1. Order Management and Ancillary Modules

3. Integrated
Similar to prior versions of Meditech ordering is integrated with other modules
PHA
ITS
LAB
PCS
Most of the Order build in OM happens in the other modules, so subject to build decisions and progress are dependent on other teams. We had a weekly meeting that involved the leads from each of these modules and brought ad hoc attendees as needed for particular topics. It is important to note is that PHA LAB ITS are still in NPR while OM is MAT code.

4. PHARMACY

5. PHA CMS issues PCS integration moved out of PHA Order strings
Incremental dosing, cumulative dosing

6. Differences Incremental Dosing- Next update
Cumulative dosing (acetaminophen on MAR)-Next update
FDB Cloud API for interaction checking
Dosing sets are at the initial look up level in OM

7. Comparison

8. CMS issues Drug dictionary and NDC maintenance Dosing sets
Order string/Order sets
Drug Type
PHA utility
Multiple pushes
-.1 or .STD
Ghost meds and duplicated strings

9. PCS integration outside PHA
Assessments attached in Med Doc Workload, a PCS dictionary.
Pros: Location or facility specific build
Cons: Location or facility specific build
Weight based route additions to the IV spreadsheet

11. Order Strings Build the premix , no more dummy
Our decision to utilize more in pharmacy
Cons: protocols are built in a dx for OM, not integrated with pharmacy
Pros: lookup more consistent with OM

12. Wins
One FDB load!
Fresh start
Order strings
IV spreadsheet

14. LAB/MIC/BBK/Pathology INSERT PICTURE BELOW OF MICROSCOPE OR SOMETHING

15. LAB Standard Content Timing of build and testing
Integration with OM different
Collection process- PCS/LAB
Locations and label printing, pre-collection labels

16. Standard Content Determine which tests work/don’t work for you
(non-editable fields)
Department
Test Type (panel vs individual result)
Alpha/numeric
May need to expunge to free up print number ranges.
Determine which standard content should be expunged, then expunge rather than inactivating tests first. Once there is a custom flag, expunging will not work correctly.

17. Map out Test Build in Advance
Decide which standard content tests you can use, and map print numbers accordingly for build
Develop a master spreadsheet to be used during and after build for mapping current and future build
Include print #s, mnemonics, test names, departments, test type, alpha/numeric, EMR IDs on the spreadsheet
As much as possible, test name should match EMR ID

18. Loaders and Utilities
Use loaders and utilities as much as possible. This will be a time saver.
LAB test loader – phase 1 builds tests in Standard if copying from 5.6
Phase 2 copies reference ranges to target
MIC Procedure Prompt Loader
MIC Organism Loader
Meditech can customize loaders

19. Timing of Build and Testing
Dependent on access
Dependent on CMS decisions
Timing of Lab to OM push – lab dictionaries should be cleaned up as much as possible prior to push
Build was still in progress when we did integrated testing

20. Shared Build in Standard
Coordination of test build is necessary between lab builders in target rings
Recommend building new tests as active in Standard, but set CMS to propagate as inactive to target. Do this at beginning of build, to avoid confusion due to active tests which do not pertain to that target ring
This will minimize problems when the Lab to OM push takes place

21. Lab Build must be Closely Coordinated with OM
Determine responsibilities for each group (who builds Customer Defined Screens)
OM Order Sets – setup process, differences in ordering from Order Set versus individual tests, future editing policies
OM Categories (Lab Departments) - ordering by test name or category in PCS

22. Differences in Integration to OM
Biggest benefit of 6.1 for Lab is that lab test build flows to OM & AMB. In CS, we built tests three times (Lab/OE/AMB)
Custom flags & other issues can cause OM orders to not cross to Lab, or to allow orders of tests which should not be orderable
Standard vs Target – what is built where
LIS only field

23. LIS Only/OM/AMB Interactions

24. Collection Options in OM

25. Collection Process Nurse to collect Send phlebotomist to collect
Has been collected
Can default in response at category and test level
Pre collection label - determines timing of order crossing to lab and printing label
This build is all on the OM side

26. Education for Nursing on Lab Ordering and Collection
How to order lab tests
Marking as collected
When orders will and will not cross to Lab
Workflow is different if using Pre-collection labels

27. Locations and Label Printing
Label printer setup in IT and LIS
In LIS dictionaries, can set label printers by location or by PC
Pre-Collection Label functionality set in OM Toolbox Parameters

28. BBK and PTH Conversions
Conversions available for BBK and PTH historical data
Validation process is labor intensive
Allow several months or longer to complete
Workaround in interim is access to histories in CS

29. Gaps & Wins
Gap Lost some client billing functionality which was available in 5.67
Win - Pathology now orderable from OM
Win - Lab test build flows to OM and AMB

30. Imaging & Therapeutic Services
Reports

31. Imaging Procedures
Charging only procedures
Outpatient Departments
Wound/Ostomy
EEG
Nutrition Services
Reports

32. CMS / Standard content
Shared content with affiliates for Imaging procedures,
Naming convention used for Reports which involves Document building for both PDoc and dictated Reports
Radiologists read at multiple facilities
Mammography = MM
MR = MRI and MRA

33. Campus query Don’t need for acute Do need for ambulatory –
Performing Site
Performing Doctor
Rule broke – started showing weird meds that shouldn’t have been there

34. Ambulatory billing One procedure built for all facilities
Using ‘sites’ to assist with ordering in Web Ambulatory
ITS Site references Revenue sites/Performing Location
can use different billing numbers per site
Preference is to send information to the Coder Worklist as Clinics do not want direct billing

35. Tracker Available in Priority pack 33
We will review this new feature when testing our next Priority Pack update
Will need to evaluate space and a large monitor will work best in the Tech areas

36. Order Managment

37. OM

39. CMS Implications Timing of ancillary build/decisions
Zynx Order sets integrated
How to share updates?
Mapping PHA entries using the PHA Utility
Map items that are formulary at one facility but not others?
Similar decisions in ITS/LAB

40. Set build In 5.67 added by mnemonic In 6.15 standard ordering lookup
Kal in standards –all orders
Which test/med to choose?
Personal
Target only
Update

41. Differences Suggested sets Embedded sets
No substitution
Embedded sets
Can’t embed collapsed
Select all on orders on order sets
Understanding and communicating the differences in ordering
Tomorrow AM
Could service time substitute
Time was an issue with identifying gaps.

42. DME Durable Medical Equipment: partial list supplied in FDB data
DME field in Amb drug dictionary, but doesn’t change required fields
Web Amb drug concept- not modifiable
No separation of output format

43. Dietary Clinical print screens

44. Home Med List

45. Home med conversion Dose ranges didn’t convert correctly-Resolved
Zero dose v. See dose instructions-Resolved
Have to dig to identify audit
Pros: not starting from scratch
Cons: bad data
Recommendation: if proceeding, use caution

46. Allergy conversion A smoother conversion
NKDA in Ambulatory wasn’t mapped properly
Delay in recognizing and resolution

47. Discharge Document v Discharge Plan Provider view v Ancillary View
Workflow decisions-which access point
Signing of the ‘orders’/document
Provider view v Ancillary View
Same core components
Customizable for provider
Convert routine
Consider highlight/required carefully

49. Discharge Transfer Swing Bed Multiple facilities New functionality
Used at St Lukes
Multiple facilities
Used at Kalispell
New functionality
Better than restorable orders
Code order issue
Does not cross accounts.

50. Discharge Transfer

52. Recommendations Never have too much training
Departments list- Make sure no one gets left behind!
Assign HIT contact to each department
Turnover can bite you (Meditech and internal staff)