here if you prefer that format Click +ADD to add New meds and ALSO can order labs or other tests from same Phone message (be sure you have Between Visit FIN!) Provider Cerner Education Session 3 01.31.2019

Addressing Proposed Medications/eRx Renewals Medication proposals will fall under Renewal Requests or eRx Renewals in Message Center = Accepts this proposal only = Rejects this proposal only = Accepts this proposal only, with modifications. This will prompt the order details window to open for modifications = Rejects all proposals in the message = Accepts all proposals in the message = Accepts all proposals in the message and moves to the next proposal message Provider Cerner Education Session 3 01.31.2019

Mmodal Training: Provider Cerner Education Session 3 01.31.2019

Provider Cerner Education Session 3 01.31.2019

Speech Mike Setup Be sure Record button is set to “Hold to Talk” EOL is COMMANDs only! F1 – leave at “Correct Selection” Other F buttons can be set to different key combinations Provider Cerner Education Session 3 01.31.2019

Set up Microphone with Advanced Setup Add buttons to your Speechmike or Mobile Phone Provider Cerner Education Session 3 01.31.2019

Provider Cerner Education Session 3 01.31.2019

Creating Commands 1. Highlight the text you would like to save for later use with the mouse or select the text via voice command (such as “Select All”) 2. Hold down the EOL “Command” button; and Say the command “Save this text.” This will open the Command Details box. 3. Dictate or type the command name in the Name field. Dictating is preferred to ensure proper spelling. a. Use an “action verb” at the beginning of each command name (i.e. "Insert", "Print", “Macro”, “HPI”, “PE”, “ROS”, “Instructions” etc.). b. Make sure the command is more than one word. (i.e. “PE Vandiver 1”). Best to use a phrase you would never say in straight dictation. 4. Click OK to save the command 5. The exact Name of the command must be dictated to have it execute i.e. “Insert physical exam”, not just “Physical exam” 6. To see all of your personal commands, click on the Control Bar (your name) > Commands or say “Open commands.” Here you can create new commands or edit existing ones. Provider Cerner Education Session 3 01.31.2019

Build you own Command for “PE Full”. General: A [ Well developed, well nourished, ] [in no acute distress. Appears stated age.] Head: [Normocephalic, atraumatic.] Eyes: [Pupils are equal and reactive to light and accommodation. Conjunctiva are clear. Vision grossly normal.] Ears: [TMs clear AU, EACS WNL] Nose: [Patent, without discharge.] Mouth: [There are no ulcers or lesions noted. No inflammation, no post nasal drip, no plaques nor exudates.] Neck: [Supple, no adenopathy or thyromegaly.] Lungs: [Clear to auscultation bilaterally. No rales, rhonchi or wheeze noted. Good air flow in all fields.] Heart: [Regular rate and rhythm. No murmurs, click, rubs or gallops are noted. ] Abdomen: [Bowel sounds present in all quadrants. The abdomen is soft, nontender, with no masses or organomegaly noted. No hernias are noted. ] Msk: [Joints are nontender, without swelling, redness, nor effusions. Range of motion is observed to be normal. ] Pulses: [Peripheral pulses are equal and palpable bilaterally. ] Extremities: [No clubbing, cyanosis nor edema is noted. ] Neurologic: [Gait and station normal. Cranial Nerves 2-12 intact. Motor strenth grossly symmetrical and intact. No sensory loss. Balance normal. ] Skin: [No rashes, ulcers, or sinister lesions noted. Turgor is good. Skin color is good. Hair and nails are without abnormalities.] Psych: [Normal eye contact, affect and mood appropriate, and normal interactions. Patient is alert and appropriate to context.] Provider Cerner Education Session 3 01.31.2019