Order Entry is a process of electronic entry of medical practitioner instructions for the treatment of a patient. Orders are used for many areas including pharmacy, laboratory, radiology, communication, and procedures. Orders can be placed individually or as part of a group known as Order Sets/SmartSets. The Manage Orders Activity is used for reviewing and placing inpatient orders.

Resources

The following resources provide information on Order Entry functionality.

Ordering Basics

  • EpicCare Ambulatory: Ordering in an Outpatient Context (MDAMB107) - (eLearning: 7 min) Efficiently find, place, and manage outpatient orders.
  • EpicCare Inpatient: Managing Orders (MDINP107A) - (eLearning: 9 min) Manage inpatient orders.
  • Add-On Lab Orders - (Handout) Place add-on lab orders to recently collected specimens.
  • Communicating Pended Orders for Signing - (Handout) Some ancillary or nursing staff will place and pend orders that will then need to be signed by an authorizing provider. The authorizing provider will be notified of the order(s) needing to be signed using an In Basket notification.
  • Expected Date for Orders - (Handout) Most After Visit Lab and Follow-Up orders now require an Expected Date. The Expected Date clearly communicates to clinical and scheduling staff when the order needs to be completed or scheduled.
  • Managing Inpatient Orders - (Handout) The Orders activity provides one place for inpatient clinicians to work with orders while simultaneously reviewing other clinical documentation. Review existing orders on the left while making ordering decisions in the sidebar on the right. The sidebar keeps track of order changes as you go.
  • Place and Sign Outpatient Orders Using the Visit Taskbar - (Handout) The visit taskbar is a one-stop shop for placing and signing orders in outpatient encounters. Available in nearly every activity, the taskbar appears at the bottom of the workspace throughout the encounter so that a new order can be placed at any point during the visit.
  • Visit Taskbar (POSS073) - (Video: 2 min) Learn how to use the new Visit Taskbar more efficiently. Note: Outpatient visits scheduled in Hospital Outpatient Departments (HODs) will not see the new Visit Taskbar.
  • Placing Orders for Non-UIHC Imaging - (Handout) Follow these steps to place an order for radiology tests that will be done at a non-UIHC radiology location, such as a local hospital.
  • Placing Orders Quick Reference Guide - (Handout) Assists clinicians with determining type of order and different ordering workflows.
  • Placing Standing Orders - (Handout) Place one standing (recurring) order rather than multiple individual orders to be made available for release multiple times (current and/or future encounters).

Ordering Efficiency

  • Create an Order Preference List - (Handout) Create preference lists to include orders that have been saved as favorites. This will decrease the time needed to place orders and increase efficiency.
  • Creating User Order Panels - (Handout) Create a custom order panel to make any group of orders available in one click. Select orders in either the Visit Taskbar or the Manage Orders activity, then click Create Panel to save a new panel containing those orders on the user’s preference list.
  • Discharge Medication Reconciliation - (Handout) Instructions for when you are ready to discharge patients.
  • Find Orders and Save Your Favorites - (Handout) Efficiently finding and placing orders can help speed up your workflows. Add the orders you place most often to your preference list for quick access in the future.
  • Manage Pending Orders Efficiently with In Basket - (Handout) To ensure that orders are signed quickly and efficiently, nurses can now send a Pending Orders In Basket message to a clinician to sign. This new Pending Orders folder allows clinicians to identify and appropriately prioritize signing these orders so that they're available when the patient needs them. Clinician can sign the orders without leaving In Basket, using buttons similar to Rx Request messages.
  • Med Rec Efficiency (POSS114) - (Video: 1 min) Learn how to see reconciled medications in the sidebar, and how to see inpatient meds and home meds side-by-side during discharge med rec.
  • Personal Preference Lists (POSS023) - (Video: 2 min) Learn how to add and use personal preference lists to speed up ordering.
  • Preference List Organization (POSS024) - (Video: 1 min) Learn more advanced Preference Lists strategies to streamline your ordering workflows.
  • Preference List Sharing (POSS053) - (Video: 2 min) Learn how to borrow a colleague's preference list to use as a starting point for your own list.
  • Setting Multiple Orders - (Handout) Clinicians can set multiple orders to the same frequency more efficiently by editing them all at once. This is especially useful when editing the frequency of labs.

Admission-Related Orders

  • Admission Bed Request - Ambulatory Clinics - (Handout) When a UIHC ambulatory clinic provider determines that a patient requires admission to the UIHC, an Admission Bed Request order with level of care is required before Bed Planning to a UI Healthcare unit can occur. The bed request order will trigger the Admission & Transfer Center (ATC) to find a bed for the patient.
  • Admission Order Requirements Prior to Patient Discharge - (Handout) CMS guidelines require that the Admission order be signed by a provider with admitting privileges PRIOR to discharge. Best Practice Advisories (BPAs) will remind staff of these requirements and will fire if the Admission order hasn’t been signed and the Patient Class is INPATIENT or OBSERVATION and/or the Level of Care is INPATIENT.
  • Code Status Considerations - (Handout) Staff needing to review and better understand code statuses ordered for patients will find some explanation here as well as Key Points and Recommendations.
  • Medication Reconciliation – Using Signed & Held Order Status - (Handout) Patient safety around medications given within a hospital encounter relies on several key factors, such as, review and use of home medications for ongoing treatment of chronic conditions, updating active order lists with each patient encounter, and utilization of tools within the Electronic Health Record (EHR) accurately.

Discharge-Related Orders

  • Discharge Now vs Discharge Pending - (Handout) This document is a guide to utilizing the Discharge Patient order (ADT8) and new required question to capture specific criteria for a patient to meet prior to discharge or when all tasks are complete, and the patient can discharge immediately.
  • Placing Service Specific Discharge Follow-Up Orders - (Handout) Discharge follow-up orders can be placed at any time during a patient’s hospital stay.  For many specialty-specific services who consult or co-manage patients during their stay, placing a follow up order earlier than the time of discharge will ensure the Patient Access Center (PAC) or scheduling staff have an opportunity to schedule the appointment prior to the patient’s discharge from the hospital.
  • Provider Discharge Workflow - (Handout) When a patient is ready to be discharged, complete the Discharge Order Reconciliation before signing the Discharge Summary.

Transfer-Related Orders

  • Transfer Order - (Handout) A transfer order should be placed when the patient is physically moving locations (i.e., unit to unit) or is changing primary service (e.g., intensivist team to hospitalist team). When a provider completes and signs a transfer order, the order will automatically create a Bed Request.

Manage Orders

  • EpicCare Inpatient: Managing Orders (MDINP107A) - (eLearning: 9 min) Manage inpatient orders.
  • Order Review - Viewing and Releasing Orders - (Handout) Order review is your activity to see what orders have been placed and detailed information about the orders. It also allows you to release labs and/or release future, standing, and signed and held orders.
  • Releasing Signed and Held Orders - (Handout) Inpatient nursing staff use the Signed & Held activity to release all reconciled transfer orders for new admission or transfer patients. Also, inpatient nursing needs to release Procedural and Surgical Phase of Care orders following the guidance provided here. Signed & Held orders are inactive until released.
  • Save Work Pended Orders - (Handout) Staff sometimes collaborates on placing and approving orders for particular patients. In other cases, staff may not wish that others see pended orders.

Medication/Pharmacy-Related Orders

  • Add / Replace Preferred Pharmacy (and Send Orders to Multiple Pharmacies) - (Handout) Update the pharmacy (or pharmacies) that new prescriptions will be sent to both for the current encounter and to save time in future encounters.
  • Cancel Rx - (Handout) Cancel Rx will electronically send a cancellation message to pharmacies via SureScripts.
  • E-Prescribing of Controlled Substances - (Handout) UIHC uses Bio-Key fingerprint technology to confirm provider authority to prescribe controlled substances. This document shows how to use this function after a provider has been registered in the program.
  • Electronic Prescribing of Controlled Substances (EPCS) for Nursing Staff - (Handout) Beginning December 4th, 2018, all UIHC Providers who are authorized to sign controlled substance prescriptions can now send them electronically to eligible pharmacies via SureScripts. The process to send controlled substance prescriptions will mean that providers must provide dual-authentication while signing the prescription. At UIHC, we use Bio-Key fingerprint technology and Epic Login Credentials as our dual-authentication tools.
  • Ordering and Verifying Non-Stock Medications for During Visit Orders - (Handout) Providers may place clinic or inpatient during visit orders through Non-Stock Medication entry when there is not a UIHC inpatient formulary option.  The order acts as a placeholder for the verifying pharmacist to initiate an allergy or interaction check.  
  • Place a Hold on an Active Medication - (Handout) Providers can place holds on active scheduled medications from the Orders activity. Holds can be set to expire within a certain timeframe, at a certain time, or until manually unheld. This hold is visible to nursing staff on the MAR and also displays for the pharmacy staff. A Best Practice Advisory (BPA) reminds providers when a medication has been held for two or more administrations.
  • Placing Three, One Month Prescriptions for Controlled Substances - (Handout) The process for setting up multiple prescriptions orders for the same medication ensures that the medical record accurately reflects what prescriptions the patient has and what they should be taking.
  • Reviewing Estimated Patient Medication Adherence Levels - (Handout) Medication Adherence uses reported prescription fill information to assign a specific percentage value to estimate how compliant a patient has been with taking their prescribed medications.
  • Viewing Prescription Drug Monitoring Program (PDMP or PMP) - (Handout) Iowa’s Prescription Drug Monitoring Program (PDMP or PMP) can now be viewed by providers from Epic; providers and Pharmacists can access the PDMP from the patient Storyboard.
  • Ordering Prescriptions for Pharmacists - (Handout) For specific workflows as defined by collaborative practice agreement (CPA), Pharmacists can place and sign prescription orders.
  • Order Up Scheduling (formerly Order Up Second Dose Scheduling for Clinicians) - (Handout) Order Up allows staff to schedule an order quickly and easily from the order.
  • Placing Discharge/Readmit Orders from Medication Reconciliation - (Handout) Placing orders for prior to admission (PTA) medications between encounters should be completed using the Discharge and Readmit tab in the Discharge navigator.
  • Viewing Real Time Prescription Benefits - (Handout) Clinical staff members, such as Nursing staff, Pharmacists, Licensed Independent Practitioners (LIPs) and Advanced Practice Providers (APPs) are able to view Real Time Prescription Benefits (RTPB).

Order Sets/SmartSets

Role or Department-Specific Orders

  • Adding a New Level of Care Order - (Handout) When Indicia recommends a different Level of Care than the one specified in the provider’s Admission Bed Request order, Nurse Navigators (and others managing these situations) should follow this workflow to place a new LOC order.
  • CCC Follow Up Orders - (Handout) To ensure all necessary information is provided and that scheduling can move forward smoothly, communication with the Clinical Cancer Center about appointment details are included in the CCC Follow-Up Order Panel. Multiple follow-up appointments can be requested within a single CCC Follow-Up order panel. 
  • Document a Follow-up in Wrap Up - (Handout) To ensure a patient’s Follow-up visits are documented and scheduled, in Pediatric Nephrology, Follow-ups are now documented in the Wrap-Up activity. When you close the encounter, the Follow-up section must have both a return date and Follow-up For documented. Any additional labs/imaging still need a separate order to be placed and signed.
  • Genetic Counseling Consult Orders for LIP - (Handout) Placing the genetic counseling order correctly will automatically route the Genetic Counseling Consult order to the appropriate department for scheduling.
  • Homegoing DME Orders - (Handout) When a DME order is placed, the DME supplier must be documented via a DME Acknowledgment Task in the Wrap Up activity. The choice of supplier determines what happens next: eSignature, printed form, and/or e-mail and In Basket notifications sent.
  • Offsite Visit Workflow - (Handout) The Offsite Visit Workflow is used when providers at UI Community Clinics or Outreach perform services at external hospitals or facilities (inpatient rounding, consults, surgeries, etc.).
  • Outpatient to Emergency Department Referrals for Providers - (Handout) To streamline transitions of care to the emergency department (ED), an order-based workflow has been created. The Emergency Department Referral (UIHC ED Only) order is used to relay pertinent information from the patient’s ambulatory visit to ED staff. This version is for providers.
  • Reviewing and Updating a Patient's Legal Status - (Handout) The legal status of a patient can be viewed in the Storyboard and provides links to historical documentation of a patient’s legal status and scanned legal documents. Certain legal statuses require continuation through order placement prompted by Best Practice Advisory (BPA) Notifications.
  • Surgical Workflows - (Presentation) Detailed description of the documentation workflow for the surgical patient, including terminology, pre-procedure, pre-operative, and post-operative workflows. Refer to slide 2 for a clickable links to jump to specific steps in the workflow.
  • Using CareSelect when Placing Radiology Orders - (Handout) When placing orders for advanced imaging procedures (CT, MR, PET, NM), Epic uses CareSelect to evaluate the appropriateness of the order for that patient. When CareSelect identifies exams that may be more appropriate for the patient, a Best Practice Advisory (BPA) displays with a list of suggested alternatives, allowing you to easily change your order.

Schedulable Orders - Cadence Workflows

Therapy Plans

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