EPIC Queries

Unknown
in CDI Talk Archive
Hi Everyone,

I know we have a few EPIC users and wondered if anyone has come up with a query process that works. Coding has a coding query process in EPIC but I don't believe that this is the way to go on this because our information will be released. Physicians will see the word coding query and run.

We have version 2008 but will be upgrading this fall to the 2010 version. Does anyone know if this version has a process for CDI.

Carla Heyn, RHIT,BS
Elliot Hospital, NH

Comments

  • tiffany_susantiffany_susan
    edited May 2016
    I don't know how willing the would be to share, but BonSecour health
    system has a great query process in EPIC, they sent info to my EPIC people
    and we are looking to see if it will work as we are still hybrid with HIM
    not added for another year .......

    Thank You,

    Susan Tiffany RN, CCDS
    Supervisor Clinical Documentation Program
    Guthrie Healthcare System
    phone: 570-887-6094
    fax: 570-887-6768
    email: tiffany_susan@guthrie.org

    "Twenty years from now you will be more disappointed by the things you
    didn't do than by the ones you did do. So throw off the bowlines. Sail
    away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
    Discover." Mark Twain
  • sharon.colesharon.cole
    edited May 2016
    We use Epic but not the query part. Our documentation program is through Allscripts. We felt there queries were leading though, so we had them scan in the ones we had made ourselves.
  • dvitalone1dvitalone1
    edited May 2016
    Where do you place your queries, since there is no chart to put them on, or are you hybrid and still have charts.
  • dsmith12h@aol.comdsmith12h@aol.com
    edited May 2016
    We use EPIC. Our queries are not part the the Medical Record. We use the "sticky note" feature. With our version of EPIC, the sticky note is the first thing seen when the patient file is opened (it has a pale yellow background). It is requested that the physician document his response in the progress note. If they disagree or have a question, they can use the add/edit feature on the sticky note for their posting or call our extension listed with our signature. We have been using this for >1 yr. (since we went EPIC live) and have had good success.

    Debbie S.
  • tiffany_susantiffany_susan
    edited May 2016
    We had decided not to use the sticky notes after our legal department
    reviewed them. Have you had any issues legally with the sticky note
    feature? Has your legal/compliance department reviewed and okayed them?

    Thank You,

    Susan Tiffany RN, CCDS
    Supervisor Clinical Documentation Program
    Guthrie Healthcare System
    phone: 570-887-6094
    fax: 570-887-6768
    email: tiffany_susan@guthrie.org

    "Twenty years from now you will be more disappointed by the things you
    didn't do than by the ones you did do. So throw off the bowlines. Sail
    away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
    Discover." Mark Twain
  • sharon.colesharon.cole
    edited May 2016
    We're hybrid and still have charts.
  • dvitalone1dvitalone1
    edited May 2016
    Do you have a contact person and number for BonSecour Health? My email is dvitalone@comhs.org. Thanks!
  • dsmith12h@aol.comdsmith12h@aol.com
    edited May 2016
    Susan,

    We have not had any problems thus far. What type of issues did the legal dept. see that may be of concern (if you can share).
  • dbutlerdbutler
    edited May 2016
    We had used the sticky note feature for awhile. Felt it was not a problem because we have an alternate avenue to retain the worksheets and queries (generated from our consultant's electronic system that unfortunately does not link with the EPIC system) as an electronic portion of the administrative record (ie, not part of the defined legal medical record).

    Since, we use the staff message feature that deliveries to the in-box separately from the coding queries. This has it's own set of problems, the medical staff are confused (the coding query is part of the legal record, so they can respond directly....etc.). Looking at the possibility to use the same avenue for both CDI & coding (and CDI query would then be part of the LMR).

    Don
  • dbutlerdbutler
    edited May 2016
    I would appreciate the same, or forward my information to your contact.

    Thank you!
    Don

    Donald A. Butler, RN, BSN
    Manager, Clinical Documentation
    PCMH, Greenville NC
    dbutler@pcmh.com
  • tiffany_susantiffany_susan
    edited May 2016
    The main concerns were related to discoverability of the query. All
    information in the electronic record is discoverable in one form or
    another, the legal department felt the sticky note did not provide a means
    of monitoring and tracking and in turn could look as if we were "hiding"
    information. Currently we are not a permanent part of the medical record,
    but we do save all queries should they be requested.

    Thank You,

    Susan Tiffany RN, CCDS
    Supervisor Clinical Documentation Program
    Guthrie Healthcare System
    phone: 570-887-6094
    fax: 570-887-6768
    email: tiffany_susan@guthrie.org

    "Twenty years from now you will be more disappointed by the things you
    didn't do than by the ones you did do. So throw off the bowlines. Sail
    away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
    Discover." Mark Twain
  • dsmith12h@aol.comdsmith12h@aol.com
    edited May 2016
    thank you, I will bring this up at our next meeting to see if we need to revise our process.
  • Unknown
    Does anyone use the HIM coding Query process in EPIC?
  • sherri.shockeysherri.shockey
    edited May 2016
    We use the EPIC query process. Please feel free to contact me via email address below.

    Sherri Shockey, RHIT, CCS, CHC
    Director, Coding Integrity & Quality Review Services
    Health Information Management
    5201 Harry Hines Blvd
    Dallas, Texas 75235
    sherri.shockey@phhs.org
    (214)590-1917
    www.parklandhospital.com
  • toni.stastnytoni.stastny
    Interesting, I am going to have to ask IT about sticky notes.
    We are going to go live with Hospital progress notes and physician orders this fall.
    Currently, they are looking into ways to do our queries. They have a program that coding will use do their queries and the CDS are to use the same module. The only issues they are post hospital stay and we do concurrent reviews.
    I do have some smart phrases built for our query notes. I have been using InBasket to the providers that are currently live on Epic (clinic providers are live). I have the disclaimer that "this is not part of the medical record".
    I am wondering how effective and how to do track the sticky note communication?
  • fishdl@shands.ufl.edufishdl@shands.ufl.edu
    edited May 2016
    We went live with EPIC in May. The decision was made for the CDI Team to do ALL the physician queries - concurrent as well as post-discharge. It was also decided that ALL queries would be a permanent part of the medical record. We create our queries using the Coding Query feature and do not use the Sticky Note feature at all. We have 20 (so far) SmartText query templates - including a generic one. Whenever a Coding Query is created, we create a Deficiency and the Coding Query goes into the providers' In-Basket. Some problems we've encountered so far include:
    The provider marks the Deficiency as Done/Completed, but didn't address the Coding Query
    The provider creates a New Note to answer the Coding Query instead of responding on the Coding Query with the clarification request
    The provider opens the Coding Query but instead of responding, it lives in his/her In-Basket
    The provider doesn't know how to respond so they'll call and we'll walk them through the process
    The provider doesn't understand the question so they'll: call for clarification, Accept the note without a response, or the response doesn't "fit" the question
    We must address all queries to the Attending Physicians. As a teaching hospital, we not only depend on the Residents/Interns/Extenders to respond to our queries, but also have a responsibility to teach them good documentation habits
    This is still a work in progress. Fortunately we have really good support from our IS group, as well as a great team of CDI Specialists who are able to deal with the changes with grace, patience, and humor.

    I would welcome off-line communication with other CDI Specialists who are going through - or who have already transitioned to EPIC.
    Donna
    fishdl@shands.ufl.edu
  • toni.stastnytoni.stastny
    I see how this will be my nightmare at Aspirus.

    Okay, the InBasket first will be a new functionality for the physician to use. Yes, this creates much confusion and they are very overwhelm with how to response to InBasket message as it is not like Outlook.

    If the coding query folder - the message would have the patient's name listed, then would be linked to the Inpatient encoutner? If so then then can open to that patient's admission to the current query. I believe it is our HAR numbers that link each hospital stay. I am not sure how it works in the Inpatient world. I use to train the Outpt Epic for the clinics.

    I was trying to do smart links but they do not work the same when dealing with Inpatient data - I might need to review with IT why it is not the same as Outpt smart links.

    I have created smart phrases to use when we go live in Nov 2011.

    That was another concern because we have Hospitalist and UW residents. Usually they have one physician assigned but if they are off, then other one will cover. Could address to the primary MD and then CC the group. The question is - will they response when the Primary MD is off?

    Epic still needs to improved the process. It seems to be to be very clunky.

    Toni Stastny
    toni.stastny@aspirus.org
Sign In or Register to comment.