User Guide
Notifications about Consults and Requests
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- Bu səhifədəki naviqasiya:
- Enabling Notifications
- New Service Consult/Request
- Consult/Request Resolution
- Consult/Request Updated
- Consult/Request Cancel/Hold
- Special Considerations for Discontinued Orders
- Consult/Request Has an Added Comment
- Order(s) Require Electronic Signature
- Significant Findings for a Consult
Notifications about Consults and RequestsDuring your session, you may notice: You have PENDING ALERTS Enter "VA VIEW ALERTS to review alerts Select Clinician Menu Option: This appears on the screen before each prompt. You may enter VA at any menu prompt in which this message appears to view patient information related to pending notifications. There are five notifications relating to consults:
The purpose of these notifications is to allow you to take appropriate follow-up action. This might involve merely reading new information, or it might involve several actions on your part such as scheduling an appointment, signing a consult, resubmission, etc. *NOTE:
To initiate the follow-up action, enter VA at the prompt after the view alerts message. In the following example, a user follows up a notification by signing an order: You have PENDING ALERTS Enter "VA VIEW ALERTS to review alerts Select CPRS Manager Menu Option: VA View Alerts 1. CPRSPATIENT,ONE (C4723): New order(s) placed. 2. CPRSPATIENT,THREE (C3456): Consult/Request DENIED To Service: PODIATRY 3. CPRSPATIENT,ONE (C4723): Order requires electronic signature. Select from 1 to 3 or enter ?, A I, F, P, M, R, or ^ to exit or RETURN to continue: 3 Processing alert: CPRSPATIENT,ONE (C4723): Order requires electronic signature. Searching the patient's chart ... Unsigned Orders Sep 24, 1997 09:22:04 Page: 1 of 1 CPRSPATIENT,THREE 666-12-3456 2B MAR 3,1960 (40) Selected date range: None Selected
1 >> Weight *UNSIGNED* | CPRSPROVIDER,O unr 2 Consult to CARDIOLOGY Consultant's Choice | CPRSPROVIDER,O unr *UNSIGNED* | 3 Consult to CARDIOLOGY Consultant's Choice | CPRSPROVIDER,O unr *UNSIGNED* | Enter the numbers of the items you wish to act on. Enter the numbers of the items you wish to act on. >>> + Next Screen - Previous Screen Q Quit
CPRSPATIENT,THREE 666-12-3456 2B MAR 3,1960 (40) Selected date range: None Selected
1 >> Weight *UNSIGNED* | CPRSPROVIDER,O unr 2 Consult to CARDIOLOGY Consultant's Choice | CPRSPROVIDER,O unr *UNSIGNED* | 3 Consult to CARDIOLOGY Consultant's Choice | CPRSPROVIDER,O unr *UNSIGNED* | Enter the numbers of the items you wish to act on.
Enter the numbers of the items you wish to act on. >>> Change Sign Discontinue Detailed Display S  elect: Quit// S
Consult to CARDIOLOGY Consultant's Choice – Enter your Current Signature Code: SIGNATURE VERIFIED Consult to CARDIOLOGY Consultant's Choice signed. Searching the patient's chart ... (Continued on the next page.)
CPRSPATIENT,THREE 666-12-3456 2B MAR 3,1960 (40) Selected date range: None Selected
1 >> Weight *UNSIGNED* | CPRSPROVIDER,O unr 3 Consult to CARDIOLOGY Consultant's Choice | CPRSPROVIDER,O unr *UNSIGNED* | Enter the numbers of the items you wish to act on. Enter the numbers of the items you wish to act on. >>> + Next Screen - Previous Screen Q Quit
In many cases Notifications will not come to you automatically. To find out what Notifications you should be getting, you can run the Show Me the Notifications I Can Receive option from the Notifications Management Menu. If this report shows any notifications you want to receive that are disabled, you may enable them with the Enable/Disable My Notifications option. In this example we run the Show Me the Notifications I Can Receive report and then enable Consult/Request Cancel/Hold, Consult/Request Resolution, and New Service Consult/Request (Notice that Order(s) Require Electronic Signature is already on): Select Notification Mgmt Menu Option: ? 1 Enable/Disable My Notifications 2 Erase All of My Notifications 3 Set Notification Display Sort Method (GUI) 4 Send me a MailMan bulletin for Flagged Orders 5 Show Me the Notifications I Can Receive 6 Set Surrogate to Receive My Notifications Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text. Select Notification Mgmt Menu Option: 5 Show Me the Notifications I Can Receive Would you like help understanding the list of notifications? No// Y (Yes) DEVICE: HOME// Notification List Help Message Page: 1 The delivery of notifications as alerts is determined from values set for: Users, OE/RR Teams, Service/Sections, Inpatient Locations, Hospital Divisions, Computer System and Order Entry/Results Reporting. Possible values include 'Enabled', 'Disabled' and 'Mandatory'. These values indicate a User's, OE/RR Team's, Service's, Location's, Division's, System's and OERR's desire for the notification to be 'Enabled' (sent under most conditions), 'Disabled' (not sent), or 'Mandatory' (almost always sent.)
or Clinical Coordinators. Individual users can set 'Enabled/Disabled/Mandatory' values for each specific notification via the 'Enable/Disable My Notifications' option under the Personal Preferences and Notification Mgmt Menu option menus. 'ON' indicates the user will receive the notification under normal conditions. 'OFF' indicates the user normally will not receive the notification. Notification recipient determination can also be influenced by patient location (inpatients only.) This list does not consider patient location when calculating the ON/OFF value for a notification.
............... DEVICE: HOME// -------------------------------- --------------------------------------------- ABNORMAL IMAGING RESULTS ON OERR value is Mandatory ABNORMAL LAB RESULT (INFO) ON User value is Mandatory ABNORMAL LAB RESULTS (ACTION) OFF OERR value is Disabled ADMISSION ON OERR value is Enabled CONSULT/REQUEST CANCEL/HOLD ON User value is Mandatory CONSULT/REQUEST RESOLUTION ON User value is Mandatory CONSULT/REQUEST UPDATED OFF OERR value is Disabled CRITICAL LAB RESULT (INFO) ON OERR value is Mandatory CRITICAL LAB RESULTS (ACTION) ON OERR value is Mandatory DC ORDER OFF OERR value is Disabled DECEASED PATIENT ON OERR value is Enabled DISCHARGE OFF OERR value is Disabled DNR EXPIRING OFF OERR value is Disabled ERROR MESSAGE OFF OERR value is Disabled FLAG ORDER FOR CLARIFICATION ON OERR value is Enabled FLAGGED OI EXPIRING - INPT OFF OERR value is Disabled FLAGGED OI EXPIRING - OUTPT OFF OERR value is Disabled FLAGGED OI ORDER - INPT OFF OERR value is Disabled FLAGGED OI ORDER - OUTPT ON System value is Enabled FLAGGED OI RESULTS - INPT OFF OERR value is Disabled FLAGGED OI RESULTS - OUTPT OFF OERR value is Disabled FOOD/DRUG INTERACTION OFF OERR value is Disabled FREE TEXT OFF OERR value is Disabled IMAGING PATIENT EXAMINED OFF User value is Disabled IMAGING REQUEST CANCEL/HELD ON OERR value is Enabled IMAGING RESULTS OFF User value is Disabled IMAGING RESULTS AMENDED OFF OERR value is Disabled LAB ORDER CANCELED OFF OERR value is Disabled LAB RESULTS OFF OERR value is Disabled MEDICATIONS EXPIRING OFF OERR value is Disabled NEW ORDER OFF OERR value is Disabled NEW SERVICE CONSULT/REQUEST ON User value is Mandatory NPO DIET MORE THAN 72 HRS OFF OERR value is Disabled ORDER CHECK OFF OERR value is Disabled ORDER REQUIRES CHART SIGNATURE ON OERR value is Mandatory ORDER REQUIRES CO-SIGNATURE OFF OERR value is Disabled ORDER REQUIRES ELEC SIGNATURE ON OERR value is Mandatory ORDERER-FLAGGED RESULTS OFF OERR value is Disabled SERVICE ORDER REQ CHART SIGN ON OERR value is Mandatory STAT IMAGING REQUEST OFF OERR value is Disabled STAT ORDER OFF OERR value is Disabled STAT RESULTS OFF OERR value is Disabled TRANSFER FROM PSYCHIATRY OFF OERR value is Disabled UNSCHEDULED VISIT ON OERR value is Enabled UNVERIFIED MEDICATION ORDER OFF OERR value is Disabled UNVERIFIED ORDER OFF OERR value is Disabled URGENT IMAGING REQUEST OFF OERR value is Disabled
Select Notification Mgmt Menu Option: 1 Enable/Disable My Notifications Enable/Disable My Notifications ------------------------------------------------------------------------------- ------------------- Setting for User: CPRSPROVIDER,ONE ------------------- Select Notification: cons 1 CONSULT/REQUEST CANCEL/HOLD 2 CONSULT/REQUEST RESOLUTION 3 CONSULT/REQUEST UPDATED CHOOSE 1-3: 3 CONSULT/REQUEST UPDATED Are you adding CONSULT/REQUEST UPDATED as a new Notification? Yes// Value: ? Code indicating processing flag for the entity and notification. Select one of the following: M Mandatory E Enabled D Disabled
Select Notification: Select Notification Mgmt Menu Option: New Service Consult/RequestThis notification is triggered by the Consults package when a new consult has been requested by a user. In the following example, the system displays three notifications for new Consults: CPRSPATIE (C5377): New consult Neuro (Stat) CPRSPATIE (C3456): New consult CAR (Routine) CPRSPATIE (C6572): New consult PLM (Routine) Enter "VA VIEW ALERTS to review alerts Select Systems Manager Menu Option: As a follow-up action, the system displays the consult in a Consult/Tracking screen so that the recipient can take appropriate action. To initiate the follow-up action, enter VA at the prompt and select the notification you want to follow-up on. After selecting this notification from the View Alerts menu, the system deletes the notification. In the following example, a new consult is first examined and then a receive action is performed: 1. CPRSPATIE (C2342): NEW consult CAR (Routine) 2. CPRSPATIE (C2432): Consult COMPLETED: CAR Select from 1 to 3 or enter ?, A I, F, P, M, R, or ^ to exit or RETURN to continue: A
CPRSPATIENT,NINE 666-24-2342 1A MAR 3,1960 (40) Wt.(lb): 184
1 12/16/97 p CARDIOLOGY EKG Portable Enter ?? for more actions SP Select Patient FR Forward CT Complete/Update RT Results Display CV Change View ... CX Cancel (Deny) MA Make Addendum PF Print Form 513 RC Receive DC Discontinue SF Sig Findings RM Remove Med Rslt SC Schedule CM Add Comment DD Detailed Display ER Edit/Resubmit Select Action: Quit// DD Detailed Display Compiling Report... CONSULTS DETAILED DISPLAY Dec 19, 1997 08:12:04 Page: 1 of 5 CONSULT DETAILED DISPLAY Consult No.: 731 TRAT,JACK 234-24-2342 DOB: (74) Wt. (lb): No Entry Current Inpatient/Outpatient: Inpatient Ward: 1A To Service: CARDIOLOGY From Service: 1A Consult Type: EKG Portable Provisional Diagnosis: Cardiomyopathy Reason For Request: Rule out alternate diagnosis Status: PENDING Service is to be rendered on an INPATIENT basis ATTENTION: CPRSPROVIDER,SEVEN Place: Bedside Urgency: Stat
CPRS RELEASED ORDER 12/16/97 15:52 CPRSPROVIDER,SEVEN CPRSPROVIDER,SEVEN + Enter ?? for more actions
CPRSPATIENT,NINE 666-24-2342 1A MAR 3,1960 (40) Wt.(lb): 184 Number Date St Service Procedure 1 12/16/97 p CARDIOLOGY EKG Portable Enter ?? for more actions SP Select Patient FR Forward CT Complete/Update RT Results Display CV Change View ... CX Cancel (Deny) MA Make Addendum PF Print Form 513 RC Receive DC Discontinue SF Sig Findings RM Remove Med Rslt SC Schedule CM Add Comment DD Detailed Display ER Edit/Resubmit Select Action: Quit// RC Receive Who received it?: CPRSPROVIDER,SEVEN SC Date/Time Actually Received: NOW// (DEC 19, 1997 @ 08:12) (Continued on the next page.) Consult/Request Alerts Dec 19, 1997 08:13:01 Page: 1 of 1 CPRSPATIENT,NINE 666-24-2342 1A MAR 3,1960 (40) Wt.(lb): 184 Number Date St Service Procedure 1 12/16/97 a CARDIOLOGY EKG Portable Enter ?? for more actions SP Select Patient FR Forward CT Complete/Update RT Results Display CV Change View ... CX Cancel (Deny) MA Make Addendum PF Print Form 513 RC Receive DC Discontinue SF Sig Findings ER Edit/Resubmit SC Schedule CM Add Comment DD Detailed Display Select Action: Quit// Continue Processing ALERTS ? Y// Consult/Request ResolutionThis notification is triggered by the Consults package when it determines that a consult is complete. In the following example, the originating provider receives notifications that consults are complete: CPRSPATIE (C3456): Completed Consult CAR HOLTER CPRSPATIE (C1996): *Completed Consult CAR CPRSPATIE (C8910): Completed Consult PSURG Enter "VA VIEW ALERTS to review alerts Select Systems Manager Menu Option: As a follow-up action, the system displays the Consult/Request and results/report. To initiate the follow-up action, enter VA at the prompt and select the notification you want to follow-up on. After viewing, the system deletes the notification. Notice the asterisk on the second notification. This means that there are significant findings for that consult. Consult/Request UpdatedThis alert is triggered when a comment is added to consult or the consult is scheduled. Comments may be added either with the Add Comment (CM) action or the Schedule (SC) action. The text of the alert is altered depending on which one of these actions initiated the alert as follows: Adding a Comment #63 "Comment Added to Consult: . . ." Scheduling #63 "Scheduled Consult: . . ." As a follow-up action, the system displays the consult with comments. If appropriate, the clinician may write an additional comment or take other actions as needed.
This alert is also used by the Healthcare Claims Processing System (HCPS) to notify VA providers the status of a patient who has been referred to a Non-VA Care provider or facility. When an HCPS user enters a comment in RAS, CPRS is updated. The HCPS user might not be a user in VistA; a proxy user will display for ‘Responsible Person’ and ‘Entered By’ in the CPRS, as shown below: Facility Activity Date/Time/Zone Responsible Person Entered By ------------------------------------------------------------------------------- ADDED COMMENT 08/08/14 22:31 HCPS,APPLICATION HCPS,APPLICATION (entered) 08/08/14 22:40 Author: DOE,JOHN Consult/Request Cancel/HoldThis notification is triggered from the Consults package when a Consult request is cancelled, discontinued, or put on hold. In the following example, a user receives notification of a discontinued and a denied consult: CPRSPATIE (C2342): Cancelled consult CAR CPRSPATIE (C9876): Discontinued Consult MEDICINE CPRSPATIE (C3456): Cancelled consult POD Enter "VA VIEW ALERTS to review alerts Select Systems Manager Menu Option: As a follow-up action, the system displays consult with comments. If appropriate, the submitter may resubmit the consult based on this new information. To initiate the follow-up action, enter VA at the prompt and select the notification you want to follow-up on. After viewing, the notification is deleted by the system. In the following example, a cancelled order is edited and resubmitted:
Enter "VA VIEW ALERTS to review alerts Select Consult Service Tracking Option: VA View Alerts 1. CPRSPATIE (C2342): Cancelled consult to PLM 2. CPRSPATIE (C3456): Discontinued consult to CAR 3. CPRSPATIE (C2432): Completed Consult CAR Select from 1 to 3 or enter ?, A I, F, P, M, R, or ^ to exit or RETURN to continue: 1 Processing alert: BAXTER,NA (B8840): Cancelled consult PLM (Continued on next page.) Edit Consult Order Feb 26, 1999 15:58:08 Page: 1 of 2 Edit Consult for Patient CPRSPATIENT,EIGHT Consult Number: 1336 Sending Provider: CPRSPROVIDER,SEVEN Field Name Current Field Contents CURRENT STATUS: (Not Editable): CANCELLED CANCELLED BY (Not Editable): CPRSPROVIDER,SEVEN CANCELLED COMMENT (Not Editable): Testing edit. ------------------------------------------------------------------------------ CANCELLED BY (Not Editable): CPRSPROVIDER,SEVEN CANCELLED COMMENT (Not Editable): Testing edit/resubmit. ------------------------------------------------------------------------------ SENDING PROVIDER (Not Editable): CPRSPROVIDER,SEVEN REQUEST TYPE (Not Editable): Consult ------------------------------------------------------------------------------- 1 TO SERVICE: PULMONARY 2 PROCEDURE: 3 Performed as INPT OR OUTPT: Outpatient + Enter ?? for more actions ED Edit A Field RS ReSubmit Consult Select Action: Next Screen// Edit Consult Order Feb 26, 1999 16:01:18 Page: 2 of 2 Edit Consult for Patient CPRSPATIENT,EIGHT Consult Number: 1336 Sending Provider: CPRSPROVIDER,SEVEN + Field Name Current Field Contents 4 URGENCY: Routine 5 PLACE OF CONSULTATION: 6 ATTENTION (CONSULTANT): 7 PROVISIONAL DIAGNOSIS: 8 REASON FOR REQUEST: Pt has trouble breathing. 9 COMMENT(S): (Add Only) ADDED COMMENT (Not Editable) Entered: Jan 11, 1999 BY: CPRSPROVIDER,SEVEN Testing, more testing. Enter ?? for more actions ED Edit A Field RS ReSubmit Consult Select Item/Action:Quit// 7 (Continued on the next page.) Edit Consult Order Feb 02, 1999 10:44:38 Page: 2 of 2 Edit Consult for Patient CPRSPATIENT,NINE Consult Number: 1366 Sending Provider: CPRSPROVIDER,SEVEN
Pt is having chest pains. 9 COMMENT(S): (Add Only) Enter ?? for more actions ED Edit A Field RS ReSubmit Consult Select Item/Action:Quit// ED Edit A Field Select the fields to edit: 7 Provisional Diagnosis: Angina
Edit Consult for Patient CPRSPATIENT,EIGHT Consult Number: 1336 Sending Provider: CPRSPROVIDER,SEVEN
4 URGENCY: Routine 5 PLACE OF CONSULTATION: 6 ATTENTION (CONSULTANT): 7 PROVISIONAL DIAGNOSIS: Angina 8 REASON FOR REQUEST: Pt has trouble breathing.
Testing, more testing. Enter ?? for more actions ED Edit A Field RS ReSubmit Consult Select Action: Quit// (Continued on the next page.) This Consult Has Not Been Resubmitted!! Resubmit Or All Edits Will Be Lost!! Do you wish to resubmit now? ? YES// Y YES Resubmitting Consult ... One moment please ... Filing Tracking Data...
2. CPRSPATIE (C2432): Completed Consult CAR Select from 1 to 2 or enter ?, A I, F, P, M, R, or ^ to exit or RETURN to continue:
When an order is Discontinued, who gets the notification depends on the source of the discontinuation. This is dependent on the NOTIFY ON DC field in file 123.5 for the service to which the consult was directed. This field is set by the Set up Consult Services (SS) command of the Consult Management Option. Consult/Request Has an Added CommentIf a comment is added to a consult by someone in the receiving service, that person is prompted to send notification to the originator of the consult and to any other persons. Other recipients of this notification are controlled as a New Service Consult. In the following example, a clinician in the Surgery service has added a comment:
Enter "VA VIEW ALERTS to review alerts Select Consult Management Option:
Order(s) Require Electronic SignatureIf you do not sign a consult at the time you initiate it, the CPRS triggers a notification reminding you of the need for an electronic signature. In the following example, three notifications are presented for Consults that need an electronic signature: CPRSPATIE (C3456): Order requires electronic signature. CPRSPATIE (C4723): Order requires electronic signature. CPRSPATIE (C3234): Order requires electronic signature. Enter "VA VIEW ALERTS to review alerts Select Systems Manager Menu Option: The follow-up action is to display the orders requiring electronic signature in a CPRS screen so that you can use the Sign action. The system deletes the notification after you have signed the order. Significant Findings for a ConsultIf the status of the Significant Findings Flag is changed in any way, an alert is sent by the Consults package. As far as the recipients and delivery, this notification is treated like a Consult/ Request Resolution. This alert may be delayed, at the user’s option, until the consult is complete. In the example that follows, three significant findings notifications are present. One for a completed consult, one for a pending consult, and one for the Significant Findings Flag being turned off on a completed consult: CPRSPATIE (C3456): Sig Findings for consult CAR CPRSPATIE (C6572): Sig Findings for consult CAR CPRSPATIE (C1432): No Sig Findings for consult PLM Enter "VA VIEW ALERTS to review alerts Select Systems Manager Menu Option: The follow-up action is to display the orders that have had a change in the Significant Findings Flag in the CPRS screen so that you can examine them. Yüklə 0,82 Mb. Dostları ilə paylaş:
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