Transcript McKesson-upgrade-HHS-education-Oct-2013

McKesson Upgrade - ER 11/12
What is ER 11/12?
• ER is “Enterprise Release” and
11/12 is the software version. This
release will upgrade many parts of
the McKesson software used in
iCare EMR documentation. A few
of these changes will impact the
user while others will not be seen.
• Many of the changes in this upgrade
support our efforts to meet the
“meaningful use” guidelines.
Remember meaningful use goals
include using data in meaningful
ways to promote overall patient
safety and quality across the
continuum of care.
• Education related to the ER 11/12 upgrade has been broken into modules.
• You may be assigned more than one of these modules in HealthStream.
THIS MODULE IS RELATED TO CHANGES IN
THE ADMISSION DATABASE,
IMMUNIZATIONS,
SURGERIES AND PROCEDURES,
HOME MEDS,
CARE ORGANIZER
THIS SECTION IS RELATED TO CHANGES IN
THE ADMISSION DATABASE
Admission Database
There have been a few changes to the Admission Database
• Added
o Family History section
• Updated
o Medical History Past and Present
• Removed (and placed in another location)
o Immunizations
o Surgery/Procedure History
Admission Database
Family Medical History is now located at the
bottom of Medical History Past and Present
To Enter Information
Click on the ellipsis
(aka: 3 dots in a box)
Shows that no
information has
been entered for
this patient
Check here if
family history
is unknown
Admission Database
Adding Family Medical History
Click on the ellipsis (3 dots in a box)
to “Add, Edit or Remove” Family Medical History and this screen appears
• Box will be empty if no family history was entered previously
• Click “Add” to enter information
Adding Family Medical History
3. Complete Who, Age at
Onset and Living
4. Enter Comment if needed
1. Select
Problem from
Common List
5. No need to
include which
brother, sister, child
or grandparent if
multiple in family
2. Click Select
6. Click “Done” or “Done and Add Another”
Editing or Removing Family Medical History
If Family Medical History is
present, you are able to Edit or
Remove items from this window
Editing or Removing Family Medical History
• Click
• Editing window allows you
to change the family
member, age at onset, if
they are living or add a
comment
• Click Done when finished
Final Step in Adding, Editing or Removing
Family Medical History
When you have finished adding/editing
or removing information, click “Done”
Admission Database
Family Medical History Completed
The Family Medical History will display much like the rest of the past medical history
Patient’s Medical History Past and Present Upgrade
Upgraded State
Current State
“No history
of…” box above
system heading
Grayed out
 “No history of…” will become longitudinal, meaning the information will stay from one admission to
another
 However, this information must be reviewed with the patient at each admission
 Cannot check “No history of…” and add information.
 Check box must first be unchecked, then the ellipsis can be clicked.
Admission Database
• With the addition of the Immunization Record and the
Surgery/Procedures module (discussed next few slides),
this information will no longer be entered in the
Admission Database.
• There is a reminder message directing you to the new
module where each of those sections used to be in the
database. Once those modules have been addressed,
return to the database and place a checkmark in the box
to document that the database is complete.
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This section is related to changes in
IMMUNIZATION RECORD
Immunization Record
• The addition of the “Immunization Record” provides a location for:
• documentation of immunizations given during a hospital
stay within the ProMedica system
• documentation of immunizations administered by another
provider
• Once entered, this information is available on all subsequent
admissions
• Immunizations must be reviewed upon each admission to all
ProMedica facilities
Immunization Record
On admission:
• Go to Chart 
Immunizations
Click “View detail”
panel to see
more information
• Review
immunization history
with patient
Status:
• Given = administered during an
inpatient stay at a ProMedica facility
once Immunization Record
becomes active
• Historical = administered by
another provider
Immunization Record
Specific information
regarding the administration
can be viewed
• Vaccine specific info
• Administration date/time
• Consent
• Information provided
Immunization Record- Historical/Previous Provider
• If the patient has
received an
immunization from
another provider, the
information must
be entered into the
Immunization
Record
To add immunization data on
admission, click “Add”
1. Select immunization from
Common List or Search
Immunization Record-Historical/Previous Provider
4. Choose “Historical” and select a source
2. Select the
appropriate age
group from the
dropdown
3. Once item is
selected from the
list, click “Select”
5. Enter when immunization
was received
• May type info into box or
use calendar icon
6. Click Save
Immunization Record
Documentation of Immunization Administration
• Scan the patient
• Open the Immunization Record from Chart menu to verify that it was not
already given
• Go to HED Vitals/Meds/IO All Meds Admin
• Scan the medication
• Select a site
• Re-open Immunization Record as shown below -This must be completed
for the information to cross to the iCare Immunization Record!
After selecting a site, click
Open Immunization Record
Documentation of Immunization Administration
After the “Open Immunization Record” button is clicked, you will be asked to verify
consent for immunization data to be sent to the state registry.
• Consent for the data to be sent is given when the patient signs the Consent for
Treatment on admission.
• Verify that Consent for Treatment has been signed.
It is now necessary for hospitals to have the ability to submit immunization data to
the state registry.
Address consent for
immunization data to be sent
to the state registry; click OK
Documentation of Immunization Administration
1.Choose Info Sheet
2.Choose Publication date
(located at the bottom of
the vaccine information
statement)
3.Click Add
Auto-fills when
drug is scanned
Enter
Manufacturer, Lot
# and Exp. date
Ex of info that can be placed in comments:
“Parents gave verbal consent &
acknowledges info has been received”
NOT APPLICABLE
Do Not complete this section
Select Eligibility (for pediatric
patients only if applicable)
Click Save
Documentation of Immunization Administration
Once you click Save, you return to the med administration screen.
Complete administration of immunization:
• Scan the patient
• Give the immunization
• Scan yourself
Immunization Record
Registry consent can be seen
in right-hand corner. If it is
necessary to change it, click
on the Registry Consent
button.
THIS SECTION IS RELATED TO CHANGES IN
THE SURGERY/PROCEDURE MODULE
Surgery/Procedures
• Surgery/Procedure history has been removed from the Admission Database
• Surgery/Procedures module is accessed from the Chart menu
Adding Surgery/Procedures
• Surgery/Procedure
information is
reviewed upon
admission
• To enter new
information, click
“Add Procedure”
Click Add Procedure
Type in name of procedure
Adding Surgery/Procedures
Fill in body site if
applicable
Enter procedure date
by:
Click Add it as free text
procedure
1.
2.
3.
4.
Date OR
# years ago OR
At X years old OR
Other
Click Save or Save and Add Another
Editing Surgery/Procedures
Procedures can be Confirmed,
Edited, Removed or Added here
To edit previously
entered information,
click on Edit Details
Editing Surgery/Procedures
Change information as
necessary
Triangle indicates
what was changed
Click Save when done
Removing Surgery/Procedures
If an incorrect procedure has
been added, it can be
removed
• Highlight the incorrect entry
• Click Remove
Details shows
when data
was updated
Removing Surgery/Procedures
• Verify that this is the procedure to be
removed
• Choose the reason
• Click Remove
THIS SECTION IS RELATED TO CHANGES IN
HOME MEDICATIONS
Home Medications
Changes to Home Medications
• The order of Status, Dose, Route, etc. has changed
has been added to the main section
• Special Instructions is now
• Comments is now called
Home Medications
Before
Home Medications
print on the Patient
Discharge Medication List
DO NOT show up on
Discharge Medication List
THIS SECTION IS RELATED TO CHANGES IN
CARE ORGANIZER
Changes to Care Organizer
• Care Organizer will now open
to “Changes view” instead of
“To Do”
• Active view has been
reorganized.
• It will display as follows:
o Stat Medication orders
o Stat Non-medication
orders
o Medication orders
o Non-medication orders
(Listed alphabetically by
group)
Please direct questions regarding the McKesson
Enterprise Release 11/12 Upgrade to your facility’s
Hospital IT Support.
This education was created in collaboration with Clinical IT, Nursing Leadership, and the
ProMedica Center of Nursing Excellence in support of the ProMedica System-Wide
Standardization Initiative.