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EMR Frequently Asked Questions

Top Five FAQs

Will the provider still be able to dictate or write a note?
Yes. JUP's EMR has both capabilities. Providers can dictate notes using the Dragon™ speech recognition application. Documentation may also be done with electronic templates or forms that will consist of structured pick lists, text templates and optional dictation markers to allow the physician to quickly document meaningful and legible progress notes.

What happens if the system goes down?
The system is being designed to minimize down time. However, should down time occur, procedures will be established. The length of the system down time will determine the procedure to follow. Patient care will continue and be documented. Appropriate back-up processes will be established should an event occur that causes a lengthy system down time.

Can I use the TouchWorks™ EMR from outside of the office?
Yes, providers will be able to access TouchWorks™ as long as they have a VPN and an Internet connection.

During "Go Live" should we expect patient process flow delays?
During any new implementation, a practice should always make accommodations for staff learning curves. The literature recommends decreasing provider's schedules by 30-50% during the first few weeks.

What types of devices will the practices utilize?
The practices can choose any device that their practice environment will support. We will be conducting technical assessments and sending out hardware surveys to ascertain practice preferences.

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Documentation

Will patients get their medical record on a CD?
A patient record can be printed in a paper format or saved as a PDF file on a CD.

Do medications have to be associated with a diagnosis?
No, however for reporting purposes this is very important.

A lot of doctors see chronic patients with the same diagnosis. Will the diagnosis from the last visit be the first to appear on the current visit?
Diagnoses appear on the encounter form based on what was selected during the patient visit. The order of the diagnoses can be changed in the charge module.

Can two people be in the chart at the same time?
Yes, as long as you are not documenting in the same note at the same time.

Can a template be created for notes/reports for implant visits/hearing aids?
Yes, we can build templates for implant visits and hearing aids. Different templates can be built to accommodate all visit types.

Will patients be able to input medical history prior to their appointment?
The functionality is currently not available in TouchWorks™.

Will the provider still be able to dictate or write a note?
Documentation will be done with electronic templates or forms that will consist of structured pick lists, text templates and optional dictation markers to allow the physician to quickly document meaningful and legible progress notes.

Will referring physicians be able to receive or send information in the EMR?
Yes, as long as they are part of the JUP network and information resides in Flowcast™ and TouchWorks™.

When a chart is scanned, how will the patient be identified?
Name, social securtiy number, MRN, and date of birth.

Is bar-coding being explored?
Not at present time.

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Results

When a result comes through the interface will it be attached to the original order?
All lab orders for TJUH, Quest, and Lab Corp will be attached to the original order. Radiology orders will need to be completed once the result is attached to the chart.

How will tests results from other facilities be captured in the EMR?
Test results from other facilities can be scanned into TouchWorks™ or manually entered.

Will labs/radiology results float into the note?
Each note can be set up to cite labs and radiology results.

How will results from an instrument get into the system?
If the device can be interfaced with TouchWorks™, then information will automatically flow into the patient's record, or it can be manually entered/scanned.

Will abnormal labs be flagged?
Yes

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Tasks

When a task is completed will a notice be sent to the task originator?
When creating a task, the user has the option to request notification upon completion of the task.

Can tasks be setup by priority?
Tasks can be prioritized as urgent, ASAP, or routine.

How will we monitor incomplete tasks?
A view can be created to display incomplete tasks.

Is there a time on the task so we'll know when it hasn't been handled within 24 hours?
A user has the option of keeping the defaulted overdue date and time or indicating the date and time the task will be considered overdue.

Will online/electronic messages from patients be entered into the EMR?
Electronic messaging with patients is not presently a capability of the system. However, phone messages from patients will be captured using the call processing module and tasked to the appropriate team or individual.

Will surgery schedule tasks automatically be prioritized as ASAP?
Each individual user selects the priority of the task.

Will the call center forward messages to the tasklist?
The call center will enter messages directly into the call processing module of TouchWorks™. The message will either become a note in the chart or be placed on the appropriate team's or individual's task list.

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Billing/Authorization

Will billing be affected by the EMR?
Charges will not need to be manually entered. Once the physician submits the electronic encounter form, a task will be generated to review the encounter form. The biller will review the information, make any necessary corrections, and submit the charges to Flowcast™.

Is TouchWorks™ linked to insurance companies?
TouchWorks™ is not presently connected with insurance companies.

Are inpatient charges viewable via the EMR?
TouchWorks™ has the capability of capturing and viewing inpatient charges.

Will there be charge entry?
Charges will be entered by the physician, and the biller will review each encounter in TouchWorks™ for accuracy and submit to BAR.

Will the system remind the providers if they have forgotten to code the encounter?
A task will be generated reminding the physician to complete the encounter form.

How will the nurses make a request to see if procedures need authorization?
When a procedure is ordered that requires an authorization, an authorization task will be generated. Nurse/clinical staff may also generate a task to the precert department to investigate insurance coverage.

How will an established patient who needs to have an injection authorized have their diagnosis communicated?
When an injection is ordered, the nurse will select the ICD9 code that is applicable. The information will appear in the order details. If financial authorization is set as part of the orders build, a task will be generated once the order is committed. The precert department will view the task, and the order details will include the diagnosis.

Will TouchWorks™ be able to accept ICD9 code 5th digit?
Yes

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Interfaces

Will the EMR replace JeffChart?
JeffChart will not be replaced by TouchWorks™, however information from JeffChart will be readily available in the patients chart, including:

Lab and diagnostic results
Operative reports
Maternity notes
Discharge summaries

Will information from Methodist be sent to TouchWorks™?
Methodist is scheduled to "Go Live" on Carecast. Once the system conversion has been completed, patient information from Methodist will flow to TouchWorks™ the same way as TJUH.

Will there be an interface between TouchWorks™ and pharmacies?
Yes, pharmacies will electronically receive prescriptions through SureScripts™. TouchWorks™ interfaces with SureScripts™ to electronically submit prescriptions to pharmacies. SureScripts™ operates the Pharmacy Health Information Exchange, which facilitates the electronic transmission of prescription information between physicians and pharmacists.

TouchWorks™ will communicate via the SureScripts™ network when:

The script action is set to send to retail or mail order.
The provider prescribing has been registered with SureScripts™.
The pharmacy selected is part of the SureScripts™ network.

If all three conditions are met then the script will be faxed according to the fax number defined in the pharmacy dictionary.

Will TouchWorks™ interface with the ER?
The ER currently has paper documentation. When an electronic system is implemented, we will investigate the possibility of interfacing patient discharge information.

Will results for lab work performed outside TJUH be linked?
All labs ordered from LabCorp and Quest will be automatically attached to the patient's EMR.

What happens if the system goes down?
The system is being designed to minimize down time. However, should down time occur procedures will be established. The length of the system down time will determine the procedure to follow. Patient care will continue and be documented. Appropriate back-up processes will be established should an event occur that causes a lengthy system down time.

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Access

Will everyone in the practice have the same level of access to the chart?
Access to the chart will be based on your position's role and responsibilities. There will be periodic monitoring via an audit trail ensure staff are not accessing information inappropriately.

Will providers/clinical support staff have access to the EMR in TJUH?
Yes.

Can I use the TouchWorks™ EMR from outside of the office?
Yes, providers will be able to access TouchWorks™ as long as they have a VPN and an Internet connection.

Can a user look up patients existing appointments?
Yes.

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Marketing

How will our patients learn about our practice's initiation of the EMR?
Letters, signage, and through the implementation of JUP's marketing plan.

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Training

How will I know when I will receive training?
A training schedule will be made available 6-8 weeks prior to the practice's "Go Live".

When is "Go Live"?
The first practice is slated to "Go Live" April 2008.

Will learning the EMR be difficult?
Learning styles differ from individual to individual, however multiple methods of education and training will be available to meet your needs.

During "Go Live" should we expect patient process flow delays?
During any new implementation, a practice should always make accommodations for staff learning curves. The literature recommends decreasing provider's schedules by 30-50% during the first few weeks.

Will my job change?
The EMR project is going to change the way clinical information is gathered, documented, and stored. Each position in the practice will be affected in some way by the new process over the course of the next 18 months. Your current position may be partially or completely redefined. It is the intent of the JUP EMR Project to assist everyone in the practices and to ensure that they are provided with the skills and training necessary to work in the EMR system. Your active participation in the process and willingness to embrace change will be the necessary ingredients to your personal success.

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Hardware

What types of devices will the practices utilize?
The practices can choose any device that their practice environment will support. We will be conducting technical assessments and sending out hardware surveys to ascertain practice preferences.

How do you protect the computers from being vandalized?
Care needs to be considered when choosing the type and location of the device. Departments can request recommendations for available options from the EMR project team.

My monitor is not working.

  • Make sure far right side button is depressed and a green light is on.
  • Check power cord exiting the monitor and be sure it is plugged in.
  • Check video cable (black cable white tip) is tight on monitor as well as back of PC.

My computer will not power on or my monitor is black.

  • Check both the monitor and CPU for power lights. If the CPU or monitor does not have a power light, try pressing the power button. If there is still no power to the unit, check the power cable to make sure it is plugged into the CPU or monitor. Check the power strip to see if it is powered on. If the cables are connected, try moving the power plug to a different outlet.
  • Try another plug in the power strip or choose new wall outlet.

PC powering on and making loud buzzing sound.

  • Is there an orange light? Could be a power supply issue.
  • Any beeping during boot up? Could be a hard drive/BIOS issue.
  • Issues of this nature are technical issues best handled by the technical support team at 3-2000.

Keyboard/Mouse is not working.

  • Follow the cord leaving the keyboard or mouse; make sure the USB connectors (ends) are snug in the pc.
  • Double check your settings for caps/num lock.

The PC is "locked" what do I do?

  • EMR Class devices can be easily unlocked by verifying the Login ID (PCS number) and typing the password in the Password field. Verify that the domain chosen is "TJU-MST".
  • Never share the password with patients or non-practice employees.
  • For workstations other than EMR class devices, the individual who last logged on must unlock the device. If the person is unavailable, you must restart the PC.

How do I restart the PC?

  • The proper method to restart a PC is to press Ctrl>Alt>Delete and choose "restart".
  • If the PC cannot be restarted using option 1, press and hold the green lit button on the front of the pc to reboot. This is called a "hard reboot".
  • Turn off the power strip to the computer and turn back on. Then push the button on the front of the pc to turn on. This option should be used if the PC cannot properly shut down (as in option 1) and the PC power button is not responding.
  • Unplug the power cable to the pc and plug back in. Turn on pc. Again, this option should only be used if the PC cannot properly shut down.

EMR printer is not working.

  • Verify you are on the TJU-MST domain.
  • Check to see of the black power cord is in the back of the printer.
  • Check to see if there is a flashing light at the back of the printer next to the network cable (yellow / purple / white).
  • Read the LCD panel on the printer. Document the comment on the LCD panel and have a Super User call the EMR Service Desk at 3-2000.
  • Confirm the appropriate printer location (hallway 1, hallway 2, hallway 3, hallway 4).

How do I login onto an EMR class PC or Slate?

  • EMR Class PCs will be clearly labeled as "EMR Class PC".
  • The TJU-MST User Name is the device's Equipment ID (PCS) number.
  • Enter the password specified for your practice.
  • Verify that the domain name in the Domain field is TJU-MST.

I am not getting connected to the TJU-MST domain.

  • Verify that the network cable secured in pc and wall. (Purple, yellow or white cable).
  • Verify that there is a blinking light on back of the pc (next to the network cable).
  • Is anyone in group able to log onto domain?
  • Check your Caps/Num lock.
  • Double check password.
  • Are you choosing TJU-MST?
  • Has the password failed 3 times? If so speak with your Super User to initiate a password reset with the EMR Service Desk.
  • If multiple people cannot log onto domain, verify the approximate number of users affected. Speak with your Super User to initiate a password reset with the EMR Service Desk.

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