Top Efficiency Tips for Outpatient Providers...To add a column, select it from the Available Columns list and click Add to include it in your schedule. For example, select the Meds

Date Last Revised: 3/21/2017 Date Last Printed: 3/21/2017

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Top Efficiency Tips for Outpatient Providers Top Efficiency Tips for Outpatient Providers ....................................................................................... 1

Schedule...................................................................................................................................................... 3

Choose which info appears in your schedule ...................................................................................................... 3

Customize your report toolbar ............................................................................................................................ 4

Create a sticky note reminder about a patient .................................................................................................... 5

Chart Review ............................................................................................................................................... 6

Filter information in a patient's chart .................................................................................................................. 6

Keep clinical information on hand in the sidebar ................................................................................................ 8

Rearrange the sections in a Chart Review report ................................................................................................ 9

Review information from several visits at once ................................................................................................ 10

Graph data and view flowsheets from Chart Review ........................................................................................ 11

Open an encounter from Chart Review ............................................................................................................. 12

Categorize and find your notes using bookmarks ............................................................................................. 13

Copy information from a patient's chart for use in a letter or note ................................................................. 14

Diagnoses and Problems ............................................................................................................................. 17

Review and update the patient's problem list ................................................................................................... 17

Prioritize a patient's problem list ....................................................................................................................... 19

Record a diagnosis for the visit .......................................................................................................................... 20

Notes and SmartTools ................................................................................................................................ 21

Copy a previous note ......................................................................................................................................... 21

Write your note in the sidebar .......................................................................................................................... 24

Jump start routine notes with speed buttons ................................................................................................... 25

Create a NoteWriter macro to record your common findings .......................................................................... 26

Organize, edit, or delete your note macros ....................................................................................................... 28

Find your favorite SmartTexts faster ................................................................................................................. 29

Use SmartPhrases and SmartLinks..................................................................................................................... 30

Create a SmartPhrase to reuse text you commonly type .................................................................................. 32

Customize your SmartPhrases ........................................................................................................................... 33

Use SmartLists .................................................................................................................................................... 35


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Orders ........................................................................................................................................................ 36

Edit multiple orders at the same time ............................................................................................................... 36

Create Preference List sections ......................................................................................................................... 37

Add orders to your Preference List as you place them ..................................................................................... 38

Edit your Preference List .................................................................................................................................... 39

Copy Preference Lists from other clinicians ...................................................................................................... 40

Browse your Preference List to find orders ....................................................................................................... 41

Wrap Up ..................................................................................................................................................... 42

Personalize your LOS section ............................................................................................................................. 42

InBasket ..................................................................................................................................................... 43

Search for messages in your InBasket and save your searches ......................................................................... 43

Reorganize your InBasket folders ...................................................................................................................... 44

Create personal distribution lists for InBasket messages .................................................................................. 45

Send yourself reminders that appear when you need them ............................................................................ 47

Create QuickActions to write and route result notes ........................................................................................ 48

Create QuickActions to write routine QuickNotes ............................................................................................ 49

Create QuickActions to send routine staff messages ........................................................................................ 50

Create QuickActions to respond to routine Rx Requests .................................................................................. 51

Clean up your InBasket by postponing messages .............................................................................................. 52


3

Schedule

Choose which info appears in your schedule Customize your schedule to see the patient information you find most useful. Consider adding or removing columns and changing the order in which they appear to suit your personal preferences.

1. Open the Schedule activity and select a folder under My Schedule. Your personal schedule appears.

2. Click above the folder list and customize your schedule in the Properties window.

a. To reorder your columns, select one in the Selected Columns list and click or to move it.

b. To add a column, select it from the Available Columns list and click Add to include it in your schedule. For example, select the Meds Due column to see whether the patient has a medication due, or select the Referring column to see the referring provider for the visit.

c. To remove a column, select it from the Selected Columns list and click Remove. For example, you can remove the Provider column if your schedule lists only your visits.

3. Click Accept when you're finished.

Change the report buttons that appear in your schedule by clicking on the report toolbar. Refer to p. 4 for more information.


4

Customize your report toolbar Add, remove, or rename buttons on your report toolbar so you can quickly find the reports you use most often.

1. Click on the report toolbar. The Add or Remove Buttons from Toolbar window opens. 2. In the Report field, enter the report that you want to appear as a button on the toolbar. 3. In the Button Name field, enter a name for the report. This name appears as the button name. Enter a

brief name, if possible, so more buttons can fit on the toolbar. 4. Continue to add reports in the Add or Remove Buttons from Toolbar window as needed.

Use the and buttons to change the order in which the buttons appear on the toolbar.

5. Click Accept. The report buttons appear on the toolbar.

To add the report you are currently viewing to the toolbar, click and then click Add Current.


5

Create a sticky note reminder about a patient Use sticky notes to record personal reminders about your patients, such as the name of a patient's pet or her hobbies. The sticky note appears when you open the patient's chart, providing a convenient prompt about some of your past discussions.

1. Open a patient's chart and click in the patient header. The sticky note window appears. 2. Write your reminder. The information in the sticky note doesn't become part of the patient's

permanent chart and isn't available to other providers, so don't record any clinical information. 3. Click to save your note and close the window.

The next time you open the patient's chart, the sticky note automatically appears. You can add to or edit the information as needed.


6

Chart Review

Filter information in a patient's chart To find specific information in Chart Review more quickly, you can filter the data that appears on a tab. For example, you can choose to see only visits in a certain specialty.

1. While you're reviewing data on a Chart Review tab, such as Labs, click Filters. The filter pane appears.

2. Select the type of data on which you want to filter, such as Order. 3. Select an order from the list below or enter terms into the free-text search field. For example, you

could type "cbc, complete blood count," and then press Enter to make sure your filter catches labs that use both the acronym and the full name of the lab.

The filter options you see are based on the information in the patient's chart, so they vary by patient.

To quickly see the lab results over time in a table view, click Lab Flowsheet.


7

Create Quick Filters You can find specific patient data faster in Chart Review by creating Quick Filters. For example, you can create a Quick Filter that shows only encounters for which you were the provider. You can also filter on specific medications, orders, chief complaints, and more. Quick Filters appear for all of your patients. Other clinicians can't see your Quick Filters.

1. In Chart Review, apply one or more filter criteria. 2. To save your current combination of criteria as a Quick Filter, click Save as New Filter. The Save

Quick Filter window appears. 3. Enter a name for your Quick Filter and click Accept. The filter appears as a check box with the name

you entered above the list of encounters.


8

Keep clinical information on hand in the sidebar You can keep a Chart Review report visible while you're charting by pinning it to your sidebar. For example, it might be useful to keep a summary of the last visit in the sidebar while you complete your charting for the current visit. This keeps more information in view and reduces your need to move between different activities and reports.

Note that Chart Review reports show information from a longer period of time, not just from the patient's current admission.

1. In Chart Review, identify a report that you want to view while you chart, such as a summary of the last visit on the Encounters tab.

2. Right-click the row for the report and select Display in Chart Sidebar. A Visit Report tab appears in the sidebar on the right side of the screen.

Click between an activity and the sidebar to temporarily hide the sidebar. Click to view the sidebar again. You can also resize the sidebar, making it wider or narrower, by clicking and dragging its left edge.

3. If your computer has two monitors, consider moving the sidebar to the second monitor. To do so, click the arrow on the Visit Report tab at the top of the sidebar and select Move to Floating Window. The sidebar opens in a separate window that you can move.

Click Return to Sidebar to return the sidebar to its original position if you have it open as a floating window.


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Rearrange the sections in a Chart Review report While reviewing a report in Chart Review, you can rearrange the report to make the information that's most important to you appear toward the top in your personal view. For example, you might want results to appear at the top so you don't have to the scroll through the report to see them. After you rearrange a report, the report appears this way for all patients until you or an administrator updates the report. Note that certain sections of a report cannot be moved.

1. Open a patient's chart, access Chart Review, and select a report.

2. Select the Preview check box or right-click and select Show Preview to view a preview of the report.

3. Click . The Customize sidebar appears. 4. Rearrange the report by dragging and

dropping a section.

To discard your changes, click Reset.

5. Click Accept to save your changes and close the sidebar. Now, when you view this report for any patient, it appears in your preferred order.

Select the Auto-Apply check box at the bottom of the Customize sidebar to see your changes in the report as you rearrange it. If this check box is

selected, click Close to finalize your changes.


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Review information from several visits at once If you want to review several of a patient's visits or search for information across multiple visits, you can view all this information in a single report, within which you can then search for specific phrases or keywords. For example, if you want to review all office visits in which you addressed a patient's diabetic foot ulcerations, select only visits with a diagnosis of diabetes, and then search for the term "ulcer" in the consolidated report.

1. In Chart Review, go to the Encounters tab and select the visits you want to review.

If the visits are next to each other in the list, press Shift while selecting the first and last encounter you want to review.

If the visits aren't next to each other in the list, press Ctrl and select each visit you want to review.

2. Click Review Selected to view a report that includes information from all of the visits you selected. 3. Press Ctrl+F to search for a specific phrase or keyword across all of the visits you selected. 4. Enter the words you want to search for in the Find field and press Enter. The word is highlighted each

time it appears in the report. 5. Continue pressing Enter to jump to the next instance of your search term in the report.

You can also use this method on other Chart Review tabs to review a report that includes multiple labs, procedures, medications, or notes.


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Graph data and view flowsheets from Chart Review You can identify trends in a patient's lab results from Chart Review by comparing several past results in a lab flowsheet or graph. You can also compare several of a patient's past results by viewing the results in a lab flowsheet.

1. In Chart Review, select the Labs tab and select the most recent result of the test you want to review.

2. If there are a lot of results, click Filters and select the check box for the test you want to see. Only results for the filtered test appear.

3. In the report for this result, click to see all of the patient's previous values for this lab in a table format so you can graph the information. The results appear by date, with abnormal results highlighted in yellow.

4. Select the rows and columns of data you want to graph and click Graph Region.

You can view results in a bar graph by clicking Bar Chart while you're reviewing a graph.

You can change the orientation of a flowsheet by selecting a different date option while you're reviewing the flowsheet. You can choose to see the dates as column headers or row names.


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Open an encounter from Chart Review Speed up documentation by opening an encounter from within Chart Review. For example, if you're reviewing a patient's encounters and decide you want to add a note to an upcoming encounter, you can open it without leaving Chart Review.

1. On the Encounters tab in Chart Review, right-click the encounter you want to document. 2. Click Edit or Addend. The encounter opens.


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Categorize and find your notes using bookmarks To quickly find information later, add bookmarks in Chart Review or the Notes activity. For example, when you write a note about a patient beginning to experience nausea, apply the Symptom Change bookmark. Later, you can sort notes by whether or not they're bookmarked to quickly review all your notes about the patient's symptom changes.

1. While writing or viewing a note, click Bookmark. The Add Bookmarks window appears.

2. Select a bookmark category and click Accept. A bookmark icon ( ) appears next to the note in the Notes activity and Chart Review.

3. To sort notes in Chart Review, click the Bookmark column header. Hover over the icon to view a bookmark's categories.

4. To add, edit, or remove a bookmark, go to Chart Review or the Notes activity and click Bookmark. The Edit Bookmarks window appears.

Select another bookmark category to add it. Select an existing category

to clear it.

Click Remove Bookmarks to clear all bookmark categories from the note.


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Copy information from a patient's chart for use in a letter or note Use your PasteBoard to collect information for a note or letter as you review a patient's chart or document his visit. The information you add to your PasteBoard for a patient persists until you remove it. When you're ready to add the information to a letter or note, you can open your PasteBoard and quickly insert the appropriate text.

The content you add to your PasteBoard for a patient appears in the PasteBoard only for you. Other clinicians do not see the content you've added when they open their PasteBoards for that patient.

The information that you copy to your PasteBoard isn't updated with the most recent patient data. Information that might change over time, such as a patient's lab results, medication list, or problem list, appears as it did when you copied it to your PasteBoard. You can see the date on which you copied the information at the top of each entry.

Copy information to your PasteBoard You can copy information to your PasteBoard from several places in a patient's chart, including Chart Review reports, SnapShot reports, notes, and letters.

1. Select the text you want to copy.

2. Right-click the text and select Copy to PasteBoard.

The PasteBoard can hold several items for each patient.


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Modify the contents of your PasteBoard To open your PasteBoard, click on any report toolbar or on the SmartTool toolbar in a note or letter. You

can also right-click text and select Launch PasteBoard.

From your PasteBoard:

A. Add a description to an entry on your PasteBoard by clicking Click to add description. This title appears only in your PasteBoard as a reminder to you.

B. Select one or more entries and click Clear Selected to delete those entries.

C. Click Clear All to delete all entries.


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Insert information from your PasteBoard into a note or letter In a note, letter, or other field that allows you to access your PasteBoard, place your cursor in the spot where you want to insert the content.

A. To insert a single entry, double-click that entry or click for that entry.

B. To insert multiple entries, select each entry you want to insert and then click Paste Selected.

C. To insert all the entries on your PasteBoard, click Paste All.


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Diagnoses and Problems

Review and update the patient's problem list 1. To add a problem, enter the first few letters of the problem in the Add a new problem field and press

Enter. A list of matching problems appears. 2. Double-click the appropriate problem. 3. Enter information about the problem, such as its priority and whether it's a chronic problem.

You can change whether a problem is marked as chronic after it has been added to the list.

means that the problem is chronic. Click the red pin to remove it. Hover in the column and click to mark the problem as chronic.

4. When you've finished, click Accept.

5. To add a problem to the patient's visit diagnoses, click in the Visit column. means that a problem has been added as a visit diagnosis.

6. To update an existing problem, click the problem's name and then click Details. 7. To view and modify additional details, including related goals and related medications, click More

Detailed View. The Problem List opens in a new activity tab.

8. To specify which information you want to see in your view of the problem list, click Options and

then Choose Columns. Then select or clear check boxes to add or remove columns. When you've

finished, click Accept.

9. If a problem has been resolved, click the problem's name and then click Resolve. The problem is removed from the list, but you can still view it by selecting the Past Problems check box.

10. When you've finished with your updates, click Mark as Reviewed. The patient's chart is updated to indicate that you reviewed the problem list, and the date and time appear.


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View a patient's resolved problems and medical history in the Problem List View a patient's resolved problems and past medical history together with her problem list to see a more complete picture of her medical issues.

1. In the Problem List section, select the Past Problems check box. Resolved problems and past medical history appear on the problem list.

a. Resolved and historical issues appear in plain text rather than bolded text and are labeled as resolved or as from the patient's past medical history.

2. To group resolved problems and past medical history separately from active problems, click and select the Status option.


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Prioritize a patient's problem list Use priorities to sort a patient's problem list. Unlike most information in Epic, your changes to a problem's priority appear only to you and not to other clinicians. Therefore, you can use priorities to personalize a patient's problem list in a way that makes sense to you without considering how your changes affect other clinicians.

1. In the Problem List section, click and select the Priority option to group the problems by priority.

You can also add the Sort Priority column to sort the patient's problems by priority without separating them into groups.

2. Expand a problem and click the Sort Priority link to select a new priority.


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Record a diagnosis for the visit To record a diagnosis that shouldn't also be on the patient's problem list, document it in the Visit Diagnoses section. The patient's previous diagnoses and current problems appear as menus, and a configurable list of common diagnoses appear as buttons.

If the diagnosis you need appears, click that button or select it from the appropriate menu. If not, enter the first few letters of the diagnosis in the Search for new item field and press Enter.

Double-click the appropriate diagnosis from the list that appears.

If a more specific diagnosis is required for billing at your organization, the Diagnosis Calculator appears so you can add more details.

Click to move a set of buttons to a drop-down menu. Click the menu and select Expand menu to buttons to have the patient's previous diagnoses or current problems appear as buttons.

Click in the PL column to add a visit diagnosis to the patient's problem list. A icon means that a diagnosis is on the problem list.

The first diagnosis specified for the visit is automatically marked as primary. To mark a

different diagnosis as primary, click in the P column to the left of that diagnosis. The symbol denotes the primary diagnosis.


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Notes and SmartTools

Copy a previous note Instead of starting from scratch each time you write a note, you can start from a copy of a similar note. For example, if the patient was seen recently for the same problem, you can copy the note from that visit and then make changes to it as needed. If the note includes SmartLinks, they refresh automatically so your note includes the most recent data.

Copying notes can be efficient, but if it's not done carefully, it can lead to unnecessarily long notes with inaccurate or outdated information.

When you're reviewing notes, you can hide copied text to de-emphasize content pasted from other sources, like previous notes. You can also hover your mouse over a section to see who originally wrote it.


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Copy a note in the Notes activity 1. In the Notes activity, click . The Copy Note window opens.

2. Select a note from the list to see a preview in the lower pane.

a. To see older notes, click More. b. To see only notes you've written, select the Show only my notes check box.

3. Select the note you want to copy and click Accept. The note is copied to your new note, and you can edit it as you normally would.

To copy only a portion of a note, highlight the portion you want and click Add Text Only.


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Copy a note in NoteWriter In NoteWriter, you can quickly copy all or part of the information in a patient's previous note to use for the note you're writing. For example, if most of the ROS findings from a previous note still apply, you can copy that information forward with a few clicks. Any findings you document before copying the note are preserved, and you can make more changes afterward to make sure the note is up-to-date.

1. Open a new note in NoteWriter.

a. To copy an entire note, select any tab and click Copy Note. b. To copy only a specific part of the note, such as ROS or physical exam, select the appropriate tab

and click Copy HPI/ROS/Physical Exam (depending on which tab you've chosen).

2. In the Copy window, select a note and review the text in the pane below. 3. Click Accept to add the information to your current note. 4. Update the copied note as necessary to ensure the note is accurate for the current visit.


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Write your note in the sidebar If you write your note in the sidebar, your note text remains open when you move between activities. This is useful for referring to other information, like lab results, while writing your note.

1. Click Move in the upper right corner of the Notes activity and select Move to Sidebar. The sidebar shows your note text, and you can write your note here as usual.

If you switch to another activity, like Chart Review, the note remains open.

If you are using NoteWriter to compose your note, the text of the note in the sidebar changes as you make selections on the NoteWriter tabs.

If you switch to a different activity, you can return to the NoteWriter by clicking the buttons at the top of your note, such as HPI or ROS.

2. To return the Notes activity to the list of tabs on the left,

click on the Notes tab in the sidebar and select Move to Left Pane.

3. Click Accept to save your note.


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Jump start routine notes with speed buttons Add personalized buttons to your notes navigator sections or sidebar so your most commonly used note templates are available in one click. You can create a button that starts a new note using a specific SmartPhrase or SmartText.

1. Click the in the upper-right corner of a notes navigator section or sidebar. The Notes Personalization window opens.

2. Click to add a new button.

a. In the Caption field, enter the name that you want to appear on the button. b. Add either a SmartPhrase or SmartText.

3. Click Accept. The button appears at the top of your notes section.


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Create a NoteWriter macro to record your common findings A NoteWriter macro can help you document a typical exam or procedure more efficiently. A macro is a set of signs, symptoms, and pertinent negatives that you commonly record during an ROS or physical exam, or information that you commonly record in a procedure note. For example, during an ROS, you can document the patient's symptoms and then apply a macro to note all pertinent negatives. Anything you document before applying the macro is preserved, and you can also make changes after applying it.

Create a macro on the fly Follow these steps to create a macro on the fly, based on the documentation you've recorded for the current patient.

1. After making your selections on the ROS, Physical Exam, or Procedures tab of the NoteWriter, click

to the right of the Manage Macros button and select Create macro from current data. 2. In the Macro Selection window, enter a name for your macro in the Macro field and click Accept.

Note any age and sex restrictions that appear. For example, the macro you create might apply only when you're doing a review of systems for females age 13 and older. These restrictions allow you to create different macros for female, male, and pediatric patients.

3. In the SmartBlock Macro Editor, select any other items that you commonly record. Then select the

Active check box and click Accept. Your macro is now available for use.

Note that any additional changes you make in the editor are not automatically applied to your note for the current patient.

To share this macro with a colleague, list her name on the Owners/Users tab in the SmartBlock Macro Editor.

4. To apply this macro at a future visit, click

the new button that appears at the top of the NoteWriter.

If you have multiple macros for a tab, select the Set as primary macro check box in the editor to make your most commonly used macro appear first in the list.


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Create a macro at your convenience Follow these steps to create a macro at any time.

1. In NoteWriter, click Edit Note or go to the sidebar. When your note text appears, right-click the orange review of systems, physical exam, or procedure text, depending on the type of macro you want to create. Note the SmartBlock name in parentheses, which you'll need in step 4.

2. Select Epic button > Tools > SmartTool Editors > SmartBlock Macro. 3. In the Macro Selection window, enter a name for your macro in the Macro field. 4. In the SmartBlock field, enter the name you noted in step 1. Enter any necessary age and sex

restrictions and click Accept.

For example, you can make the macro available only when you're doing an ROS for females age 13 and older. These restrictions allow you to create different macros for female, male, and pediatric patients.

5. In the SmartBlock Macro Editor, select the signs and symptoms you commonly review during an exam or the prep steps you frequently perform before a procedure, for example.

6. Select the Active check box.

7. Click Accept. Your macro is now available for use. 8. To apply this macro at a future visit, open the NoteWriter tab for the type of macro you created, click

the new button that appears at the top of the tab.


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Organize, edit, or delete your note macros In the Macro Manager, you can organize how your macros appear in the NoteWriter so that the ones you use most often are easily accessible. You can also edit, hide, and delete your macros from the Macro Manager.

1. In the NoteWriter, click Manage Macros. The Macro Manager opens. 2. In the Select a SmartBlock field, select the SmartBlock for which you want to create, edit, or organize

macros, such as Review of Systems by Age. The SmartBlock you were working with when you launched the Macro Manager appears in this field automatically. Your macros for this Smart Block appear in the table below.

If you want to look up macros for all types of SmartBlocks, clear the Hide SmartBlocks I don't use check box.

3. Make changes to the available macros and click Accept to save your changes.

Organize: To rearrange macros so that the most common ones are listed first on the NoteWriter toolbar, drag and drop the macros until they're in your preferred order.

Edit: To modify the selections in a macro, click . The SmartBlock Macro Editor opens so that you can make your changes.

Hide: If shared macros created by other users appear in your list, and you don't use them, select the Hide check box for those macros.

Delete: If you own a macro and no longer want to use it, click next to that macro. Deleted

macros are listed in the bottom pane. If you want to use a deleted macro again, click to reactivate it.


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Find your favorite SmartTexts faster There are hundreds of available SmartTexts, but you probably use only a handful. Find the ones you use most often with just a few clicks by marking them as your favorites.

1. Open a new note. 2. In the Insert SmartText field, enter the first few letters of the SmartText you want and press Enter. The

SmartText selection window appears. 3. Select the correct SmartText and click Add Favorite. 4. Add other commonly used SmartTexts to your favorites by searching for them in the Match field and

repeating step 3. 5. Select the Favorites tab and click Make Tab Default.

From now on, when you click in a new note, your favorite SmartTexts appear. Additionally, when you search for a SmartText in the Insert SmartText field, only your favorites

appear. If you can't find the SmartText you need on your Favorites tab, select the Encounter Matches tab and search for it in the Match field.

6. Click Accept to insert the SmartText in your note, or click Cancel to save your favorite selections without inserting them into your note.


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Use SmartPhrases and SmartLinks

Use a SmartPhrase SmartPhrases allow you to type a few characters that automatically expand to a longer phrase or paragraph. For example, typing ".aaa" expands to "abdominal aortic aneurysm." Typing ".hpipneu" and selecting the HPIPNEUMONIAGEN SmartPhrase expands to a long paragraph.

1. In a SmartTool-enabled field, enter a period (.) followed by the SmartPhrase's name (".aaa"). As you type, a list of matching SmartPhrases and SmartLinks appears.

2. Use the arrow keys to select the SmartPhrase you want to use in your note and press Spacebar to insert it.

3. Complete any SmartLists and wildcards (***) in the SmartPhrase.

A wildcard (***) is a placeholder. Press F2 to jump to a wildcard and type over it with the text you want to add, or delete it.

Use a SmartLink SmartLinks help you write notes quickly by pulling, or "linking," information from the patient's chart directly into your documentation. For example, typing ".lastcbc" pulls in the patient's last CBC result.

SmartLinks often appear within SmartPhrases, but you can also use them on the fly. Enter a period (.) followed by the SmartLink's name, as you do when using a SmartPhrase.

When inserting a SmartLink, press Enter to start a new paragraph after pulling in the SmartLink. Press Spacebar to continue with the same sentence or paragraph.


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Browse available SmartPhrases and SmartLinks 1. Click on the SmartTools toolbar. The SmartLink/Phrase Butler opens and any SmartPhrases you've

created appear. If none appear, select System SmartPhrases to see all available phrases.

The Abbrev column shows you what to type after the period (.) to use the phrase or link in a note. The Expansion column shows you the text that the phrase or link pulls in or, for longer phrases,

includes a general description of the text.

indicates a SmartPhrase. indicates a SmartLink.

2. To find phrases and links, you can:

a. Use the Filter tab to select the SmartTools you want to see. b. Search for specific links or phrases.

c. Click to mark links and phrases as favorites. d. Use the Sort tab to control which items are listed first.

3. Double-click a SmartPhrase or SmartLink to insert it.

To see all available phrases and links, enter ".?" in a note.


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Create a SmartPhrase to reuse text you commonly type If you often type the same phrases and sentences while charting, create a SmartPhrase to save time in the future.

Create a SmartPhrase from text you type 1. While charting, type the text you want to save as a SmartPhrase. Make sure the text doesn't include

any patient-specific information, so you can reuse it for other patients.

You can create a SmartPhrase anywhere you see this toolbar:

2. Select the text and click . The SmartPhrase Editor window appears. 3. In the Name field, enter a short, intuitive name for your SmartPhrase. This is the name you'll type to

insert the SmartPhrase in a note.

You can't include spaces or symbols in the name. Tip: Preface the name with your initials so you can find it

easily.

4. Enter a summary of your SmartPhrase in the Short Description field.

When you search for your SmartPhrase, this description appears in the results after the SmartPhrase name.

5. If you want to make your SmartPhrase available to other users, designate them on the Owners & Users tab.

Owners can update the shared SmartPhrase. Users can only use the SmartPhrase.

6. Click Accept to save and close your new SmartPhrase. 7. To use your SmartPhrase in a note or letter, type a period immediately followed by the SmartPhrase

name. Press the Spacebar to insert your SmartPhrase in the note.

Create a SmartPhrase from a SmartText If you frequently make the same changes to a certain SmartText, save your edited version of the text as a SmartPhrase.

1. Open a new note.

2. Click to open the SmartPhrase Editor. 3. Click to open a list of SmartTexts. Search for the SmartText you want to edit and click Accept. The

SmartText appears in the SmartPhrase window. 4. Edit the text to reflect your preferences. 5. Follow steps 3-6 of the "Create a SmartPhrase from text you type" section of this guide to name and

save your new SmartPhrase.


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Customize your SmartPhrases To write notes more efficiently, add SmartLinks and SmartLists to your personal SmartPhrases. You can also add synonyms to make your SmartPhrases easier to find.

To edit a SmartPhrase you created, click Personalize on the main toolbar and select My SmartPhrases.

The SmartPhrase List activity opens and a list of your personal SmartPhrases appears. Double-click the SmartPhrase you want to edit. The SmartPhrase Editor opens, and you can begin customizing your SmartPhrase.

You can delete your duplicate or unused SmartPhrases from the SmartPhrase List activity.

Select the SmartPhrase you want to delete and click Remove.

Add a SmartLink to pull in patient-specific information Use SmartLinks to pull information from another part of the patient's chart into your SmartPhrase, such as the patient's name or last CBC results.

1. In the location where you want the SmartLink to appear, enter a period followed by the first few letters of the SmartLink's name. A list of matching SmartLinks appears.

2. Double-click a SmartLink to add it to your SmartPhrase. The SmartLink appears in your SmartPhrase between @ symbols, such as @NAME@.

3. Click Accept. Click Close. The next time you use this SmartPhrase, patient-specific information appears where you added the SmartLink.


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Add synonyms to quickly find your SmartPhrases Add synonyms to make your SmartPhrases easier to find. When writing a note, you can pull in your SmartPhrase with its name or a synonym.

1. Select the Synonyms tab. 2. In the Synonyms field, enter any other names you might use to search for this SmartPhrase. For

example, you might name a SmartPhrase ABDOMINALPAIN and include a synonym of STOMACHPAIN. 3. Click Accept. Click Close. In the future, you can pull in the SmartPhrase by typing a period followed by

either the SmartPhrase name or the synonym.

Add a SmartList to select from a predefined list of choices Use SmartLists to select from a list of common choices when writing your note. For example, add an abdominal pain SmartList in a SmartPhrase so you can select a different pain level each time you use the SmartPhrase to chart the patient's progress over time.

1. In the Insert SmartList field on the right, enter the first few letters of the SmartList and press Enter. The SmartList window opens, and a list of matching SmartLists appears.

2. Double-click the SmartList you want.

3. Click Add to SmartPhrase to insert the SmartList into your SmartPhrase. The SmartList appears in your SmartPhrase in braces.

4. Click Accept. The next time you use this SmartPhrase, you must make selections from all included SmartLists before you can sign the note.


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Use SmartLists SmartLists are lists of common choices that help you quickly customize your documentation. For example, the respiratory history SmartList contains choices like asthma and COPD. SmartLists are used in SmartTexts and SmartPhrases and look something like this: {resp history:19195}.

Select from a SmartList 1. Press F2 to highlight the next SmartList or wildcard (***) in your note. Some values in a SmartList might

be selected for you. 2. Click other values to select them.

A yellow background indicates that you can select only one value. A blue background indicates that you can select one or more values.

3. If you accidentally select a value, click again to clear it. 4. Right-click in the SmartList to save your selections and move to the next SmartList or wildcard.

Try the mnemonic "left to pick, right to stick" to remember which mouse button to use.

You can save time by documenting any abnormal values first and then applying any default values for the remaining SmartLists in one click. After selecting abnormal values, click on the SmartTool toolbar to apply any available default values for the remaining SmartLists.

Undo a SmartList selection To undo your last selection, click or press Ctrl+Z.

To undo any SmartList selection, right-click the SmartList and choose Reselect This SmartList's Selections.

Use keyboard shortcuts to complete SmartLists. With a SmartList selected, press Up Arrow and Down Arrow to move through the list. Press Spacebar to select a choice. Press Enter to accept your choices and move to the next SmartList or wildcard (***).


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Orders

Edit multiple orders at the same time After entering a set of orders, you might notice that several of them require the same type of change, such as a different status, class, resulting agency, or interval. To speed things up, you can edit them at the same time instead of individually. For example, you can mark a set of related lab orders as Standing and give them an interval of every 12 weeks. Or, you can quickly change the class to indicate that all the labs will be done at an external lab.

1. In the Meds & Orders section, enter several lab orders and click Edit Multiple at the bottom left of the section.

2. In the Edit Multiple window, click Select All to quickly select all of your orders. 3. If you also entered medications, select the Procedures check box instead. 4. If necessary, clear the check boxes for any orders you don't need to edit. 5. Edit the details of the orders on the right side of the window.

a. For instance, enter "External" as the class, "Standing" as the status, "m+9" as the expiration date, "Every 12 weeks" as the interval, and "3" as the count.

6. Click Accept to apply these values to each of the labs you selected and return to the Meds & Orders section.

7. If you're done placing orders,

click Sign.

If you decide not place an order, you can remove it by selecting the order and clicking Remove Selected. The order is removed from the Edit Multiple window and from the Medications & Orders section.


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Create Preference List sections For efficient preference list setup, first create sections that are useful to you, such as disease or body system sections. Then, when you place a commonly used order, you can save it as a favorite and add it to the correct section in your preference list.

1. Click Personalize on the main toolbar and select Preference List Composer. 2. From the list that appears, double-click your outpatient or inpatient Orders preference list. The list is

called "<your name> Orders Preference OP" or <your name> Orders Preference IP."

You need to choose the Orders list, because when you place an order and save it as a favorite, those orders are automatically added to the Orders preference list.

3. Click New Section in the toolbar. 4. Enter a display name for the section.

Add sections that are appropriate for your specialty and that group orders you often place at the same time. For example, you might add sections for diseases or body systems.

5. In the Sort alphabetically in order entry field, indicate whether you want the orders in this section to appear alphabetically when you are browsing your preference list.

6. Click Accept. 7. To add a subsection, select the section it should appear under, and click New Subsection.

Add subsections that group orders appropriately for your specialty. For example, you might add subsections for meds, labs, and imaging to various disease sections.

Reorganize the sections and subsections in your preference list by dragging and dropping them or by using the and buttons at the bottom left of the activity.

8. Click Close when you're finished adding sections. To use your updated

preference list, click New Order in the Meds & Orders navigator section.


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Add orders to your Preference List as you place them 1. Look up and select an order as you normally would. Then edit the order details and click Accept.

2. Before signing your order, click to add it to your preference list. The Add To Preference List window opens.

3. Enter any other details you want to use when you place this order in the future, such as instructions or answers to questions, and click Accept. Remember that these details appear only for you, and you can always update them later.

a. In the Display name field, enter an easy-to-remember name for the order. The next time you need to place this order, you can search for your saved order using this name.

b. In the Section field, enter the section of your preference list in which you want this order to appear. Or, click New Section to add another section to your list.

Consider adding the same order to your preference list more than once with different di splay names and order details. For example, you might have one entry called "Cipro UTI 3 days" for Ciprofloxacin UTI with a dose of 250 mg Q12h x 3 days and another called "Cipro Sinus 5 days" for Ciprofloxacin sinusitis with a dose of 500 mg Q12h x 10 days.


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Edit your Preference List 1. Click Personalize on the main toolbar and select Preference List Composer. 2. From the list that appears, double-click your outpatient or inpatient Orders preference list. 3. In the Preference List Composer, select the preference list section you want to edit. 4. To move an order from one section to another, click the order's name and drag it to the section you

want.

Orders you starred automatically appear in the My Favorites section.

5. To modify details about the order, such as frequency or display name, double-click the order's name. In the window that appears, change the order details as needed and click Accept.

6. To change the name of a section or subsection, select that section or subsection and click Properties in the toolbar.

7. When you're finished making changes to your preference list, click Close.


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Copy Preference Lists from other clinicians To save time creating a preference list, you can copy the lists that other clinicians have created for certain types of orders. Sharing and copying preference lists between clinicians also helps spread experience and expertise throughout your organization.

1. Click Personalize on the main toolbar and select Preference List Composer. The Preference List Selector opens.

2. At the bottom of the screen, click Copy User. The PrefList Copy User activity opens. 3. In the From user field, enter the name of the user whose preference list you want to copy. 4. Verify that your name appears in the To user field. 5. Select a copy option.

If you want to add the other user's list to your existing list, select Merge. To completely replace your list with the other user's list, select Replace.

6. Select the check boxes for the types of lists you want to copy.

The columns under your name and the other provider's name show how many orders are on each of your preference lists.

To see the orders on your colleague's list, double-click the number of items on his list.

7. Click Copy. A confirmation window appears. Edits you make in the new list do not affect your colleague's list.


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Browse your Preference List to find orders After you have set up your preference list, you can speed up ordering by clicking New Order in the Meds & Orders section and selecting the orders you need from the list.

1. To see only your personal preference list entries, select the Only Favorites check box on the Browse tab.

2. Right-click an order in the Preference List Browser to change the details you saved, such as the display name or dose.

3. Select the orders you want to place and click Accept.


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Wrap Up

Personalize your LOS section Edit the Level of Service section to speed up documentation at the end of a visit. You can add up to 25 LOS buttons, personalize button names, and choose how the buttons are ordered and grouped.

1. In the Level of Service section, click . 2. Edit your LOS buttons:

a. To add a new button, click in an empty rectangle. Add a caption and code in the window that opens.

b. To edit a button caption, hover over an existing button and click the icon that appears. c. To rearrange buttons, drag and drop buttons to where you want them to appear.

3. When you have finished editing, click Accept.

Click Restore Defaults to undo your changes and return to the default setup.


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InBasket

Search for messages in your InBasket and save your searches Quickly find specific messages in your InBasket with the Search feature. For example, you can search for all Results messages that have been marked as Done within a certain timeframe. If you often search for the same type of message, you can save your search for use in the future.

1. From your InBasket, click Search on the In Basket toolbar. 2. Enter your search criteria in the window that appears. For example, to search for messages with a high

priority, clear the All check box above the Priorities pane and select High. 3. If you're searching for specific message types, clear the All check box above the Message Types pane

and select the appropriate message types. 4. Modify other criteria as needed and click Search. 5. For searches you want to use again in the future, click Save As in the search window, enter a name for

your search, and then click Accept. Your search now appears under your name in the Available Settings pane for future use.

6. Your search results appear at the bottom of the InBasket screen. Click any folder to browse its contents. You can also browse the results of your search using the folders under the Search Results tab on the left.


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Reorganize your InBasket folders To make it easier to find important or frequently used folders, you can move them to the top of the list. Or, if you prefer, you can alphabetize the entire list.

1. On the InBasket toolbar, click Settings. The User Settings window opens. 2. Select the Display Order tab. 3. Select your most frequently used folders in the Default Display Order column and click Add > to move

them to the Keep Near the Top column.

To remove a folder from the Keep Near the Top column, select it and click < Remove.

4. In the Keep Near the Top column, select a folder and use the and buttons or drag and drop to rearrange folders. When the folders in this column contain messages, they appear at the top of the folder list pane in the order you've specified.

The remaining folders continue to appear in the default display order below the folders you've moved to the top.

5. Click Accept to save your preferences.

To alphabetize all your InBasket folders, click Add All >> and then A -> Z.


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Create personal distribution lists for InBasket messages If you frequently route notes, results, letters, or addenda to the same set of people, you can save the recipients in distribution lists called My Lists, which you can use to add recipients to your messages in just a few clicks. For example, you can create a results My List that includes one of your colleagues and the nurses in your department. Your letters My List could include the support staff who edit and send your letters.

1. Open an activity where you can send messages to your colleagues. For example, from your InBasket, open the Patient Calls folder, select a message, and click QuickNote. Or open a patient's telephone encounter and go to the Routing section.

2. Click Build My Lists. The Build My Recipient Lists window opens with the appropriate tab selected. For example, when creating a My List from a Patient Calls message, the Call Enc tab is selected.

3. Enter your preferred recipients for this type of message in the Recipient list. To add a pool, such as your department's nurses, enter "p" followed by a space and the name of the pool.

4. Select the Allow selection of individual recipients? check box if you want the option of adding only some recipients from your list. This option is useful, for example, if you route some messages to residents, some to nurses, and some to both.

5. Click Accept to save your list.


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6. To use the My List you just built to send a message, click Add My List. Your preferred recipients are added.

a. If you selected the Allow selection of individual recipients? check box in step 4, an Add Recips button appears instead of the Add My List button. Click Add Recips and select the specific recipients to add, or select the Add My List option to add your entire list.

b. To add recipients from other My Lists, click on the Add My Lists button and select the list you want to use.


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Send yourself reminders that appear when you need them With InBasket's time delay feature, you can send a reminder to yourself or your staff that won't show up until you need it. For example, after seeing a patient, you can send yourself a reminder to follow up with her about an upcoming surgery and set the reminder to appear a week from now.

Follow these steps to send yourself a reminder:

1. Go to Epic button > Patient Care > Remind Me. 2. Complete the reminder message with any relevant information:

a. Enter a subject for your message. b. Enter a patient, if appropriate. If you create the reminder while you're in a patient's chart, that

patient's name is automatically attached to you message. c. Optionally, select a flag to remind yourself of the task you need to complete. Flags appear in the

Reminder column in InBasket, so you can see what you need to do at a glance. d. Enter a due date. You can sort your messages by due date so the tasks due soon appear at the top

of your list.

3. Change when the message will appear in your InBasket by adjusting the send date on the Options tab. 4. Click Accept.


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Create QuickActions to write and route result notes If you receive Results messages that require routine follow-up, you can write and route your standard result note in a few clicks using a QuickAction. For example, you can create a QuickAction that creates a note asking a nurse to call the patient, sends the note to the nurse pool, and removes the associated Results message from your In Basket.

1. Click Manage QuickActions on the In Basket toolbar to open the QuickAction Manager.

2. Click New QuickAction > Result Note. 3. Enter a brief name for your QuickAction, such as "Normal - Call", in the Button name field. 4. Configure this QuickAction to meet your needs:

To have a chance to edit the result note before it's filed, select the Show note before filing check box.

To automatically remove the associated Results message from your In Basket, select the Mark In Basket message as complete after filing check box.

5. Specify which results should be attached to your note. In the Orders to select section, choose:

All to attach your notes to all results in a message. None if you don't want to attach your note to any results. You can choose results on the fly if you

selected the Show note before filing check box in step 4. This option is not recommended, because it's faster to locate your note when it's attached to a result.

Abnormal results to attach your note to only the abnormal results in a message.

6. To send your note to a colleague, select the Route note to check box and specify the recipients for your Result Note message. For example, send it to the patient's PCP or to other recipients, like a pool of nurses.

7. Enter your note in the Result Note field on the right. Any SmartLinks you use are personalized for the patient when you use this QuickAction.

8. To release the result to the patient, select the Release to MyChart check box. You can write a comment for the patient in the MyChart Comment field.

9. When you're finished, click Accept. A new QuickAction button appears on the report toolbar in all of your Results messages.


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Create QuickActions to write routine QuickNotes Use QuickActions to write and route standard QuickNotes in a few clicks. For example, if you often respond to cosign messages by writing an attestation note, you can create a QuickAction that files the note to the related visit, sends a response to the resident, and removes the associated message from your InBasket.

1. Open a message that includes the QuickNote button, such as a Cosign - Chart message. Click QuickNote on the folder toolbar.

2. Click Save as QuickAction at the bottom of the QuickNote window to open the QuickAction Editor. 3. Enter a brief name for your QuickAction, such as "Attest", in the Button name field. 4. Enter your message in the text box. Any SmartLinks will be personalized when you use this

QuickAction. 5. To send your note to a colleague, select a recipient from the list or enter her name in the Recipient

field. For example, send it to the patient's PCP or reply to whoever sent you the InBasket message. 6. Configure the options at the bottom of the window as needed:

To have a chance to edit your note before it's filed to the patient's chart, leave the Show note before filing check box selected.

To automatically remove the associated message from your InBasket, select the Mark In Basket message as complete after filing check box.

7. When you're done, click Accept. A new QuickAction button appears on the report toolbar in all messages of this type.


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Create QuickActions to send routine staff messages Use QuickActions to send common messages, such as Staff messages, in a few clicks. For example, you could create a QuickAction to send yourself a reminder Staff message in a week to make sure that a patient's symptoms have improved. Any QuickActions you create are available from InBasket and within a patient's chart, so you can quickly send messages about specific patients.

1. On the InBasket toolbar, click the arrow to the right of the Manage QuickAction button and select Send Message. The Send Message QuickAction Editor opens.

2. Enter a brief name for your QuickAction, such as "Personal Reminder," in the Name field. 3. In the For field, select the type of message you want to send. 4. Enter your preferred recipients, such as yourself or your clinic's nurse pool, in the To and Cc fields. 5. Configure the rest of the fields to meet your needs. Note that you'll have a chance to change these

settings before sending your message:

a. In the Subject field, enter a title for your message. Note that this field does not appear for all types of messages, such as Patient Call Back.

b. In the Priority section, optionally change the priority of your message to High or Low. c. In the Send on field, enter the date you want your message to be sent. If you leave this field blank,

the message is sent immediately. Use date shortcuts, such as "t" for today and "w" for week. For example, to have the system send your message in a week, enter "w+1".

d. If you want to distinguish these messages with a flag, select one from the Flags list. e. In the text box, enter a template for your message using free text or SmartPhrases. Or search for a

SmartText in the Insert SmartText field.

6. When you're done, click Accept. Use your new QuickAction in the following places:

In your InBasket, by selecting it from the New Msg menu on the InBasket toolbar. In a patient's chart, by clicking More > Send Msg and selecting the QuickAction. When you use

your QuickAction from a patient's chart, the patient is automatically attached to your message. If you don't want the patient to be tied to your message, access your QuickAction from InBasket.


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Create QuickActions to respond to routine Rx Requests Respond to routine Rx Request messages in a few clicks using QuickActions. For example, you can create a QuickAction that refuses a request, indicates that the patient needs an appointment, files a note to her chart, and removes the associated message from your In Basket.

1. On the In Basket toolbar, click the arrow to the right of the Manage QuickActions button and

select Rx Request Refuse or Rx Request Approve. 2. Enter a brief name for your QuickAction, such as "Needs Appt", in the Button name field. 3. Configure the QuickAction to meet your needs:

a. To have a chance to edit your response before it's sent, select the Show before filing check box. b. To automatically close the refill encounter after sending your response, select the Close encounter

after filing check box. This option is helpful if no additional follow-up with the patient is necessary. c. For approvals, select the number of refills to approve. Select As requested to approve all refills, or

select Other and enter the number of refills you want to sign. d. For refusals, optionally enter a reason, such as "Patient needs an appointment". e. In the Notes field, optionally write a note that will be filed in the patient's chart. Any SmartLinks

you use are personalized for the patient when you run this QuickAction. f. To send the note to a

colleague, select the Route note to check box and specify the recipients, such as the person who sent the request.

g. In the Routing comments field, enter any comments that you want to appear in the Rx Response message that's automatically sent to your nurse pool.

4. When you're done, click Accept. A new QuickAction button appears on the report toolbar in all of your Rx Request messages.


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Clean up your InBasket by postponing messages If you have an important message that you want to reference at a later date, you can postpone it. A postponed message is removed from your InBasket and reappears on the date that you choose. For example, if you receive a Results message for a patient you're seeing in one week, you can postpone the message until the day of the patient's appointment. On that day, the message appears at the top of your Results folder as a convenient reminder. You can see the date of the patient's next appointment in the message report.

Follow these steps to postpone a message:

1. Click the arrow next to the Properties button on the InBasket toolbar and select Postpone. 2. Select the date on which you want the message to reappear in your InBasket and click Accept.

Your project team can also add a one-click option for specific types of messages.

Documents

Top Efficiency Tips for Outpatient Providers...To add a column, select it from the Available Columns list and click Add to include it in your schedule. For example, select the Meds