5 tricks to chart quicker in Epic
Our MD Tech Tip article this week is find out how to chart quicker in Epic. We’re not going to bore you with a number of dot phrases or macros for our PE or ROS. Everybody is aware of that. I train our residents on find out how to chart quicker and be extra environment friendly on shift. Via hours of lectures I’ve given them, I’ve tweaked my instruction accordingly based mostly on suggestions I’ve gotten with what works and what doesn’t. Whereas the lecture and directions I give are extra detailed and nuance, there are 5 key takeaways I needed to current that may make your subsequent medical day extra environment friendly. Particularly, I deal with information gaps I’ve seen in senior residents when studying find out how to chart. Whereas a number of the following would possibly seem like delicate workflow modifications, they’ll yield vital effectivity good points.
Sickness HPI type
Use the “Sickness” template in Epic. Many have no idea about this. When doing charts within the Emergency room or clinic setting, use the sickness tab to pre-populate your HPI. I’ve discovered that utilizing Epic’s customized HPI types truly take for much longer. Manner too many clicks and variations. So for that belly ache affected person, think about using the “Sickness” HPI type as an alternative of “belly ache”. The Sickness type has an empty clean for “location”, “high quality”, “context”, and different key parts. Severity, onset and length have simple buttons to populate on this template. That is nice as a result of it offers you the factors you want in your degree of service to be excessive (1-5). I can’t emphasize this manner sufficient. It’s a small factor, however makes your HPI a lot quicker over time. I first fill out the “Sickness” type, after which will leap into the Narrative field and can dictate just a few traces accordingly. Complete time utilizing this setup to finish your HPI is lower than a minute.
Dictate, dictate, dictate (actual time)
You probably have the flexibility to dictate, dictate. Actual time dictation is the most effective. Transcription shouldn’t be splendid. For my part, having to attend for a transcription service after which overview it for accuracy hours later shouldn’t be environment friendly. Dragon actual time dictation has been a life changer. I’m solely annoyed that I didn’t use it sooner when it was accessible. If you’re not conversant in actual time dictation, it’s the potential to make use of a dictation software program, comparable to Dragon dictation, along side the EHR. For my setup, actual time dragon dictation is constructed proper into epic, and we have now energy mics that permit us to dictate on the press of a button proper into the chart. You possibly can even put in orders with the assistance of dictation.
I’m a kind of millennials who grew up on keyboards and was very pleased with my phrases per minute. Due to this, I assumed that I might at all times maintain typing quicker than I might dictate. For a full 12 months that our hospital turned on dictation I refused to modify over, feeling that I might sort quicker. Lastly, a fellow college member satisfied me to at the very least simply give it a attempt to it was a whole life changer. I’m not exaggerating in any respect. I discovered myself having the ability to save about an hour per shift of charting, and actual time dictation has saved me lots of of hours of my life that I might have in any other case spent typing. I used to be in a position to attest residents charts and in addition do particular person affected person charts a lot quicker. Publish switching over to actual time dictation, I used to be in a position to end charts rather more simply on shift and have virtually each chart finished previous to the tip of a shift. In case you’re a kind of that hasn’t converted to actual time dictation, please do. In case you’re at a system that doesn’t have actual time dictation accessible, push for it. You’ll get help out of your administration just by saying it’s going to assist get charts finished quicker in order that insurance coverage can billed sooner. In case your hospital needs to do one thing about morale, that is a straightforward lever they’ll pull.
Reduce your dot phrases
Set up your medical determination making(MDM) with a common dot phrase. The extra common you might be the higher. I’ve seen suppliers with greater than 20 dot phrases for customized MDMs. I’m unclear how that helps with effectivity. The extra customization you’re doing together with your chart, the extra time and complexity you’re including. Preserve it easy (not at all times attainable with some sufferers, I get it).
My common dot phrase for my MDM is the next:
ER supplier interpretation of Imaging / Radiology:
ER supplier interpretation of EKG:ER supplier interpretation of Labs:
@EDLABS@
@WETREAD@Differentials thought of:
Key drugs administered within the ER: @EDMEDS@
Medical Resolution Making:
Key discharge directions:
Clearly, arrange your common dot phrase in your medical determination making or evaluation and plan accordingly. No matter you resolve, simply be sure you are conserving it common. It’s a lot simpler to go and delete sure components of your common dot phrase than creating a number of variations. Once more, cut back muddle and complexity.
Use floating home windows
Many suppliers don’t find out about Epic’s floating home windows choice. After I train this to my senior residents, many come again and inform me that is the characteristic that helps them essentially the most. This characteristic solely works properly when you have got a two monitor arrange. When enabled, floating home windows are an effective way to optimize charting by permitting you to multitask and in addition citing an incomplete observe each time you’re in a affected person chart. To entry floating home windows, go to your observe author. On the “edit observe” tab that reveals up, you’ll see a tiny downward pointing arrow, click on this and also you’ll see the choice for “transfer to floating window”. This permits your observe to point out up on a separate monitor, permitting you to do extra chart overview whilst you’re filling out your observe.
My favourite effectivity characteristic from that is that when it’s enabled, each time you open the sufferers chart, your observe pops up if in case you have not pended it or accomplished it. It’s a relentless reminder to complete your observe or replace it.
Be certain that your entire “wrenches” are optimized!
Epic has tiny wrenches all through a lot of the screens you’re in. These wrenches are essential as a result of they help you customise each display and the way information is introduced to you. Don’t use the default setup! It’s worthwhile to spend 20 to half-hour on the primary screens you utilize to customise the menus you wish to seem in entrance of you. This can help you entry historic take a look at outcomes higher, help you see important indicators higher, and rather more. I can’t let you know what number of instances I’ve discovered merely reconfiguring a residents wrenches permits them to avoid wasting just a few clicks on each affected person chart.
Two final items of recommendation. Solely chart what you do. Please be cautious of how you utilize macros and ensure your charts are correct. Lastly, chart in actual time as a lot as you possibly can. Even when it’s simply filling out the HPI, ROS, and the bodily examination. You don’t wish to finish your medical day or night time with an inbox of charts which are clean!
Do you have got any extra ideas you’d like me so as to add to this? Message me on twitter (@iltifatMD) and I’ll add them to this record!