CDI in Epic Presented by Karen Mac Arthur

CDI in Epic Presented by: Karen Mac. Arthur, RN, BSN, CCDS UCSF Benioff Children’s Hospital Oakland, CA Marietta Morhardt, RN, BSN, CPN, CCM Children’s Hospital & Medical Center, Omaha, NE

UCSF Benioff Children’s Hospital Oakland In the process of affiliating with University of California San Francisco Located in Oakland CA 190 Bed facility with 10, 000 discharges/year Around 70% Medi. Cal population

BCHO CDI Workflow in EPIC: Work Queues

BCHO CDI Workflow in EPIC: Dashboard Pros and Cons

Pros and Cons Pros: We don’t have to move from a program to EPIC/no input of patient data It is in the chart and care providers can go to the record and/or reply to our queries Easy to see who is responsible for the query Cons: Must cut and paste to send to other providers Reports are difficult to build No place to record verbal query without sending inbox message

EPIC Physician Workflow Hold for screen shot of physician query

Question to the Group In Progress Notes, and other notes as well, we pull in the problem list. How do your coders handle these notes? Code NOT Code Query if it is not documented anywhere else?

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Children’s Hospital & Medical Center Fast Facts Children’s Hospital & Medical Center is the only full-service, pediatric healthcare center in Nebraska, providing expertise in more than 50 pediatric specialty services to children across a five-state region and beyond. We are home to Nebraska’s only Level IV regional Newborn Intensive Care Unit and the state’s only Level II Pediatric Trauma Center. Our regional heart center offers expertise in pediatric heart transplantation. Children’s is recognized as a 2018 -19 Best Children’s Hospital by U. S. News & World Report in five pediatric specialties: Cardiology and Heart Surgery, Pulmonology, Gastroenterology & GI Surgery, Orthopedics, and Diabetes & Endocrine Disorders. In 2017: Total Patient Visits: 623, 700 Patients: 138, 500 Medicaid Patients: 46, 500 50+ Outpatient Specialty Services 145 Beds 11 Regional Clinics In 3 States

Omaha Children’s Workqueue List

Omaha Children’s Workflow Initial List gets reviewed by CDI Reconciler Goes to Subsequent List, which is reviewed by CDS. Date for re-review is determined by CDS’s Query List keeps track of outstanding queries CDI Manager Review list is for final coding or if case needs special attention, i. e. SOI mismatch with encoder, coding issues, etc. When ready for matching up initial with final DRG, goes to Validation If discharged prior to coding being completed, or if awaiting response from practitioner in relation to coding will go in “Discharge waiting for coding” list

Queries

Pros & Cons of In Basket Queries Pros: 1. Goes directly to practitioner 2. Able to ascertain if it has been read or not 3. They are able to respond ask further questions and/or clarify if needed 4. You can then respond in kind if additional questions Cons: 1. Can only send to one practitioner at a time 2. Doesn’t directly send the reader to the problem list to amend or the progress note to address 3. If you need to send same query to another practitioner, and it has been read by the original recipient, you cannot cut & paste the query. 4. Have to add residents/APRN’s to treatment team in Epic in order for them to see the query. (shows up in their “to do” list)

Dashboard (Children’s) Dashboard is still a work in process, trying to figure out what information is the most useful at a glance

QUESTIONS? ? ?