CPRS GUI V27 Overview of New Functionality Sheri Kreuz, EPSClin2

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CPRS GUI V27Overview of New FunctionalitySheri
Kreuz, EPS/Clin2
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Medication Order Changes

• Administration Times
• Changes to Infusion Order Dialog
  (PSI-05-065,PSI-06-014,PSI-06-045, PSI-06-066)
• Meds Tab Sorts
• Pending Renewals (PSI-06-023)
• Day-Of-Week Schedule Builder

• Expected First Dose (PSI-05-026)
• Schedule Type
• Provider Comments (outpatient ordering process)
  (PSO-07-057, PSI-07-203)
• Accidental Signing of Old Orders (PSI-05-106)

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Administration Times

• CPRS now displays administration times when
  writing inpatient medication orders in the unit
  dose and infusion order dialogs.

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Changes to IV Dialog

• Added IV Type Selection Field
• Added Medication Route Selection Field
• Added Schedule Selection Field
• Added Give Additional Dose Now Field
• Added Infuse Over Time Field
• Added Administration Time
• Added Expected First Dose

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New IV Medication Route Field
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New IV Medication Route Field
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New IV Medication Route Field
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Continuous IV Type
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Intermittent IV Type

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Meds Tab Sorts
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Pending Renewals

• CPRS provides the user an option to DC the
  pending renewal and/or the original order.
• When a pending renewal is discontinued, it will
  return to its original status.
• The following message will display if the
  original order has not expired

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Day-Of-Week Schedule Builder
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Expected First Dose Modifications

• Inpatient meds will not display expected first
  dose for a schedule of one time or on call.
• Inpatient meds will accept the schedule format
  days_at_schedule from CPRS (Tuesday_at_BID).
• Expected first dose will not show if give
  additional dose now is checked.

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Schedule Type

• The Give additional dose now box is removed for
  Delayed orders and Schedule type of Once or One
  Time.
• Duration cannot be assigned to an Intermittent IV
  Order if the schedule has a Schedule Type of
  ONCE.
• Administration times will not show for the
  following schedule times PRN, One time, On Call.
  
• CPRS will store the schedule type of the finished
  order from pharmacy.
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Provider Comments

• Potential of inappropriate or misleading provider
  comments automatically included on new medication
  orders.
• Provider comments will display in the Sig until
  the order is finished, then only if copied into
  the patient instructions.
• If an order is later edited, copied or renewed,
  the finished patient instruction text will be
  retained in the new order instead of the original
  provider comment.
• The Transfer action will allow provider comments
  to roll over into the order dialog for review by
  the new ordering provider.
• CPRS will continue to include both the provider
  comments and the patient instructions of the
  original order text in an audit trail.

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Order Changes
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Radiology ORDERS

• Added Reason for Study Field
• Remove Default Desired Date Default (E3R 19834)

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Lab Collect vs. Ward Collect

• System changes the order from lab collect to ward
  collect
• Previously, for inpatient lab orders that are of
  type lab collect or immediate collect, if a
  continuous schedule was selected (such as QD or
  QWEEKLY) and a child order falls on a day when
  the lab cannot perform the collection (for
  example, weekends or holidays), the collection
  type was automatically changed to ward collect
  but CPRS did not warn to the user.
• Resolution Developers added an advisory window
  that initially appears when the user selects
  Accept for that order, advising of any such
  changes to child orders. If these orders are
  left unsigned, the same advisory window will also
  appear at the point when they are signed or
  released at some future date.

PSI-05-048
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ORDERS Cancelled on Discharge from Observation

• Delayed Orders Entered for Transfer to Surgery
  Cancelled on Discharge from Observation (Remedy
  180390, E3R 20065)
• When an inpatient was in a ward with an
  observation treating specialty and the patient
  was transferred, the delayed orders were
  inappropriately cancelled.
• Resolution Developers changed CPRS so that
  transfer events will no longer be selectable from
  the delayed orders event selection list for
  patients in an observation treating specialty.

PSI-07-046
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ORDERS - Dietetics

• Diet Quick Orders Do Not Prompt for Late Tray
  (Remedy 69260)
• Sequence Problem with Delayed NPO at Midnight and
  Other Diet Orders (PSI-07-212)

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ORDERS

• REASON FOR FLAG Field Changed from Free-Text to
  Drop-Down List with Free-text Allowed

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ORDER CHECKS - Override Text

• Order Check Override Text Not Transmitted to
  Ancillary Services (PSI-05-103)
• Order checking screen (dialog) can now be
  resized.
• A "Return to Orders" button was added. Pressing
  the button does not cancel the order, only the
  signature process.
• Extra informative text above the critical order
  check justification was added

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ORDER CHECKS
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Accidental Signing of Old Orders

• Accidental Signing of Old Orders in CPRS. The
  review/sign order form will be changed to group
  orders together by the current session, previous
  session and by all other user orders written in a
  previous session.

PSI-05-106
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Accidental Signing of Old Orders

• When canceling orders that are unsigned, orders
  that are canceled outside of the session will no
  longer be deleted but actually canceled and
  retained.
• Old unsigned orders will now be lapsed based on
  the OR LAPSE ORDERS and OR LAPSE ORDERS DFLT
  parameter values.
• A nightly task job will flag lapsed orders.
• Option OR LAPSED ORDERS will be added under the
  OR PARAM COORDINATOR MENU. This is a utility to
  pull up reports on orders that have been lapsed
  due to providers failure to sign the order
  before the lapse period expires.

PSI-05-106
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ORDERSOriginal Verbal Orders Signature

• Problem
• A verbal order is entered by a nurse and the
  receiving service makes a service correction and
  fills the order. Because of this the ordering
  provider is not getting a chance to sign anything
  related to the order because of the service
  correction.
• Resolution
• The original verbal order will stay in need of a
  signature despite the service correction and will
  show on the ordering provider's unsigned orders
  list.

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Encounter vs Inpatient Location

• Scenarios
• Patient is an inpatient and is being seen at an
  outpatient location
• Patient is admitted while being seen at an
  outpatient location and the provider is in CPRS.

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Encounter vs Inpatient Location

• Old Forms in CPRS 26
• Non-IMO location
• IMO location

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Encounter vs Inpatient Location

• Changes for CPRS 27
• Standard form for both IMO and Non-IMO clinics.
• Allows location to be assigned to individual
  orders.
• Allows provider to determine encounter location
  when refreshing the chart instead of CPRS
  automatically going back to the inpatient
  location.

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Encounter vs Inpatient Location
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Encounter vs Inpatient Location
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Encounter vs Inpatient Location
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ALERTS
REASON FOR FLAG to Display When Processing
Flagged Order Alert
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ALERTS
Flagged Order Alert Processing
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ALERTS
Improved Surrogate Validation and Forwarded
Comments Button
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ALERTS

• Remedy 215189, NSOC ticket VA08853 - Sensitive
  record check bypassed when using CPRS GUI to
  process alerts. This has never worked correctly,
  but is now fixed in v27. There are 2 known
  issues remaining, both only when an alert can't
  be processed at all because viewing that patient
  is denied
• If that alert is the first in the list to be
  processed, then following the "access denied"
  message, the patient selection screen will open,
  and any subsequent alerts that were previously
  selected will need to be selected again.
• In any other sequence, alerts up to and including
  the "access denied" message will process
  correctly. At that point, the user cannot
  continue processing alerts using the NEXT button
  or menu, and must go back to the patient
  selection screen to continue, or reselect
  additional alerts.

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ALERTS
Make Anatomic Pathology, Pap Smear, Mammogram
Notifications Action Alerts
PSI-05-001/PSI-06-068/PSI-06-134/PSI-07-14/PSI-07-
031
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CONSULTS

• Consults completed without viewing reason for
  consult
• Added right-click option to note editing menu to
  display details of consult being completed while
  editing a consults-titled note

PSI-04-012 (Part 4)
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CONSULTS
Direct Edit or Skip Reason for Request Field When
Using Templates
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DISCHARGE SUMMARY

• Discharge Summary attending physicians now
  respect user class business rules.
• They must be in the PROVIDER user class, or one
  of its descendent user classes.
• They must be in a user class that does not
  require a cosigner, based on the selected
  document title.
• Only users that meet the above criteria will
  display in the list of providers that can be
  selected as attending physicians.

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PATIENT RECORD FLAGS
Category I Flags stand out from Category II flags.
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REPORTS
Viewing Multiple Anatomic Pathology Reports
PSI-05-027and PSI-07-135
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REPORTS
Viewing Multiple Anatomic Pathology Reports
PSI-05-027and PSI-07-135
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Personal Team Lists
Control Visibility to All Users
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OR3243 (CPRS GUI v27)

• CPRS GUI v27 Functionality includes
• Project Initiatives (10 projects)
• Patient Safety Issues (43)
• Remedy Tickets (100)
• ClearQuest tickets deferred from v26 to v27
  (approximately 100)
• 508 Compliance Modifications (approximately 200)

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OR3 (CPRS GUI v27.n)

• CPRS GUI v27.n Functionality includes
• Combat Vet Identifier
• Issues introduced by CPRS v27

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Combat Vet Identifier

• This project will provide a way for clinicians to
  distinguish these veterans from others when
  setting priorities in scheduling appointments and
  enable them to receive care during their
  entitlement.
• CV Identifier information will display on
• Patient Lookup Screen
• Patient Header Bar
• Consult Request Order Dialog on SF 513
• Notifications for priority scheduling

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VBECS Order Dialog Overview

• Claudette Murch, EPS/Clin 2
• Cheryl Leiferman, Functional Analyst/CPRS

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Signing On

• Find your student number by your
  computerClick this Icon
• Access Code VEHU
• Verify Code VEHU
• Your patient isltyour number spelled outgt,patient