Chronicles Navigation

• Name of the database upon which all Epic applications are built. 
• All Epic applications access the data in Chronicles.

EPT file

• Patient Master File- patients information is stored in this file
• Each record has questions (items) to capture info about patients (values)

SER

• Provider master file
• Records in this master file are needed for any person or thing (modality, lab, etc.) that needs to be scheduled with patients, has credentials, can write or authorize orders, or can write referrals.

EAP

Facility (EAF)

• Epic uses the term to mean your entire organization.
• There is always one—and only one—facility record, and 
• It’s always record #1 in the Facility (EAF) master file
• Comprised of single or multiple service areas which are all linked to the facility

Service Area

• represent separate business entities within your organization
• Each service area tracks accounts receivable separately. 
• This level in the hierarchy exists mainly for the purposes of Epic’s billing applications.
• Mechanism to limit individual locations from accessing other locations’ confidential information (such as revenue data) while sharing facilitywide information (such as patient data).

Revenue Locations

• Represent clinics and hospitals. 
• Revenue locations (also known as simply “locations”) represent the level in the facility structure where revenue is generated and tracked. 
• They are usually comprised of multiple departments.

Departments

• It defines where services are rendered.
• Many imaging reports and documentation tools are department-based.
• When a user logs in to the system, she is logging in to a department.
• Provider and resource schedules are associated with departments.
• User security can be controlled at the department level.

How does the department influence the Radiant workflows?

The department influences the Radiant and Cupid workflows in several ways:

• It defines where services are rendered.
• Many imaging reports and documentation tools are department-based.
• When a user logs in to the system, they log in to a department.
• Provider and resource schedules are associated with departments.
• User security can be controlled at the department level.

Centers

• This field can be used to group geographically close departments for scheduling purposes.
• A center has no revenue implications and is a tool for grouping departments.
• Centers aren’t records; they’re values on a category list (DEP 100). 
• To create one, you simply add a new value to the category list. You can then specify your newly-created center in any department records you want to group together.

DEP

Department master file

Department Information Screen (text)

How can the 'Specialty' field be used? 

• This category list can be used in reporting and to limit which visit types can be scheduled in this department.
• When building visit types, you can restrict scheduling by specialty.

• For Radiant the field is designated as Radiology

Department Information Screen (text)

How is the 'Center' field used?

• This field links the department to a specific center.
• Can be used to group geographically close departments for scheduling purposes. 
• A center has no revenue implications and is a tool for grouping departments. 

Example: If you want the users to have access to EMH Radiology 

Radiology/Cardiology Filter Settings

(Department Text)

• This screen controls which users can be listed as: User type for technologists & supporting staff, and Specialty for physicians in the Staff Info section of the End Exam Navigator.
• There is a field in the user record which defines the type of user. 
• If filters are turned on, the system only allows those whose user record type matches that set on this screen to be listed in End Exam.

Department Information Screen 2 (text)

Revenue Locaton field: 

• This key field links the department to a location in the facility structure.
• Once this is set, you cannot change it from this screen. 
• Reason: changing this field after go-live can affect the revenue stream, this field becomes read-only after it is set on this screen.

Department (text)

Release of Blocks

Department (text)

Context-based Charging screen

• to set up charging for procedures performed in this department, you need to designate which steps in workflow trigger technical fees & professional fees.
• Established in clinical system definitions, the service area, the revenue location, or the department record.
• This is where you enter the workflow context at which charges should be triggered in this department. The context options are: 

 Imaging end exam  
 Imaging result study  

 Invasive Procedure Log Complete

Then fees are set at Pro, Tech, or Global level.

Radiology/Cardiology Settings screen

(Department Text)

• This screen is where reading pools can be linked. 
• If a study has not been assigned to a specific pool or physician, it will be assigned to those listed in the Master Pool. 
• This may be overridden for visit types listed in Master Pool Overrides or by linking a reading pool in a specific procedure or category of procedures.

Provider Master File (SER)

When order is placed what happens?

1. Radiant looks for authorizing provider based on item in SER
2. To schedule an order, provider record needs to be active for scheduling in dept.
3. For results sent SER helps determine who receives it.
4. Additionally, records must be built in SER for imaging modalities so pts. can be scheduled.

Providers

The Big Picture:

Provider master file affects what steps in the imaging workflow?

1. An order is placed, Radiant looks for an authorizing provider, which is based on an item in the Provider master file. 
2. To schedule an order, the provider record needs to be active for scheduling in the department in which the appointment is to take place
3. The results are sent, the Provider master file is used to help determine who should receive those results
4. Records must be built in the Provider master file for imaging modalities so patients can be scheduled for exams

Creating Provider Records

(Criteria)

Anyone or anything that meets at least one of the following conditions needs his/her/its own provider record:

             Orders or authorizes orders

               Refers or is referred to

                  Credentialed or has a specialty/discipline

                     Schedulable

ORCS

Provider Information Screen (text)

This screen captures basic information about providers

1. Provider type: This information indicates the type of practioner the provider is. This helps filter information on reports. This is not a required field.
2. Resident:
3. Ref Src Type: Indicate whether this provider should be a referral source. That is, can patients be referred from this provider?
4. Specialty
5. Status: If blank, active is assumed

Provider/Resource Information Screen

• Screen sets up which type of provider this is for scheduling purposes
• Which departments a provider can be scheduled in, and physicians’ reading roles.
• For residents, this screen allows linking a supervising pool for reading studies and a number of approvals needed for studies.

Proxy Provider Information Screen

The middle section of this screen is where 

• A provider can be configured as an authorizing provider for medication orders and/or procedure orders. 
• In imaging workflows, an authorizing provider can be found in the Provider field in Ancillary Orders.
• A provider can be the authorizing provider for medications, procedures, and other orders in workflows carried out by the care team for a patient.

Provider/Resource Info. screen (text)

Scheduling Type (modality)

• The type of record: Person, Resource,or Class.
• It must be a type of Resource to be able to enter a modality type.
• On this screen, you define in which departments your modality can be scheduled.
• There are also some key differences between human and non-human providers, including choosing a scheduling type other than Person and the ability to specify a modality type.

Provider/Resource Info. screen (text)

Modality Type

Facts:

• The Technologist Work List will only display appointments for modalities that have a Modality Type listed in their provider record. 
• Therefore, if the Modality Type field is left blank, no appointments for that provider will appear for the technologists.
• This field is only available if the Scheduling Type is set to Resource. 
• This field is used to filter the Technologist Work List.

Pool Master File

Reading, Scheduling, & Supervising

• Each type of pool record is built exactly the same;
• There is no setting in the pool record that determines which type of pool it is. 
• The important thing to understand about building pools is this: where the pool is linked determines the type of pool it is.
• At which level the pool is linked will depend on how physicians at your organization do their resulting.
• Automatic assignment of studies to pools of providers is at the department, procedure category, or procedure level
• Linking at proc. cat or procedure level allows more specifity.

Reading Pools

Peform two tasks in pool record:

1. Make the record active
2. List the provider (SER) records that should be included

• Reading pools can also be set in procedure or procedure category records which overrides settings made in the department.

Scheduling Pool

• a scheduling pool can either be a group of human providers or a group of non-human providers (modalities, rooms, etc.) for scheduling.
• Setting "sort by availibility" to Yes tells the Auto Scheduler to sort the providers in the pool by most available. Distributes workload.
• Randomize: determines whether or not the providers in this pool will be randomized when they are loaded into the Auto Scheduler.
• Yes, the providers will be randomized when loaded into the Auto Scheduler.
• No, the providers will be loaded into the Auto Scheduler in the same order that they are entered.

Linking Pools

• All pools contain a list of Provider (SER) records and can become any type of pool depending on where they are linked.

1. A reading pool is linked in the Department, Procedure Category, or Procedure record.
2. A Supervising Pool is linked in the Provider record.
3. A Scheduling Pool is linked in the Visit Type record 

• Reading and supervising pools should always contain human providers,
• Scheduling pool contains human providers or modalities.
• Linking your pool to dept. indicates all studies performed in department should be sent to this pool of providers
• Unless that study has a specific reading pool specified in the procedure category or procedure records.

ORT

• Order Resource Types Master file
• Allow organizations to specify a max. # available of provider types to avoid overbooking, across departments or physical locations. 
• Specific providers can be assigned to the appointment at any time, based on the workflow of your organization.
• Resource types are values on a category list. 
• Created in a different way than most category lists are. 
• Tied to resource type records in a master file (ORT)

Resource Types (ORT)

The Big Picture

In radiology

• Same nurses may be needed to help patients during CT guided biopsies and interventional radiology procedures. 
• In Epic, you’d create one resource type of Radiology Nurse, then specify that one of those nurses is required for CT biopsy appointments (in the visit type record), and all procedures done in IR (in the department record). 
• Individual providers who perform that function would have the resource type linked in her provider record.

Who and where are typical resource types used?

When scheduling:

• Nurses for particular types of exams
• Radiologists for particular types of radiology exams
• Cardiologists for particular types of cardiology exams
• Technologists if you have more modalities than techs
• Anesthesiologists across departments
• Shared equipment

What are important ORT workflow benefits?

Allows departments to perform conflict checking:

1. Within one department 
2. Across multiple areas of the hospital
3. Or even multiple facilities that share resources

What are three main build steps for creating and using ORT resource records, which include staff and equipment?

1. Create resource types and define availability.
2. Specify which resources are needed for particular visit types or departments.
3. Specify resource type in appropriate provider records.

What does an ORT control?

1. Adds the resource type to the resource type category list.
2. Defines how many simultaneous appointments or cases requiring this resource type can be scheduled.
3. Defines how many simultaneous appointments or cases each individual of this resource type can be assigned to.

Where do you create a record for any resources used in radiology or cardiology, including staff and equipment?

• The Resource Types (ORT) master file 
• This master file stores information about the types of resources you have at your organization, not the individuals.
• For example, if you have nurses on staff, you would create one ORT record called “Nurse” that represents a single type of resource.
• You wouldn’t list the names of the actual nurses you have on staff here– that is done in the provider record (SER).

How do you create your own resource type?

To create an ORT record from scratch. To do this:

1. Log in as your administrator.

2. Use Chart Search to find Resource Types.

3. Select the Create tab.

4. In the Name field, enter “<Your Initials> ????.”

5. In the Type field, enter “Staff.”

6. Click Accept.

You can do this for other resource types as well.

Why is important to define the total number of available resources?

• Allows Radiant to complete conflict checking during appointment (and case) scheduling.
• Ensures you don’t schedule more appointments than have resources of that type available

For example: If you have ten nurses on staff at your hospital, but only 4 of them are on shift at any given time, your availability form for nurses should have 4 openings

Hyperspace

The Availibility form (within ORT) allows you to define ... hint 4 things?

1. Whether this type of resource is available for cases only, for appointments only, or for both.
2. Whether or not you want the system to let you know if you’ve run out of this type of resource. 
3. Which areas of your hospital share this resource type.
4. How many resources of this type you have available at one time in each area of your hospital.

For example: If you have 4 nurses and you’ve
scheduled 5 simultaneous appointments requiring nurses, you want the system to warn you when you schedule that 5th appointment.

ORT Availibility Form Terms:

Perform conflict checking while scheduling ths resource

• Select this check box for resources that are at risk of being overbooked.
• This allows the system to make sure you don’t schedule more simultaneous cases or appointments than you have resources available

ORT Availibility Form Terms:

Show area limits

Select this check box to do conflict checking between

locations and departments that share resources.

For example: If you have 4 nurses on shift that float between the cath lab, non-invasive cardiology and the IR, selecting this check box allows you to be sure that no more than 4 nurses can be required in simultaneous appointments or cases scheduled across all three of these areas.

ORT Availibility Form Terms:

Overbooks

• Some resources might have emergency resources that can be pulled in.
• Use this field to allow those with security to overbook the resource.

For example: If you always have 4 nurses working at one time, but there is a 5th that could be called in when needed, enter “4” in the Openings field and “1” in the Overbooks field.

How do you link a Resource Type to a Provider?

• Easy to find in Hyperspace.
• Using Chart Search, search for “Edit Provider” and open the appropriate provider record.
• The Resource Type(s) is specified on the Resource Types form. 
• You can specify one or more types that this provider should be considered.

Explain the general settings of the Visit Type master file:

General Form

1. First form in a Visit Type record
2. Where the abbreviation and status of the visit type are configured. 
3. Abbreviation will appear on several work lists as well as some reports. 
4. Default length - indicates the time, in minutes, of the usual study length
5. Remember - An inactive visit type cannot be scheduled.

Advanced Visit Types

What happens when you say 'yes' to 'Use Advanced?'

Set this to Yes to enable options such as:

• Scheduling with pools
• Controlling the sequence of visit types
• Restricting scheduling based on potential interaction with other procedures

Explain the general settings of the Visit Type master file:

Instructions Form

• Scheduling Instructions: Use these lines to instruct the scheduler on any special information for scheduling this visit type.
• Patient Instructions: These lines are for instructions to the patient
• You can also include these instructions in letters that you send to patients.
• These instructions appear in two different places during the scheduling workflow.
• The Scheduling instructions appear in the Make Appointment activity before the appointment has been scheduled.
• The Patient instructions appear after an appointment time has been selected in theAppointment Review window.

Explain the general settings of the Visit Type master file:

Restrictions Form

• This form allows you to restrict where this visit type can be scheduled. 
• You can restrict scheduling based on the login department, or who is actually scheduling it.
• Specialty Restrictions - restricts WHERE a Visit Type can be scheduled- "Can Schedule with all others" should be set to Not Allowed.
• Security Classification Restrictions - restricts WHO can schedule a Visit Type

Explain the general settings of the Visit Type master file:

After VT Entry 

• To define questionnaires that appear to schedulers when scheduling a specific visit type.
• Questionnaires are configurable and gather additional information required for the visit.
• Can also be used to alter or prevent the scheduling of the visit based on the answers to the questions provided
• Selection Action: options are custom form, extension only, questionnaire, scheduling code 

Explain the general settings of the Visit Type master file:

Advanced Form

• Defines more complex information about an appointment 

• Including the times during which it can be scheduled and agents (such as contrast) used in the procedure that may conflict with other procedures scheduled for the patient.

• Additionally, you can define pools of providers/modalities to schedule the appointment

Advanced Form  Abbrev.- Visit Type

VTM, SLT, PRIM, OFF#, LEN#

VTM = visit type modifier length-(most common, recommended method for primary pools): tells system to use the visit type’s default length unless modified times have been specified for individual provider records.

SLT = slot length

PRIM = length of first pool -For secondary pools, the system uses the length specified for the primary pool.

OFF# = offset of specified pool-where # is the line number of another pool for the visit type. The system uses this pool’s offset as the pool’s length.

LEN# = length of specified pool-where # is the line number of another pool for the visit type. The system uses this pool’s length for the pool’s length.

Explain the general settings of the Visit Type master file:

• The setting that determines how the Auto Scheduler searches for availability is called the search method
• Found on the Restrictions form 
• Search method can be either horizontal or vertical.
• A horizontal search method is most common and searches for the earliest time slot across all providers before advancing to the next time slot.
• A vertical search method searches from beginning to end of the day for one provider before checking the availability for another provider in the pool

Explain the general settings of the Visit Type master file:

Additional Resources Form

• If a visit type always needs a certain resource type to be assigned at scheduling, 
• Save time for your front desk users and let the system add the resource request to the appointment.

For example: If IR sedation appointments always require a sedation nurse, you can allow the system to create the request for a sedation nurse.

• can set up automatic resource requests for specific departments or specific visit types.
• can also use rules to include or exclude patients who meet certain criteria from automatically having certain resource types assigned. 

For example: you could configure the system to only assign a sedation nurse for pediatric patients.

Procedure Category Master File

• Exists to group together similar procedures and store information shared between them. 
• Every procedure must be linked to a procedure category
• The system always searches the procedure record first, but when an item is left blank at the procedure level, the system uses the value set in the procedure category. 
• The majority of settings made in the individual procedure will override the settings in the procedure category.

Why check the procedure category first before creating a new procedure?

• The system searches the individual procedure before the category. 
• Once a value is found, the system stops searching (with only a few exceptions). 
• Because of this, if a value is specified in both the procedure and procedure category the system uses the value set in the procedure.

Radiology/Cardiology Options 2

What setting allows the radiologist to have the correct protocoling options?

• SmartForm Protocols field example “RIS CT CHEST.”

• This setting ensures the physician will have the correct protocoling options available.

Procedure only settings are.....

Procedure ONLY Settings

Code

Charge Code

Procedure Type

Synonyms

Anatomical Regions

Supplies

Reading Macros

Procedure and Procedure Category

Settings are....

Order Type

Default Order Class

Default Priority

Begin/End Exam Questionnaires

Order Specific Questions

Protocols

Navigator topics

Combine Procedures when Scheduling

Visit Type

Procedure Category Setup Screen:

EpicCare Order Type:

The order type that describes the kind of resources
involved with this procedure category.

Allowed Order Classes:

• Indicate which order classes are allowed for procedures in this procedure category.
• Order class determines where in the facility a given order will be handled (Radiant typically uses Ancillary Performed or Hospital Performed).

Procedure Category Specific Questions (screen)

• The questions listed for outpatients and inpatients behave independently from one another. If a question needs to be asked in both scenarios it must be listed in both fields.
• Each procedure linked to this procedure category can specify whether these questions should be overridden.

Procedures (screen):

Visit Types

• This link is what allows the order to appear in Radiant and Cupid (on the Snapboard Depot) and be scheduled.
• Typically set at the procedure level because each procedure may require own scheduling setup
• Common to have VT linked in category as backup

Can you dentify the record in which reading macros can be linked?

Text- Procedure screen-

Radiology/Cardiology Options 3 

• Enter the reading macro(s) to appear on the reading palette toolbar for one-click results.
• Listing a reading macro here will add the procedure in the macro record, and vice versa.

Procedures (screen):

Radiology/ Cardiology Options

• Configure Hyperspace to display questionnaires for specific procedures at both Begin and End Exam
• Also attach a Study Review Advantage Activity record (HAA) which controls the configuration of the physician’s reading palette when a procedure linked to this category is resulted.
• If HAA left blank at all levels, then default Study Review is used.

Procedures (screen):

Radiology/ Cardiology Options 2

• Allows for configuration of protocols and productivity tracking, although these fields are more commonly used at the procedure level. 
• The Foundation System has the medication preference list used for the automatic ordering functionality attached in the procedure category.
• Items listed are Protocol Category, Protocol Meds, SmartForm Protocols, and Productivity Tracking

Can you identify where a protocol meds preference list is linked in text?

• Procedure Category –Radiology/Cardiology Options 2 Screen

• Protocol Meds Medications on the preference list entered here will be available for ordering from the Protocol Work List for orders of this procedure category.

Procedures (screen):

Radiology/ Cardiology Options 3

• If a certain number of signatures should be required by a different specialty, the Radiology/Cardiology Options 3 screen can be used to configure this. Any
• Required signatures listed on this page must be given to a study before it can have a status of final.

Procedures (screen):

Radiology/ Cardiology Options 5

• Setting the modality type allows you to associate historical procedures with a certain type of modality (since they may have been scheduled outside of your organization and were not scheduled to a modality with a record in Epic). 
• Also allows print groups in reports that show a patient’s relevant prior exams. 
• Print group is often used in the Reading Palette so that radiologists can see prior exams for the patient without leaving the Reading Palette activity.

Visit Type Screen

Radiology/Cardiology Advantage Activities

• The Show UI for Activity field on this screen determines whether the begin and end exam activities appear if no begin or end exam questionnaire is defined for an exam.
• For example: If you enter Begin Exam in this field, and do not have an End Exam questionnaire configured for your exam, the End Exam navigator does not appear
• Specify a navigator template and procedure topic for Begin and End Exam at the visit type level.

Visit Type Screen

Radiology/Cardiology Advantage Activities:

Show UI for Activity

• Begin Exam: By default, only the Begin Exam navigator opens.
• End Exam: By default, only the End Exam navigator opens. Because most technologists document after the exam is completed, this option is the most common.
• Both: By default, show both the Begin Exam and End Exam navigators.
• None: By default, show neither the Begin Exam nor End Exam navigators.
• A blank field defaults to 'None'

Advanced Visit Types

(text)

Show UI for Activity

If tech can't see begin & end exam navigators what is missing in setup?

Show UI (user interface) needs to be set to Both.

(in visit type build, under tech workflow)

The Big Picture:

Schedules

• For patients to schedule imaging appointments, providers and modalities require schedules.
• In Epic, a template is a schedule for a provider in a department.

Steps for defining a scheduling pattern?

• The first step is to define to which week and which days of that week this pattern will be applied.
• Next time slots should be defined which includes begin time, end time, slot length, #open, and #overbook
• note: End users must have the correct security to schedule into overbook slots.

Schedules

Creating a Template using Patterns:

Two ways to build a template:

• Using a pattern with the Edit Pattern activity or Manually create a template
• Useful for providers with same weekly schedule or multiple providers
• Patterns are not provider specific
• Think of them as stamps, stamping out a schedule

Schedules

Restrict Time Slots: Cadence Security

• Only allow overbooks (ex: # Open: 0, # Overbook: 1). Users must have the overbook Cadence security point to schedule into these slots.
• Apply a block
• Set time range as private time by de-selecting the Public slot check box. Users must have Cadence private access security in the department to schedule in these slots.
• Make the time range unavailable by entering an Unavailable reason. Users must have an override Cadence security point to schedule into these slots.
• Delete the time range all together (the time is removed from the schedule). Users must have an override Cadence security point to schedule into these slots.

Scheduleing -

Edit Pattern

• In the Edit Pattern activity, you can define time ranges and slots on which the pattern is based. 
• Patterns are generic and are not associated with date ranges, departments, or providers. 
• They will be applied repeatedly to stamp out a schedule. Because patterns are not provider specific, they can be reused for multiple provider schedules.

Schedules

Apply Patterns to Provider's Template and Set Defaults

• You create templates in the Provider Pattern activity.
• It is a powerful tool that allows you to apply patterns directly to the provider template for specific date ranges, as well as set up automatic template extension according to the patterns you apply
• The defaults that must be set answer three questions:

1. What is the default slot length of a specific provider’s schedule?
2. Does the provider allow overbooking?
3. How far into the future does the provider allow scheduling?

Schedules

EPIC Terms:

release date, template date range, & release date offset

• Release date is the last date on which appointments may be scheduled. The schedule is released, or available, for scheduling until the release date. 
• Release date offset slides the release date forward in time. Using this setting, the system moves the release date forward.
• Template date range is all of the template that is available. Like the release date, the template date range will also end on a specific calendar date.

Schedules

Automatic Template Extension

• Similar to release date offset, automatic extensions ensure that the template will never run out.
• Automatic extension adds additional time to the template when there is less than a defined amount of template remaining.
• The Set Default fields allow you to set a default date range and set up automatic template extension using the existing patterns.

Blocks:

Patient Level Blocks

• Blocks reserved for specific types of patients are commonly referred to as patient level blocks.
• Examples of patient-level blocks include Inpatient, Confidential, and Employee.

Blocks:

Visit Type Blocks

• Blocks reserved for specific types of visits are referred to as visit type blocks. 

• Examples of visit type blocks include Fasting Exams and Same Day Visits.
• Visit level blocks are stricter than Patient level blocks

Blocks:

Unused  Blocks

• Releasing blocks that go unused or changing them to another block. 
• Example: If a slot reserved for a certain type of appointment, such as a barium swallow, is not used by a certain time, you may choose to have the block change to another block, such as a same day, or you can choose to remove the block from the slot entirely.

Blocks:

Patient vs Visit Type Blocks

• Patient level blocks keep the wrong kinds of patients out. 
• In other words, if you create a block of time for inpatients, you can schedule only inpatients during that time; if you try to schedule an outpatient, you’ll encounter a warning (which you can bypass with overrule security).
• However, you can also schedule inpatients during other times of the day.
• Visit type blocks are more restrictive; a visit type associated with a block can be scheduled only into that block and not anywhere else (unless a user has overrule security). 
• That is, visit type blocks keep the right type of appointment in the blocked slots.

Block Factoids

1. Before you can begin working with blocks, they must first be created in the block category list.
2. The block category list can be edited in the Category List Maintenance activity in Hyperspace. 
3. The block category list is item 60 in the Provider master file.
4. Only one person can add to a particular category list at one time.

Block Factoids

Visit Type (VT) Blocks

• Prevent appointments of that visit type from being scheduled into time without the appropriate block.
• You link a visit type to a block on the Block Types screen in the visit type record.
• You will see this screen only if the Restrict Visit Types by Block field in Cadence System Definitions is set to Yes.

Questions and Questionnaires

Building Questions

Two main types - Form and Order-Speific

Two tools to build questions and questionnaires:

the Question Editor and the Questionnaire Editor

1. Order-Specific questions appear when placing an order in Ancillary Orders or Order Entry. 
2. Form questions appear during scheduling or in the Begin or End Exam navigator. 
3. Form questions are also the building blocks for questionnaires.

Building Order Specific Questions:

What do order-specific questions allow users to do?

Order-Specific questions allow users to answer questions before an order is

placed in the system.

Building Order Specific Questions:

What does it allow users to enter?

The Order-Specific Question Editor allows you to enter the details of the question: 

• what should appear
• whether or not the question should be advised
• which patients the question should be asked.

Building Order Specific Questions:

What happens when the question is marked 'adviced'?

• Marking the question as Advised means that the question will either be 
• required (a red stop sign will appear in the field) or 
• recommended (a yellow yield sign will appear in the field). 
• The system will look to the user’s profile to determine which should appear.

Order -Specific Questions 

Facts about linking to procedure or procedure category:

• Must be linked to a procedure or procedure category to appear in Hyperspace. 
• Remember that within the procedure record, questions are the exception for the override relationship: Questions listed in the individual procedure will be added to questions listed in the category unless the Override Procedure Category Questions field is set to “Yes”. 
• If the same question record is listed in both places, it displays only once.
• Linking in Procedure Category can effect all procedures linked to it.

Building Form Questions

• Similar requirements to Order-Specific Questions
• Must be released to be available
• No advised field, must check required to make it manditoy

What are the three types of common questionnaires and when do they appear?

1. Visit Type questionnaires - during scheduling
2. Imaging Order questionnaires - Begin Exam and/or End Exam navigators & appears for each order
3. Imaging Appointment questionnaires - Begin Exam and/or End Exam navigators & appears once per appointment

Like questions, the type of questionnaire determines

where it appears in Hyperspace.

Where are the three questionnaire types linked?

1. Visit type: questionnaires are linked in the Visit Type Master File- in visit type record in Hyperspace
2. Order type: questionnaires are linked in the Procedure or Procedure Category master files - (text) on Radiology/Cardiology options screen
3. Appointment type: questionnaires are linked in the Visit Type master file -must be linked to a visit type record in text -on Radiology/Cardiology screen

Supplies and Implants

What is the difference in EPIC between Inventory Items, Implants, and Instruments?

• Inventory items or supplies are your consumable supplies. This would include things like sutures, drapes, linens, blades, needles, sheaths, guide wires, needles, and catheters. 
• Similar to inventory items, implants are sterile and consumable. This includes items like pacemakers. 
• In Epic, reusable items that are sterilized between uses are built as instruments.

Building Supplies

When building supplies in the Inventory Items (SUP) master file, you are able to?

1. Specify a clear naming convention
2. Allow for a single supply to link to different chargeables based on location
3. Specify a lot number and expiration date
4. Make sure your supply is compatible with barcoding.

Implants vs. Implantables

• Distinction is made between the supply that you have on hand (implantable), and the actual device that is placed in a patient (implant).
• Implantables are the generic items that you may use during an invasive procedure.
• They are supplies in the Inventory Item master file (SUP) and are typically created by members of the project team. 
• Implants are actual devices, implanted into patients, exist in the Implants master file (IMP).
• Implant records are usually created by documenter in the Procedure Log when they document that a device has been implanted.

Big Picture for

Security Classes and Users

User (EMP) 

1. Provider (if necessary) (SER)
2. User Template (EMP)

User Role (E2R)

Profile (LPR)

Security Classes (ECL)

-General Procedural

-Radiology

-Cardiology

-Cadence

-EpicCare

-EpicCare Inpatient

-In Basket

-Shared etc.

General Security Class Build

• The security points in the General Procedural security class are permissive, which means they grant users access to features or functionality rather than restricting access. 
• When building security classifications, therefore, you list security points for the functionality that each group should be able to access

Report Security section

There are four levels of report security:

• Administrator: Allows you to create and edit both columns and public report settings.
• Power User: Allows you to create and edit both columns and private report settings but not public ones.
• User (with edit): Allows you to change settings on existing private and public report settings, but you cannot save them permanently. You cannot edit columns, nor can you add or remove columns from existing reports.
• User (no edit): Allows you read-only access to existing report settings

EpicCare Security Class

• The EpicCare security class contains security points shared across Epic’s clinical applications. 
• It also contains all of the security points specific to EpicCare Ambulatory. 
• For imaging users, common uses for EpicCare security include entering orders, editing results in Enter/Edit Results, and accessing patient charts.

Candence Security Classes

How are they built differently?

• Cadence security classes are built differently than other security classes. 
• You enter “Yes” for each security point that a user with this security class should have, and “No” for any that they shouldn’t have.

Results Routing

Row Logic

• Results routing starts by evaluating row one first. If no match is found, it continues looking in order of the row number until all the conditions of a row are matched by the result. 
• When it matches, it follows the directive (In Basket Recipients).
• If you put too general of criteria in a row above more specific criteria, results are usually not routed appropriately.

If no row can be satisfied, the result is sent to the default recipients.

Results Routing Hierarchy

Once the scheme has been configured, it must be linked to one of three levels to take effect. The three levels are:

 Provider

 Department

 Clinical System Definitions

• The system looks to the authorizing provider’s provider record first to determine if a results routing scheme is entered. 
• If a scheme is listed here, that is the scheme the system uses.

Procedure (text)

Radiology/Cardiology option 3

Reading Macros Enter the reading macro(s) to appear on the reading palette

toolbar for one-click results.

Listing a reading macro here will add the procedure in the

macro record, and vice versa.