Physician Reference Guide Paragon Clinician Hub

Version 13.0

2

Table of Contents

Clinician Hub 13.0 4‐5

Clinician Hub 13.0

Key Features

6‐7

Clinician Hub 13.0 How to Unlock an Applica on

8‐9

Clinician Hub 13.0 ‐ Census How to Create a Census

10‐13

Clinician Hub 13.0 ‐ Collec ons What is a Collec on?

14

Clinician Hub 13.0 ‐ Collec ons How to create a Collec on

15

Clinician Hub 13.0 ‐ Collec on How to add a pa ent to a Collec on

16‐17

Clinician Hub 13.0 ‐ Collec ons View pa ents in a Collec on Clearing a Selec on Rename a collec on

18‐19

Clinician Hub 13.0 ‐ Collec ons Remove a pa ent from a Collec on

20‐21

Clinician Hub 13.0 ‐ Collec ons Delete a Collec on

22‐23

Clinician Hub 13.0 – Manage Consultant Rela onships Assign Yourself as a Consultant Remove Yourself as a Consultant

24‐25

Clinician Hub 13.0 ‐ Card and List View 26‐27

Clinician Hub 13.0 ‐ Physician Work Queue 28‐29

Clinician Hub 13.0 ‐ Overview Window Pa ent Sidebar

30

Clinician Hub 13.0 ‐ Overview Window Vitals I & Os

31

Clinician Hub 13.0 ‐ Overview Window View Results View Orders View Meds & IVs

32

Clinician Hub 13.0 – FlowSheet View Flowsheet

33

3

Table of Contents

Clinician Hub 13.0 View Previous Date

34

Clinician Hub 13.0 ‐ Ordering

Real Time Dropdown Search Results

Admission & Transfer Med Rec

(Defer Remaining Home Meds)

37

Clinician Hub 13.0 – Med Rec Discharge Med Rec

(Cont, DC & AMEND)

38‐39

Clinician Hub 13.0 Bulk Sign Off Order Pa ent Orders Sign Off Diagnosis Search

40‐41

Clinician Hub 13.0 Prescrip on Writer

42‐49

Clinician Mobile 50‐55

Order Sets 56‐57

PhysDoc: Addendum

58‐59

PhysDoc: Invalidate

60‐61

Deficiencies: Signature Missing Text Dicta on

62‐67

Clinician Hub 13.0 ‐ Ordering How to cancel Request

68‐69

Clinician Hub 13.0 ‐ Ordering How to Discon nue Request

70‐71

Clinician Hub 13.0 ‐ Ordering Label Maintenance

72‐73

4

Paragon Clinician Hub

13.0

5

Access to Paragon Clinician Hub is via Microso ® Internet Explorer with appropriate access to the hospital’s internal network.

An applica on ‘lock’ can occur for a pa ent visit when certain ac vi es are performed by Paragon and Clinician Hub users. Some examples of ac ons that might cause a lock include: Medica on Reconcilia on dra is locked while

home meds are being updated in Pa ent Profile

Clinician Hub mes out with a medica onreconcilia on dra s ll open

Clinician Hub 13.0

6

Key Features

Paragon Clinician Hub replaces Websta on for Physicians

Icon Descrip on Census View/Informa on

Physicians can request cover‐age from another physician. Shows cases for surgeons booked via ORM.

Physicians can view/complete deficiencies for One Content deficiencies only

Refreshes the screen

Appointments schedule or available mes for scheduling

Referen al content and pa‐ent educa on

Personal links are useful links (URLs) that can be added by the physician to suit specific needs. Up to 24 personal links can be entered.

Reset selected filters

Save selected filters

7

Key Features Icon Descrip on

Provider Name

Help

Lock

Logging out of applica on

Default physician census

The default view of the physicians’ pa ent list.

Alternate view of the physicians’ pa ent list.

A grouping of pa ents

Search

Op on to view the physicians’ rounding report and other ac ons.

Filter criteria

The physicians’ current work queue

Includes the categories of filters (Group, Loca‐

on and Demographic)

Displays selected filters

8

Clinician Hub 13.0

How to Unlock an Applica on

Step Ac on

1. Click the pa ent name link on the pa ent card for which you need to un‐lock an applica on. The pa ent is put in focus

2. Click the down arrow for your user name select the Super User op on.

3. Click for the desired applica on you want to unlock.

Note: The applica on is no longer displayed on the window to indicate that it is unlocked.

4. Repeat step 3 for another applica on, if

desired, or click

Note: A user with Super User Authority security can unlock applica ons as necessary.

9

How to Secure a Session

If you need to walk away from your session, you can secure it to prevent others from performing ac ons using your login.

Note: If you leave a session secure for 30 minutes, the system automa cally signs you out.

Clinician Hub 13.0

Step Ac on

1. On the Naviga on Banner:

Click

2. When you return: Type your Password

Click

10

Census

Clinicians can find the pa ent(s) they need using the Census tab in PCH. Via the census, clinicians can: Create a census based on a variety of filters

Search for an individual pa ent

Create one or more collec ons (personal lists) to trackspecific subsets of pa ents.

Select the ac on they wish to take on a pa ent theyselect

Access their Physician Workqueue, which contains tasksand ac ons they need to take on all of their pa ents

How to create a Census Step Ac on

1. In the Group, Loca on or Demographics category, click the filter name

2. Select the check box or radio bu on next to the desired entry for the filter. If there are more entries for a filter than can dis‐

play in the window, use the scroll bar to dis‐play/select the desired filter values.

Note: The filter turns blue to show that a selec on has been made; the filter is applied to the search and the search results display

11

Step Ac on

3. Repeat Step 2 un l all desired filters are selected.

4. To modify your selected filters, click

5. To remove a filter, click next to the filter.

6. To clear all filters, click

7. To close the View Filter String, click in the upper right corner of the View Filter String window.

Census

8. Once the filter is set, click

9. Name the filter,

then click

10. The filter appears in the Filter dropdown list. To make this filter the default filter that is used when accessing the census screen, select ‘Set as default’

12

Census

Addi onal Tips

Refining Census

The default ‘My Pa ent’ census may contain pa ents you do not wish to include on a daily basis, for example outpa ent visits or ED pa ents.

Use the filters to restrict pa ent type (inpa ent, observa on, other relevant types) and the pa ent status to restrict to ‘admit’.

You may also want to filter the rela onships to include admi ng, a ending, and/or consul ng only.

Save this modified filter for future use with it’s own name (e.g.: ‘My census’) and set this census to show as your default census.

13

Notes

14

Collec ons

A collec on is a grouping of pa ents. Collec ons are user‐specific and are therefore not visible to other users of the system. (i.e. “follow‐up cultures” , “labs’ “Ortho pa ents”, "Chemotherapy pa ents" or "Dialysis pa ents").

Collec ons are at the pa ent level first and then the visit level.

A collec on must be created before pa ents can be added to it.

What is a collec on?

15

How to create a Collec on

Step Ac on

1. Click the Collec ons drop‐down arrow. The drop‐down expands to show MyCollec ons.

2.

Click the entry. A field displays.

3. Enter the name for the collec on in the field provided. It must be unique. Up to 50 alphanumeric characters can be entered.

4.

Click . The following message displays “the collec on is saved and available in the My Collec ons list.”

Collec ons

16

Adding pa ent to a Collec on Method #1

Collec ons

Step Ac on

1. With the census displayed, select the pa ent you want to add to a collec on.

Note: You can Mul ‐select pa ents to add to a collec on if desired.

2. In the List view, click for the pa ent you want to add to the collec on.

3. Click

4. Use the drop‐down to select the Collec on to which you want to add the pa ent

5. Click

6. Click to close the ‘Pa ent Added to Collec on’ dialog box. (The box will close automa cally a er a few seconds)

17

Collec ons

Adding pa ent to a Collec on Method #2

Step Ac on

1. With the census displayed, select the pa ent(s) you want to add to a collec on.

2. Click the Select An Ac on... drop‐down arrow

3. Select Add selected pa ents to a collec on

4. Use the drop‐down to select the Collec on to which you want to add the pa ent

5. Click

6. Click to close the ‘Pa ent Added to Collec on’ dialog box. (The box will close automa cally a er a few seconds)

18

Viewing pa ents in a Collec on

Collec ons

Step Ac on

1. On the Census tab, click on Collec ons Select the desired collec on in the drop‐down list.

Note: The pa ents in the collec on display on the window.

Note: If desired, you can use the Pa ent Filters to filter the collec on. For example: The "Chemotherapy pa ents" collec on is

selected in the Collec ons dropdown list. You can click the Sex filter and select the Male check box to filter your Chemotherapy pa ent collec on to display only male pa ents.

Note: If a pa ent search is performed or a saved search is selected prior to choosing a collec on, the search is cleared and the collec on displays. The search is not used in combina on with the collec on.

19

Rename a Collec on

Step Ac on

1. Click the Collec ons drop‐down arrow on the Census tab

2. Click

3.

In the list of your collec ons: Highlight the name of the collec on you want

to change Type in the new name for the collec on.

4. Click

5. Click OK to close the dialog box.

Clearing a selected Collec on

Collec ons

Step Action

1. With the collection selected on the Census tab, click

in the Collections field.

The Collections field clears.

20

Collec ons

Remove a pa ent from a Collec on Method #1

Step Ac on

1. On the Census tab: Select the name of the collec on that

contains the pa ent you want to remove in the Collec ons drop‐down list.

2. In the List view: Click the down arrow for the pa ent to expand the view.

In the Card view: Click the More Hyperlink to change to the

expanded List view.

3.

Click ( Remove from Collec on) .

The Remove from Collec on dialog box opens.

4. Click

21

Remove a pa ent from a Collec on Method #2

Collec ons

Step Ac on

1. On the Census tab: Select the name of the collec on that

contains the pa ent you want to remove in the Collec ons drop‐down list.

The pa ents in the collec on are displayed.

2. Click the pa ent(s) to remove from the collec on.

3. Select Remove selected pa ents from current collec on in the ac on drop‐down list on the Census tab.

The Remove from Collec on dialog box opens.

4. Click

22

Collec ons

Delete a collec on

Step Ac on

1. On the census tab:

Click

2. To display a list of your saved collec ons

Click

3. Click next to the collec on name to be deleted

23

Addi onal Tips

24

PCH allows the user to assign a consultant rela onship to a pa ent. Note that only the ‘consultant’ rela onship can be managed by the user, not ‘a ending’ or ‘admi ng’.

Step Ac on

1. On the census screen (the pa ent with whom you want to create the consult rela onship):

Click

2. On the next screen

Click

3. On the next screen Select your name from the dropdown list

4. Click

Manage Consultant

5. You are now assigned to the pa ent as a consultant.

Click

Assign yourself as a consultant

25

Remove yourself as a consultant

Step Ac on

1. To remove yourself as a consultant

click

2. Acknowledge the confirma on

Click

3. You are now removed from the care assignments.

Click

Rela onships

PCH allows the user to remove a consultant rela onship to a pa ent.

26

Card & List view You can view the pa ents in your census in either

Card or List view. Both views present the same pa ent informa on. The default view for the Census pane is the List view,

but it can be easily toggled back and forth to suit your preference

Note :The minimum number of cards in the view is 3 per row and the maximum number of cards depends on the window size

Card View

List View

A er performing a pa ent search or selec ng a collec on:

click

The window changes from the List view to the Card view format

A er performing a pa ent search or selec ng a collec on:

click

The window changes from the Card view to the List view format

27

Physician Workqueue The Physician Workqueue displays on the right side of the PCH window allowing important items to be viewable by the clinician even as they are working with a par cular pa ent. That way, if a cri cal lab result comes in for another pa ent, the physician can immediately see it and take ac on if necessary. When working in pa ent context, the full workqueue remains in collapsed format on the right .

The Physician Workqueue allows the physician to view all of his/her tasks, alerts and messages across all of his/her patients. It also includes coverage requests from other physicians.

Click to expand the Physician Workqueue.

Click to collapse the Physician Workqueue

28

Physician Workqueue

View ac ve or historical items

Sort by:

Date (Chronological or ReverseChronological)

Name (Ascending, Descending) Loca on (Ascending, Descending)

The Bulk Sign‐Off module provides the ability to sign off for ORDERS only ‐ not all tasks .

29

Click an entry in the work queue to dis‐play addi onal informa on about it on the le side of the work queue window. Ac ons you can take on a work queue entry depend on the content of the entry. Complete Document Coverage Request Co‐Sign in CPOE Co‐Sign Physician Documenta on Medica on Reconcilia on Medica on order Renewal Sign off on Orders Assign/Remove Care Assignment Assign/Remove Care Team Sign‐off Reject (Wrong Physician)

Alerts are generated in the Physician Work queue for: New Results Discharge New Results (Research) New Cri cal Results Vital Signs out of range Order Alerts (generated via Paragon

Rules Engine) Cri cal alerts display at the top of the list, highlighted in red. If a cri cal alert is added during an open session of Clinician Hub, a message dis‐plays to no fy you of it.

Tasks are generated as a result of ac ons taken/not taken in the Paragon. To avoid ge ng le ers from Medical Records physicians must keep task list clean.

Currently, Paragon does not support any other messaging.

This is reserved for future use.

Physician Workqueue

30

Overview Window

When you choose to put the selected pa ent in focus, the Overview window opens.

You can also put a pa ent in focus by double clicking the pa ent name hyperlink in the Pa ent Census (Card or List view)

Pa ent workqueue is default op on for menu. It also lists Pa ent profile data.

The Overview window displays when the pa ent is in focus. It allows you to view pa ent informa on:

Pa ent Sidebar

Pa ent Card

Pa ent Workqueue

Pa ent Card Pa ent Workqueue Vitals I & Os

Results Orders Meds & IVs Flowsheet

31

Vitals

I & Os

The following vital sign displays in a graphical format in this tab:

Temperature Systolic and Diastolic BP Respira on

Pulse Oxygen Satura on Pain

Overview Window

This area of the Overview screen displays the most recent Intake and Output informa on in a condensed format.

Net Input and Output totals for last 24 hours Current shi and since admission Latest weight and previous weight

32

View Results

View Orders

View Meds & IV

Overview Window

The names of recent results show in this module‐not the result itself.

This tab displays Order date/ me and status for re‐cent orders for the pa ent.

This tab displays summary medica on and IV order Informa on.

33

Flowsheet

Flowsheets provides a single point of access to medical informa on, displayed in a meline format, with visual indicators to alert you to out‐of‐range values.

This informa on includes: Nursing documenta on, Medica on administra ons I & Os Test results

The columns of the Flowsheet represent an interval of me, displaying the data documented within that

span of me.

You can change the view of the data by selec ng: me interval or exact me.

Flowsheet data displays in chronological order with the most recent data on the right side of the window.

View Flowsheet

34

Flowsheet

View Previous Data

Step Ac on

1. To include data from previous visits:

click

2. Select the visits you wish to view and Click again to close the dropdown.

3. Data from the selected visits displays. Selec ng a visit in the header moves the flowsheet to informa on from the selected visit.

35

Notes

36

Notes

37

Clinician Hub 13.0

Real Time Dropdown Search Results

Admission & Transfer Med Rec:

Sugges ons will generate as the end usertypes.

The results will match text anywhere within the order or order set name. To select desired order:

Click on choice to go directly to order.

Make certain to scroll down to the bo om to see bulk ac on bu ons. “Def” (i.e. defer) means medica on not

given in hospital, but stays on home med list for future use.

“Defer remaining home medica ons” onlyaffects home meds that are not touched.

NOTE: You can pick home meds to con nue before or a er. Choosing the bu on will

not change selec ons already addressed.

38

Clinician Hub 13.0

Make certain to scroll down to the bo om to see bulk ac on bu ons.

“D/C remaining inpa ent orders” willdiscon nue any order than is not labeled as home medica on.

This can be done before or a er addressing any hospital meds that need to be con nued at home. It will not change selec ons already addressed.

“Aware remaining home meds” meansprovider is aware of meds, but not specifically taking ac on. *See NOTE on next page*

This will show up in discharge instruc ons as ‘Provider is aware of the following medica ons”.

If you specifically want to con nue med, use “Cont” bu on; not “Awr” bu on.

Discharge Med Rec:

“Cont”: The home medica ons can becon nued directly.

“DC”: Hospital medica ons will beautoma cally discon nued.

NOTE: There is no need to discon nue the hospital med before con nuing the home med.

39

Clinician Hub 13.0

Discharge Med Rec: Amend

Allows the addi on of new medica ons to apreviously finished med rec without star ng a new med rec.

The newly added med is con nuedautoma cally.

If changes are needed to any exis ng medica‐ons, a new med rec will need to be started.

NOTE: There is no need to address previously ordered home meds.

NOTE: *Aware is not an acceptable medica on status for pa ents going to Skilled Nursing Facili es. For a SNF discharge one needs to Con nue, D/C or Modify the medica on.*

40

Clinician Hub 13.0

Bulk Sign Off Orders

In PCH, the bulk sign off bu on is located on thePhysician Workqueue header

My orders includes only telephone andverbal orders recorded by nurse for all of your pa ents.

The page can show up to 250 items at oneme. There may be more than one page.

All items checked are marked complete. Unchecked items stay on ac on list for

individual rejec on.

DOES NOT INCLUDE:

Countersignatures

Med rec ac on items

Physdoc ac on items

e‐Rx items

Patient Orders Sign Off

Pa ent orders includes all telephone and verbalorders that exist for the pa ent.

Allows sign off of partner/groups orders by othermembers of group for that pa ent.

In pa ent context, theBulk Signoff op on is located in the ‘More’ menu.

41

Diagnosis Search

This func onality now looks for words in any order. The ‘Contains’ bu on is present but no longer changes the search, Use addi onal specific wording to narrow your search ‘Normal Newborn’, ‘Diabetes Type 1’, ‘Le conges ve heart failure’, etc.

Clinician Hub 13.0

42

Prescription Writer

43

Additional Tips

When accessing a pa ent for the first me a er e‐prescribing has been enabled, there may be a dialog box asking whether the pa ent has given permission to get their medica on history.

This can be answered ‘Yes’ as it is covered in the Ridgeview general pa ent consent.

This is only answered once a year for each pa ent.

If it has already been addressed by another provider, it will not display again, and the ban‐ner will display the green ‘Med History Consent’ icon shown above.

Prescrip on Writer

44

To start Rx Writer: Select desired pa ent Click CPOE Click Medica on Reconcilia on Locate Discharge Med Rec and click:

When in the Med Rec Click:

Address the Dispense: Click the Quan ty radio bu on and specify

quan ty For Refills: Select the desired number of

refills from the drop down.

Click

To save a completed prescrip on as a template for future use:

click

Prescrip on Writer

45

Address all medica ons in the Discharge Med Rec, click:

In Type/Status:

The pharmacy delivery confirma on will be visible once the prescrip on is successful.

Select Printer

Note: The Prescrip on icon will appear next to medica ons with prescrip ons.

Click Yes

Click Submit

***This may take a few minutes to update ***

Prescrip on Writer

46

Add New Prescription

If the medica on is not listed on the Discharge Med Rec, then use the ‘Add Prescrip on’ bu on. To start the process, click:

Type the desired drug in the search field, click:

Select the desired medica on form and dose. Con nue entering the Dispense informa on.

Prescrip on Writer

47

Additional Tips

There is a limit to the number of characters that can be typed in to the ‘Sig’ field.

If this is exceeded, the counter in the lower le of the instruc ons window will turn red and you will not be able to send the Rx electronically.

This warning will be displayed upon submission if the limit is exceeded.

To renew a script, click:

If the medica on or DME cannot be found, it can be free texted.

Click both ‘Free form’ and ‘Compound’ boxes to send a Free Form Rx electronically.

Prescrip on Writer

48

Prescrip on Writer

To create a Regimen in Rx Writer:

Click

Then Click

Create a Regimen

Click Hint: lower le of the screen

Name the Regimen

Click

Select the desired medica on form and dose.

Click

Click Hint: lower le of the screen

Click

49

Prescrip on Writer

To Use Your Regimen

Click

Click

Select the desired regimen

Select the desired medica on form and dose.

Click

Click

Hint: lower right of the screen

Click

50

Clinician Mobile

Clinician Mobile

51

Patient Census

When you log in; the Pa ent Census will launch

Census with Navigation Pane **no patient in focus**

Clinician Mobile

52

Patient Overview

Patient Navigation Pane

To view a pa ent’s overview: ‐ Tap on the desired pa ent

The pa ent naviga on pane is only available when a pa ent is in focus.

‐ To access : tap

Clinician Mobile

53

Patient Profile

Additional Tips

To access the pa ent profile: ‐ Tap Profile in the Pa ent Naviga on Pane

Treat your I‐Pad as a HIPPA document. Do not leave in area where content can be viewed by others.

Alerts and ac ons items are view only. They can be addressed in WSP.

The mobile app will allow you to search for any pa ent using search icon in upper right corner of census page using any part of name or MRN.

You can also search for pa ents by viewing floor census in le hand naviga on pane.

Clinician Mobile

54

Clinician Mobile Icons

Clinician Mobile

55

Clinician Mobile Icons

Clinician Mobile

58

PhysDoc If you need to make change a er a document has been sign

59

Addendum

In the upper le corner:

2. Click the drop down arrow‐Select “Addendum Note.

3. Click the green +

4. Enter Addendum note

‐ Scroll to Sign

ned, the Addendum func onality in PhysDoc can be used.

On the Documenta on tab:

1. Select the Final (Signed) document

60

PhysDoc If you need to delete or invalidate a document, the InvalidaIn the following example, a “Preliminary Document” (i.e. do

61

Invalidate ate func onality in PhysDoc can be used. ocument that has not been signed) is invalidated.

On the Documenta on tab:

1. Select the desired document toinvalidate

2. Click

3. Click the invalidate icon

4. Select a reason

5. Click

68

Ordering: How t

Can be used if the processing

status is Add Pending status

69

to Cancel Requests

The order has not been

acknowledged by the receiving

unit (i.e. Pharmacy, Radiology,

etc.)

70

Ordering: How to D

Can be used if the order

status is Ac ve

71

Discon nue Requests

The order has been acknowledged by the receiving unit (i.e. Pharmacy, Radiology, etc.) and the pa ent is currently receiving (i.e. med, lab is scheduled. Etc.)

72

Ordering: Labe

73

el Maintenance