Dear Colleagues, Care Transformation Services (Intermountain Informatics) is reorganized and focused on major improvements in areas of Clinic Scheduling, Surgery Scheduling, CPC workflows and Hematology Oncology & BMT. These major projects are coordinated with the University of Utah, PCH, and Intermountain. While these are of high importance and broad application, but many other more smaller scale but high priority optimizations are taking place concurrently. Our iCentra analysts and specialists continue to meet with providers and are happy to meet with you to provide additional training and troubleshooting.   Remember: a 24/7 physician coach is available by dialing x23456 then hit the number 8  Tips and tricks:  1. Key Advanced Skills for inpatient providers: Managing orders using the orders profile View 

When caring for complex, extended stay inpatients, especially those who transfer between units, using the following skills can help you more easily and safely write orders and  keep the orders up to date: “Merge View” and “View Excluded Components” 

  

 a. View Excluded Components: In the screenshot above, you are seeing the “PED Intravenous Electrolyte Replacement 

Limited” powerplan that was previously ordered. The default display is to show only the orders from that powerplan that were ordered when the powerplan was originally signed. When you click an individual powerplan (like the blue‐

highlighted powerplan in image above) and click “View Excluded Components” you’ll be shown that whole powerplan, enabling you to see all the other orders from that powerplan, not just the ones that were originally ordered.  

 This key skill enables you to use decision support within the powerplans and avoids duplicate entry of the same powerplan.  

b. Merge View: The default display is to show only the orders from that powerplan that were ordered when the powerplan was originally signed. If you click “Merge View” you’ll be shown the orders active on the patient’s profile in the same class as this Magnesium Sulfate order: 

  

2. Dealing with erroneous documents to sign in your message center: for more information, see this Wiki article  a. You may receive deficient document requests or notes forwarded to you to sign and in some cases you may have never seen 

the patient or there may be other reasons you feel the deficient document is in error. Here is what to do when… b. The note was sent to you and should have been someone else and you know who that someone else is: 

 c. There can be other reasons to refuse a note. They may include: 

 When not refusing the note and forwarding to another attending, you may send the note to the “HIM NON‐PERSON, CERNER, refusal” address simply by typing the following characters into the search box: 

then hit the tab, or enter key and you’ll see the following show up: 

 d. You could use this approach when there is a deficient document notice you can’t otherwise seem to get rid of: 

 e. Using these comments are fine when forwarding notes, but for handling message center results, like when communicating about 

labs to patients/families or staff, you should not use them – see next tip.  

3. *This tip is particularly relevant for providers of ambulatory care:  Don’t use the comments section when communicating about results to patients/families or staff. They are hard if not impossible to see 

 

Instead, Create one of the message types: 

 

 4. Acute vs maintenance prescription medications  

a. You may have noticed when writing a prescription that there is an indicator for “acute” or “maintenance” 

 This has implications for how long a medication remains on the patient’s home medications profile. 

The attached “Prescription Therapy Type Change” PDF goes over the details. Briefly, there has been an effort underway to change the default setting to acute for prescribed medications when that would be the expectation – example: pain medications. You can always manually change this if necessary.  

5. Q: Where can I see POLST/POST documentation? (Physician Order for Life‐Sustaining Treatment/Physician Ordered) A: In Documents, but they are also surfaced in the Important Patient Notifications component in your workflow Mpage.  

         If you can’t see the IPN component… 

                   If you still cannot see it, call x23456 option 2 and let iCentra support know you’d like to see it by submitting a ticket. 

  Update: “Help2 Archived Notes and Results” will be coming soon. We apologize for the confusion ‐ it was not ready when we believed it would be. Look for more from Dr. Glissmeyer when that will be available. For now, continue to use the HELP2 link in the iCentra Table of Contents Menu and the HELP2 desktop icon will persist for now – stay tuned for an update of when it will be unavailable.    

  Upcoming: You will hear more soon about changes coming to the patient‐facing discharge information and discharging providers’ role in generating it. 

 These and all other previous iCentra tips and tricks emails are available here on the iCentra wiki site.  Eric W. Glissmeyer, MD cell 8018603338 Assistant Professor of Pediatrics Division of Pediatric Emergency Medicine, University of Utah Director of Medical Informatics, Primary Children’s Region, Intermountain Healthcare iCentra Implementation Provider Adoption Lead, Primary Children's Hospital iCentra Emergency Department Development Team, Intermountain Healthcare   

© Intermountain Healthcare | January 2018 | v 1.3 | Page 1 of 2

Unpublished Work − Confidential − All Rights Reserved

Default Prescription Therapy Type Change AMBULATORY AND ACUTE PROVIDERS

What is changing and/or what needs to be communicated? Starting 02/06/2018, certain prescription orders will now default to an Acute therapy type. Previously, most medications defaulted to a Maintenance therapy type.

What is the difference between Acute and Maintenance therapy types?

• Acute prescriptions are those where the patient should only be take the medication for a defined period of time. Prescriptions for antibiotics or short term pain management are good examples. Because of the time limitation, Acute prescriptions require a Stop Date and the prescription order will fall off the patient’s prescription profile at that time.

• Maintenance prescriptions are medications that the patient is taking indefinitely (such as blood pressure medications, diabetes medications, antidepressants, etc.). Maintenance prescriptions do not require a stop date.

What should I do differently when prescribing? Any prescription that is defaulted to an Acute therapy type will require either a Stop Date or a Duration before the order is allowed to be signed.

Default Prescription Therapy Type Change

© Intermountain Healthcare | Created January 2018 | v 1.3 | Page 2 of 2

Unpublished Work − Confidential − All Rights Reserved

Why is it changing?

• Defaulting some medications to Acute prescriptions will stop the risk of the system automatically calculating a 30-day dispense quantity for medications where that is inappropriate, such as opioid prescriptions.

• Automatically removing completed medications from the medication list makes the medication list more accurate and reduces risk for prescribing errors on future visits.

• Automatically removing completed medications from the medication list makes completing medication reconciliation in future visits simpler and faster.

What if I think that a medication is inappropriately classified as Acute?

• You can still manually change the Type of Therapy field to Maintenance when you place the order.

• You can also submit an iCentra ticket, requesting that the medication’s default settings be changed.

Who will it impact? Providers

When is it changing? 02/06/2018