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EMR 9.8, Clinical List Changes and On-Hold Documents

Bugs, Known Issues, Open Cases

Last Post by Anonymous 1 second ago

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kgrasso

(@kgrasso)

Posts: 3

Active Member

Topic starter

We recently upgraded our Centricity EMR from 9.5 to 9.8. In EMR 9.5, our admin asst would start an update, order procedure types as tests due to our billing system, and then route the document for signature to a nurse supervisor. Then the admin asst would start another update for the same patient with a different date of service and do the same thing. When she routed the document, she was not checking the "Sign Clinical List Changes" box. While all this was happening, other nurses were adding lab values to flowsheets. If the nurse supervisor needed to make a change to what the admin asst ordered, she would change it. Since upgrading to EMR 9.8 this workflow has been disrupted. If the admin asst goes to route the document and doesn't check the box to "Sign Clinical List Changes", she can't start a new update for another date of service and other nurses can't update flowsheets.

Our VAR is telling us that Centricity EMR 9.8 is behaving the way it's supposed to be working. Has anyone else had this same experience with Centricity EMR 9.8 and if so, do you have a reasonable workaround for it? Would appreciate any help we can get. Thanks!

Posted : September 18, 2015 10:12 am

dcarpenter

(@dcarpenter)

Posts: 323

Reputable Member

We are on CPS 12.0.10, and this is the way Centricity has always worked for us (been live since CPS11.) If a document has unsigned clinical list changes, you cannot add new orders, meds, obsterms, or any other clinical list changes until the ones in the first note are signed. I am assuming it is a security measure to prevent the dreaded double charting, which can lead to some nasty scenarios (Double prescriptions for Class III Medications anyone?)

I do not know of a workaround for your particular scenario, since our program came this way from the start, but perhaps someone more experienced than I will have some suggestions?

Posted : September 18, 2015 10:26 am

drobinson

(@drobinson)

Posts: 41

Eminent Member

Orders are part of the clinical list thus the need for the admin assistant to have the sign clinical list changes box checked. The reason for this is not just double charting but a safety measure to ensure that clinical staff is working with all the latest clinical data. Decisions based on that clinical data need to be made on a regular basis and you would not want someone putting a bunch of data in the chart that influenced a providers medical directive and then all of a sudden it is gone because the document that housed said data was discarded. It is working as intended and I would advise the users to come up with a better workflow as the previous workflow was not ideal in the first place.

Posted : September 21, 2015 10:19 am

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