Below are standardized Ambulatory visit workflows utilized across Primary Care at UIHC, IRL, and UI Community Clinics. Please contact your Clinical Informatics Specialist with specific workflow questions or change requests: Clinical Informatics

Pediatrics Primary Care

Provider Resources

Epic Welcome Questionnaire Workflows for Well Child Checks

  • General Pediatrics Questionnaire Assignments - (Handout) Included are the standard questionnaire auto-assignments for all General Pediatrics departments based on visit type and patient age. Please check with the provider if there are other questionnaire assignment rules set for their patients. All questionnaires release to MyChart 5 days before the visit unless listed as Welcome Only, which do not release to MyChart and must be completed upon check-in via the Welcome Tablets.

  • Bright Futures for Well Child Checks - (Handout) Bright Futures questionnaires will now file to flowsheets. You can view and/or change the patient’s answers within its new navigator section. For every Well Child Check a Well Care tab will show with age-based questions. The patient/parent can fill the answers out in MyChart, on a tablet, or nursing/clinical staff can complete/change the answers in the room within the Well Care tab.

Well Child Check Documentation Resources

  • Fluoride Application Workflow - (Handout) Fluoride exposures reduce the risk of dental caries (tooth decay) and prevent future caries. Once teeth are present, fluoride varnish may be applied to all children 5 years and younger ONLY at well-child visits. Fluoride will appear as a Health Maintenance topic for patients in Family Medicine, but not Pediatrics. The Fluoride order will be available in the CareGap order set for both Family Medicine and Pediatrics but will only be default selected for Family Medicine at this time. Nursing staff can sign the Fluoride order per protocol.

  • Growth Charts - (Handout) To view a patient’s growth statistics mapped out on a growth chart curve, a clinician can use the Growth Chart activity. Several growth chart datasets and corresponding curves are available in the activity depending on the patient’s age, sex, and diagnoses.

  • Documenting OAE Hearing Screens - (Handout) Scott Blvd Pediatrics will start using the new Otoacoustic Emissions (OAE) Hearing Screen Machine to help with post nursery hearing screen follow-ups, high risk follow-up infants at 9 months and eventually at well child visits as recommended by Bright Futures.

  • Bright Futures - (Website) AVS handouts that are auto-printed for all Well Child visits.

Adult Primary Care

Provider Resources

  • New Provider Epic Start Guide - (Handout) In this document, you will find tips to help you get started in Epic such as customizing your schedule, personalizing settings, and saving favorites.
  • Family Medicine Questionnaire Assignment - (Handout) Included are the standard questionnaire auto-assignments for all Family Medicine departments based on visit type and patient age. Please check with the provider if there are other questionnaire assignment rules set for their patients. All questionnaires release to MyChart 5 days before the visit unless listed as Welcome Only, which do not release to MyChart and must be completed upon check-in via the Welcome Tablets.
  • Medicare Annual Wellness Visit Workflow- (Handout) Provides workflow for completion of Medicare Annual Wellness Visit Workflow by nursing staff and providers.
  • Medicare Wellness Express Lane - (Handout) The Medicare Wellness ExpressLane was created to streamline the process and meet all requirements from Medicare for nursing and LIPs. The Medicare Wellness ExpressLane (LIPs) and Medicare Wellness Navigator (nursing) will fire for all patients scheduled to Medicare Wellness Visits ( Initial Medicare, Welcome to Medicare, Subsequent Wellness).
  • HCC Coding for Providers - (Handout) The Centers for Medicare & Medicaid Services (CMS) created the Hierarchical Coding Categories (HCC) coding model. HCC coding utilizes International Classification of Diseases (ICD)-10-Clinical Modification (CM) coding to assign risk-adjustment scores to patients. This document provides education on how to address the HCC Coding Best Practice Advisory (BPA) from Storyboard.
  • Depo Provera Workflow - (Handout) Place standing orders for Depo Provera and follow-up appointments to make sure patients are getting their shots and being scheduled for their Annual Physical Exam (APE) with in the 11-13 weeks. This ensures patients stay on the 3-month Depo schedule.
  • Lung Cancer Screening - (Handout) Lung Cancer Screening is now available for primary care to order the baseline and annual CTs for patients that they are following who qualify for Lung Cancer Screening. CareGap OrderSet will show qualification guidelines and instructions.

Provider In Basket Resources

  • Creating Out of Contact Occasions - (Handout) Make sure In Basket work is covered when someone is away by creating an Out of Contact Occasion..
  • MyChart Patient Messages Workflow - (Handout) MyChart allows established patients to message their provider for various medical questions they may have. If the patient question results in medical decision-making, then providers can bill for those services by dropping an approved Evaluation and Management (E&M) charge.
  • MyChart Patient Messages FAQ - (Handout) MyChart allows established patients to message their provider for various medical questions they may have. If the patient question results in medical decision-making, then providers can bill for those services by dropping an approved Evaluation and Management (E&M) charge.
  • Closing an Open Clinic Encounter from In Basket - (Handout) Open Clinic Encounters may be viewed and signed (a.k.a. closed) from the My Open Charts In Basket folder. Note: Users other than the provider should NOT sign encounters unless authorized to do so.
  • Reviewing Lab Results from In Basket - (Handout) Learn how results are released to MyChart and how to review results from In Basket. You can also send a result note right from the In Basket activity.
  • QuickActions Quick Start Guide - (Handout) A comprehensive guide to creating, using, and editing QuickActions.

Nursing Resources

  • Primary Care Rooming Workflows - (Handout) This document outlines Family Medicine Rooming workflows by Visit Type including Pre-Charting, Epic Documentation, and visit specific considerations.
  • UICOM Family Medicine INR Workflow - (Handout) This document outlines the Anticoagulation monitoring workflow and documentation requirements for UICOM Family Medicine Clinics when patients have labs drawn internally or when receiving INR results from an external lab.
  • UICOM INR Charge Report - (Handout) The Anticoagulant Mgmt for Pt Taking Warfarin charge (CPT 93793) should be dropped by nursing staff for all INR Lab Only and Patient Not Present visits. Use this report to track which encounters have the charge dropped. If the charge is missed it can be dropped on encounters up to 6 weeks old.
  • Adult Blood Pressure Checks (Family Medicine) - (Handout) The Guideline for Nurse Only Adult Blood Pressure (BP) Checks in the Family Medicine Clinics (DN.G.AC.38.2) provides guidance for nursing staff when a patient’s blood pressure reading is greater than 180 systolic or 100 diastolic. First, document Vital Signs (which may include multiple blood pressure readings) in the Assessments section of the Rooming navigator. Then, complete the following documentation steps.
  • Depo Provera Workflow - (Handout) Place standing orders for Depo Provera and follow-up appointments to make sure patients are getting their shots and being scheduled for their Annual Physical Exam (APE) with in the 11-13 weeks. This ensures patients stay on the 3-month Depo schedule.
  • Processing Prescription Medication In Basket Requests for Nursing Staff - (Handout) Patients have many modes of sending initial (new) or renewal prescription medication requests to their care team. The Care Team will begin the process of getting an initial or renewal prescription authorized.
  • Remote Patient Monitoring - Hypertension - (Handout) Remote Patient Monitoring (RPM) programs help patients stay healthy from the comfort of their homes while receiving treatment and clinical assistance. Clinical staff can review incoming data in Epic via the 3rd party vendor, CareSimple. Patient Outreach Encounters are used for clinical documentation and dropping RPM charges.
  • Reprinting Lab Labels - (Handout) Beaker is Epic’s laboratory application by which specimen labels are printed and collection tasks managed. There are two ways for Inpatient and Ambulatory nursing staff to reprint labels.
  • Transitional Care Management (TCM) - (Handout) Transitional Care Management (TCM) services are reported for a new or established patient requiring moderate to high complex medical decision making who are transitioning from an inpatient setting to a community setting once per 30 days post discharge. This workflow is currently live at UICC Family Medicine locations.
  • Tuberculosis (TB) Skin Testing - (Handout) Nursing staff can order the TB Skin Test per protocol.  This tip sheet will review the TB Skin Testing workflow including:  (1) Screening the patient for contraindications, (2) Ordering the TB Skin Test Panel (PPD), (3) placing the PPD, and (4) Reading/Resulting the test.

Primary Care General Resources (All Staff)

  • Order Up Scheduling - (Handout) Order Up allows staff to schedule an order quickly and easily from the order.
  • Capturing Electronic Signatures for the Consent for Operation or Procedure Form - (Handout) How to capture electronic signatures for the Consent for Operation or Procedure form.
  • Documenting Preferred Labs - (Handout) A patient’s Preferred Labs can be documented under Demographics to ensure external lab orders are sent to the correct lab. Lab orders will not be automatically sent to lab listed as the Preferred Lab and will need to be sent manually.
  • Placing Three, One Month Prescriptions for Controlled Substances - (Handout) It is important that all fillable prescriptions appear as active orders in Epic for our UI Health Care Pharmacies to be able to fill them. Providers should NOT use the Reorder button when initially placing a patient on a controlled substance that requires multiple prescription orders, as it automatically discontinues the previous prescription, rendering it unfillable by our UI Health Care Pharmacies.
  • Homegoing DME Orders - (Handout) Durable Medical Equipment (DME) is defined as devices or equipment that provides therapeutic benefits to a patient in need because of certain medical conditions and/or illnesses. Homegoing DME Supply orders should only be used for outpatients or patients who need to pick up supplies to take home.
  • Outgoing (External) Referrals - (Handout) When a provider in a UICOM clinic places an order for an external procedure, such as a sleep study or radiology, that are not taking place at a University of Iowa hospital or clinic, it generates an outgoing referral. These referrals will be on a UICOM Outgoing Referrals workqueue to track the progress of the referral, until they are manually closed.

AVS/Home Care Instructions

  • Adding Patient Instructions to AVS - (Handout) The Patient Instructions activity allows you to add in depth information and patient instructions to the AVS quickly.
  • Patient Education - (Website) Provides access to internal handouts and videos for patient education.

Related Pages

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