@EXITCONFIRM and Transfer Review

[Michael Burrows]

Since our recent uplift to 12.0.2.8, we have had some issues when an existing Exit Check and Transfer Review are combined.

We have an exit check that checks to see if the patient has a specific telemetry order. If they do, then HEO displays an iForm which requests the MD to review the telemetry order if it is more than 48 hours old. If it is not more than 48 hours old, the iForm triggers an "@EXITCONFIRM" which pushes the user past the exit check and to the confirmation screen.

Now when a physician performs a transfer review and if the patient has a telemetry order (i.e., if the exit check is triggered), an "Internal System Error" screen is displayed, and says, "Failed to add the transfer review order for this session on the patient. Please contact your system administrator."

My theory is that the "@EXITCONFIRM" command pushes the system beyond where it expects to confirm the transfer review order(s). But I can not be sure.

Apparently, this problem did not occur before the uplift (I knew nothing about the transfer review process until this became a problem). In viewing the release notes, we did see a change that might be related:

"20051404: 

Previously, Horizon Expert Orders incorrectly performed an exit check when:

- A nurse played back a PreOrder set

- A physician co-signed an order and performed no other actions during the

session

- A transfer review was initiated

- No changes were made in a session

In this release, the exit check is not performed under these circumstances"

This doesn't give me much to go on, and I'm sure we will need to enlist McKesson to fix this, but I was wondering if anyone has seen anything similar or has any advice. Screenshot of error attached.

Thanks,

Mike Burrows

Phoebe Putney Health System

[Scott Morris]

Mike,

This is a bit of a "shot in the dark" but try using @EXITREQUEST instead of @EXITCONFIRM in your code to see if that helps.  I've found that @EXITCONFIRM will largely skip your exit check processing while @EXITREQUEST will close the ordering session and trigger the exit check.  Seeing that it operates slightly differently in that way, it may help.

Either way, let us know if that works.

Regards,

Scott Morris

[Michael Burrows]

Thanks for the idea, Scott. Unfortunately that didn't change anything; we still get the same error.

We are going to take it to McKesson and if they can't help, we anticipate completely reworking the way our exit check works.

I noticed that this only happens if you initiate your HEO session with a transfer review and then "Continue" (instead of "Save and exit") to place orders in HEO. So, worst-case scenario, I think we could train providers to adjust their workflow so that they perform the TR separately.

I am interested to know if anyone else has this issue, though. I know there are some users out there who force an "@EXITCONFIRM"... If any of you have a chance, try to initiate your HEO session with a transfer review, then try to exit HEO in a way that would trigger your @EXITCONFIRM command. Presumably, you would get an Internal System Error. Assuming this is just a problem with the most recent patch, it is something you probably need to be aware of anyway.

Thanks,

Mike Burrows

Phoebe Putney Health System

[ckittred]

I see these @ commands pop up now and then either here or on Dr. Pratt's calls, yet I've never actually seen them documented anywhere. Can you perhaps put together a list of all the ones you know and what they do?

On Tuesday, September 9, 2014 3:42:38 PM UTC-4, Scott Morris wrote: