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 INTHE ADMISSION DATABASE

Admission Database

There have been a few changes to the Admission Database

• Addedo Family History section

• Updatedo Medical History Past and Present

• Removed (and placed in another location)o Immunizationso Surgery/Procedure History

Admission DatabaseFamily 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)

Check here if family history is unknown

Shows that no information has been entered for this patient

Admission Database

Adding Family Medical History

• Box will be empty if no family history was entered previously

• Click “Add” to enter information

Click on the ellipsis (3 dots in a box)to “Add, Edit or Remove” Family Medical History and this screen appears

Adding Family Medical History

6. Click “Done” or “Done and Add Another”

5. No need to include which brother, sister, child or grandparent if multiple in family

1. Select Problem from Common List

2. Click Select

3. Complete Who, Age at Onset and Living

4. Enter Comment if needed

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

Editing or Removing Family Medical History

When you have finished adding/editing or removing information, click “Done”

Final Step in Adding, Editing or Removing Family Medical History

Admission DatabaseFamily Medical History Completed

The Family Medical History will display much like the rest of the past medical history

Current State

“No history of…” box above system heading

“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.

Grayed out

Patient’s Medical History Past and Present UpgradeUpgraded State

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.

√ √

This section is related to changes inIMMUNIZATION 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

• 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

Click “View detail” panel to see

more information

On admission:• Go to Chart

Immunizations

Immunization Record

Specific information regarding the administration can be viewed• Vaccine specific info• Administration date/time• Consent• Information provided

Immunization Record- Historical/Previous Provider

To add immunization data on admission, click “Add”

• If the patient has received an immunization from another provider, the information must be entered into the Immunization Record

Immunization Record-Historical/Previous Provider 1. Select immunization from Common List or Search

5. Enter when immunization was received

• May type info into box or use calendar icon

6. Click Save

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”

Immunization Record

• 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

Auto-fills when drug is scanned

1.Choose Info Sheet2.Choose Publication date

(located at the bottom of the vaccine information statement)

3.Click Add

Enter Manufacturer, Lot # and Exp. date

Select Eligibility (for pediatric patients only if applicable) Click Save

NOT APPLICABLEDo Not complete this section

Ex of info that can be placed in comments:“Parents gave verbal consent &

acknowledges info has been received”

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

Documentation of Immunization Administration

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 INTHE 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

Adding Surgery/Procedures

Enter procedure date by:

1. Date OR2. # years ago OR3. At X years old OR4. Other

 

Click Save or Save and Add Another

Type in name of procedure

Click Add it as free text procedure

Fill in body site if applicable

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

Details shows when data was updated

If an incorrect procedure has been added, it can be removed• Highlight the incorrect entry• Click Remove

Removing Surgery/Procedures

• Verify that this is the procedure to be removed

• Choose the reason• Click Remove

THIS SECTION IS RELATED TO CHANGES INHOME MEDICATIONS

Home Medications

Changes to Home Medications

• The order of Status, Dose, Route, etc. has changed• Last taken has been added to the main section• Special Instructions is now Patient Instructions

• Comments is now called Internal Comments

Home Medications

Before

Home Medications

• Patient Instructions print on the Patient Discharge Medication List

• Internal Comments DO NOT show up on Discharge Medication List

THIS SECTION IS RELATED TO CHANGES INCARE 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 orderso Stat Non-medication

orderso Medication orderso Non-medication orders

(Listed alphabetically by group)

Changes to Care Organizer

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.

Please direct questions regarding the McKesson Enterprise Release 11/12 Upgrade to your facility’s

Hospital IT Support.