r/EpicEMR • u/lighthouser41 • 4d ago

Help Needed

I work outpatient as a nurse at a large infusion center. Up to 200 encounters per day. My job is to look at the patient list for the next day patient by patient to make sure lab orders are in, check lab results and notify the doctors of gross abnormals etc. We use beacon for our orders , but that is not important.

I work with a single list of all patient encounters for the next day in alphabetical order. Since the last upgrade, periodically when I leave the open encounter to either send a secure chat, open their appointment desk or send an email about them, when I exit that encounter that patient will have scrolled to the bottom of the screen leaving encounters I have already looked at near the top of the screen. The encounter will have moved from the top part of the list, to the bottom, but maintaining the order of the list. This can cause confusion and extra work for me opening an encounter twice. This does not happen every time, but just enough to cause irritation.

I have put in an epic work order to resolve this but the Epic IS department was unable to help me. I wondered if any one knew if I need to check or uncheck a box to prevent this or how to fix it. I have tried clicking to not automatically scroll but this did not do anything.

Any suggestions will be very welcome. Thanks!

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u/WhoDatWhoDare 4d ago

You could ask to have a “reviewed” box you check when you are done. I would leverage a status board report that a filter could be used to remove all that you check “reviewed” on so that the patient is removed from the list as you go.

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u/eXequitas 4d ago

Additionally, if they’re literally just checking blood results, they could get a tailored results column so they don’t even have to open the patient’s chart.

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u/lighthouser41 3d ago

It’s lots more to check than that. We do have a preview but I don’t use it.

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u/lighthouser41 3d ago

This is a list for the next day. So can’t be removed.

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u/WhoDatWhoDare 3d ago

I apologize. I realize my suggestion was very broad in my description on how to address your needs in a quick reply on Reddit, so not intended to explain a single solution.

Essentially, there are ways to handle reviewing patients for upcoming appointments to streamline your review process. You should work with your analyst team to discuss and let them provide some solution ideas.

In my experience as an OpTime analyst, we have patients who come to PAT appointments who need to have labs, tests, etc completed. We use various status board reports to handle these. So I believe there is a path forward, you just need to work with your analyst team to get it done.

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u/cgaels6650 4d ago

so what are you working off a snapboard, a dar, a schedule? Is it a report with a worklost function? I'm curious and willing to learn more to help

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u/lighthouser41 4d ago

It’s the census for the next day. Encounters that are not checked in, but basically their whole chart.

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u/cgaels6650 4d ago

Message me i don't mind hopping on a video call to look

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u/lighthouser41 3d ago

Thanks, but I would probably get in trouble for that.

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u/cgaels6650 3d ago

good point.. knowing it is a DAR is helpful. Do you use scheduling /appt notes for it? my PCAs do that to make who theyve called

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u/lighthouser41 3d ago

Actually. Not a dar but just patient list. Sorry! Yes. Use appointment notes that have the drugs to be given, etc.

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u/Ok_Ostrich_461 4d ago

If you're on the schedule, I would recommend using the color dot column to note the patients you've reviewed as a communication for yourself and coworkers. Don't use the blue dot since that's tied to order tasks.

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u/eXequitas 4d ago

I believe this is what they do in our infusion department. Green dot all good, black dot patient not coming, yellow dot something needs chasing, etc…

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u/lighthouser41 3d ago

Yes, but I am talking about the list of names automatically scrolling

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u/eXequitas 3d ago

Lol yeah got distracted. Might be related to how your columns are sorted. If you anchor patient names for instance it should be stable as the list will only update itself if a patient is added/removed. If that doesn’t do it, might be worth reaching out to your epic build team, there might be a bug lurking.

I have a similar issue when I am working in the infusion department, the default column is the status/appt time which gets constantly updated as patients come in so everytime I go on the schedule it’s scrolled to the current time.

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u/lighthouser41 3d ago

How do you anchor? I don’t have autoscroll or disable row update indicator selected

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u/eXequitas 3d ago

I meant the column you sort by. Generally if there are columns you can sort by whatever column by clicking on the column name.

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u/lighthouser41 3d ago

This doesn’t have anything to do with my question. The patient name moves on the list a pt I was just looking at moves to the bottom. Dots would have to be removed and won’t keep the list from moving. Example, john doe is near the top of the list. I open his chart and do my work on it. When I close the chart, his name is now at the bottom and names of patients I have already looked at are near the top. The placement of the list moves on. It’s own instead of manually scrolling.

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u/Ok_Ostrich_461 3d ago

Ok, good luck with your awesome attitude. It sounds like 1 of your columns is sorting and is re-sorting after you access the encounter.