Epic for the Clinic

Signing in

• From home: citrixnet7.gmh.edu

• Enter username/pw

• Search for your pod

Checking your schedule

1. Schedule icon

2. Select date

3. Find your name in drop-down menu

Types of visits

• EST – established patient

• OVB1 – overbook

• NEW – new patient visit

• DC – hospital discharge

Your Inbasket

• Check results prior to leaving clinic

• Within two weeks:

– Call patients with abnormal results

– Mail abnormal results

• Ask pod lead or attending you signed out to if questions

Sending a message

• “New message”

• Search name

• F3 to link patient

• “Accept”

Pre-charting

• No more than 5 mins per patient

• Review:

– Encounters since last PC visit

– Labs/imaging

– “My Sticky Note”

Accessing a patient chart

• Click “chart” button, OR

• Double click encounter

Snapshot

• Demographics

• Problem list

• Meds/Allergies

• Recent visits

• Future appointments

Chart review

• Encounters, Notes

• Rx30, Pulmonary for PFTs

Results Review

• Includes labs

and imaging

Alternate way to view results

• Chart Review tab

– Labs, Imaging, Cardiology (EKG)

Charting in clinic

Pre-visit planning

• Day of clinic, prior to patient arrival

Pre-visit planning allows you to…

• Update problem list

• Start your note

• Put in orders

Review vitals

• “Triage” tab

– Visit Info: CC

– Vital signs

Review vital trends

• “Review flowsheet”

– Select “vitals”

Inputting new vital signs

• “Triage” tab → “Vital Signs”

Update the problem list

• Edit, resolve or associate with this visit

Mark Meds/All as reviewed

• Under “Triage” tab

Mark medical history as reviewed

• Under “History” tab

– Medical

– Surgical

– Family

– Social

Update health maintenance

• Postpone or discontinue

• Fulfilled elsewhere • Change frequency

A note on health maintenance

• Not all items are included in HM tab

• PCC note template has a thorough list:

Start your note

Useful Dotphrases

.PCCGENNOTE2019

.NAME

.AGE

.SEX

.PROB

.PMH

.PSH

.MEDS

.ALG

.SOCHX

.FAMHX

.ROS

Borrowing note templates

• AKA “Smartphrases”

Make your own note template

• “New” then paste/edit and name your smartphrase

Be careful with copy/forward!

• Your note should accurately reflect what happened in your visit with the patient

– ROS

– PE

– Labs/imaging reviewed

– Assessment/plan

Add a new visit diagnosis

• Input your own or use “Common” diagnoses

Add orders

• Search for an order, hit enter; it appears bottom right

Medication changes

• “Meds and Orders” tab

– pencil icon to adjust

– “x” to discontinue

Adjust sig

• Hit “Accept” when finished

Changing pharmacy

• Click on pharmacy name under “Meds and Orders”

• Search for new pharmacy using name and address

Associate orders with visit dx

• “Dx association” then check appropriate box

Sign your orders

• After signing out to attending, designate them as cosigner

Follow-up

• Input when you would like them to return

Patient instructions

• Search under “References” for frequent conditions

• Free text

Sharing normal results

• Create a letter from your inbox

• Route to your PAR

to print and mail

Sharing abnormal results

• Call patient!

• Create a telephone encounter to document

Questions?

• Up next: Epic scavenger hunt