Physician Training Manual Eclipsys Sunrise Acute …physician.clarkmemorial.org/MD_Training_Manual.pdfPhysician Training Manual Eclipsys Sunrise Acute Care 5.0 (View Only Training)

- 1 -

Clark Memorial Hospital

Physician Training Manual

Eclipsys Sunrise Acute Care 5.0 (View Only Training)

CONTACT: Margee White RN, BSN

Nursing Informatics Systems Specialist Clark Memorial Hospital Office: (812)-283-2821

Cell: (502)-744-3969

DATE: March 1, 2010



2

QUEST UPDATE As you know, on April 1, 2010, Clark Memorial Hospital will be activating a new suite of software products as part of its QUEST Project. This activation will close out Phase 2 of the project to replace disparate systems currently in place across the hospital (Siemens Invision), pharmacy (WORx), centralized scheduling (ORSOS) and the Emergency Department (IBEX) with an integrated software platform from Eclipsys. Cycle 2 of Integrated Testing was completed on December 29, 2009. This involved the Clinical Team, Radiology, Lab, HIM, Admitting, and Finance. Orders and Results were entered and analyzed to make sure they were entered correctly, went to the proper departments, and were charged correctly. Issues that came up during testing were fixed and retested during the next two weeks. Cycle 3 of Integrated Testing started on January 19, 2010 and completed on January 31st with further testing and addressing issues uncovered during the process.

The physician advisory group (PAG), led by Dr. Ray Knight and Dr. William Templeton has provided guidance and assistance with the build from the perspective of the clinician. The group’s membership is a cross-section of the CMH Active Staff – Family Practice, Internal Medicine, Surgery, Ob/Gyn, Pulmonology, Infectious Diseases, and others. Patient lists, result displays, order set composition, clinical summary, and workflow has all been designed with the physician perspective in mind. Training for physicians will start the last week in February and continue through activation. Numerous opportunities for one-on-one instruction and hands-on use of the training system will be provided. Several important changes for physicians will begin on April 1, 2010:

Daily census listing will no longer be printed each morning and placed in physicians’ mailboxes. A real-time list of patients will be available through any computer terminal in the hospital or your home or office.

CMH patients will no longer be accessible on MD Valet. Instead, a much improved web-enabled product called Clark Valet will be available from home or office.

On-line availability of facesheets, laboratory results, transcription and other documents to avoid paper printing costs.

Mobile carts will be added throughout the hospital as well as additional terminals and other devices in the Doctors’ Lounge; current PCs at nursing stations will remain available for use.

Sovera access will be integrated into the Eclipsys desktop. When a patient is accessed in Eclipsys, the patient’s Sovera record can be opened by clicking a button at the top of the screen with full access and display of prior visit records.

Currently, the plan is for physicians to begin order entry activities in late 2010.



3

PATIENT DOCUMENTATION MATRIX April 1, 2010

* All Outside Documents brought into the hospital for the patient will be placed on

Paper Chart *

Document Paper On-Line SAC Tab Cardiology Special Proc.

Report X

Cardiolite Stress Test X

Cath Lab Procedure Reports e.g. Cath Lab Tilt Table

X

CT Heart

X Cardiology section – Documents

Radiology section- Results

Echocardiogram X

EEG X Documents

EKG X

Emergency Dept. Documentation

X Documents – Scanned Reports

EMG X

Facesheet X Reports

Labor & Delivery Notes X

Lab Results X Results

Med Admin Record (MAR) X Tasklist Viewer

Nursing Documentation X

Pathology Results and Reference Labs

X Documents – Scanned Reports

Physician Notes and Orders X

Physician dictated Reports (H & P, D/C Summary, Consult,

OP rpt)

X Documents

Radiology Results (Nuc Med)

X Cardiology section-Documents

Radiology section- Results

Surgery Documentation X Documents

TEE X

Wound Care Documentation X

PFT X

Clinical Documentation from PT/OT, FNS, Ancillaries not

listed X



4

TABLE OF CONTENTS

QUEST UPDATE ........................................................................................................... 2

PATIENT DOCUMENTATION MATRIX ........................................................................ 3

Introduction .................................................................................................................. 5

Exercise Objectives ..................................................................................................... 5

Helpful Hints ................................................................................................................. 5

A. General Screen Navigation ........................................................................... 7

B. Creating a Criteria Based List (My Patient List) ........................................... 10

C. Printing Patient Lists ................................................................................... 13

D. Adding Yourself as a Care Provider ............................................................ 14

Viewing the Patient’s Chart ....................................................................................... 15

A. View Results Tab ......................................................................................... 16

Adding Annotations to Lab or Radiology Results ............................................... 19

B. View Orders Tab .......................................................................................... 22

C. View Flowsheets Tab ................................................................................... 24

D1. Transcribed Reports .................................................................................. 27

D2. Scanned Reports ....................................................................................... 28

E. Clinical Summary ......................................................................................... 29

F. Task Viewer ................................................................................................. 31

G. Viewing Multiple Patient Charts ................................................................... 33

H. Log Off ......................................................................................................... 34

Personal Lists ............................................................................................................ 36

A. Creating Personal Lists ................................................................................ 36

B. Maintaining Your Personal List ................................................................... 37

Clark Valet .................................................................................................................. 40



5

Introduction The following scripted exercises have been designed to teach you how to use the Sunrise Acute Care (SAC) System. The exercises will take you through patient assignments and show how to log-on, check allergies/reports and other Chart View functions. Please follow the exercises and ask for assistance from the instructors when needed.

Exercise Objectives After practicing the scripted exercises you will be able to:

Locate patient information

Create patient lists

View results

View orders

View documents such as transcribed reports and scanned reports

Use the SAC help function

Helpful Hints

The pencil icon indicates a note or tip of special interest. For example, in an exercise covering a certain form, a note may indicate what form is used to establish values for a field in the current form.

The bomb icon indicates the potential for a negative outcome. Warnings will help the participant steer clear of risky activities.



6

SECTION 1

General Navigation



7

A. General Screen Navigation

Once logged into SAC, the first screen you see is the Patient List Screen. This screen displays a default patient list based on your security settings. Here you will see many rows, columns, flags, and information about the patients on the list.

Flags

Click on Column name to sort in ascending or descending order

Refreshes Patient list

Once patient selected Patient Header information displays here



8

Patient Header displays important information about the selected patient. The patient header displays:

Name ID/Visit Number Location Demographic information Allergy information Height/Weight

Admission/discharge date Code Status Isolation Status/Precautions Date of birth Age

SAC is an integrated system which means the various components are designed to work together to share more information across departments as the patient moves through the hospital. Unlike today where different areas of the Hospital use systems from different vendors and only pass a minimal amount of data between themselves, SAC is integrated with the Enterprise Scheduling and Registration System, Radiology Information System, Billing, and Decision Support. Through a strategic partnering arrangement, the surgical information system and the radiology PACS system are integrated into SAC.



9

SECTION 2

Using Patient Lists



10

B. Creating a Criteria Based List (My Patient List)

A list type you can create is a Criteria Based List. Unlike Personal Lists, Criteria Based lists will update with ADT activity. Criteria Based List are built on certain criteria that you define. For the patient to show on the list they must meet all the criteria you define. Criteria Based List can be based on one or more of the following:

o Provider Roles o Patient Location o Providers

o Service o Visit Status o Specific Orders

1. From the menu bar: Select File > Maintain List > New

The Client Selection Criteria dialog opens

2. “Your Role” Tab Select the check box



11

3. From here you can create the list based on any role you have or selected roles (ie. Attending, Ordering, Consulting)

4. Select Ok 5. Type in a name for your list, and select OK.

1. This places your criteria based list in the drop down list accessed in the Current List window.



12

How to delete a list:

1. Select the list from the Current list drop down 2. Go to Edit>>Delete Current List

3. A pop up window will display

4. Select OK 5. The list deletes



13

C. Printing Patient Lists

1. Select the Printer Icon on the tool bar:

2. The Report Selection window opens. In the Report Category drop down list

choose “Patient Lists”.

3. Select the list you want, list by patient name or location. Select Preview, then hit Print:

a. MD Patient List by Pt Name b. MD Pt List by Location



14

D. Adding Yourself as a Care Provider

1. Click the Find Patient icon . 2. Enter “Testhalley” in the Last field and enter “Ryan” in the Given field. 3. Click the Search button. Additionally you can click the Options tab and limit the

visits to Admission 4. Select “Testhalley, Ryan” and click Show Visits. 5. Double Click the inpatient visit 6. This Patient is now on a Temporary list

7. Highlight the Patient and Click the Add Provider Icon

8. Select the Add Me add yourself as a Care Provider. 9. Select the Role 10. Click OK. 11. To confirm, go to My Patients list and see if the patient is there. If the patient is

not there, hit refresh .



15

Viewing the Patient’s Chart SAC is used for more than just order entry and medication documentation. Clinical results and patient information are also accessed via the system and through the various tabs across the top of the patient information:

Lab Results Orders Flowsheets Documents Transcribed Reports SIS Reports Scanned Documents Clinical Summary



16

A. View Results Tab

Let’s look at your patient’s available information.

1. Click the Patient List tab. 2. Select a Patient 3. Click on the Results tab to view their lab results

Result Tab with no Filters set:

The results displayed are based on the selections you make in the View Control Panel, on the left side of the Results tab. Note: Results may have security rights assigned to it that specifies who can view it. For example, an HIV result may be restricted.

Date/time order placed Order Name

Result Result Status



17

The results displayed are based on the selections you make in the View Control Panel, on the left side of the Results tab. You may change the results filtering as follows:

4. Click the Chart drop down arrow and select This Chart. 5. Click the Received radio button beneath the Since section.

You may also click in the box next to Abnormal, if you wish to see ONLY those test results that have abnormal values.

This symbol is displayed if you have limited (filtered) the results to be shown on the screen.

View Control

Panel



18

. Select the Trend view to show results at the time they are entered into SAC

6. Select the Summary view to show results grouped in categories (Chemistry,

Microbiology, and Radiology). 7. Select the Summary view and click on a Red, Yellow or Green flag to view

individual results.

Using the Trend View display, select the graph box to view graph comparisons when Trend view is selected.



19

Adding Annotations to Lab or Radiology Results

1. To add Annotations to Results, right click on the result and select Annotations>>Add to Chart



20

2. Type the annotation and click save to result

3. Results with annotations will have this icon next to them



21

4. By hovering the icon you can view the notation or right click the result, select

annotations, view



22

B. View Orders Tab

Let’s look at your patient’s available order information.

1. Click the Patient List tab 2. Select Patient 3. Click on the Orders tab to view their orders.

This is the Orders Tab without filtering on the Control Panel.

The Orders displayed are based on the selections you make in the View Control Panel, on the left side of the Orders tab, similar to the one used for Results.



23

Setting Filters/Limits:

1. Click on the Chart dropdown and select This Chart 2. Click One Month ago in the Since view 3. Click on Active in the Status/Priority

Changing the Display format changes how the orders are organized (grouped)

There also is an Alternate tab available. On this tab you can further filter/limit what orders you would like to see

This symbol is displayed if you have limited (filtered) what orders are displayed.



24

C. View Flowsheets Tab

Let’s look at your patient’s available vital signs and other documentation.

1. Click the Patient List tab 2. Select Patient 3. Click on the Flowsheets tab to view

Again from here you can Filter the view based on the Control Panel

Observations



25

From here you can set the dates you want to view, or you can filter to Abnormal only. You can also graph the flowsheet.

1. Select the check box next to the Observation(s) you want to graph



26

2. Select Graph View from the bottom of the flowsheet

3. Adjustments to the graph can be made by making changes to the control panel.



27

D1. Transcribed Reports

Transcribed Reports will be found on the Documents Tab. Select your patient from the patient list then select the Document Tab.

By clicking View and selecting Report you can open this view and select the exact document to open, by double clicking. By clicking Group By the documents can be grouped by: Author, Date, Discipline, Category, Document, Status, Health Issue or Finalizing Provider.



28

D2. Scanned Reports

Some reports are not fed to SAC through the interface engine. Instead, these documents are scanned directly into the system for access by clinicians. Short term, Pathology Reports and some ER documentation will be scanned into the system. Long term, the Pathology Reports will come through the interface engine like the rest of the lab results. To access these reports:

1. Click the Patient List tab 2. Select Patient 3. Click on the Documents tab. 4. Click on the Scanned Images button and you will see the following box appear. 5. Pathology Reports will be located under the “Results” folder. 6. Click on the “Results” folder to open up the directory and then select the

pathology report of interest.



29

E. Clinical Summary

The clinical summary is a single view that pulls together information from throughout the chart. Select your patient from the patient list then Click the Clinical Summary Tab. Each Section is called a “Tile”. Some tiles are view only; others are interactive for getting additional information. This Clinical Summary looks to the Start of Chart, click the drop down to choose other starting points.

1. Click the arrows to see other tiles, in a “next page” sort of way. 2. Click the Scroll Checkbox (in the upper right corner) so you can scroll all

available tiles without having to page through to see other tiles.



30

3. Hovering over the medication name will display the dose/order information.



31

F. Task Viewer

Task view is accessed through the icon in the icon bar. From here you can see the medications and tasks that have been administered to your patient.

Using filters you can filter down what information you want to see. Once you have the filters the way you want them click Update. A √ means that the task/medication was done and the initials of the person who did it are in the box An “X” means the task/medication was not done and the initials of the person who did it are in the box.



32

To find out more about a task, right click on the square you want to know about and choose Document Details

From the right click you can also view the Order Details, Status History and the Order/Task Summary.



33

G. Viewing Multiple Patient Charts

1. Highlight patients on the list :

2. Click the tab that contains the information you want to view for each patient. For this example the Clinical Summary Tab



34

3. In the upper left corner the > to the right of the people becomes active once you click on a tab. If the < to the left of the people is grayed out that means this is the first patient in the list that was highlighted. If the > to the right of the people is grayed out it indicates this is the last patient in the list that was highlighted. 4. Using the < and > arrows the users can go back and forth between the patients selected. To change to a different tab simply click on the tab. Using the < and > you can go through information on the tab for the other patients highlighted in your list

H. Log Off

1. To log off “go out the door” in the icon bar



35

APPENDIX A

Using Patient Lists – Advanced



36

Personal Lists

A. Creating Personal Lists

Select the Patient List tab.

1. Press and hold the Ctrl key, use the mouse to highlight the multiple patient names you want on the list, and then release the Ctrl key.

2. Or to select several patient in a row highlight the first patient in the list then press the Shift key. While continuing to hold the Shift key down, using the mouse, highlight the last patient in the list you want to select. The system will highlight/select all the patients between those 2 patients you highlighted.

3. Click the Save Selected Patients button to display the Save Selected Patients window.

4. Click the New List Name radio button, and type Your Name List (ex. Jane’s List) for the list you are creating.



37

5. Click OK to close the Save Selected Patients window, and the system will take you to the Patient List tab, which displays your newly created patient list.

B. Maintaining Your Personal List

Personal Lists must be maintained, meaning patients will not automatically add or drop from personal lists as they are admitted, transferred or discharged. To remove a patient from your list:

1. Highlight the patient’s name.

2. Click on the Remove Patient icon .



38

A personal list is noted by a * preceding the list name. To add a patient from a different location to your list:

2. Click the Find Patient icon . 3. Enter “Testhalley” in the Last field and enter “Ryan” in the Given field. 4. Click the Search button.

5. Select “Testhalley, Ryan,” and click Show Visits. 6. Select the inpatient visit (If your patient has had multiple visits to Clark Memorial

Hospital, both inpatient and outpatient, you will be able to select the appropriate visit from the list.)



39

7. Click the Save Selected Patients button. 8. Select the Add Patient to Selected List button. 9. If you are not listed as a care provider on the patient’s chart: The Override

Chart Access window will display. In the Reason field type Consult or the reason you need access to the chart.

10. Select the list you would like to add the patient to, or you can create a new list. (See illustration on next page.)

11. Click OK.



40

Clark Valet Accessed through a secured web, you can access Quest from Clark Valet. For training this will be accessed through the Quest website:



41

After Training Clark Valet will be accessed: After Training, Clark Valet can be accessed two ways: 1. Via the CMH physician portal --- http://physician.clarkmemorial.org/ and clicking on the Clark Valet link

2. A Physician can setup a shortcut icon on their own desktop and go directly to the Clark Valet website From here, using the same login as you use to access SAC/QUEST login to Clark Valet

From this dashboard you can access various information, get messages and announcements from Clark Memorial Hospital, weather and other information and links.



42

From the menu bar Select Patient List to access your list of patients:

Once you are on the patient list, select the patient you want to view the chart of.

The patient’s name and demographics appears in the header area.



43

Once you have selected your patient you can view their orders, Results, Patient info and documents by clicking the choices in the menu bar. Orders:

Don’t forget to change the options on the left to increase or decrease the range

of orders displayed.



44

Patient Info: Displays demographic information, significant events, chief complaint and other information.



45

Results:

Click the “H” icon to see the historical results (any updates or corrections)



46

Documents:

The view can be adjusted by changing the dates to the left. Selecting the document name opens the document



47

Finding a patient using Clark Valet:

1. Select Find Patient

2. Type in Last and Given Names “Testhalley, Ryan” 3. Fill in any other information to limit results 4. Click Search



48

5. Select the Patient

6. Select the visit