Pharmacy and Immunization Computer Scene Investigation

(CSI)

Crime Scene:Can’t add immunizations

• Police Report:– Nurse is trying to enter in an immunization however

they report to you that the option to ADD a new immunization is grayed out?

– How do they get that option back?

• Immunization parameters for EHR• BEHIMMDIE

– Set at appropriate level– “Yes” means NOT able to enter…

CPT Stop Immunizations from Adding CPT Codes DIE Disable Immunization Editing ICD Stop Immunizations from Adding ICD Codes

Select Immunization Configuration Option: DIE

Disable Immunization Editing may be set for the following:

100 User USR [choose from NEW PERSON] 200 Class CLS [choose from USR CLASS]

Enter selection: 100 User NEW PERSONSelect NEW PERSON NAME: niesen NIESEN,MARY ANN------ Setting Disable Immunization Editing for User: NIESEN,MARY ANN ------Value: ?

Enter either 'Y' or 'N'.

Value: y YES

Crime Scene:Can’t add immunizations

Crime Scene:No lot number

• Police Report:– The good news is that they can now order an immunization and they

are extremely grateful for the EXCELLENT services you provided them.

– As they are singing your praise they notice that someone has mysteriously hid the lot numbers for each of the vaccines.

– Since you did such a great job with getting the immunizations to work they call you and ask if you can figure out what happened to their lot numbers – can you?

• Need to be entered and active in the Immunization package

• Need security keys to enter these (BI namespace)

• Can track inventory if desired• Be cautious if more than one division uses

the same lot numbers– Some sites use letters at the end of the lot

numbers to differentiate• IMMMGRLOT

Crime Scene:No lot number

Imm v8.3 * * * ADD A LOT NUMBER * * *

Lot Number:__________________________________________________________________

Lot Number: ZTESTING123 Vaccine: CHOLERA (CHOLERA) Status: Active Manufacturer: MEDIMMUNE Expiration Date: JAN 31,2009 Source: NON-VFC

Starting Count: 10 Doses Unused: 10 Doses Used: 0 Low Supply Alert: 3 (calculated)

Facility:__________________________________________________________________Exit Save Refresh

Crime Scene:No lot number

Crime Scene:Provider Entered Refill too Soon-

How Do I Cancel it?• Police Report:

– Pharmacy is screening today’s orders in OERR when they notice that the provider put in a refill request for a patient who recently had this medication filled.

– The pharmacist can not process it due to the 30 day billing policy – so the pharmacist ask you how can they cancel the request without changing the original order?

Refill request too soon

This RX was filled on 11/18 – to soon for pharmacy to process

even though provider has requested it in EHR.

Refill request from provider – needs to be DC’d since it is too soon to process.

At the Select Action: Quit// prompt type DCIt will ask which order you want to DC and you will enter the number of the refill request.  In the comments please enter why you are DCing it

as I did in the example.  It will ask who the requesting provider is – leave your name as the requesting provider.

Crime Scene:Why don’t I see orders in RPMS OERR

and I see it in EHR? • Police Report:

– Pharmacist contact you about orders in EHR that are not showing up in RPMS. They were not aware of any problems until patients started to present to pharmacy an hour after waiting for their prescriptions.

– They don’t understand why the orders are not showing up in OERR and request your help in solving this mystery.

• Look at the “CPRS ORDERING INSTITUTION” field in your Outpatient Pharmacy Site Parameters.

• You have a division in CPRS that the pharmacy package is not set-up to receive orders from.

Crime Scene:Why don’t I see orders in RPMS OERR

and I see it in EHR?

Crime Scene:Wrong Co-Signer Assigned

• Police Report:– User selected wrong co-signer prior to signing

off on their note.

• Solution #1:– User:

• Prior to signing the note– Change co-signer by clicking the “CHANGE” button

• After signing the note– Can use the menu option “Assign Additional Signer” option

» Located on Action Menu» Also located by right clicking on signed note

Crime Scene:Wrong Co-Signer Assigned

• Solution #2:• Medical Records Supervisor

– Must have the chief MIS user class– Must have the following business rule setup:

» An UNCOSIGNED (CLASS) PROGRESS NOTE may BE EDITED by a CHIEF, MIS

– Use the action menu or right click on the note

Crime Scene:Wrong Co-Signer Assigned