MLK MedPeds Continuity Clinic Epic Orientation

1. MLK MedPeds Continuity ClinicEpic Orientation Frene’ LaCour-Chestnut, M.D. Internal Medicine-Pediatrics 2013

2. Objectives: Part I • Epic 2012 upgrade • Clinic Flow • Notewriter • Smartsets • Lab and in-basket follow up • No show handling • Closing encounters

3. Epic 2012 Upgrade • Upgrade goes live July 15th • Go to Harris Health Intranet and click on Epic Central for training • Practice in Epic Sandbox • Widescreen • Multiple sections open at once while documenting

4. Clinic Flow • Patients sign in with registration • Patient checked in and VS being done • Roomed in Pediatric Hall or Adult Hall • Patient being seen by physician • Patient ready for discharge • Patient has been discharged and Note needs to be completed

5. Nursing Staff • Shirley Israel!!! • Patient Care Technician (PCT) • Mari Ponce • Marcia Posada • LVN • Kim Chavez • Barbara Boykin • Ada Luz Lopez • RN • Carolina Lemaster

6. Notewriter • A tool that is used for more efficient note writing • Used to track quality measures • Recommend using notewriter for all progress notes except well child checks • Different HPI are launched depending on the Chief complaint • Con: note can be closed without note being fully complete

15. Smart sets • Generally used in our clinic for WCC and vaccine ordering • Can be used for specific CC such as cough, dysuria, etc • Benefit of having all ordering in one place (some recs are out of date) • Driven by chief complaint and age

22. In-basket Rules: • Check your in-basket 2 to 3 times per week even if you aren’t on a BT or HCHD rotation • Goal is to respond to all abnormal labs or studies and refill requests within 48-72 hours • Why?: PCMH criteria/guidelines and more importantly because you are exceptional physicians with excellent patient care as your primary goal

23. Encounters • Very important to complete note prior to leaving clinic • If not is not complete prior to leaving clinic then complete with 24 hours and CLOSE ENCOUNTER • Demonstrate how to handle no show encounters • Efficiency is KEY! • Type while talking with patients • Notewriter is a shortcut • Importance of A/P

24. STOP

25. Objectives: Part II • Learn how to respond to and properly route refill requests • Learn how to respond to abnormal and normal lab results • Learn what a pool is and how to use it • Learn what to do when you get a message regarding a referral • HEMS

26. Pharmacy • A pool = group • Pharmacy pool at MLK is: p ml pharm • When you respond to a refill please send it to the pool of pharmacists at MLK otherwise it sits in one person’s in-basket

35. 22 yo LAF with obesity seen for WWE • Pap smear was normal • Screening cholesterol and a1c was normal • Gc/chlamydia was negative How would you handle this ? • Call patient and tell her everything was normal and come back in one year • Send normal result letter • Send Shirley a message telling her to recall the patient for lab results • Email Shirley and ask her to send a normal letter to patient • Anything but C or D

36. 22 yo LAF with obesity seen for WWE • Pap smear was normal • Screening cholesterol and a1c was normal • Gc/chlamydia was negative How would you handle this ? • Call patient and tell her everything was normal and come back in one year • Send normal result letter • Send Shirley a message telling her to recall the patient for lab results • Email Shirley and ask her to send a normal letter to patient • Anything but C or D

37. Normal Labs • Several ways to skin a cat: • Quick note/Result note • Note to pool to send normal letter • Create letter yourself and route to pool • Call patient and create a telephone encounter • Route to medpeds pool: p ml med ped

39. Option #1 • Result note • Send message to pool to send normal result letter

42. Option #2 • Create your own letter • Send that letter to the pool so they can print it and mail it to the patient

47. Option #3 • Call patient yourself and notify them of their normal results • Make sure you document with a telephone encounter