FirstNet Provider Training

1. FirstNet Provider Training Presented by: Kim Olney RN, Senior IT Trainer

2. Instructions • View the Computer Based Learning Module

3. Rewind Pause Back Forward Audio (on/off) Closed Caption Exit Information • Action buttons are located at the bottom of each screen when completing a module through Ascension Health University: • The functionality of each button has been listed below. • Please use the buttons to navigate through the module.

4. Objectives • NOTE: • Please remember this module demonstrates Cerner functionality only. • Consult your Clinical management team with any questions you may have about clinical workflow or daily operations. • Upon completion of this CBL the learner will have a basic understanding of how to: • Navigate the FirstNet Patient Tracking List • Look up Results • Place Basic Orders • Prescription Writing Process • Depart Process

5. Introduction • Today I will be giving you an overview of the FirstNet Application used in the emergency departments at Borgess Medical Center, Borgess Lee Memorial Hospital, Borgess Pipp Hospital and Woodbridge Immediate Care facility. NOTE: There are slight variations of the application depending on which site you are working.

6. Click on the FirstNet Prod Icon From your desktop, click on the BIEHR Icon

7. Enter your User Name and Password. (passwords are case sensitive)

8. Click Yes to be an Available provider.

9. Provider Role & Default Relationship fields: Click on the drop-down arrow and choose the appropriate role/relationship. • Associated Provider Color; click on the box to open the window: choose a color and click Ok. • Place a checkmark in the box next to Available Reviewer. • Click OK

10. Click on the Physician tab for your site. • BMC Physicians • PIPP Physicians • WBIMC Physicians • LM Physicians

11. Click on a patient row then click on the Assign Provider Icon to assign yourself as the provider for that patient.

12. Title Bar Menu Bar Overview of Patient Tracking List Tool Bar Tracking List Icons Links to chart sections • Title Bar: Your name displays here; Secure session function by right click and choose from drop-down menu. • Menu bar: Task=Password Change, Reports & Exit • Tool bar: Patient Tracking, SolCom (use drop-down to see other links), Exit (Formal way to exit the application), Calculator (metrics), Depart (Patient discharge) • Tracking List Icons: Assign provider, Open pt. chart, Provider Check-In/Out, Discharge (hovering over an icon will open a description). • Links: takes you to that specific section of the chart.

13. Tracking List Columns • Left to right: • The first column has star indicators for abnormal or critical lab results. • A blue arrow pointing to the pt. row. • Bed number the patient is assigned • A=acuity • Name: Last, First and (pre-arrivals) • Age/gender (pink=female, blue=male) • LOS-length of stay • Allergy (hover over icon to see allergy information) • Latex allergy • Continued: • Chief complaint why they are being seen. • Lab/Rad columns (functionality discussed next slide) • Orders • MD=attending doctor initials • RN’s initials, • MLP initials • RES initials • PCP primary care provider • Comment and Isolation fields.

14. Hovering over an Icon or field will produce a drop-down with information pertaining to that field. Yellow Star=abnormal lab results Red Star=critical lab results Double left click in the Lab or Rad column will open the Quick Flowsheet.

15. Quick Flowsheet Double clicking in a Radiology field will open up the report. Clicking on the Review button will mark results as reviewed and closes the window.

16. The abnormal/critical star will fall off after you have marked reviewed.

17. Opening the Patient’s Chart To open the patient chart click on the yellow folder icon. Choose the section you want to access.

18. The Demographic banner • Demographic banner: • Patient Name • Allergies • HX of MDRO (***) • Age, DOB, Gender • MRN & FIN numbers • Type of Admit-Emergency (Admit date/time) • Loc: location of patient

19. Key sections of the Menu • Menu: • ED MPage Summary • Document Viewer • Documents-Provider • Documents-Other • Orders • Medication List

20. ED MPage Summary • Provides a consolidated and concise view of a patient’s chart. • Contains forward, back, and “Home” icons which can be used for quick “web-style” chart navigation. • Allows you to “link” to specific areas of the chart for example: Allergies • “Hovering” over many items on the page will display additional information.

21. Document Viewer • Where Documents specific to the Provider role can be viewed, modified/edited and signed. • Documents are listed in chronological order with the most recent on top in Document Viewer.

22. Documents-Provider • Where Documents specific to the Provider role can be viewed and printed. • Documents-Other are specific to non-provider roles (RN, RT, PT, OT, Dietary, MSW, PCA etc.). NOTE: Documents-Other are specific to non-provider roles (RN, RT, PT, OT, Dietary, MSW, PCA etc.).

23. Customized View for Orders and Medication List Windows Click on Current then click on Customize View

24. Custom View Set-UpBefore • Highlight the selections from the Available columns list. • Click Add

25. After • Now arrange the list in the “Selected Columns” section by using the arrowsto the right. • Use the drop-down arrows for the fields at the bottom of the page, make the selections as seen here. • Click OK NOTE: Must be done for the Orders window and the Medication List window to view to be appropriate.

26. Advanced Filters Setting Advanced filters for the Order window will allow you to see all non-medication orders. • Click on Displayed: All Active Orders • Change Display to All Active Non-Medications • Click Apply

27. Order Entry • The Add Order window is where orders are searched for and added to the orders scratch pad. • Most orders for FirstNet are on the Homepage or in the folders on the homepage. Click the Addbutton • Click on an order (CBC with Diff), then click Done

28. Order Sentences • Some orders contain pre-built Order Sentences. • Click the appropriate order sentence. If no order sentence is appropriate, click None then OK. • You will be able to fill in the details later in the process. (T:N = today and now) • Repeat until all orders have been selected. • Click Done to close the window

29. Note: When entering multiple orders for the same patient (multiple labs, x-rays), it is advisable to continue the order entry process, rather than selecting Done and entering each order individually. This saves time and also simplifies the process for the departments who receive the orders.

30. . Order Details This is the Orders Scratch Pad. This lists all the orders entered and allows you to add or change order details prior to signing. • To start entering the order Detailsclick on the desired order to highlight it. • (repeat process for all orders). • Review the order and click Sign. Note: A next to the order indicates required information must be entered before signing the order.

31. When done, the entered orders will be in the Processing status. • To complete the process, click on the Refresh button.

32. Depart Process • When ready to discharge the patient click on the patient’s row. Then click on the Depart button at the top of the window.

33. The Depart Process window has 2 sides. • The Left side is the menu. Sections highlighted in yellow are required. • The Right side is the Patient Summary (what is printed and sent home with the patient). Click on the pencil icon to open the sections. Let’s start with Meds/Prescriptions...

34. Prescription Writing • Click on the Add Button to open the Add Order window. • Search for a medication (example-Norco), multiple choices will populate the window. Single left click on a medication, repeat the process if more than one prescription will be sent home with the patient. • Click Done after all needed medications are selected.

35. Click on a medication to fill in the Details for that medication, repeat for each medication. NOTE:Before you sign you must choose a printer. See next slide.

36. Adding/Selecting Printers Click on the dropdown arrow next to the Send To field. Click on Other

37. Apply to: set to All Pending… Default: Always treat my… When at BMC, LEE or PIPP all the Rx printers for that site are in separate folders. Open the folder for your site and choose your printer. (You may right click on the printer and add it to your favorites) See the next slide.

38. When at WB IMC the Rx printers for that site are in the BORGESS AT WOODBRIDGE HILLS folder. Click on the name of the folder, the printers will display on the right side and choose your printer. (You may right click on the printer and add it to your favorites) See next slide. NOTE: RX printers all end in_rx (you also might need to grab and drag the column to the right to see the RX printer.)

39. Setting a Default Printer • Click on your Favorites tab. • Select the printer you want to print to • Then right click on it to Set as Default

40. Sign and Print All pending RX’s will print upon signing

41. Patient Discharge Instructions and Follow-up • Patient Education and Follow-up share the same window. • You can toggle between the 2 tabs.

42. Click on Instructions • Search for the appropriate instruction or from the left side of the window choose a category, then select from the right side of the window the instruction you want.

43. The instructions will display in the lower right side. • Now click on the Follow-Up tab at the top of the page.

44. Who: provider, organization/clinic or Free-text • Quick Picks: when other choices aren’t appropriate. • When: hours, days weeks etc. • Where: Address and phone # for provider. • Comments: Predefined/editable.

45. Provider Search • Click into the Provider field and type part of the provider’s name. • Click on the binoculars. The Provider Selection window opens. • Choose the provider from the list. • Click OK,

46. When done Click Save • You will be returned to the Depart process screen.

47. Medication Reconciliation is not currently being done in FirstNet. (skip these sections). • Special Medication Instructions can be free texted in the PowerForm. Click the green check mark to sign and close the form. • Now Click on Discharge approved by Attending? Sign Save Cancel Free Text Here

48. Review the Patient Summary • Sign/Close

49. Now the House Icon will appear in the To Do column. (Indicator the patient may be discharged by the nurse). • At the end of your shift, click on the Provider Check-Out Icon. • Click OK

50. Exiting the application • Now you may close the application by clicking on the Exit button. (closing the application with the red X isstrongly discouraged).