RE: Erlanger IT Technology Letter from the Erlanger Chief Medical Informatics Officer Stephen Adams, MD

Transcription

1 June 26, 2015 RE: Erlanger IT Technology Letter from the Erlanger Chief Medical Informatics Officer Stephen Adams, MD Dear Incoming Resident, On behalf of the Erlanger IT staff, I d like to welcome you to Chattanooga. It has been a pleasure for me to be involved in resident training for almost 18 years, and I look forward to getting to know many of you in the coming year. I m writing this document to outline for you some of the technology available to you at Erlanger. We are in a period of transition. We are using multiple EHR systems but have selected a single integrated system (EPIC) to replace all the other systems. You will be a part of that transition during your training here. The purpose of this letter is NOT to be a comprehensive guide to EHS technology. Instead, I want to provide you with a basic idea of what is available here and to address some of the common questions regarding IT. You ll get training relevant to your specialty at the beginning of your residency. Included below is: 1. How to access data on inpatients 2. How to access imaging studies 3. Medical records completion and viewing old patient data 4. Outpatient EHR 5. Medical library Remote access 8. How to get help 9. PHI and security Our current inpatient EHR is Net Access. You can access it from the Physician s Portal: (Erlanger Home Page when you are on an Erlanger Computer via the Intranet )

2 When you log into the Physician s Portal, you have links to Net Access, medical record completion and medical record lookup, and multiple useful links. Net Access allows you to view your patient s test results, orders, vital signs, and to place new orders via CPOE. It also has options for eprescribing at discharge. Net Access is easy to learn and you ll have little difficulty getting used to using it. It has a simple toolbar on the left side of the screen and patient data is displayed in the center.

3 A little known feature that will be helpful to you is the ability to view summary of care documents imported from both the ER EHR (Optum Pulsecheck) or the outpatient EHR (GE Centricity). Look for a link that says CCD or CCDA. You have three options to view radiology studies. There are direct links to PACS within Net Access that show up when you view a patient s radiology report.

4 The second option is to type PACS into the Internet Explorer address bar, or click the desktop icon.

5 You can configure your own default view in PACS so that when you log in you have folders (left side of the screen) that have the studies you want to view available, based upon the location of care that you select.

6 Both of the options above require you to be on an Erlanger computer or connected via a VPN (virtual private network). The third option works anywhere and from any device: go to images.erlanger.org and you can view images with most of the functionality of the full PACS system. Your medical record status is visible on the right side of Physician s Portal:

7 You can launch HPF ( Horizon Patient Folder ) by clicking on the deficiency number (either personal or group in my case the number 25 above). This link gives you the option to edit or to sign your dictations. Prompt medical record completion is a priority for the hospital, and late records are a sure way to get unwanted attention from the administration. Please complete your records regularly! All dictations and test data is available through Net Access, but other things (e.g. handwritten notes) require accessing HPF. Click the Medical Record Search button above to view that data. Outpatient EHR: Most residency clinics use Centricity EHR. If you are in a program that uses it, you ll receive separate training and a username/password that is distinct from your regular Erlanger username/password.

8 Centricity contains specialty specific forms and content, and also has the ability to show care summary reports from the ER system and Net Access. You can launch Centricity from the desktop icon (all clinic computers and many hospital computers have it installed on the local drive). Computers that don t have it installed can still launch it via Citrix (link on the Erlanger homepage):

9 The following page will be displayed. At this point you will use your Windows login as you are authenticating to the network and not the Centricity Your Centricity EHR login info will be given to you during training: Once you are logged in you will be prompted with the applications you have access to in CITRIX. For Centricity you will click on this icon: For helpful Centricity manuals and a pocket guide please click here. The medical library has a wide variety of tools available to you, including UpToDate, epocrates, PubMed with full article access, Visual DX (dermatology search engine and reference), Micromedex (drug database), and many others. Erlanger provides you with the ability to have UpToDate and epocrates on your personal devices. Simply create an UpToDate account online, and log in to it once a month from an Erlanger computer. As long as you continue to log in monthly from an Erlanger computer your account will remain active at no charge to you. Your epocrates account will be set up when you begin training. You ll be given an Erlanger account. All official communications from the College of Medicine and the hospital will come through that account. It allows you to send encrypted s (set the confidentiality level to confidential ). It also can be synced to your personal device in a secure, encrypted fashion. Remote Access There are several options for remotely accessing the Erlanger system. If you have a specific computer assigned to you, you can connect to that computer via our VPN ( Virtual Private Network ).

10 Alternatively, you can access the system via a virtual desktop ( VDI ). Both options are available at It is possible to connect remotely with almost any desktop computer operating system (Windows, Apple, Linux) but it is NOT currently possible with most tablets or Chrome OS. Detailed instructions for home access are available on the EHS intranet. In my experience, Apple users typically have more difficulty than others with access (HINT: Apple users - Use Firefox, not Safari, Windows users Use IE or Firefox, not Chrome). Patient Keeper (PK) Patient Keeper is a program that offers apps for ios and Android that allows you to view data on inpatients (demographics, test results, orders) from your mobile device. Currently the hospitalists are also using it to submit patient care charges. How to get help Anthelio is an IT outsourcing company that provides most of Erlanger s IT support. Anthelio can be reached at 778-TECH or ServiceDesk@antheliohealth.com Anthelio also has a physician only hotline, cell number, and address. (Insert here) Please call for urgent issues; non-urgent issues can be sent via or text. Please be prepared to give the computer name of the device you re having problems with. You can get the name by clicking the lightbulb icon on the desktops:

11 In addition to servicing Erlanger computers, Anthelio can help you if you have problems connecting to Erlanger with your personal device. Anthelio s contract doesn t allow them to support your personal devices beyond connection problems. We need your help maintaining the rapid responsiveness of the physician support team. Please don t allow other staff to abuse this service. If you need help with Centricity, there is a support team available at GEEMR@erlanger.org ( off campus x4191 on campus). Please note that password resets can be handled with the 24x7 Anthelio helpdesk (778-TECH (8324) off campus or x8324 on campus). Many of you will be involved in research projects during your residency. Our informatics team is happy to help with data acquisition. You can contact Gail Maynor (Gail.Maynor@erlanger.org) or you can contact me personally to discuss your needs. Protected Health Information (PHI) and Security Here s a list of DO s and DON Ts: 1. DON T give your password to anyone else. There is an audit trail associated with each action in the system, and you don t want to be held responsible if someone uses your account in an inappropriate or illegal way. 2. DON T install or upgrade software on Erlanger computers. Our system requires specific versions of many programs (e.g. Internet Explorer, Java) and if you upgrade them then the programs won t work. 3. DO use the Chrome browser when you access residency related programs such as New Innovations. 4. DON T use any flash drives other than the IronKey you will be issued. 5. DON T share imaging studies or other PHI outside of the patient s care team. There are legitimate uses of this data as a part of teaching. DO consult your faculty to get specific guidance. NOTE: The state of Tennessee has a law banning distribution of radiology imaging studies for nonmedical purposes. Before you share humorous or imaging studies with your friends, remember there are harsh penalties for doing so. 6. DON T post patient information on social media. 7. DON T try to access file sharing sites, Google Drive, Gmail, or DropBox. Erlanger has experienced intense hacking attempts using these sites and has had to block them. 8. DO use strong passwords.

12 Once again, WELCOME to Erlanger! Stephen Adams, M.D. Chief Medical Informatics Officer