Meditech 5.64.21 Physician Training (Designed for initial training for Inpatient Physicians) September, 2011 Page 1 TABLE OF CONTENTS Interoperability and Connection……………………………3 Purpose………………………………………………………………4 MHS Key Resources…………………………………………….5 Meditech Login & Password Change……………………..6 View Patients……………………………………………………..8 Reviewing Patient Information……………………………..12 Creating Your Own Patient List…………………………….15 Patient View and Menu……………………………………….19 Laboratory Panel…………………………………………………20 Microbiology Panel………………………………………………21 Pathology Panel………………………………………………….22 Graphing Results…………………………………………………23 Special Panels…………………………………………………….24 Imaging Panel…………………………………………………….25 Nursing Notes…………………………………………………….26 Care Trends and Care Activity……………………………..27 Nursing History…………………………………………………..28 Page 2 Medication Administration List……………………………..29 Order History and Audit Tracking…………………………30 Allergies…………………………………………………………….31 Printing Reports………………………………………………….32 Other Reports…………………………………………………….33 Reprint Facesheet……………………………………………….34 Patient Coding Summary……………………………………..37 Patient Census……………………………………………………39 Incomplete Records by Doctor……………………………..43 Lab Summary……………………………………………………..45 OR Schedules…………………………………………………….47 Rounds Report……………………………………………………49 Medication Summary…………………………………………..52 Summary……………………………………………………………54 Contact Information…………………………………………….55 INTEROPERABILITY AND CONNECTION ► ► ► MHS through the Meditech Health Information System is now interoperable for all five Medical Centers regarding sharing and medical access to patients electronic health records Future goals will be to have all MHS ambulatory services also fully connected to Meditech Long term goals will be to have a MHS regional health network that includes physician offices May 2008 3 Page 3 PURPOSE ► This training module has been designed to help you learn and navigate through the Meditech EMR and its various functions ► This is one of four training sets available on the MHS web site http://www.methodisthealthsystem.org ► Please take an opportunity to view the other training documents: Remote Access Electronic Signature Physician Consult Ordering ► For additional training materials please access the MHS Intranet site http://intranet/cpoe/default.aspx May 2008 4 Page 4 MHS KEY RESOURCES For MDMC, MMMC, MCMC: MHS Help Desk 214-947-1999 MHS Help desk email: helpdesk@mhd.com ► For MRMC and Bush/Renner: Methodist Richardson Help Desk 972-498-4756 MRMC Help desk email: ishelpdesk@richardsonhealth.com ► Medical staff offices : MDMC: 214-947-2875 MCMC: 214-947-7699 MMMC: 682-622-2069 MRMC: 972-498-4684 ► PACS – Radiology: Toby Lopez – PACS training 214-947-2465 Email: tobylopez@mhd.com ► May 2008 5 Page 5 MEDITECH LOGON & PASSWORD CHANGE ► ► ► ► This screen is now the MHS Meditech site and requires that you have a Meditech user name and password This is different from your token sign on First time users will get a one time use Meditech password assigned. Put this one time use password in old password line ► Put in your new password and hit enter and then reenter new password and hit enter again Meditech will acknowledge your new password change as successful ► Subsequent logins will not prompt for a new password unless expired ► If you forget your password, one can always get assistance by calling: the MHS Help Desk 214-947-1999 or MRMC Help Desk 972-498-4756 ► October 2006 6 Page 6 CHANGE PASSWORD ► ► ► Depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below From “ITS”, go to “Change Password or Create PIN”, then “Change Your Meditech Password” From “EMR”, go to “Change Password or Create PIN”, then “Change Your Meditech Password” 2 1 3 1 “ITS” “EMR” May 2008 Page 7 2 3 VIEW PATIENTS ► ► ► From “ITS”, click “Provider” On the “Provider” screen, select “EMR” From “EMR”, click “View Patients” 2 2 1 1 “ITS” “ITS” May 2008 Page 8 3 “EMR” VIEW PATIENTS ► ► ► ► October 2006 This applies for all users You now have several choices on how to search for your patient(s) Use the menu on the right panel of the Meditech window You can choose to search by: Admitted Emergency Dept New Results Recent Access Any Location Any Record Rounds Report 9 Page 9 VIEW PATIENTS ► ► ► This example shows searching by “Any Record” Type the last name of the patient, and click “OK <F12>” From the list of Patients, select the correct Patient 2 1 3 May 2008 Page 10 VIEW PATIENTS ► Now select the correct Visit 1 2 May 2008 Page 11 REVIEWING PATIENT INFORMATION ► ► ► Once you select a patient, EMR opens to the “Summary View” You can choose what you want to view using the view selection buttons Or you can view “Special Panels” 1 2 3 May 2008 12 Page 12 VIEW BY RECENT ACCESS ► ► ► This example shows searching by “Recent Access” This shows all patients you have recently accessed From the list of Patients, select the correct Patient 1 2 May 2008 Page 13 VIEW BY ANY LOCATION ► ► ► ► This example shows searching by “Any Location” This shows all patients at the location you select Choose the facility From the list of Patients, select the correct Patient 2 1 4 May 2008 Page 14 3 CREATING YOUR OWN PATIENT LIST ► You can create a patient to list to use by either of two methods. ► You can use the “Recently Accessed List “choice which is automatic and involves you only having to open a patient and view results to add to your list. Patients automatically get dropped off after 14 days of discharge. Or you can make selection “remove from recently accessed list” ► You can alternatively make a “Personal List”. This requires more maintenance on your part but gives more control on who gets on your list and when they get taken off. May 2008 May 2008 15 Page 15 CREATING YOUR OWN PATIENT LIST May 2008 May 2008 ► Create a personal list by selecting the patients you want to add to list and then hit “Add to personal list” ► This adds a little more maintenance but allows a printout of your personal list and report with all your patient locations ► You can see your list at any time by selecting “personal list” 16 Page 16 CREATING YOUR OWN PATIENT LIST ► ► ► May 2008 May 2008 Page 17 Removing Patients It is easy to manage your patient list by removing those patients you discharge Once you click “Remove from personal list,” the name is removed as indicated CREATING YOUR OWN PATIENT LIST ► ► ► ► ► May 2008 May 2008 Printing your list You can select print or view “Personal List/Report” Select all or a specific facility Select “View” or “Print” The “Personal List Report” includes location, patient name, bed, room number, MD, sex/age, medical record number, physician, room, bed 18 Page 18 PATIENT VIEW AND MENU ► ► ► ► ► The admitted patient default screen will be the 24 hour view Patient Information is on the top panel Right panel has individual clinical modules Red color of individual clinical module means new results since your last viewing of record Anything new is listed here for 5 days: vital signs, I and O, reports, lab results etc… 2 1 October 2006 19 Page 19 LABORATORY PANEL ► ► The right side of the Meditech desktop contains the Lab menu Select panel, and view the results 2 1 3 Use the Laboratory menu option to view information for Hematology, Blood Gas, Coagulation, Chemistry, Urine, Toxicology, Other Body Source, Immunology, Miscellaneous, and Serology To get the numerical reference ranges point your arrow at the test name and click on it. Another window will appear and show the ranges for that test. October 2006 Page 20 MICROBIOLOGY PANEL May 2008 2006 October ► Click on picture of Report/Grid to view microbiology report ► Once on your screen, the report can be printed. When done hit ESC to go back to patient record 21 Page 21 PATHOLOGY PANEL The right side of the Meditech desktop contains the Pathology menu ► Select panel, and view the results Use the Pathology menu option to view pathology specimens in reverse chronological order with the most recent specimen appearing at the top of the 2 1 panel. The Pathology panel includes three columns. The left column of the panel includes the date and time of the report. The middle column includes the name of the report (or the EMR ID if the report was scanned). The right column includes the result icon. Click the result icon to view the report October 2006 ► Page 22 GRAPHING RESULTS ► 1 2 ► You can right click on your mouse on each selected lab values up to three or vital signs and then select graph for viewing You can then print screen the graph if desired 3 4 May 2008 October 2006 23 Page 23 SPECIAL PANELS ► ► ► ► The “Special Panels” selection on third line of top right menu will take you to some pre-built specialty results panels For instance, below is an example of the Diabetic Panel You can select time intervals from 5 minutes to 24 hrs. You can see entire encounter by selecting Earlier or Home if there are more results May 2008 2006 October 24 Page 24 IMAGING (RADIOLOGY) PANEL ► ► 2 1 ► ► ► October 2006 Page 25 Radiology studies will be found under “Imaging” Go to the round balloon and click to see report Once report viewed, you can go to top of screen and File/Print Some radiology reports may not print well on non - HP printers Make sure all print drivers are current NURSING NOTES ► ► ► May 2008 October 2006 The “Notes” selection has all the nursing notes, as well as other allied health notes. To see all the listed information click “i” in last column Nursing notes can also be printed from physician “Rounds Reports” 26 Page 26 CARE TRENDS AND CARE ACTIVITY May 2008 May October 2008 2006 Page 27 ► “Care Trends” displays a group of panels grouped by body system and special categories (for example, GI/GU and Integumentary) ► “Care Activity” displays multiple assessments together, allowing you to view them in context with each other and compare information that would otherwise be found in separate locations ► Nursing assessment “History” includes all positive findings including MRSA and VRE, allergies, and vaccination 27 NURSING HISTORY ► ► May 2008 May October 2008 2006 The History menu option displays a group of panels that shows the responses to the questions asked during the Medical History Assessment. The responses are put into categories for display Nursing assessment “History” includes all positive findings including MRSA and VRE, allergies, and vaccination history 28 Page 28 MEDICATION ADMINISTRATION LIST ► ► ► 1 ► Active, Discontinued and ALL medications choices can be selected Toggling boxes below can also help to see earlier as well as current view Clicking the headings at the top of each column will sort and give more detail on each medication Clicking on the Medication will show order details and history May 2008 October 2006 29 Page 29 ORDER HISTORY AND AUDIT TRACKING ► 1 ► This allows tracking and auditing of physician orders Click on the date next to the medication to view the “Audit Trail”, which shows when orders removed, completed, etc 2 May 2008 May October 2008 2006 30 Page 30 ALLERGIES ► ► ► ► May 2008 May October 2008 2006 The “Allergy” selection is very important Once an allergy is logged in any visit or hospitalization it will be in patient’s record within system forever Click on the blue “i” to see allergy information Click “Process” to add comments, view audit trail, etc 31 Page 31 PRINTING REPORTS ► ► ► You may need to print reports from Meditech Select the print option (default is “View”, which displays on screen) You can also choose: Print (you will select a printer) Download (you will choose a download path to save the report to) Browser (this will load the report to your Internet Browser) 1 2 3 October 2006 32 Page 32 OTHER REPORTS ► 3 2 1 ► ► ► October 2006 Page 33 Use “Other Reports” for: History and Physical Operative notes Consults Discharge summaries etc that have been dictated by physicians Status shows as Signed, Draft, etc Find report and click on balloon to open report Once the report is open, you can print it by selecting File/Print REPRINT FACE SHEET ► ► ► ► Depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below From “ITS”, go to “Reprint Facesheet” From “EMR”, go to “Reprint Facesheet”, then select a facesheet This will include most recent information for patient demographic information for billing 1 2 2 3 1 “ITS” “EMR” October 2006 34 Page 34 REPRINT FACE SHEET ► ► ► ► ► Enter patients CA… DA… MA… RA… number sequentially as all CAPS There are 10 digits in the account numbers (CA0000000042) You MUST enter the leading zeroes These numbers can be found on patient record when in view patient module Multiple numbers can be entered at one time - just use tab and cursor goes to next line October 2006 35 Page 35 REPRINT FACE SHEET ► ► ► October 2006 Patient face sheet with demographics useful for office staff for billing services This report is always current and available by remote access by office staff with Meditech username and password After viewing report select printer icon at top of menu bar for print copy 36 Page 36 PATIENT CODING SUMMARY ► ► ► From “EMR”, go to “Patient Coding Summary” This will include most recent information for patient demographic information for billing, and the patient’s billing coding summary done in MHS HIM Most useful to physician’s office personnel for ICD9 codes at patient discharge from hospital 1 “EMR” October 2006 Page 37 2 PATIENT CODING SUMMARY ► ► 1 ► At prompt put in CA or DA account number and click OK Select View or Print You should now have a summary of HIM hospital coding for your patient 2 October 2006 38 Page 38 PATIENT CENSUS ► ► From “EMR”, go to “Census Report”, then “Census”, select a Census There are 3 census reports available: ► Alpha ► Doctor ► Nurse Unit 1 2 3 “EMR” October 2006 Page 39 4 PATIENT CENSUS (ALPHA) ► ► Alpha Census: Put the patient name(s) on both blank spaces, click ok 1 2 October 2006 Page 40 PATIENT CENSUS (DOCTOR) ► ► ► ► ► Doctor Census: Put the Doctor’s mnemonic(s) on both blank spaces Select your preferred Sorts Select Report Format (usually Standard) Click OK 1 2 3 4 5 October 2006 Page 41 PATIENT CENSUS (NURSE UNIT) ► ► ► ► Nurse Unit Census: Type the Date Select your preferred Location(s) Click OK 1 3 2 4 October 2006 Page 42 INCOMPLETE RECORDS BY DOCTOR ► ► ► ► Depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below From “ITS”, go to “Incomplete Records by Doctor” From “EMR”, go to “Incomplete Records by Doctor” Incomplete records can be selected by you to know which records are in progress in HIM and days to calculate deficient days 1 2 2 1 “ITS” “EMR” October 2006 43 Page 43 INCOMPLETE RECORDS BY DOCTOR ► ► ► ► Put the Doctor’s mnemonic(s) on both blank spaces Select your “Minimum Number of Days Outstanding” Select Category (usually “ALL”) Click OK 1 2 3 4 October 2006 Page 44 ► Days in process is the approximate value for delinquent days in MR. Delinquency reasons also listed with initials under reasons ROUNDS REPORT Depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below From “ITS”, go to “Rounds Report” From “EMR”, go to “Rounds Report” ► ► ► 1 2 2 “ITS” 1 “EMR” October 2006 Page 45 ROUNDS REPORT ► ► ► ► ► This report can be run for an individual MD, for MD group, by Location, and by Facility, or with a combination of any of the four factors Consultants must be entered into Meditech by a physician order to be linked to this report This report offers the following information: All inpatients and 23 hour observation patients linked to physician can be printed by MD, MD group, location, facility and any combination Results include: 48 hr VS, I&O, Labs active medications nursing notes Insurance Allergies patient demographics 72 hr micro results October 2006 Page 46 ROUNDS REPORT ► ► Make your selections in the four fields Click “OK” October 2006 Page 47 SUMMARY ► You now understand basic Meditech functions: Logon, change password View Patients Clinical Panels ► You have learned about the additional physician desktop EMR icons that contain more functions within Meditech: Reprint Face sheets Rounds report, Census report, Incomplete records report Patient coding ► This document is one of four: Remote Access Meditech Training (this document) Physician Consult Ordering Electronic Signature October 2006 48 Page 48 CONTACT INFORMATION ► If you are having problems with your access at MDMC, MCMC, or MMMC please contact 214-947-1999 the MHS Helpdesk or helpdesk@mhd.com ► If you are having problems with your access at MRMC or Bush/Renner please contact the Richardson HelpDesk at 972-4984756 or ishelpdesk@richardsonhealth.com ► MHS does not have a team to come to your office to repair PCs. October 2006 49 Page 49