Is there capacity in Message Centre to put in an ‘out of office’ where would indicate that the messages would not be reviewed daily, and urgent matters requires a phone call to X? I understand the proxy option is there but where there is no one to proxy to as we don’t have staff daily, could we do the ‘out of office’?
There is no out of office and I don’t think there needs to be, remember that messages, particularly from admin, will likely go to the Pool unless it is a message for a particular clinician.
The Future (On Hold) status is specific to orders to scheduling. It simply means that it has been ordered but not yet booked, this is of course different to inpatient orders which will say ordered once you have signed them. So this will be the status for any outpatient order.
Regarding review orders, what you do is dependent on what will be the outcome of attendance. You will do either the Schapptbook method OR you place a review order, see appropriate step below dependent on Outcome of attendance.
- Another appointment given – Clinician has provided another appointment using Schapptbook
- Appointment to be given at a later date – Clinician has ordered a review appointment and admin will book appointment as per order
- Discharged from consultants care – No further appointment required, no order required or booking via Schapptbook
There is a clerical step between clinician placing an order and it appearing on the triage list. We are not training clinicians how to do this as it is an administrative task. So unless that clerical step is completed, you will not see the patient on your triage list. I have set up specific triage lists so that you do not have to do this clerical step.
The process is as followed:
- Clinician places referral via Orders in Powerchart
- Admin create encounter and change status to requiring triage
- Clinician can view referral in appropriate triage list
This will go to a rebooking worklist with RMC/W&C admin to follow up depending on the outcome selected
If a patient turns up for an appt where there is no admin support to “Check in” the patient t, does the clinician need to update it themselves to “Attended – checked in” or can we skip this step and go to “In room”. Or vice versa, can we “check in” the patient and not use “in room” if no one else in the clinic will be waiting to see the patient?
If there is no admin support, at a minimum the clinician will need to “Check in” the patient, which will update the status to “Attended – checked in”. The “In Room” status is the optional status
“Check in” and “Check out” correspond to Arrived and Departed in IPM. You can amend these times but you need to do this in Scheduling Appointment Book
No, anyone can send a message to a pool, but it is like sending the global email.
For EMR Phase 2.1 we are introducing message centre predominantly for specialist clinic communication and this has been reflected in the fact that pools have been created for allied health SCs.
It will be an allied health decision regarding whether message centre will be used for inpatients, not an EMR decision.
External referrals remain the same as current state. For Paeds that is using the S:drive and for Adults that is on paper.
You will be able to view a report on the Cerner Reporting Portal, which can be exported to Excel
Through Orders and Referrals, type MBS into Search and make sure Outpatient for Administration is selected, choose appropriate MBS code, then you can enter who this is being billed for in Supervising Consultant. This then goes directly to Finance
The zebra label printers should already have been set-up by IT
During the EMR Phase 2.1 design workshops, feedback from key stakeholders helped the EMR team to better understand the complexities surrounding the proposed move of community referrals (in paper or BOSSnet) and appointments (in iPM), including reporting, to the EMR as part of the EMR Phase 2.1 implementation.
The EMR team listened when advised of the complexities around community referrals and appointments, as opposed to the more straight-forward specialist clinics referrals. Through this feedback the EMR team understands the need to spend longer on the ambulatory referral design to ensure the build is tailored to suit the unique requirements.
As a result, a decision has been made to remove these workflows from the EMR Phase 2.1 scope, and to commence a separate project which will allow the detailed analysis required to ensure this functionality is tailored to the unique community referral workflow requirements.
This is a chance for the EMR team to investigate the administrative workflows in more detail and ensure they are properly scoped and the requirements understood. The undertaking of this project after EMR Phase 2.1, will allow the EMR team to develop greater experience in the unique referral workflows and to better support affected clinicians and administrators and their requirements.
What will still be delivered in the EMR Phase 2.1 scope?
Clinical documentation went live as planned with EMR Phase 2.1. You are now able to document all the assessments and care provision for your patient throughout their enrolment in your service, enhancing continuity and visibility.
You can document in the EMR in the same way as other Western Health clinicians – bringing consistency across the organisation and an opportunity for other clinicians to view your notes. All clinicians using the EMR have access to the full picture of care.
In summary, clinical workflows are still in scope for EMR Phase 2.1, you are able to view and input patient information, but administrative workflows will not be in scope.
What’s staying the same as what you do now?
Internal referrals to your services will remain the same. They will be sent, received and triaged on paper or BOSSnet – this is the only clinical activity not in the EMR following the Phase 2.1 Go-Live.
External referrals continue to be scanned in to BOSSnet, which is consistent with external referrals for Specialists Clinics Outpatients. They will be triaged the same as now, on paper for BOSSnet.
All scheduling of appointments and reporting of contacts remain in iPM.
Yes after the EMR Phase 2.1 Go-Live in July 2023 we still have iPM in the inpatient setting but all outpatient appointments are scheduled in the EMR.
iPM will be fully replaced by the EMR with the EMR Phase 2.2 Go-Live.
ED and ICU are both on the EMR and so referral orders are sent through the EMR in the same way as in EMR inpatient spaces.
In the inpatient setting the collection of statistics has not changed from pre-Go Live processes.
In outpatients, the statistics will be collected and VINAH reported via the EMR.