[MEDITECH-L] eMAR Discontinued from ER?
Roberta Laurimore
We have been live with a 5.6 upgrade for a few months and have an issue
with our eMAR. Patient's in the ER have meds which at one time would
get DC'd when the patient was departed from the ER. When they were
admitted to the units the medications remained DC'd. We felt this was
the correct path we should be on.
Since the upgrade something changed in the system and Meditech keeps
saying it is FAD. The medications get reactivated. Can anyone out
there tell me how they are handling the medications from the ER to the
Floors. MT thinks our only option is to give patient's a new visit
number.
Any help would be greatly appreciated!!!!!
Roberta Laurimore, RN
Clinical Analyst
Culpeper Regional Hospital
540-829-4359
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m...@rphinformatics.com
think that's "working as designed"? WOW...
Kevin McConnell, PharmD.
Clinical Consultant
(713)480-6810
ke...@RPhInformatics.com
Alice Rogers
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Delsesto, Marc
Marc
Analyst
St Joes of RI
McNamara, Tara
system where they can hit F4 and type in WAD-working as designed. :-)
It does not mean the design is good!
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Roberta Laurimore
PHA Toolbox parameter # Hrs to Fix DC'd meds. Which when we had it set
to 0, the meds would not reactivate. That no longer works. Do you have
this working the way it should be working?
Roberta
>>> m...@rphinformatics.com 5/20/2008 11:32:24 AM >>>
Roberta Laurimore
that way. We have a few orders that get ordered PRN or X3 and those are
the one's causing us problems.
Roberta
>>> "Delsesto, Marc" <mdel...@saintjosephri.com> 5/20/2008 12:08:43
PM >>>
Exactly what I was thinking.. Aren't most ED meds entered as STATs?
Marc
Analyst
St Joes of RI
Amber Holcombe
one a FAN
(That's Flat A@# No)
Keep pushing!
Howard Chase
meds back. Sometimes you do an undo of discharge to fix something else and you don't want your
meds back. You set the parameter to the point where it is most advantageous to your
orgabnization and causes the least harm.
MG PHA 2692 - Parameter to determine length of time after DIS, UNDO will FIX DC meds
Available in Releases: 4.8 Request Type: Correction
Associated Requests: N/A
Features: N/A
Search Flags: Canadian: N; Parameters: Y; Conversions: N; Data Definitions: Y
General Description
Within the Admissions Module, the Discharge of a patient could be 'UNDONE'
within any timeframe of the Discharge. When the event of Discharge was Undone,
all Pharmacy orders that were DCD (Discontinued due to Discharge) would
automatically be fixed. Missed doses would automatically be debited.
A new Pharmacy TOOLBOX Parameter has been created. '# HRS UNDO FIX DC RX'S'
will control when DCD RXs will be changed to Fixed DC. For example, if this
parameter was set to 24 Hours, any Undo done after 24 hours of Discharge would
not change the status of the orders. They would remain in a DCD status.
Parameter Changes
A new NPR Pharmacy TOOLBOX Parameter has been created. '# HRS UNDO FIX DC RX's' will allow the
hospital to set a time limit for DCD RXs to be changed to Fix DC orders. For example, if this
parameter was set to 24 Hours, any Undo done after 24 hours of Discharge would not change the
status of the orders. They would remain in a DCD status.
Data Definition Change
A new data definition was created called: hrs.since.pat.discharge.
This data definition was created in the segment PHA.PARAM.main.4.
hrs.since.pat.discharge is |38 in the above segment.
Hope this helps..
Howard Chase, RN
Senior Clinical Analyst
Androscoggin Valley Hospital
59 Page Hill Road
Berlin, NH 03570
(603)326-5669
Sheral Graham
What kind of med reconcilliation are you using from ED to the units? Paper? Meditech? It would seem to me that the meds need to be DC'd, and "re-written" when the patient arrives on the unit. Including anything ordered PRN x 3.> Date: Tue, 20 May 2008 12:19:35 -0400> From: RLaur...@CulpeperHospital.com> To: MEDIT...@MTUsers.com; ke...@rphinformatics.com; mdel...@saintjosephri.com> Subject: Re: [MEDITECH-L] eMAR Discontinued from ER?> > Most of the meds are entered as STAT. They are OK. They DC and stay> that way. We have a few orders that get ordered PRN or X3 and those are> the one's causing us problems.> > Roberta> > > >>> "Delsesto, Marc" <mdel...@saintjosephri.com> 5/20/2008 12:08:43> PM >>>> Exactly what I was thinking.. Aren't most ED meds entered as STATs?> > Marc> Analyst> St Joes of RI> > -----Original Message-----> From: meditech-...@mtusers.com > [mailto:meditech-...@mtusers.com] On Behalf Of> m...@rphinformatics.com > Sent: Tuesday, May 20, 2008 11:32 AM> To: 'Roberta Laurimore'; MEDIT...@MTUsers.com > Subject: Re: [MEDITECH-L] eMAR Discontinued from ER?> > Why would a DC'd order get reactivated and more important, why would> MT> think that's "working as designed"? WOW...> > > > Kevin McConnell, PharmD.> Clinical Consultant> (713)480-6810> ke...@RPhInformatics.com > > www.RPhInformatics.com > > > > > -----Original Message-----> From: meditech-...@mtusers.com > [mailto:meditech-...@mtusers.com] > On Behalf Of Roberta Laurimore> Sent: Monday, May 19, 2008 3:42 PM> To: MEDIT...@MTUsers.com > Subject: [MEDITECH-L] eMAR Discontinued from ER?> > Patient's from the ER to the Floor:> > We have been live with a 5.6 upgrade for a few months and have an> issue> with our eMAR. Patient's in the ER have meds which at one time would> get DC'd when the patient was departed from the ER. When they were> admitted to the units the medications remained DC'd. We felt this was> the correct path we should be on. > > Since the upgrade something changed in the system and Meditech keeps> saying it is FAD. The medications get reactivated. Can anyone out> there tell me how they are handling the medications from the ER to the> Floors. MT thinks our only option is to give patient's a new visit> number.> > Any help would be greatly appreciated!!!!!> > > > Roberta Laurimore, RN> Clinical Analyst> Culpeper Regional Hospital> 540-829-4359> > > ====================================> > Keep up to date on recent announcements about MUSE by visiting the> meditech-l web site at MTUsers.net and go to the tab labeled "MUSE -> Dallas> 05/08" > > If you want to ask a question from the meditech-l users who will be> attending MUSE or share something about MUSE with each other, you can> post> messages on the web site on the tab "MUSE - Dallas 05/08"> > > > ====================================> > Keep up to date on recent announcements about MUSE by visiting the> meditech-l web site at MTUsers.net and go to the tab labeled "MUSE -> Dallas 05/08" > > If you want to ask a question from the meditech-l users who will be> attending MUSE or share something about MUSE with each other, you can> post messages on the web site on the tab "MUSE - Dallas 05/08"> > > > ====================================> > Keep up to date on recent announcements about MUSE by visiting the meditech-l web site at MTUsers.net and go to the tab labeled "MUSE - Dallas 05/08" > > If you want to ask a question from the meditech-l users who will be attending MUSE or share something about MUSE with each other, you can post messages on the web site on the tab "MUSE - Dallas 05/08"
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cre...@mah.harvard.edu
If it's a one time order it should not get "reactivated."
However if it's an order for example for a respiratory med that is
scheduled then it should remain "active" until it is edited or d/c'd. So
my question would be why or are your ED doc's ordering meds other than
"One or STAT?" Is there a new parameter out there that got changed that
hasn't been looked at?
Christian Renaux,RN
Manager Software Applications
Mt Auburn Hospital
cre...@mah.harvard.edu
-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of McNamara, Tara
Sent: Tuesday, May 20, 2008 1:22 PM
To: Alice Rogers; ke...@rphinformatics.com; Roberta Laurimore;
Christensen, Katherine A.
I have a line check LC="Y"=c.show.detail. How do I code for lower case
user input also?
Thanks!
Kathy
Roemer Donna, Information Systems
Thanks,
Donna Roemer
Information Systems Department
Deborah Heart and Lung Center
609-893-1200 x4742
roe...@deborah.org
-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of Christensen,
Katherine A.
Sent: Wednesday, May 21, 2008 12:23 PM
To: MEDIT...@MTUsers.com
Thanks!
Kathy
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Mitch Lawrence
Mitch
-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com]
On Behalf Of Christensen, Katherine A.
Sent: Wednesday, May 21, 2008 11:23 AM
To: MEDIT...@MTUsers.com
Subject: [MEDITECH-L] Coding for upper or lower case user entry
David S. Dickason
Roberta was right in that, upon transfer to the floor, ALL the ED meds SHOULD be discontinued. THIS IS A JCAHO REQUIREMENT ( all pt orders are DC'd upon transfer of location or level of care).
Tara is also very correct, that WAD has nothing to do with good. Meditech seems to feel that WAD is a conversation ender. It should not be. Wrong is wrong, whether by design, mistake, or fate. The answer can also not be "put in a MIX request". I believe many of these get "MIXed" in with the trash on garbage day.
The facts seem to show that Meditech took a process that was working properly and "designed it" to NOT work properly. There may have been a good intention as to why they have changed the process, but, again, if it's wrong, it's wrong.
Rant completed.
David Dickason RN
Nursing Informatics Specialist
ThompsonHealth
Canandaigua, NY 14424
585.396.6041
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-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of Christensen,
Katherine A.
Sent: Wednesday, May 21, 2008 11:23 AM
To: MEDIT...@MTUsers.com
Subject: [MEDITECH-L] Coding for upper or lower case user entry
cea...@hsd.cccounty.us
only want to see if a patient had the same drug in the ED and what time he had it given, so we need to set our Sort to be by Medical record number and to
see all orders that were DC'd in the last 24 hours. However, we also see anything else for that Medical record that isn't Dc'd - such as outpatient or
discharge orders.Your problem is worse though and the only thing I can think of is to have all of your ED meds entered as ONE or STAT
. Since your patient is apparently being "DISCHARGED from the ER" and readmitted as an inpatient with the same account number, is it possible to alter
the ADM settings that reactivate dc'd meds when a patient is accidentally discharged?
Or, if the patient has the same visit number, is it possible to have admits from the ED "transfer" to the inpatient room, which would not appear as a
discharge and readmit to the system.
I don't know how other ED's work though, or exactly how Meditech classifies what is inpatient,outpatient, discharge and transfer because it seems to
be different depending on where you are working in the system. Our ED is considered "outpatient" for admissions and drug dispensing and billing, but for
something like POE, I think MT considers the ED as an inpatient site.
Our ED is not using profile on the dispensing machines and they are not using Meditech's standard eMAR because it just didn't work well. I think our
EDM support nurse built our ED's MAR in OE.
What's going to happen with that if we start using the eMAR inhouse, I don't know.
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"Roberta Laurimore"
<RLaur...@CulpeperHospital.com>
Sent by: meditech-...@mtusers.com To
<MEDIT...@MTUsers.com>, <ke...@rphinformatics.com>, "Marc Delsesto"
<mdel...@saintjosephri.com>
05/20/2008 11:23 AM cc