Order Checks February 2008

Order Checking –Component of order entry –Based on a system of rules, which review orders to see if they meet defined criteria. –If they meet the criteria, an electronic message is sent to the ordering provider before the order is completed (such as duplicate order, drug- lab interaction, etc.). The provider can then choose to cancel the order or override the order check and place the order

Order Checks & Notifications Order Checks Review existing data and current events to produce a relevant message that is presented to patient care- givers. A real-time process that occurs during the ordering session and driven by responses entered by the ordering provider. Messages are displayed interactively during the ordering session. Notifications Review existing data and current events to produce a relevant message that is presented to patient care- givers. Notifications occur behind the scenes, monitoring data as it flows through RPMS and when certain trigger events occur.

Order Checks  NOTE: All order checks are exported disabled at the system level. When IRMS turns them on at the system level, they are then turned on for everyone.  IRMS, Clinical Coordinators, Individuals, or services can then disable individual order checks if they choose

Order Checks Exported with EHR ALLERGY-CONTRAST MEDIA INTERACTION ALLERGY-DRUG INTERACTION AMINOGLYCOSIDE ORDERED BIOCHEM ABNORMALITY FOR CONTRAST MEDIA CLOZAPINE APPROPRIATENESS CT & MRI PHYSICAL LIMITATIONS DRUG-DRUG INTERACTION DUPLICATE DRUG CLASS ORDER DUPLICATE DRUG ORDER DUPLICATE ORDER ESTIMATED CREATININE CLEARANCE GLUCOPHAGE-CONTRAST MEDIA LAB ORDER FREQ RESTRICTIONS MISSING LAB TESTS FOR ANGIOGRAM PROCEDURE ORDER CHECKING NOT AVAILABLE RECENT BARIUM STUDY RECENT ORAL CHOLECYSTOGRAM RENAL FUNCTIONS OVER AGE 65

Order Checks Order checks are displayed to the clinician when they begin to write an order and when they sign the order Order checks with a danger level of high require the clinician to enter a reason for continuing with the order.

Order Checking Management Menu

Enable/Disable an Order Check Processing Flags –E (Enabled) –D (Disabled)

Enable/Disable an Order Check

Set Clinical Danger Level for an Order Check

Clinical Danger Level for Order Check (cont) Set Clinical Danger Level [BEHOORCX CLINICAL DANGER LEVEL]

Clinical Danger Level for Order Check (cont) Order Check Clinical Danger Level may be set for the following: 1 Division DIV [DEMO HOSPITAL] 2 System SYS [DEMO.MEDSPHERE.COM] 3 Package PKG [ORDER ENTRY/RESULTS REPORTING] Enter selection: 2 System DEMO.MEDSPHERE.COM - Setting Order Check Clinical Danger Level for System: DEMO.MEDSPHERE.COM - Select Order Check: POLYPHARMACY Order Check: POLYPHARMACY// POLYPHARMACY POLYPHARMACY Value: Low// High

CT Scanner Height & Weight Limit –Can be ignored if the site does not have a CT Can scanner. –These order checks should also be disabled at the system level.

MRI Scanner Height & Weight Limit Can be ignored if the site does not have an MRI machine or for open MRI Should be disabled at the system level

Orderable Item Duplicate Order Range

Lab Duplicate Order Range Set the number of hours backwards in time to look for duplicate lab orders Could be set up differently in different locations (inpatient vs. outpatient) Package default is 48 hours for all labs except those specifically mentioned in the orderable item duplicate range

Setting Lab Duplicate Order Range

Radiology Duplicate Order Range Use this option to set the number of hours backwards in time to look for duplicate radiology orders. This range can be setup differently for different locations. The package default is 48hrs and includes all items except those covered in the orderable item duplicate range.

Additional Order Checks The remaining Order Checks should have been set up with EHR Outpatient configuration

Enable or Disable Order Checking System This option lets you determine if any order checking processing occurs in the entire Order Checking system. –E (Enabled): Indicates the Order Checking system is enabled and running. –D (Disabled): Indicates the Order Checking system is disabled and not running. This parameter is set to Disabled in the exported version of Order Checking. This MUST be set to Enabled as part of the implementation process before order checking can occur.

Enable or Disable Order Checking System

Set Order Checks to be Uneditable By Users If there are certain order checks that you wish to remain either on or off for everyone, this option will allow them to be uneditable by users. They will not be able to change the settings in their personal preferences.

Set Order Checks to be Uneditable By Users

Personal Preferences Order checks that have not been set to not editable may be changed from the GUI Personal Preferences from the Tools menu

Questions and Discussion