Transcript THE PHYSICIAN HANDOFF FINALLY WORKS

THE PHYSICIAN HANDOFF FINALLY
WORKS!!!!!!!!!!!
Mark Lepore, MD
November 18, 2014
Primary Contact
 This new field, “Primary Contact”, took the place of the
“Physician Contact” in Cerner on Wednesday 11/12/14.
Primary Contact
 When either updated from the “Physician Handoff ” or from
the “Admitting Physician” from the admission order, the
“Primary Contact” now appears on the Banner Bar, in the
former place of the “Resident” field:
Primary Contact
Assigning the Primary Contact
 In order to assign the “Primary Contact”, THE PROVIDER
MUST BE ASSOCIATED WITH A CARE TEAM.
 Therefore, if you cannot find yourself or a
provider who is to be the “Primary Contact’,
then do the following:
Assigning the Primary Contact
 Open “Physician Handoff ”:
Assigning the Primary Contact
 Open the drop down menu:
Assigning the Primary Contact
 Select “Manage Care Team Providers”
Assigning the Primary Contact
 Select a Medical Service list and select a Team from the drop-
down menus, then search for the provider to assign
Assigning the Primary Contact
 Note: There are some Medical Services (i.e.
Hematology/Oncology, Hospitalist (for Santa Paula Hospital))
that will have no teams associated with them, but others (i.e.
Internal Medicine, OB/GYN/Newborn, Surgery Orthopedics,
etc.) that will have a number of teams associated with them (i.e.
VCMC Inpatient Medicine Teams A, B, C, D and E; VCMC
OB/GYN/Newborn and SPH OB/GYN/Newborn; VCMC
Surgery and SPH Surgery; VCMC Orthopedics and SPH
Orthopedics, etc.).
Initial Population of the “Primary
Contact” Field
 The “Primary Contact” will be initially assigned from the
“Admitting Physician” field on the “Admit to Hospital”
and “Assign to Observation” orders.
 This will likely become a mandatory field on those orders,
and SHOULD BE FILLED IN BY THE ADMITTING
RESIDENT. (any objections?)
 “Resident Physician” field will likely be removed from those
orders in subsequent weeks.
Changing the Primary Contact
 Once a provider is able to be assigned to the “Primary
Contact” field (because they are associated with a “Care
Team”), that field can be updated in the same way the
“Physician Contact” has been modified:
Changing the Primary Contact
 Open the drop down menu:
Changing the Primary Contact
 Click the Primary Contact button
Changing the Primary Contact
 Assign yourself (1) or someone else (2)
1
2
Printing the Physician Handoff
 Printing either an abbreviated patient list or an expanded
"Handoff" list will both be very easily and successfully
performed from the Physician Handoff page drop down
menu
 (FINALLYYYYY!!!!!!!!).
Printing the Physician Handoff
 Open the drop down menu:
Printing the Physician Handoff
 Click the “Print” button
Printing the Physician Handoff
 Can print “Simplified” or “Detailed”
I-PASS and Physician Handoff
 To access the “Physician Handoff ” and I-PASS, click the right
arrow next to the patient name:
I-PASS and Physician Handoff
 I-PASS should pop up and can be populated with handoff data
I-PASS and Physician Handoff
 I-PASS should pop up and can be populated with handoff data
I-PASS
 Illness Severity
 Code Status
 Patient Summary
 Actions
 Situational Awareness
 Synthesis by Receiver
 (Diagnoses)
Clinical Data Tab
 Clinical Data tab gives labs over last 24 or 48 hours
Care Team Tab
Care Team Lists
 Click the “Care Team Lists” button
Care Team Lists
Patient Assignments
 To add patients to “Patient Lists”:
 Go to the patient’s chart
 Click “Patient”, then “Add Patient to Patient
List”, then choose the list to which to add the
patient
Patient Assignments
 To add patients to a “Care Team List” – MUCH more
irritating and complicated
 Long and the short, you have to find the list to
which to add the patient, then click on the
TITLE OF THE TEAM LIST (destination), and
THEN it allows you to add the patient to that
list (example would violate HIPAA since CERT
is down)
Patient Assignments
“Patient Lists” vs. “Care Teams”
 The "Care Team" concept is something new that Cerner has
introduced that nearly completely changes the way in which
teams are thought about in the hospital. The fundamental
difference between a “Team” on Patient Lists and a “Team”
with the new Care Team concept is as follows
“Patient Lists” vs. “Care Teams”
 -"TEAMS" in the current patient lists (seen on Physician
Handoff) are exclusive for patients -- you can only belong to
one team (i.e. VCMC Inpatient Medicine Team A, and NOT
VCMC Inpatient Medicine Team B or C or D (there are
exceptions which I'll ignore for simplicity)).
“Patient Lists” vs. “Care Teams”
 "TEAMS" in the sense of Care Teams are more about the
PROVIDERS and the groups that they belong to -- and then
those teams associate with individual patients.
 So, as a patient, you can now belong to "VCMC Inpatient Team
A" care team, along with the "Hematology/ Oncology" care
team and probably a whole bunch of other care teams.
 Providers will need to associate themselves with a Care Team,
and then the Care Team will be associated with the patient.
“Patient Lists” vs. “Care Teams”
 It is nearly impossible to remove oneself from a “Care Team”,
so you’ll end up on a bunch. This is quite irritating.
Something I want to work on with Cerner
 Thanks to Sanjiv Ekbote, Sabrina Clemore, Aimee Brecht-
Doscher, Carrie Holt, Terry Theobald, and all of the others
who worked on finally making this work!!!