Select - Methodist Health System

Meditech EMR
Introduction and Physician
Training Tool
James W Langley MD MS
Director of MHS Medical Informatics
October 2006
October 2006 1

Methodist Dallas Medical Center
Methodist Charlton Medical Center
Methodist Mansfield Medical Center
October 2006 2

October 2006 3

Interoperability and Connection
• MHS through the Meditech Health
Information System is now interoperable for
all three Medical Centers regarding sharing and
medical access to patients electronic health
records
• Future goals will be to have all MHS ambulatory
services also fully connected to Meditech
• Long term goals will be to have a MHS regional
health network that includes physician offices.
October 2006 4

Purpose
• This training module has been designed to help
you learn and navigate through the Meditech EMR
and its various functions
• This is one of four training sets which will soon be
available at MHS web site
http://www.methodisthealthsystem.org and
Physician Portal as “Medical Training Tools”
• Please take an opportunity to view the other
three:
– Additional desktop tools
– Electronic signature
– Remote token use for off site access.
October 2006 5

MHS Key Resources
• Information Systems Help Desk 214-947-1999
• Information Systems Help desk email: helpdesk@mhd.com
• Medical staff offices :
– MDMC: 214-947-2875
– MCMC: 214-947-7699
– MMMC: 682-622-2066
• PACS – Radiology:
Toby Lopez – PACS training
214-947-2465
Email: tobylopez@mhd.com
• Pamela McNutt
Sr. VP of Information Systems
214-947-4530
Email pamelamcnutt@mhd.com
• Medical office Staff development and liaison:
– MDMC – 214-947-2725
– MCMC – 214-947-0802
– MMMC – 682-622-2056
October 2006 6

Meditech Icon and Sign On
Screen
• Select the
Meditech icon on
the desktop
• The Meditech sign
on screen will
appear.
October 2006 7

Meditech User Name and
Password
• Meditech username and
password is provided by
IS.
• Medical staff offices can
help to obtain them.
• Use of tab key can help
with the entry.
• You will be given a one
time use password.
• A prompt will ask you to
“Change your password”
• This should ideally be a 7
digit alpha-numeric one.
• Enter new password twice
on blank spaces.
October 2006 8

Change Password Option
• You can change a
password at any
time by using
desktop icon
selection “Change
Your Password”
• This will be same
process to select a
new pin number for
electronic signature
function – “Change
your ES PIN”
October 2006 9

EMR Desktop and Functions
• Functions most commonly
used are
– “View Patients”
– “Rounds Report“
– Physician Medication
Summary”
– “Sign documents”
• Use green check as OK
or F12 key
• Red X is exit button
• Black Binoculars are look
up key or F9
October 2006 10

How to Select for a Hospital
When Prompted
• When select “View patient”
and see MCMC listed on top
and more…
• Highlight more…
• Use down arrow
on keyboard
• MDMC or MMMC will be
seen
• Highlight and select one by
using F12 key or green
check at top of menu
October 2006 11

View Patient and Recently
Accessed Patient Screen
• Open “View patient”
selection
• Your first Meditech visit will
usually show you have no
patients listed.
• Your patients are added to
list every time you select a
patient for viewing and
open that record
• Patients remain on list
unless you select “Remove
from recently accessed”
• All in-patients can be added
back to list anytime by just
selecting and viewing the
patient record again
October 2006 12

New Results in Recently Accessed
Screen
NEW RESULTS
There is a white out area
that is “New results”.
If you had anything
new this button would
be magenta
• By opening “New
results”, a list of all
patients having new
results are available to
you to open and view
their records.
October 2006 13

How Do I Find Patients?
• There are two ways to find patients
• Use menu selection “Any Location”
• Or use menu selection “Any Record”
October 2006 14

Patient Location
• If patient location
known then select
hospital and then unit
• This is easiest way to
populate a patient list
quickly through
recently accesses
patient list.
October 2006 15

Any Record
• Put your patient’s last name
with comma separating the
first in the name blank.
• You can just add last name
or just first few letters.
• Hit F12 or OK
• All names with same or
similar spelling will come up
• Select your patient
• View patient record and it
will be added to your
recently accessed patient
list
October 2006 16

Creating Your Own Patient List
• You can create a patient to list to use by either of
two methods.
• You can use the “Recently Accessed List “choice
which is automatic and involves you only having
to open a patient and view results to add to your
list. Patients automatically get dropped off after
14 days of discharge. Or you can make selection
“remove from recently accessed list”
• You can alternatively make a “Personal List”. This
requires more maintenance on your part but gives
more control on who gets on your list and when
they get taken off.
October 2006 17

Making a Personal List
• Create a personal list by
selecting the patients
you want to add to list
and then hit “Add to
personal list.”
• This adds a little more
maintenance but allows
a printout of your
personal list and report
with all your patient
locations
• You can see your list at
any time by selecting
“personal list”
October 2006 18

Remove From Patient List
• It is easy to manage
your patient list by
removing those
patients you
discharge.
• Once you hit
“Remove from
personal list,” the
name is removed as
indicated.
October 2006 19

Printing Your Personal List
• You can select print or
view “Personal list
report”
• Select all or a specific
facility
• Select “View” or
“Print”
• The “Personal List
Report” includes
location, patient name,
bed, room number,
MD, sex/age, medical
record number,
physician, room, bed.
October 2006 20

Patient Visits
• Once you select a patient
• You now have choice in
right hand menu of picking
visits by date, type of
admission, all visits or put “
X ” in box to select just the
ones you want to see as
collated results
• The symbols on patient list
– bed with a head = current
admission,
– empty bed = a discharge,
– clipboard = outpatient or
observation,
– scissors = a lab/radiology
outpatient procedure
October 2006 21

Opened Patient Visit
Right Menu Panel Interpretations
• Pale panels mean no
data available in them
• Blue printed name
means results present
and looked at least
once before.
• Magenta colored name
highlighted equals
new results in panel.
October 2006 22

24 Hour Default Patient Screen
• You can see the
magenta color
change on the
internal panels also
indicating new
results.
• You can get to any
of the panels by just
double clicking on
them to open.
October 2006 23

Opening Patient Visit
• The top line of right
menu is “Record list”
to find another patient
record
• The second line is
“Visit by date” of same
patient being viewed
but different visit
• The admitted patient
default screen will be
the 24 hour view.
• Anything new is here:
vital signs, I and O,
reports, lab results etc.
listed for 5 days.
October 2006 24

Special Panels
• The “Special panels”
selection on third line
of top right menu will
take you to some prebuilt
specialty results
panels on left.
• One is called the
“Endocrine” select it
• Then select
“endocrine” again in
drop down menu.
October 2006 25

Endocrine Data Choices
• One can toggle to close
5 panels to see better
by using + or –
• One can also select
time intervals 1 hr,
4hr, up to 24 hrs.
• One can see entire
encounter by selecting
earlier or home
• Can be useful to find
glucose levels and
administered insulin
October 2006 26

Lab and Medication View
in Endocrine Panel
• Can see finger stick
glucose and venous
acquired sample.
• Insulin administration
on bottom panel
• Nursing IT working on
creating a printed
report for sliding scale
determinations
October 2006 27

Nursing Notes
• The “Notes” selection
has all the nursing
notes, as well as other
allied health notes.
• To see all the listed
information double click
on line or magnifying
glass.
• Nursing notes can also
be printed from
physician “rounds
reports”
October 2006 28

Medication Administration Record
List in EMR
• Active, Discontinued
and ALL
medications choices
can be selected.
• Toggling boxes
below can also help
to see earlier as
well as current
view.
October 2006 29

Medication Detail and History
• Click on lines and
at top of each
column and on
each line
• This can sort and
give more detail on
each medication
• It also shows how
administered and
when.
October 2006 30

Order History And Audit Tracking
• This allows tracking
and auditing of
physician orders
• Go to top two boxes
and select “Audit “
to see who took off
orders and when.
• The “Audit trail”
shows when orders
removed ,
completed and by
whom.
October 2006 31

Allergies
• The “Allergy”
selection is very
important.
• Once an allergy is
logged in any visit
or hospitalization it
will be in patient’s
record within
system forever.
• This is called demo
recall function.
October 2006 32

Laboratory
• Laboratory panel has
all categories of lab
results.
• Abnormal results are
in yellow
• Critical results will be
in red
• Comments about
results will be in a
balloon. Click to open
or click on line where
occurs.
October 2006 33

Microbiology
• Click on picture of
Report/Grid to get
more information
on microbiology
report.
• The report can be
printed. When done
hit return to go
back to patient
record.
October 2006 34

Opening Reports
• Opening all types of
reports is a similar
process for
“Pathology”, Imaging”
and “Other Reports”
• You must click on a
bubble or icon under
report to open
• Status of report is
either signed or draft
October 2006 35

Print Layout View
• To see patient
demographics you
need to go down to
bottom of screen
and select print
layout to get all.
(arrow)
• Reports can be
printed through file
print command –
top menu bar
October 2006 36

Exiting Reports
• You will need to close
report by going to top
right screen and hitting
the X
• Then select return on
right hand menu on next
screen
• You will now see a green
check in the bubble
indicating you have
already viewed a report
October 2006 37

Care Trends and Care Activity
and Admission Nursing History
• These are nursing
activities which are
now available and
better documented in
Meditech.
• Nursing assessment
“History” includes all
positive findings
including MRSA and
VRE, allergies, and
vaccination history
October 2006 38

Summary Selection
• This “Summary”
screen can be default
screen if patient
discharged
• This selection has
– patient demographics
– contacts
– reason for visit
– patient directive DNR
documentation
– Insurance
– providers associated
with patient
– and other useful
information.
October 2006 39

Graph
• You can right click
on your mouse on
each selected lab
values up to three
or vital signs and
then select graph
for viewing. You
can then print
screen the graph if
desired.
October 2006 40

Physician Medication Summary
Report
• Select this icon in
EMR desktop
• Select correct
medical center
• Hit enter
October 2006 41

Hit Enter Twice Through Pharmacy
Prompts
October 2006 42

Finding Clinical Floor
• Use F9 lookup key
when prompted for
location of clinical
floor
• Select unit desired
for medication
report
October 2006 43

Print Medication Report
• Choose print option
• All ordered and given
medications can be seen
• Last dose given and time
can be seen
• Report printed at 10 pm
nightly on floors.
October 2006 44

EMR Desktop Rounds Report
• This report can be run
for
– individual MD
– MD group
– location
– facility.
• It can also be run with a
combination of any of
the four factors
• Consultants must be
entered into Meditech by
a physician order to be
linked to this report. Can
be done by RN/ unit
secretary with an order
by MD
October 2006 45

What Report Offers
• All inpatients and 23
hour observation
patients linked to any
physician can be
printed.
Results include:
– 72 hr vital signs
– I&O,
– labs
– active medications
– nursing notes
– insurance
– allergies
– patient demographics
– 72 hr micro results.
October 2006 46

How to Get Rounds Report
• In blank doctor space hit
F9 lookup key select
correct physician and hit
enter.
• Now Hit F12 key or the
green checkmark =
OK
• The same routine as
above can be used for
finding and selecting
groups, location, and
facilities report query.
• One can also combine
queries ie. MD and
location
October 2006 47

List versus Complete Report
• If you want a
complete rounds
report select “yes”
on “print all
patients query”
• If you want to only
see list select “no”
on this query.
• You can then select a
patient and print
individually.
October 2006 48

Printing Rounds Report
• Select view in bubble
on top and OK on
bottom for viewing
report
• Select print in bubble
and OK on bottom
for printing
October 2006 49

Electronic Signature
• Contact medical records to
get application form for E
signing and training.
• Select “Sign documents”
icon
patient
names
• All of your dictated pending
patient records will be
higlighted as noted in
example with patient names
in space
• Anything on this list is ready
for review and e signature
• Training in electronic
signature is in separate
module
October 2006 50

Conclusion
• You have now completed Meditech EMR
Introduction and Physician Training Tool
• You should be able to find patients, view
any result or report, make personal lists.
• Remember if you forget your Meditech
password call the help desk ext. 71999
• I would also recommend reviewing the
additional Meditech training modules
available including:
– Meditech Additional Desktop Icons
– Electronic Signature Training
– Remote Token Off Site Access Training
October 2006 51