EHR Inpatient Case Scenario

1. EHR Inpatient Case Scenario July 2011

2. Typical Patient Movement: Inpatient Admission ** Patient Referred from another facility • Patient Presents to ER • - Triage • Admit • Diagnose • Treat • Patient Seen in clinic • - Triage • Check in • Diagnose • Treat ** • Admission Process • Check/reserve open bed • Enter Delayed Orders in EHR • Discharge/Check out patient • Move patient to “floor” • Admission to inpatient Admit? Y N • Home • Jail • Transfer • -Mortuary • Inpatient Stay • - Medication Reconciliation • Treatment • Evaluation ** - Some facilities only admit through ER

3. Inpatient Admission Scenario • What are Delayed Orders? • How is a patient admitted? • What type of data is documented? • How is data documented? • Learn about TIU notes • Who orders more meds, labs, radiology, nursing orders? • How are orders entered? • Importance of finishing medication through Pharmacy package • Ways to review orders: Orders tab, Medications Tab, and computer generated MAR

4. Go to EHR • Hands on exercise: Admitting to inpatient • Create EHR Visit • Write Delayed Orders • Admit via ADT • See delayed order status change to pending • Finish orders in pharmacy package • See orders change to active • Document Medication Reconciliation • Write a note

5. Inpatient Discharge Scenario • Write Discharge Orders • Finish discharge meds through Pharmacy 7.0 • Discharge the patient • Discharge Process • - Enter Discharge Orders in EHR • Medication Reconciliation • Pharmacy processes orders • Patient counseling • Patient leaves hospital • Discharge patient • Home (or equivalent)

6. Go To EHR • Write Orders for discharge medications • Finish orders in outpatient pharmacy • Document medication dispensing to patient • Document Medication Reconciliation • Discharge patient through ADT • Look at Orders tab and see what happened

7. Discussion Topics • Why delayed orders? • Movement of patient in ADT and behavior of medication orders • How will pharmacy know there are new orders? • Discontinued Orders • Medication Reconciliation • How to process discharge medications