quick guide to applications: impact of downtime · quick guide to applications: impact of downtime...

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Quick Guide to Applications: Impact of Downtime System Service Provided Connected

Systems

Services Lost if System is

Compromised

Epic Emergency Department

Ancillary (Lab, Radiology,

Cardiology)

Inpatient (Orders, Clinical

documentation, BPAM,

Pharmacy)

Revenue Cycle: Billing,

Patient Access, Scheduling

Home Care

Ambulatory

All – Core

Health System

wide system

All – health system wide downtime

3M Abstracting/coding Epic Cannot code accounts

Amicas/iConnect PACS (Picture Archiving

and Communication System)

Radiology images

Epic,

Powerscribe,

Viewpoint

Radiologists unable to review

images. Radiology images unable

to be launched via EMR

Amtelco Telecom: web paging, oncall

schedules, directory

Epic Web paging, on call schedules, or

hospital directory unavailable

Angel Eyes Neonatal camera system Patient contacts cannot view babies

API Time and attendance

Staffing and scheduling

Epic Unable to see timecards, quick

badge, approve timecards. Unable

to enter requests or see staff

schedule.

Aqure Lab Gas

Analyzer

Blood gas orders/results Epic Blood gas orders/results unavailable

CareFusion PFT

(Viasys)

Pulmonary Function Testing Epic PFT recordings and reports

unavailable

CBORD Dietary system, Patient

Menus via iPads, Cash

Registers n Dining room and

Café

Epic Cash registers and inventory in

Dining Room and Cafes, Patient

Menus via iPads unavailable

Data Innovations

(DI)

Connects lab instruments to

Epic

Epic Lab orders/resulted will not be

transmitted

Dragon Voice recognition software Epic Voice recognition for

documentation unavailable

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Experian Claims Epic Cannot transmit claims

Can’t take credit card payments

File

Shares/Amon

Access to H, S, and P drives

Lotus Notes (requires N

drives)

Network drives and Lotus Notes (N

drive) unavailable

GE Centricity

Cardiology

Cardiac Cath lab images and

charges

Epic, Amicas Cardiac Cath Lab images

unavailable

GE CPN

Perinatal

GE Connect

OB fetal monitoring strip Epic Fetal monitoring strips unavailable

GE DMS Cardiology Procedure

Reports

Epic Echo and cardiac catheterization

procedures unavailable

GE Muse EKG EKG tracings and reporting Epic EKG tracings, reports and Stress

EKG tracings unavailable

GE Viewpoint MFM ultrasounds and

reports

Epic, Amicas MFM reports will not be sent to

Epic or Amicas

Hologic Bone

Density

Bone density screenings and

reports

Epic,

Powerscribe,

Amicas

Reports/images will not be sent

Hyland Onbase Scanning Epic Scanning unavailable

Image Vault Cardiac Echo images Epic, GE DMS Cardiac Echo images unavailable

Imprivata Single Sign on = Fast Log In

Cortext

Unable to use badge tap, single sign

on

Unable to access computers

Unable to send cortext messages

InterQual Utilization Review decision

support tool for patient class

determination

Epic

(embedded in

CM Navigator)

Unable to determine patient class

Lotus Notes Administration

LMS/Databases

Lotus Notes databases unavailable

Meditech MM,

GL, AP, PP

Material Management

Payroll

General Ledger

Epic, API Financial applications unavailable

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M Modal Dictation System Epic Dictation system unavailable

Morrisey MSOW Credentialing system Medical staff unable to access

credentialing system

Natus EEG EEG recordings and reports Epic EEG recordings and reports

unavailable

NDD Spirometry Respiratory program used

mostly by SSMC for

spirometry

Epic Unable to take spirometry

recordings

Omnicell Medication Dispensing Epic Medication dispensing unavailable

(can run on override)

Outlook Email

Calendar

Unable to access email or calendars

PenRad Mammography ordering,

reporting, statistics

Epic,

Powerscribe

Mammography orders and reporting

unavailable

Powerscribe Dictation – Radiology Epic, Amicas,

Powerscribe

Unable to send out Radiology

reports

QTEL Cardiac

Rehab

EKG/O2 recordings,

exercise tracking for Cardiac

Rehabilitation

Epic Reports not available to be

launched from Epic, cannot

record/report

QuadraMed Nursing acuity tool Epic Nurses are unable to classify

ICU/NICU patients for acuity levels

Quantros Incident tracking Unable to document incidents

Rhapsody Interface infrastructure Communication between hospital

systems (Epic/PACS, CBord, etc)

and with remote partners (Harbor

Medical, SSOrtho, SSPen, Atrius,

Crown OB, etc.) unavailable

rL Solutions Web based patient feedback

software

Patients are unable to enter

feedback

SnapComms SNAP messaging Snap messages unavailable

Soft Bank/Soft

Lab

Blood bank system Epic Blood bank tests and results

unavailable

Spacelabs/Full

Disclosure

Vital sign monitoring Epic Vital sign monitoring unavailable

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Stanley RFID RFID tracking of equipment

location, temperature

monitoring

Cannot see locations of equipment,

no alerting mechanism

Surescripts E-prescribing Epic Unable to e-prescribe

UniPOC Glucometers Epic Glucometers unavailable

Zoll – Rescue

Net

EMS EMR – Pre hospital

documentation

EMS EMR – Dispatching

System

Epic Pre hospital EMR information will

not cross. EMS dispatch

unavailable for tracking paper

process

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3 Levels of Downtime -

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1. Downtime Tools – BCA PC and BCA Web You can still access patient information during downtimes that can occur either as a planned part of an

upgrade or as a result of an unexpected event like a power outage. Epic provides a business continuity

access (BCA) system that contains multiple tools for use in different downtime scenarios – Supports

Ready Only (SRO), BCA Web and BCA PC.

Using Supports Read Only (SRO) During a Level III downtime, you can access a view-only version of Epic by clicking on the SRO button on

the desktop. This allows you to view all patient information accurate to approximately when the system

went down, but will not allow you to do any in-system documentation.

Accessing SRO 1. Click the SRO icon on the desktop 2. Log in with your Epic hyperspace credentials 3. View information as normal in a view-only mode

a. Notice READ-ONLY MODE at top right of the screen b. Last Refresh Time displays the time the data was last refreshed

Using BCA Web to View Reports During a Level III and Level II downtime, you can use BCA Web to view/print all BCA downtime reports

from any computer.

Log into BCA Web 1. Double-click on the icon for BCA Web on your desktop 2. Enter the same information you use to log into Hyperspace; press Enter or click Log In

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Search for Patients

1. Click Patient Search in the BCA Web toolbar 2. Enter the patient name, MRN, and any additional information you have to search for the

patient 3. In the search results, click the row for the patient to view additional information such as

admission date and current location

View Department Information 1. Click Folder List in the BCA Web toolbar to view a list of departments 2. Click the appropriate department link 3. From the list of reports that appears, click the report that you want to view to open it

List of available

folders may look

different –

search for your

department

https://galaxy.epic.com/Handler/ImageHandler.ashx?filename=U:/Images/Denali/2000001To2100000/2096347.png

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Print Information from BCA Web When viewing any of the reports available in BCA Web, click Print if you need to print a hard copy of the report

Using BCA Printing Application to View/Print Reports During a Level I downtime users will access the BCA Printing Application on specified computers to view

and print critical patient information. All designated BCA computers have the BCA printing application

installed. BCA computers have a ‘Downtime BCA Device’ sign attached to the top of the monitor.

Log Into the BCA Printing Application 1. Double-click the icon for BCA Printing on your desktop 2. Enter the information you use to log into Hyperspace and press Enter or click Sign In

Print All Available BCA Reports

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1. Click Print and choose to print all reports in the table or on the PC at once 2. In the Print window that appears, select the printer to use in the Name field and click

Print

View and Print Specific BCA Reports 1. To view all reports in a specific Department, select the department 2. To view all specific report types, select the report type 3. To view/print specific reports

a. To preview a report, select the report that you want to view and click View b. To print one or more reports, select the reports and click Print … You can select

multiple reports by using CTRL + click c. Use the tag filters on the left side to choose groups of reports that you want to view

and print

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Using BCA PC to Access Information During Network Downtime During a Level I downtime when users cannot log into the computer with their Windows credentials

users must log into the BCA computer with a generic local user.

Log Into BCA PC as Local User 1. Contact the Command Center to receive the password for the local user 2. At the Windows log in screen, enter the username EPIC-BCA and the password provided 3. At the Log on to prompt, select the computer name and click Ok

Log Into the BCA Printing Application

1. Double-click the icon for BCA Printing on your desktop 2. Enter the same information you use to log into Hyperspace and press Enter or click Sign

In

Print All Available BCA Reports 1. Click Print All… to print all available BCA PC reports 2. In the Print window that appears, select the printer to use in the Name field and click Ok


a. To preview a report, select the report that you want to view and click View

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b. To print one or more reports, select the reports and click Print … You can select multiple reports by using CTRL + click

c. Use the tag filters on the left side to choose groups of reports that you want to view and print

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2. INPATIENT BCA WEB – INPATIENT NOTES You can still access patient information during downtimes that can occur either as a planned part of an









Using BCA Web Data Entry During a Level III and Level II downtime, you can use BCA Web from any computer to enter Clinical

Notes on patients during the downtime. This data will file back into the patient’s chart in Hyperspace

when the system comes back up.

Log into BCA Web 3. Double-click on the icon for BCA Web on your desktop

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4. Enter the same information you use to log into Hyperspace; press Enter or click Log In

Search for Patients 4. Click Patient Search in the BCA Web toolbar 5. Enter the patient name, MRN, and any additional information you have to search for the



Enter Notes

1. Select patient from a unit census or using Patient Search. 2. Click the Notes Entry link from the patient home page 3. At the Type field, select the type of note. Type in free text field. 4. Click Accept to complete the note.

https://galaxy.epic.com/Handler/ImageHandler.ashx?filename=U:/Images/Denali/2000001To2100000/2096347.png

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Clinical providers have the ability to enter patient “notes” during

downtime – these notes can be seen by other providers and information

will cross over when systems come up.

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Using BCA Web to View Reports During a Level III and Level II downtime, you can use BCA Web to view/print all BCA downtime reports

from any computer.

View Department Information 4. Click Folder List in the BCA Web toolbar to view a list of departments 5. Click the appropriate link for your department/floor 6. From the list of reports that appears, click the report that you want to view to open it


List of available

folders may look

different – search

for your

department

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3. Outpatient BCA REPORTS During a network downtime when users are unable to log into the fast log in computers, users will use

the BCA Printing Application to view and print critical patient information from designated BCA

workstations. These workstations have a ‘Downtime BCA Device’ sign on the top of the monitor.

Using BCA Printing Application View/Print Reports

Log Into BCA PC 4. Contact the Comand Center to receive the password for the local user 5. At the Windows log in screen, enter the username EPIC-BCA and the password provided 6. At the Log on to prompt, select the computer name and click Ok

Log Into the BCA Printing Application 3. Double-click the icon for BCA Printing on your desktop

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4. Enter the same information you use to log into Hyperspace. Click Ok

Print All Available BCA Reports

3. Click Print and choose to print all reports in the table or on the PC at once 4. In the Print window that appears, select the printer to use in the Name field and click

Print


a. To preview a report, select the report that you want to view and click View b. To print one or more reports, select the reports and click Print … You can select

multiple reports by using CTRL + click c. Use the tag filters on the left side to choose groups of reports that you want to view

and print

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4. BCA WEB DATA ENTRY – ED Patient Access You can still access patient information during downtimes that can occur either as a planned part of an







Accessing SRO

7. Click the SRO icon on the desktop 8. Log in with your Epic hyperspace credentials 9. View information as normal in a view-only mode


Using BCA Web Data Entry During a Level III and Level II downtime, you can use BCA Web to enter new Admissions, Transfers, or

Discharges that occur during the downtime. This data will file back into Hyperspace when the system

comes back up.


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6. Enter the same information you use to log into Hyperspace; press Enter or click Log In




Patient Search/Creation 1. Search for existing patient in Support Read Only (SRO) 2. In BCA Web Data Entry, click Patient Search and enter patient’s Name, Birth Date,

and/or Sex. 3. If correct patient is found, in BCA Web Data Entry, click patient’s name and write MRN

on the blank facesheet 4. If correct patient is not found in BCA Web Data Entry, perform the following steps

a. If patient is found in SRO, obtain a downtime facesheet and write down existing patient MRN

i. Click Add Patient and enter existing demographic information including MRN

b. If patient is not found in SRO, obtain a downtime facesheet and downtime MRN.

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i. Click Add Patient and enter demographic information (populate fields that are followed by an * and additional demographic elements); enter downtime MRN; click Add Patient to continue workflow

5. In parallel to the above steps, populate patient’s demographic information on downtime facesheet

6. Once patient is found/created, you are brought to a screen that provides options to create new ED Arrival

Create New ED Arrival 1. Using the patient you just added, click Create New ED Arrival and populate fields to

arrive the patient 2. Downtime CSN will be auto-generated by BCA Web Data Entry

a. Every visit newly created via VCA Web Data Entry will have a downtime CSN auto-assigned from a pre-determined downtime number range

b. Write ato-assigned CSN on downtime facesheet c. Click Room/Admit to room patient

Discharge 1. Select a patient from a unit census or using Patient Search 2. Click Discharge

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3. Enter the information required to discharge the patient and click Discharge 4. Click Census and select the unit that you just discharged the patient from. Confirm

patient does not appear on the unit census.

Undo ED Arrival, Transfer, or Discharge created in BCA Web Data Entry

1. Select the patient who was just erroneously arrived, transferred and/or discharged using Patient Search or a unit census

2. Click Undo Last Event 3. Click Ok 4. Open the patient’’s home page and confirm that the transfer or discharge is undone.

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Using BCA Web to View Reports

View Department Information 7. Click Folder List in the BCA Web toolbar to view a list of departments 8. Click the appropriate department link 9. From the list of reports that appears, click the report that you want to view to open it


List of available

folders may look


for your

department

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5. BCA Web Data Entry – Patient Access You can still access patient information during downtimes that can occur either as a planned part of an









Using BCA Web Data Entry During a Level III and Level II downtime, you can use BCA Web to enter new Admissions, Transfers, and

Discharges that occur during the downtime. This data will file back into Hyperspace when the system

comes back up.


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2. Enter the same information you use to log into Hyperspace; press Enter or click Log In.


patient 3. In the search results, click the row for the patient to view additional information such as admission date and current location

Patient Search/Creation 1. Search for existing patient in Support Read Only (SRO) 2. In BCA Web Data Entry, click Patient Search and enter patient’s Name, Birth Date,

and/or Sex. 3. If correct patient is found, in BCA Web Data Entry, click patient’s name and write MRN

on the blank facesheet 4. If correct patient is not found in BCA Web Data Entry, perform the following steps

a. If patient is found in SRO, obtain a downtime facesheet and write down existing patient MRN

i. Click Add Patient and enter existing demographic information including MRN

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b. If patient is not found in SRO, obtain a downtime facesheet and downtime MRN. i. Click Add Patient and enter demographic information (populate fields

that are followed by an * and additional demographic elements); enter downtime MRN; click Add Patient to continue workflow

5. In parallel to the above steps, populate patient’s demographic information on downtime facesheet

6. Once patient is found/created, you are brought to a screen that provides options to create new Admission

Admit a Patient 1. Search for and select the patient’s record 2. Click Create New Admission 3. Complete information about the patient’s admission and click Admit. The patient is

admitted.

Every visit newly created via BCA Web Data Entry will have a downtime CSN auto-assigned from a pre-determined downtime number range.

4. Click Census and select the unit to which you just admitted the patient to confirm patient appears on unit census as expected

Arrive Existing Pre-Admission 1. Search for and select the patient who had a pending admission prior to downtime. 2. Complete information about the patient’s admission and click Admit

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3. Click Census and select the unit to which you just admitted the patient to confirm patient appears on unit census as expected.

Transfer a Patient 1. Select patient from a unit census or using Patient Search 2. Click Transfer under the patient’s current encounter heading 3. Enter information required to transfer the patient and click Transfer 4. Click Census and select the unit to where you just transferred the patient. Confirm the

patient appears on the unit census as expected.

Discharge a Patient

1. Select patient from a unit census or using Patient Search. 2. Click Discharge. 3. Enter the information required to discharge the patient and click Discharge. 4. Click Census and select the unit that you just discharged the patient from. Confirm that

the patient does not appear on the unit census.

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Undo an Admission/Transfer/Discharge If an admission, transfer or discharge was completed by mistake within BCA Web Data Entry, use the

Undo Last Event to undo the action.

1. Select the patient who was erroneously admitted, transferred or discharged (using Patient Search or a unit census).

2. Click Undo Last Event. 3. Click OK. 4. Open the patient’s home page and confirm that the admission no longer appears or the

transfer/discharge is undone.

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Labor and Delivery

Scenarios If newborn is delivered during downtime but was Pending prior to downtime:

1. Do not enter any information into BCA Web. Take note of time baby was delivered. 2. During recovery, admit existing pending baby with delivery time in Hyperspace

If mother presents during downtime, but delivers after downtime:

1. Click Patient Search in BCA Web and input mother’s information (use information from SRO if mother is existing patient)

2. Add mother to BCA Web following instructions from the Admit a Patient section above 3. Select L&D unit as department. Select patient class of ‘Outpatient’ 4. After downtime, verify in Epic that mother came through with ‘L&D Assessment’ status

and update status if necessary in Hyperspace.

If mother presents during downtime and delivers during downtime:

1. Click Patient Search in BCA Web and input mother’s information (uses information from SRO if mother is existing patient).

2. Add mother to BCA Web following instrucitons from the Admit a Patient section above 3. Select L&D unit as department. Select patient class of ‘Outpatient’. 4. Take note of time baby was delivered; do not enter any information for the baby in BCA

Web. 5. After downtime, change mother’s patient class to ‘Inpatient’ and set OB status to ‘Yes’

in Hyperspace. 6. Deliver baby off the mother in Hyperspace.

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Using BCA Web to View Reports

View Department Information 1. Click Folder List in the BCA Web toolbar to view a list of departments 2. Click the appropriate department link 3. From the list of reports that appears, click the report that you want to view to open

it


List of available

folders may look


for your

department

quick guide to applications: impact of downtime · quick guide to applications: impact of downtime...

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