5 tricks to chart sooner in Epic

Our MD Tech Tip article this week is how one can chart sooner in Epic. We aren’t going to bore you with a number of dot phrases or macros for our PE or ROS. Everybody is aware of that. I educate our residents on how one can chart sooner and be extra environment friendly on shift. By hours of lectures I’ve given them, I’ve tweaked my instruction accordingly primarily based on suggestions I’ve gotten with what works and what doesn’t. Whereas the lecture and directions I give are extra detailed and nuance, there are 5 key takeaways I needed to current that may make your subsequent scientific day extra environment friendly. Specifically, I concentrate on data gaps I’ve seen in senior residents when studying how one can chart. Whereas a few of the following would possibly look like delicate workflow modifications, they will yield vital effectivity positive aspects.

Sickness HPI type

Use the “Sickness” template in Epic. Many have no idea about this. When doing charts within the Emergency room or clinic setting, use the sickness tab to pre-populate your HPI. I’ve discovered that utilizing Epic’s customized HPI kinds really take for much longer. Method too many clicks and variations. So for that stomach ache affected person, think about using the “Sickness” HPI type as a substitute of “stomach ache”. The Sickness type has an empty clean for “location”, “high quality”, “context”, and different key parts. Severity, onset and period have straightforward buttons to populate on this template. That is nice as a result of it provides you the factors you want to your stage of service to be excessive (1-5). I can’t emphasize this type sufficient. It’s a small factor, however makes your HPI a lot sooner over time. I first fill out the “Sickness” type, after which will bounce into the Narrative field and can dictate a couple of traces accordingly. Complete time utilizing this setup to finish your HPI is lower than a minute.

Dictate, dictate, dictate (actual time)

You probably have the power to dictate, dictate. Actual time dictation is one of the best. Transcription is just not ideally suited. For my part, having to attend for a transcription service after which overview it for accuracy hours later is just not environment friendly. Dragon actual time dictation has been a life changer. I’m solely pissed off that I didn’t use it sooner when it was out there. In case you are not accustomed to actual time dictation, it’s the capacity to make use of a dictation software program, resembling Dragon dictation, together with the EHR. For my setup, actual time dragon dictation is constructed proper into epic, and we now have energy mics that enable us to dictate on the press of a button proper into the chart. You may even put in orders with the assistance of dictation.

I’m a type of millennials who grew up on keyboards and was very happy with my phrases per minute. Due to this, I assumed that I may at all times hold typing sooner than I may dictate. For a full 12 months that our hospital turned on dictation I refused to modify over, feeling that I may sort sooner. Lastly, a fellow school member satisfied me to at the least simply give it a attempt to it was a whole life changer. I’m not exaggerating in any respect. I discovered myself with the ability to save about an hour per shift of charting, and actual time dictation has saved me tons of of hours of my life that I might have in any other case spent typing. I used to be capable of attest residents charts and in addition do particular person affected person charts a lot sooner. Publish switching over to actual time dictation, I used to be capable of end charts way more simply on shift and have nearly each chart finished previous to the top of a shift. In the event you’re a type of that hasn’t converted to actual time dictation, please do. In the event you’re at a system that doesn’t have actual time dictation out there, push for it. You’re going to get help out of your administration just by saying it’ll assist get charts finished sooner in order that insurance coverage can billed sooner. In case your hospital desires to do one thing about morale, that is a straightforward lever they will pull.

Decrease your dot phrases

Arrange your medical choice making(MDM) with a common dot phrase. The extra common you might be the higher. I’ve seen suppliers with greater than 20 dot phrases for customized MDMs. I’m unclear how that helps with effectivity. The extra customization you’re doing together with your chart, the extra time and complexity you’re including. Hold it easy (not at all times attainable with some sufferers, I get it).

My common dot phrase for my MDM is the next:

ER supplier interpretation of Imaging / Radiology:
ER supplier interpretation of EKG:

ER supplier interpretation of Labs:
@[email protected]
@[email protected]

Differentials thought of:

Key drugs administered within the ER: @[email protected]

Medical Determination Making:

Key discharge directions:

Clearly, set up your common dot phrase to your medical choice making or evaluation and plan accordingly. No matter you determine, simply ensure you are protecting it common. It’s a lot simpler to go and delete sure components of your common dot phrase than creating a number of variations. Once more, scale back muddle and complexity.

Use floating home windows

Many suppliers don’t learn about Epic’s floating home windows choice. After I educate this to my senior residents, many come again and inform me that is the characteristic that helps them probably the most. This characteristic solely works effectively when you’ve a two monitor arrange. When enabled, floating home windows are a good way to optimize charting by permitting you to multitask and in addition mentioning an incomplete be aware each time you’re in a affected person chart. To entry floating home windows, go to your be aware author. On the “edit be aware” tab that exhibits up, you’ll see a tiny downward pointing arrow, click on this and also you’ll see the choice for “transfer to floating window”. This permits your be aware to point out up on a separate monitor, permitting you to do extra chart overview whilst you’re filling out your be aware.

My favourite effectivity characteristic from that is that after it’s enabled, each time you open the sufferers chart, your be aware pops up in case you have not pended it or accomplished it. It’s a relentless reminder to complete your be aware or replace it.

Ensure that your entire “wrenches” are optimized!

Epic has tiny wrenches all through many of the screens you’re in. These wrenches are essential as a result of they help you customise each display screen and the way information is introduced to you. Don’t use the default setup! It’s worthwhile to spend 20 to half-hour on the principle screens you utilize to customise the menus you wish to seem in entrance of you. This can help you entry historic check outcomes higher, help you see very important indicators higher, and way more. I can’t let you know what number of instances I’ve discovered merely reconfiguring a residents wrenches permits them to avoid wasting a couple of clicks on each affected person chart.

Two final items of recommendation. Solely chart what you do. Please be cautious of how you utilize macros and ensure your charts are correct. Lastly, chart in actual time as a lot as you may. Even when it’s simply filling out the HPI, ROS, and the bodily examination. You don’t wish to finish your scientific day or evening with an inbox of charts which might be clean!

Do you’ve any extra suggestions you’d like me so as to add to this? Message me on twitter (@iltifatMD) and I’ll add them to this listing!