CALLING ALL EPIC USERS.

30 long DAYS OF EPIC SO FAR. And I am searching for assistance with an issue we are having with queries.
Let me clarify, we didn't purchase the CDI portion of the EPIC program , so the CDI queries are placed as a "coding query". Once we place the query and the provider opens it, they have TWO options at the bottom of the query to answer- left side bottom is the "REPLY"  button, right side bottom is the "RESPOND" button. the RETPLY button only served to communicate with the CDI, and they are answering our questions in that arena-which gives us nothing...

THE ISSUES IS THE "REPLY BUTTON" (WHICH IS WHAT PROVIDERS GRAVITATE TOWARDS ONLY COMMUNICATES BACK TO THE CDI). It is not part of the medical record and they are using it to answer the query. The "RESPOND" button is what they should choose  and using this  "responds with a new note or responds with an existing note". EVEN the providers who have use RESPOND correctly before, then often use the REPLY button the next time. The re-work and education for this for both the CDI and provider is unrealistic and so tedious it is ridiculous.

Seemingly, since  we purchased this product and are building components to it, we would like to think we can have ithe REPLY button removed but have been told we cannot. NO REASON AS TO WHY...

So, I am asking for some assistance from anyone else who uses EPIC and the process for queries like we do. Please email be at jbovard@regionalhealth.org if you have any suggestions!~


Thanks in advance

Juli Bovard RN CCDS

605-755-8426 

jbovard@regionalhealth.org 



Comments

  • Juli, I sent you an email in November but haven't heard back. So I thought I would post in here in case it might help others as well. We also post our queries as coding queries since we don't use the CDI part of Epic. But we have had the 'Reply' communication added as a part of the LMR (legal medical record). The way we instruct our physicians is this: if their response does not require an update to patient documentation, they should use 'Reply'; if their response DOES require an update to patient documentation, they should select 'Respond with a progress note'. To our benefit our previous process only had 'Reply'. We got the 'Respond with a progress note' option with our last upgrade to V17.

  • We use EPIC, and write the query directly in the progress note section.   The MD responds directly in the query and countersigns the CDI note.   The CDI query and response is a permanent progress note. (This is the same workflow employed for residents' notes requiring countersignature).   The MD receives a notification via EPIC that a note is pending review and response and signature is required to close the note.


    Paul

  • Paul,

    If the provider does not agree with the query or has a different answer what do they do? For example, Pneumonia specificity and they do not know if gram + or -...then how do they respond in the PN...would we want that to be a part of a PN?

    We just implemented Epic March 10th and still struggling with getting the providers to answer the queries. Prior to Epic Go-Live we had a 100% response rate. Now they do not want to answer the queries (we used to print them off and were able to add addendums for them). Now the provider must add their own addendum and we decided to not allow the response in the Coding Query to be counted as an addendum since it is difficult to find per HIM.

    Any information would be greatly appreciated!

  • Sounds like we have the same process as Paul.

    We use EPIC and our queries are created as progress notes. We write the note and "pend" the note to our inbasket. We then send to the physicians inbasket and they "Edit" the note to answer. Once they edit the note and click sign, the query becomes a progress note. We have built in drop down boxes on some queries and/or areas for free text. The query is part of the permanent record even if they disagree. Each query has the option of Other so a provider can free text an answer if they don't agree with our choices. Hope this helps.

  • Jillian this is very helpful!! Thank you for this information.
  • Paul,

    If the provider does not agree with the query or has a different answer what do they do? For example, Pneumonia specificity and they do not know if gram + or -...then how do they respond in the PN...would we want that to be a part of a PN?

    We just implemented Epic March 10th and still struggling with getting the providers to answer the queries. Prior to Epic Go-Live we had a 100% response rate. Now they do not want to answer the queries (we used to print them off and were able to add addendums for them). Now the provider must add their own addendum and we decided to not allow the response in the Coding Query to be counted as an addendum since it is difficult to find per HIM.

    Any information would be greatly appreciated!


    Rebekah:  Our notes always include the options of “Other” and “Unable to Determine’.  We also make note that the MD should respond in free text, if appropriate. 

     In this way, a full range of response choice is avaialable to the respondent.  

    Yes, you need to provide a full range of responses to the MD such as based on published Best Practice Guidelines per AHIMA/ACDIS.  Hope this helps?


  • We went to Epic last October and our inpatient CDI department has Epic CDI. Our outpatient CDI program does not currently have anything in Epic that helps with CDI. Does anyone use tools in Epic that can help with outpatient CDI? Maybe you have a method of querying providers or doing a pre-visit audit in Epic? I need a more automatic way to remind providers to capture HCCs. Getting information to providers that they actually read or respond to would be nice. I feel like the in-basket isn't working and they rarely open their emails (I get it, they are busy).

    Thanks for any suggestions!

  • hi slaconis,


    Just wondering if you got a response to your OP CDI question? Please let me know because I might be able to help.

    Kathy

  • Hi Kathy,

    No, I never got a response. I would love any help you can give me!

    My email is slaconis@bch.org if it's easier to communicate that way.

    Thank you,

    Sarah

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