Note: These only include EHR enhancement requests that were submitted via the RPMS Feedback Page
CRID Submitted By Submit Date Subject
247 Calder, William 6/1/2006 Radiology
246 Schmitt, Charles 9/27/2006 TIU Template GUI Box
248 Wanca, Martha 10/26/2006 multiple patients with same name
potential for error
N/A Furniss, Jamie 11/2/2006 linking med refills to dx
249 Nelson, Rhonda 11/27/2006 Discharge Summary Footer needs
250 Nelson, Rhonda 11/27/2006 Need print format field of Last 4 of SSN
251 Nelson, Rhonda 11/28/2006 need to be able to assign multiple clinic
codes to a pick list
252 Miller, Michele 12/13/2006 Group note capability
N/A Shults, Peggy 12/21/2006 Medical Necessity For Labs
N/A Shults, Peggy 12/26/2006 Coding Queue default for incomplete
253 Shults, Peggy 1/8/2007 Enhancement for notifications
254 Lamer, Chris 1/9/2007 adding historical measurements
255 Miller, Michele 1/16/2007 Evaluation and Management codes
268 Miller, Michele 2/1/2007 RCIS notifications in EHR
266 Lamer, Chris 2/20/2007 Health factors and Exams information
263 John, Karen 3/14/2007 EHR: New Patient Data Object - POV
with ICD-9 Code
267 Mosely, Elvira 3/15/2007 adding measurements and POC test
264 Cain, Lola 3/16/2007 Medication order entry fields - days
supply & qty
270 Johnson, Katie 4/2/2007 Immunizations
271 Johnson, Katie 4/2/2007 Service Hold
N/A Johnson, Katie 4/2/2007 Problem List on Health Summary
269 Mosely, Elvira 4/3/2007 CPT codes
272 Preston, L. (Jane) 4/5/2007 Students Keys in CPRS
273 VonBibra, Lyn 4/9/2007 Fluid Balance Flowsheet
274 Vesbach, James 4/10/2007 DDS package on services tab
276 Preston, L. (Jane) 4/13/2007 Changing Order Details Printout
277 Gemelas, James 4/16/2007 Surrogate Notification options
275 Mosely, Elvira 4/23/2007 Adding BMI% and HC%
N/A George, Susan 5/8/2007 Coding Q
283 Furniss, Jamie 5/17/2007 NOTIFICATION HEADERS
284 Lamer, Chris 5/23/2007 Add comments to completed orders
290 Moore, Catherine 5/25/2007 Enhance Notifications
291 Moore, Catherine 6/7/2007 Resize lab results tab for comments
N/A Furniss, Jamie 6/7/2007 Changable Clinic Codes
292 Preston, L. (Jane) 6/8/2007 Med. Refills for Pull-Down for Diagnosis
303 Lamer, Chris 6/14/2007 Date of onset
302 Preston, L. (Jane) 6/14/2007 Adding Lab Tests to Existing Order
304 Koet, Margaret 6/18/2007 Notification of Uncompleted Consult
306 Vermilyea, Peter 6/20/2007 Graphing of labs - background should
307 Vermilyea, Peter 6/20/2007 Please add "Print" button to vital sign
N/A Preston, L. (Jane) 6/20/2007 Linking Lab Visit to Ordering Encounter
308 Vermilyea, Peter 6/20/2007 Would like to see time pharmacist
verifies orders in GUI
309 Williams, David 6/21/2007 Pharmacy Order End Dates
322 Lamer, Chris 6/27/2007 improved communication
324 Johnson, Katie 7/3/2007 Missing POV notification
N/A Habiel, Sam 7/7/2007 Make TIU note template windows non-
326 Habiel, Sam 7/11/2007 Use of aspell rather than MS Word
328 Habiel, Sam 7/12/2007 Need ordering provider when lab
notifications are received
327 Habiel, Sam 7/12/2007 Add another discontinuation reason to
329 Smith, Marty 7/13/2007 Patient Listing Options
330 Grenier, Denise 7/19/2007 Purpose of Visit/Selection
N/A Vermilyea, Peter 7/20/2007 RCIS interface to EHR
N/A Zimmet, Judy 8/7/2007 Please make a Patient Object out of
338 Doremire, Joshua 8/9/2007 Chart lookup sorted by visit time
347 Preston, L. (Jane) 8/10/2007 Ranges for BMI on Adults
349 Johnson, Katie 8/14/2007 Refusals in EHR v1.1
N/A Preston, L. (Jane) 8/17/2007 Order Check for Duplicate Active and
N/A Preston, L. (Jane) 8/21/2007 Primary Provider for Lab Orders
N/A Heisler, Michael 9/18/2007 Group Visit/Note Functionality
363 Gemelas, James 9/24/2007 Reminders for Educational goals set in
355 Johnson, Katie 9/25/2007 Inpatient Education
362 Niesen, Mary Ann 9/27/2007 TIU object request
356 Pierce-Richards, Susan 10/1/2007 Object from Pain Contract
357 Jaramillo, Joann 10/3/2007 Suicide Form and EHR
358 Mosely, Elvira 10/4/2007 Reminder Computer Findings
367 Rudd, Stephen 10/26/2007 Reminder dialogues
373 Johnson, Katie 11/2/2007 Vitals Entry
372 Bishop, Bradley 11/5/2007 Adding refills to existing medication
orders in EHR
376 Lamer, Chris 11/9/2007 Documenting a patient education code
379 Gemelas, James 11/15/2007 Education provider when entering pt ed
in reminder dialogs
378 Preston, L. (Jane) 11/16/2007 New Column on Orders Tab
N/A Riley, Mary 11/16/2007 PHN Field Labs
380 Preston, L. (Jane) 11/23/2007 Seperate Tabs for Orders
382 Gemelas, James 11/27/2007 HPV reminder
383 Gemelas, James 11/27/2007 Undo button
384 Gemelas, James 11/28/2007 Vitals refusal prompt
385 Furniss, Jamie 11/29/2007 Display Outcome & Standard button
387 Moore, Catherine 12/5/2007 add annotation tool to lab results
386 Preston, L. (Jane) 12/5/2007 Ability to Record Method of
Measurement for Vitals
449 Preston, L. (Jane) 12/6/2007 Issues with Ordering Providers and
389 Shults, Peggy 12/17/2007 Tool to update codes in ICD & CPT
390 Pierce-Richards, Susan 12/19/2007 Ability to add health factor from Pt Ed
392 Vermilyea, Peter 12/19/2007 forwarding notifications
391 Vermilyea, Peter 12/19/2007 Some clinics don't need an E&M code-
no way to set this
393 Frederick, Ronald 12/19/2007 GROWTH CHART
394 Habiel, Sam 12/25/2007 Need a centralized place from where to
395 Rudd, Stephen 12/26/2007 Surgical history
N/A Thomas, Sandra 12/27/2007 patient list by clinic
397 Jones, Jacqueline 1/9/2008 auto-inactivate dates for time limited
398 Mosely, Elvira 1/10/2008 add menu option to BEH menu
400 VonBibra, Lyn 1/16/2008 Education component on Wellness Tab
421 Mosely, Elvira 1/18/2008 Consult group update not working for
401 Preston, L. (Jane) 1/18/2008 When placing orders could EHR ask if
402 Dunnigan, Anthony 1/23/2008 Princinal Clinics interaction in EHR--
need a way to exclude them
403 Dunnigan, Anthony 1/23/2008 parameter to prevent note titles from
"breaking up" in searchable list
405 Habiel, Sam 1/31/2008 Add the ability in EHR to change
406 Preston, L. (Jane) 2/1/2008 Print Prescription Button
408 Lamer, Chris 2/5/2008 Medication objects for medication
N/A John, Karen 2/8/2008 Vital Measurement Template - user
class and service/section
411 Murphy, Sue 2/11/2008 Infant feeding choice - birth measure
410 Pierce-Richards, Susan 2/11/2008 Improvement to Adverse reaction
409 Moore, Catherine 2/12/2008 Allow only certain lab tests to be
N/A John, Karen 2/14/2008 More user-friendly patient education
459 Gebremariam, Cindy 2/14/2008 Multiple Pap Smear Results
422 Nelson, Rhonda 2/15/2008 inpatient medications listing on med tab
413 Klepacki, Stephanie 2/19/2008 Refusals for Colonoscopy and Flexible
N/A Gemelas, James 2/20/2008 Lab Clinical Indication field option
N/A Thomas, Sandra 2/20/2008 ehr notifications
N/A Niska, Lois 3/4/2008 BMI
417 Bartlett, Robin 3/5/2008 dc/edit status during inpatient POE
416 Bartlett, Robin 3/5/2008 Dual Order/Medication Tab Sorting
420 Lamer, Chris 3/6/2008 cannot enter two education codes for
415 Bartlett, Robin 3/7/2008 New Start Checkbox
414 John, Karen 3/7/2008 New object for PHN data entry
418 Stiffarm, Duane 3/10/2008 modless window
419 Martin, Lisa 3/11/2008 Documenting historical breastfeeding
N/A Lamer, Chris 3/11/2008 Per Duane Stiffarm
N/A Thomas, Sandra 3/13/2008 using the control key
423 Frederick, Ronald 3/14/2008 immunization package - skin test
424 Preston, L. (Jane) 3/14/2008 Unable to Record a Different Location
for Current Immunizations
425 Habiel, Sam 3/19/2008 Add functionality to copy
428 Pierce-Richards, Susan 3/19/2008 COPY active med order creates a
duplicate med order but no order check
427 Habiel, Sam 3/20/2008 Dialog to send a user generated
notification is very unfriendly to use
426 Johnson, Katie 3/20/2008 Signature Capture
433 Preston, L. (Jane) 3/24/2008 I&O Measurements
437 Habiel, Sam 3/25/2008 When documenting historical PPD,
cannot document date administered or
429 Preston, L. (Jane) 3/25/2008 Assigning the "Face Sheet" to a button
435 Lamer, Chris 3/26/2008 Reminder override
434 Shults, Peggy 3/28/2008 Enhance New Note Function
432 Thomas, Sandra 4/1/2008 not sure which package
436 Jones, Jacqueline 4/2/2008 Sensitive Patient Tracking vs. EHR
441 Vermilyea, Peter 4/14/2008 double click, single click
439 Vermilyea, Peter 4/14/2008 removal of primary provider
440 Preston, L. (Jane) 4/14/2008 Message: Narrative Too Long (for ICD
442 Werner, Rebecca 4/16/2008 Health Factors
N/A Dryden-Bergemann, Janet 4/23/2008 Changes to Wellness Tab
451 Ramirez, Rachel 4/25/2008 individual lab result notification
450 Hall, Terri 4/25/2008 Visit Lock
452 Preston, L. (Jane) 4/25/2008 New TIU Template Data Objects
N/A Yandell, Seth 4/25/2008 Please help get rid of point of care
blood glucose notifications
445 Johnson, Katie 4/30/2008 Print button on Medications Tab
446 Johnson, Katie 5/1/2008 Birth Measurements TIU object
N/A Dryden-Bergemann, Janet 5/1/2008 Vitals Signs for Standing, sitting and
448 Shults, Peggy 5/6/2008 Pick Lists & Associations
447 Vermilyea, Peter 5/7/2008 PharmED button change
N/A Hile, Kerry 5/8/2008 Maximize button on templates
N/A Mosely, Elvira 5/8/2008 Ability to edit inactive cpts and ICD-9
codes attached to pick-lists and
N/A Potts, Toni 5/12/2008 Patient Selection Window
453 Habiel, Sam 5/13/2008 We would like consult results
notification to be signable like labs and
454 Baughman, Todd 5/13/2008 DOCUMENTING EDUCATION
455 Vermilyea, Peter 5/13/2008 How does a user confirm that a
provider has signed off on a
458 Shults, Peggy 5/19/2008 Visit Summary
456 Preston, L. (Jane) 5/19/2008 Newborn Hearing Screen
457 Habiel, Sam 5/20/2008 Add ability to import more than one TIU
template file at a time
N/A Mosely, Elvira 5/21/2008 Adding a window function to the EHR
template dialog box.
460 Clark, Donald 5/22/2008 Primary Care Provider
461 Niesen, Mary Ann 5/23/2008 automatic CPT coding in IMM module
N/A Habiel, Sam 6/2/2008 Add ability to import multiple templates
at the same time
468 Habiel, Sam 6/3/2008 Add Regular Expression based filtering
467 Vermilyea, Peter 6/6/2008 Message field doesn't pop up on
medication quick order
463 Bowie, Albert 6/10/2008 communication tab
464 Clark, Donald 6/12/2008 Pharmacy Ordering
466 Clark, Donald 6/12/2008 Pharmacy Ordering
462 Shults, Peggy 6/15/2008 Chief Complaint Associations
465 Habiel, Sam 6/16/2008 Reminders can't look for CPT modifiers
488 Vermilyea, Peter 6/23/2008 female reproductive status suggestion
475 Bonnell, Mark 6/24/2008 word processor
471 Heisler, Michael 6/25/2008 MRSA Screening Collection Alert
472 Adams, Robert 6/25/2008 Request for addition of New OE/RR
469 Heisler, Michael 6/25/2008 Expansion of PCP Display on
460 Bonnell, Mark 6/26/2008 Designated Provider
473 Bonnell, Mark 6/26/2008 To Do List
470 Habiel, Sam 6/27/2008 Make it easier to navigate a pick list
503 Preston, L. (Jane) 6/27/2008 Nursing Patient Acuity Assessment
(ANS) - Availability through EHR
474 Johnson, Katie 6/30/2008 Transfer to Outpatient medication
476 Rauth, Leslye 7/1/2008 Womens health in EHR
477 Mosely, Elvira 7/1/2008 CNII narcotic print out format
478 Mosely, Elvira 7/1/2008 Nursing inpatient package
N/A Harris, Linda 7/1/2008 Nutrition / Activity Screening Evaluation
479 Niesen, Mary Ann 7/2/2008 ordering keys and ordering resctrictions
480 Niesen, Mary Ann 7/2/2008 verification of allergies in EHR
481 Mosely, Elvira 7/2/2008 Ability to use reminder dialogs with TIU
482 Gebremariam, Cindy 7/2/2008 Display Community Alerts
483 Palmquist, Roland 7/7/2008 Potential Medical Error due to sign in
defaults when travelling
484 Bishop, Bradley 7/7/2008 PAP Smear refusal logic
486 Rauth, Leslye 7/7/2008 v eye care in personal health
N/A Lamer, Chris 7/8/2008 ADD time pharmacist verifies a
prescription in the GUI.
485 Habiel, Sam 7/8/2008 Click and Drag
487 Lamer, Chris 7/8/2008 Enable printing of controlled drug
489 Bowie, Albert 7/10/2008 ablitity to know when a patient p/u
491 Stearle, Carla 7/10/2008 Inpatient EHR; Medication
N/A Mosely, Elvira 7/11/2008 for patient selection object to display
correct age in months for pt's under 2
490 Niesen, Mary Ann 7/17/2008 verifying certain notifications have been
492 Vermilyea, Peter 7/18/2008 more detail requested on radiology
requisitions & LMP
493 Preston, L. (Jane) 7/18/2008 New Notification Created
494 Bishop, Bradley 7/18/2008 "License expiring" popup message
N/A Preston, L. (Jane) 7/18/2008 Require POV to write Progress Note
495 Frederick, Ronald 7/24/2008 notification alert for missing notes
N/A Clark, Donald 7/24/2008 Notifications
496 Gemelas, James 7/28/2008 Medication Possession Ratio (MPR)
N/A Preston, L. (Jane) 7/30/2008 Social Services Functionality in EHR
N/A Lewis, MD, Jeffrey 7/30/2008 template saving,minimizing
497 Lewis, M.D., Jeffrey 7/30/2008 Social history
N/A Gemelas, James 7/30/2008 "Unable to screen" option in the
personal health component
N/A Thomas, Sandra 7/30/2008 screening exams
498 Preston, L. (Jane) 7/30/2008 Want Tabbed Order Page
499 Preston, L. (Jane) 7/30/2008 Change form attached to Appointment
N/A Gemelas, James 7/31/2008 Add pregnancy as a contraindication
500 Vermilyea, Peter 7/31/2008 Pressing F1 in vitals entry
504 Preston, L. (Jane) 8/4/2008 Creation of Additional Notifications
N/A Webb, Amy 8/4/2008 Completion check at the end of the visit
505 Bowie, Albert 8/4/2008 Done button.
506 Preston, L. (Jane) 8/8/2008 Print Prescription Button on
507 McIntyre, Carlene 8/13/2008 Med Tab enhancement for inpatient
508 Marsolek, Roberta 8/13/2008 having option when signing orders not a
512 Hall, Terri 8/14/2008 enhancement to EHR to add NOT
FOUND under Service Category?
513 Mosier, Gary 8/15/2008 More PCP provider notification
N/A Anderson, Maggie 8/19/2008 Temporarily Override Visit Lock option
514 Habiel, Sam 8/19/2008 Want to tie pregnancy status with the
rest of the EHR system...
515 Habiel, Sam 8/27/2008 When this dialog pops up, it needs to
send the offending dialog it references
to the top of the
516 Preston, L. (Jane) 8/28/2008 Brighter Flags
N/A Furniss, Jamie 9/2/2008 New report for visit auditor
518 Grenier, Denise 9/5/2008 On-screen guidance for users
519 Johnson, Katie 9/8/2008 Status of Imaging orders
520 Hays, Howard 9/9/2008 Enable iCare Panels in Patient
522 Thomas, Sandra 9/9/2008 visit not checked in
N/A Thomas, Sandra 9/10/2008 group entry
521 Stuart, Peter 9/10/2008 Co-signature comments
523 Habiel, Sam 9/11/2008 Chart Request Button, RPC, Routine
524 Moore, Lori 9/12/2008 remove line from complex orders
525 Bishop, Bradley 9/12/2008 Allow immunization entry from
N/A Morphet-Brown, Mary 9/15/2008 blood pressure in triage tab
526 Habiel, Sam 9/15/2008 Reports tab does not have a File > Print
Menu like the rest of the tabs...
527 Habiel, Sam 9/16/2008 Pop up messages should have a "reply"
button so that you can immediately
reply to the person
N/A Habiel, Sam 9/17/2008 Create RPC, routine, etc. to allow users
to update primary care provider in EHR
N/A Shumack, John 9/17/2008 Update qty range for quick orders.
528 Habiel, Sam 9/17/2008 Is there a way to change the color of
the notification of the Stat consult to
529 Harris, Linda 9/21/2008 Tickler file
530 Habiel, Sam 9/22/2008 After CCHIT...
531 Grenier, Denise 9/22/2008 Suicide Reporting Form
532 Thomas, Sandra 9/24/2008 rpms ehr management
N/A Bartlett, Robin 9/26/2008 Patient Data Objects - Active
Medications & Todays Orders
533 Bolte, Patrick 10/2/2008 Patient Identifier
534 Clark, Donald 10/6/2008 SIGNING ORDERS
535 Stuart, Peter 10/7/2008 HR Display
536 Preston, L. (Jane) 10/7/2008 Availablity of VUA menu item through
537 Maillett, Lynn 10/8/2008 Spirometry results
538 Sampson, Lorinda 10/8/2008 new measurement?
539 Manning, Thomas 10/9/2008 Vital signs entry
540 Habiel, Sam 10/15/2008 Add the ability to enter "No Known
Allergies" on the right click menu of the
N/A Habiel, Sam 10/15/2008 Add ability for user to be able to say
"This is an erroneous allergy/ADR" in
561 Habiel, Sam 10/15/2008 When editing a historical immunization
just after entry, you cant edit the event
541 McCann, Vanessa 10/20/2008 EHR Wish
542 McCann, Vanessa 10/20/2008 EHR Wish Pharmacy
N/A McCann, Vanessa 10/20/2008 EHR Wish for Orders
543 Goroski, Dean 10/24/2008 medication profile
N/A Mosely, Elvira 10/27/2008 Add clinic to the BEHOXQPC
REQUIRES E&M CODE parameter
544 Preston, L. (Jane) 10/27/2008 Change Title from one Class to Another
N/A Dunnigan, Anthony 10/29/2008 better pediatric growth charts
546 Habiel, Sam 11/3/2008 Change renew dialog box so that it
displays refills as a drop down box
rather than a text box...
547 Johnson, Katie 11/3/2008 Discontinue an expired med
N/A Elliott, Patricia 11/5/2008 BMI calculations and Temperature
548 Preston, L. (Jane) 11/5/2008 Want a Prompt Created for Refusals
N/A Kelley, Don 11/12/2008 Appointment times after names in
"Patient Select" window
N/A Bishop, Bradley 11/14/2008 Printing orders from EHR to local
549 John, Karen 11/19/2008 Enhancement: Temp Override Visit
Lock for User [OVR]
550 Vermilyea, Peter 11/20/2008 Broadcast functionality enhancement
N/A Gemelas, James 11/21/2008 add hysterectomy choice to Personal
Health -reproductive history
551 Cain, Lola 11/24/2008 ICD Search Tool for POV - entry
N/A Sebastian, Marianne 11/24/2008 lab accessioning from within EHR
552 Preston, L. (Jane) 11/25/2008 Ability to Print Label from Medications
N/A Singleton, Tamara 11/26/2008 demo patients
N/A Lessert, Amanda 12/1/2008 Consult management reports
553 Lessert, Amanda 12/1/2008 Completed consults report
554 Dunnigan, Anthony 12/2/2008 Infobutton integration into EHR
555 Gemelas, James 12/3/2008 Exam screening result fields for
reminder dialog prompts
556 Maynard, Tyrus 12/4/2008 EHR Notifications and Instant
Messaging Enhancement Requests
557 John, Karen 12/8/2008 New HS object - Mother and Father's
558 Beyuka, Harriett 12/19/2008 Inpatient Pharmacy Management
Report field addition
559 Mosely, Elvira 12/30/2008 print formats
560 Hartmetz, Nancy 1/5/2009 Historical allergy documentation
562 Groom, Amy 1/8/2009 Include VFC eligibility field in the
Immunziaion package in EHR
N/A Jasso, Jennifer 1/8/2009 Print Format Field
563 Mosely, Elvira 1/8/2009 trigger notification when meds are
returned to stock
564 Johnson, Katie 1/9/2009 Edit Problem List Notes
565 Chasteen, Teresa 1/16/2009 Transaction Superbill Association
566 Bishop, Bradley 1/20/2009 Display Lab Interpretation in EHR Lab
567 Grenier, Denise 1/28/2009 Suicide Reporting Form Component
568 McIntyre, Carlene 1/29/2009 Refill limit change for non-controlled
569 VonBibra, Lyn 1/29/2009 Enhancement requests x2 for the
Release Orders to Service Box.
570 Potts, Toni 2/2/2009 PICK-UP STATUS default for med
571 VonBibra, Lyn 2/3/2009 Enhancement request for Nature of
572 Flood, Bill 2/3/2009 Provider signature for Policy Orders,
per Sam Habiel
573 Flood, Bill 2/3/2009 drug screening
575 Dewing, Michelle 2/10/2009 Calendar
576 Mosely, Elvira 2/11/2009 Cac can manipulate notifications for
577 John, Karen 2/23/2009 CPT Superbill - allow multiple QTY
N/A Eggert, Toyo 2/24/2009 Selecting Clinic in EHR to get your
e RPMS Feedback Page
Request concerning the Radiology Order page and the "Submit Closed
To" box. We would request the entry in "Submit To" this
automatically default to the facility the user is logged into on
When moving up and down a note template in the GUI. The Deferred
user is forced to pop from the left side, where one opens up sub-
templates, to the right side, where the scroll bar is. Can we at
least put the scroll bar on the left side to make the mousing
easier... and even better could we have the mouse wheel
function - it functions in other Vuecentric windows.
When on EHR "select pateint" and last name is typed, if there Approved
are two or more people with the same name a warning notice
should show up "patients with same name - verify correct
patient" Currently a warning only pops up if there are 2 people in
system with same or similar SS numbers. There is a potential
for errors when 2 same names are in system because provider
could automaically hit enter when first name pops up, without
realizing there is a second person with same name right below
Recommendation on behalf of Pharmacy department: Can med Completed
refills be automatically linked to a diagnosis on the problem list
every time it is refilled/renewed on a Pharmacy visit? (Similar to
the paperless refill function, only populating the diagnosis for
you, instead of choosing it)
Request that the current Discharge Summary footer be Approved
changed to show Patient Name, DOB, Sex, Facility, HRN, Date
of Admission, Date of discharge.
Request that the field of last 4 of SSN be available for use Approved
instead of the entire SSN.
All I can find is print fields for entire SSN. Vista imaging fix is on
the way for recognizing chart #, but if I can print last 4 on the
radiology requistion (worksheet) and also as PCC+ field for
routing slips then I will have all the info that I need to be able to
successfully query & to use patient identifiers between the
PACS and the routing slip & the rad worksheet.
Now it's more urgent because of Vista and Navajo is running
out of storage.
If we have a work around until they can fix the querying by chart
# issue, then I think we could give this a go sooner. My I.T.
folks don't want the entire SSN.
The print field would be in the rad package headers and footers
& the PCC+ form fields.
In an area where you have different clinics occurring but using Approved
same pick list, it would be nice to put more than 1 clinic # to
auto pull it up.
Our Dietitians, Diabetes Educators, PHNs, and some others are Approved
currently using group encounters for documenting group
education sessions some have data entry do the group entry
and some are document on each pt seperately in EHR which is
very time consuming.
Requesting a way to enter group encounters in EHR instead of
having to log into each and every patient, creating a visit,
documenting education, etc…? Some group visits can have up
to 50 patients. Mary Hager suggested that we ask for an
enhancement to develop the VA group note capability for IHS.
I understand physicians will be prompted for medical necessity Completed
for lab orders in the next patch, however, I would like to suggest
that that diagnoses automatically poplulate todays POV's so the
doctor doesn't have to duplicate work.
We believe the default should be set to "No" instead of "yes" Transferred
when determining if a chart is complete to prevent accidentaly
releasing an incomplete chart to the 3PB pckg. Is this
something that can be set by each facility in their parameters or
not? Thanks, Peggy
We would like to be able to link a notification to a specific First part
patient visit similarly to the way you can currently link a approved,
notification to a specific patient. This will be advantageous to second on hold
the provider when coders send a notification requesting
clarification of documentation for coding purposes that relates to
a specific visit. Also could be advantageous for certain clinical
notfications. Also, (wishful thinking) it would be nice to request a
read receipt and also somehow require the provider to reply
back to the coder when the correction is made so that coding
can be completed in a more timely manner. Otherwise, the
coder has to manually keep track of what charts are incomplete
and keep checking to see when they are fixed. It would also
help to be able to automatically populate the deficiency in the
NICE package of RPMS at the time an incomplete notification is
sent to the provider through the EHR. In short, we need a
usable incomplete chart tracking system that is built into or
integrated with the EHR.
Need a way to add historical measurements through EHR - like Approved
using the PCC data entry mnemonic HMSR.
Since we are able to start billing Medicaid and PI for physician Approved
telephone calls. It would be nice to have Telephone added as a
type of service. The codes are:
99371 - Physician Phone Consultation - Brief
99372 - Physician Phone Consultation - Intermediate
99373 - Physician Phone Consultation - Complex
We currently have a superbill with these codes but it would be
helpful for our providers if they were located with the other E&M
Concerns - Future RCIS availablity in EHR. RCIS currently uses Approved
mailman. Since providers already read notifications through the
notification window in EHR and rarely use RPMS, it would be
nice if the RCIS software used the Alerts/notifications to send
updates instead of mailman. That way the provider / provider
team would have all patient related notifications in one place.
I like the idea of a display information button Similar to patient Approved
education: add a button on the health factors and exam code
component that links with information in the Health Factor/Exam
Code manual which can provide clinicians with specific
instructions on proving the screenings.
Suggest to create a new patient data object for the visit POV Denied
that includes the ICD-9 code.
For now we're using V POV MULTI-LINE, which works great,
but including the ICD-9 would be better.
Certain POC lab test are performed in the clinics by nurses or Transferred
Dr's. Some facilites do not have a process to put these into the
lab package. Some site have meters for the accucheck but
sometimes these meters are not interfaced with RPMS. Is there
any talks regarding putting a vuecentric tab which users can use
to add these test and these test are inserted into the lab
package? Also with inpatient coming on line soon. Is there any
enhancements in the future that will add IV fluids, NG drainage,
PO intake, ect. If you create these measurments, then add
these to the measurement panels in the IHS health summaries,
then we can create flowsheet using these measurments for
inpatient. Please give me feedback regarding these requests.
The process for medication order entry automatically sets the Denied
dispense quantity when days’ supply is entered for tablets and
capsules. The reverse is not true.
This generates the potential to dispense medicine with an
inaccurate days’ supply. Manual and automated requests for
refill can result in a message that it is too soon for a refill.
Resulting non-compliance with the medication regimen could
cause patient harm.
Please consider modifying software to permit automatic
calculation of the second field no matter which data is entered
When an immunization is administered and then documented in Approved
EHR while a person is admitted for an inpatient stay, the date
the immunization was given shows in EHR as the admission
I would like to request that EHR displays the date the
immunization was actually given.
In EHR, when using for an outpatient, there are instances when Completed
pharmacy needs to put a medication on "hold" - e.g. too soon to
fill per insurance, patient just received 3 month supply last
week, etc. In this case, "hold" is meaning that pharmacy is
holding on the the medication until the patient needs it. Hold
traditionally means something very different - the doctor writes
an order to hold a blood pressure medication because the
patient has been having low blood pressures or the doc wants
to hold a medication for a short amount of time to see if a side
effect improves, etc. However, in EHR, we really only have one
option for both these instances. We have chosen in our
pharmacy to leave medications pending when the patient does
not need them, but this has lead to its own problems - one being
that we can't use our "queue" in RPMS OERR to complete
prescriptions because it is full of pending meds that the patients
don't need at this time. I am requesting a new category -
something like a "service hold" for pharmacy to use when they
can't fill a med for some reason - too soon, doesn't need, etc.
The traditional hold could continue to truly mean that the patient
I would like to request that the Active Problem List ovject used Completed
in the IHS Regular Adult Health Summary be turned into a VA
Health Summary Object.
In EHR, users must remember to add thier CPT codes in the Denied
service tab when they are doing procedures. Frequently, they do
not do this. They do the treatment but they don't go to the
service tab to document the CPT. Then it is up to the coder to
review the visit file, read thier notes and enter the CPT. With
EHR, coder's workload has double if not triple with merging and
editing visits before they pass over to third party billing. Due to
this, the likelihood of capturing CPT codes for procedures
performed by clinicians using EHR quick orders would be low.
Besides, most of our clients are medicare/medicaid so we get
an all inclusive rate regardless how much work we did.
Eventually this will change and we need to align our work similar
to how the private sector align their work. Private section
perform itemize billing and will include everything in thier bills. (It
is hard to make providers use the quick orders to order and
complete procedures, then go to the service tab to put the code,
then go into thier notes to document such treatment) The
enhancement I am avocating would be to create an area within
quick order in that we can tell the system that this is a
It would be nice to have a fourth OR key for students (such as Denied
Med. Students) who can write orders with a co-signature. Right
now there is no way to capture an electronic co-signature for the
CPRS menu as there is for notes.
Add to the cover sheet under vital signs a 24hr fliud summary - Approved
all users can then see cumulative fluid balances. Has to
incorporate elements for pediactrics too.
In an effort to transition dentists to an electronic environment I Denied
am requesting that they have the capability to enter dental
services codes into the E H R via the services tab and have
those codes cross over to the DDS package.
When we print from the “Order Details” screen the printout Completed
gives us the name of the patient and their SSN on the second
line. Is there any way we can print the patient’s chart number
instead of their SSN for this printout as we don’t use SSN’s at
Is the EHR1.1 possibly going to fix the issue of assigning a Deferred
Currently everything sent to a doc comes to their surrogate.
There is no way to pick and choose what gets forwarded and
what waits. This causes issues with cluttering the notifications
board that cannot be resolved in any easy manner.
Dr Rachel Locker
I would like an enhancement that would bring the calculated Transferred
HC%, for pediatric measurement panel in the IHS health
summary measurement panel. I would also like to add the
BMI% to the adult measurement panel. These are necessary
when doing well child checks and wellness appointments for
adults. I would also like for these calculated measurement % for
Wgt, Hgt, HC, and BMI be available so that CAC can uses
these as object outside the IHS measurement panels. I know
these are more then likely computed fields, can you create an
object that would compute these calculated findings in the TIU
objects file. Also create the HC% in the pediatric measurement
panels and the BMI% in the adult measurement panels.
I find the coding queue report cumbersome. Can the "Hosp Loc" Transferred
column be removed? The clinic is listed & that's more helpful
than the location- I would rather be able to view the deficiency
as that is more helpful. Thank you.
It would be a great enhancement if the notifications could be On Hold
sorted by "sent to". This would specifically be helpful for coding
staff. We send numerous information only notifications to
numerous providers. When we review these to see if they have
been corrected, it would be a lot easier to check them arranged
by who we sent them to.
Definition from CCHIT: The system shall provide the ability for a Denied
user to attach a free text comment to a result that can be seen
by another user who might subsequently view that result.
Add "reply" to the options when a Scheduled Notification is Approved
viewed. This will allow the person receiving the Notification to
reply to the sender.
Would like to be able to resize the Most Recent lab results view Approved
so that the comments could be in a bigger box. For sites using
the interface for pap and pathology results, the results are
actually in the comment section. It is diffcult to see the whole
It would be great if the providers could change the clinic code Denied
that has been already been selected in EHR. An example of
when this is needed is when a diabetic comes in for an acute
problem, the nurse selects an 01 clinic code. Then it turns into a
Diabetes focused visit and the clinic code should be an 06 for
The following question was posted on the ListServe with others Closed
experiencing the same issue. It would be nice to have a pull-
down list to populate POV/problems when refills are ordered.
When patients present through the urgent care clinic they
sometimes ask for their other/chronic meds to be refilled.
Because there isn’t a request for diagnosis when requesting a
refill and the refill is not directly related to the current encounter
it is creating billing problems.
Besides creating 2 encounters (because it is only 1 encounter)
how have other sites handled this situation? Do the providers
have to go back to the POV list and repopulate the problems
related to the refill each time?
It would be nice if the refill linked you to possible diagnosis
options for that med.
OK, you guys are probably getting sick of me. But this one Approved
comes from Dr. Ann Bullock and I think it is a great idea. Add a
field for date of onset in the POV (linked to the POV/Problem,
so it is only entered once) that is hardcoded and can be
searched. Ann wants this for some projects. I think it would be
great for population quality measures - for example, you set
goals for your patients with DM less than 5 years to be less than
8; you set goals for your patients with DM for 15 years to be less
than 9 .. something like this anyway.
Providers should be able to add more labs to an existing order Denied
(even if the original provider is different) as long as the order is
still pending (specimen has not been collected yet). This is an
existing function in RPMS but not EHR.
Providers and patients would benefit (as would risk On Hold
management) from the ability of EHR to send a notification to
an ordering provider when a outside consult is ordered and the
consult remains incomplete after X # of days (or other assigned
interval). Is this possible in EHR?
A physician wanted to print and fax a graph of a patient's lab Approved
value to an outside specialist. When graph prints from EHR,
the background is too dark, which makes faxing almost
Nurses would like to be able to print out the vitals for patients. Approved
Need "print" button like there is for labs. Thanks.
I sent this question to the Listserv on 5/18 and have had no Closed
responses so I am forwarding the question to you for Suggested
New Functionality. Is there any way to link an encounter where
a lab is ordered (order # is created) with the lab visit (order #
becomes accessioned) so that it is clearly visible which provider
visit the lab visit is related to?
Looking at "order details" in orders tab. Open up med order, Transferred
and you can see the date and time an order was electronically
signed by the provider, but no time is noted for pharmacist
verification. This would be VERY helpful in tracking pt
complaints, and for general rx tracking. Plus then providers can
look up to see when an Rx was processed.
Chronic pain medication orders are written for 28 days. I have Transferred
been told that pharmacy orders written for less than a month will
always have an end date 30 days from the start of the original
I would the ability to provide stop/end dates for narcotics to
default to the number of days the RX is written for.
This was requested by Dr. Rusty Maynard, and is a pretty good Approved
idea. (beleive me, I'm not always hanging out on the feedback
page and I really do try to screen out alot of stuff). His request is
to have the ability to broadcast a reply. For example, if the
pharmacist messages the prescriber about a med for a patient,
the prescriber has to copy the pharmacist's message and
respond to ensure the communication is clear, accurate, and
pertaining to the right patient (especially if another pharmacist
gets the broadcast). To do this, it would be nice to have an
ongoing dialog/broadcast by replying to the broadcast and
including the original broadcast message. An alterative would
be to make the Chat application more noticable, easier to
respond to, and to provide a similar alert as the broadcast
message (an in-your-face pop-up window).
Is is possible to have the option to turn off the "missing POV" Approved
notification for patients that are on admitted to the hospital (are
Right now the difficult in template windows is that that they are Duplicate
modal, so if a user opens them and they want to look up, say, a
lab, they cannot look it up without closing out of the template. If
it is non-modal and can be minimized, it will be easy to do that.
MS Word does not have a Medical Dictionary available (and you Denied
need a license anyways). aspell does, and is licensed under
GNU. This is for the far far future; we have more urgent
business to take care of in the meantime.
It would be helpful to have more information on the lab Approved
notification such as the ordering provider. Providers get each
other's labs all the time (if one is a surrogate of another, if
ordered under the wrong provider), so it would help if they know
who ordered it.
When a medication is discontinued from the medications tab, Denied
you can select one of the following four reasons:
Requesting Physician Cancelled
Entered in Error.
A physician here suggested adding "Allergic Reaction" to that
list, which automatically brings up the allergy entry dialogue.
When displaying patient listing by clinic in the EHR patient Approved
selection box, it would be desirable to be able to list patients by
time of registration or appointment time. This would assist
nursing staff in determining the order in which patients checked
into the clinic.
OIT is currently working on functionality that supports the entry Approved
of behavioral health visits via the EHR. Behavioral health (BH)
providers need the ability to enter either ICD-9 codes or DSM-IV-
TR codes in the POV and Problem List fields. The DSM codes
are a standard set of codes utilized by BH providers for
diagnosis. This table already exists in RPMS in the Behavioral
Health System (AMH): MHSS PROBLEM/DSM IV CODE table.
More specifics on the file name can be provided. We would also
need the standard EHR POV pick-lists and related functionality
for the DSM code set.
Are there plans to interface RCIS to EHR? Winslow needs this! Duplicate
We would like the field NPI that is in the New Person file to Approved
become a Patient Object in EHR so we can add this information
to Consult documents. Apparently, we don't get reimbursed
unless the NPI is on the consult form. Currently, our Medical
Credentials office needs to supply this information upon
request. Providers will not enter the NPI into a note on their
own. Thank you! jaz
We would like to know if the lookup for patient charts list can be Duplicate
sorted by visit time rather then the patient name on the list
specific to a provider. In other words is there a way to see his
visits in sequential order that they were seen. A high number of
walk ins contribute to this request.
The BMI is an important measure for adults as well as children Approved
but we can't see adult range lines on the Vital chart as we can
see the percentiles for children. This would be nice.
Can you give the sites some control over what is on the refusals Approved
list under the personal health component? PAP Smears and
Mammograms are their own check box on the list, but other
labs or exams you have to search for. The test in particular that
my providers are interested in is the FOBT. They would like that
to be its own check box as well.
Please see message string below. Jane I don’t think there is Closed
one for pending or active order that would trigger an order
check in either lab menu or cprs menu. If you think that this
enhancement is important, send it up thru the RPMS feedback
page and see if they would do this. Thanks Elvira Mosely
MSHS, BSN, RN Commander, USPHS Clinical Program
Consultant (Medical Information) Phoenix Area Office 40 N
Central Ave Phoenix AZ 85004 Office (602) 364-5288 Fax (602)
--------- From: Preston, Lesley J (IHS/PHX) Sent: Thursday,
August 16, 2007 5:01 PM To: Mosely, Elvira (IHS/PHX) Cc:
Tracey, Amanda (IHS/PHX) Subject: RE: Duplicate Labs Elvira,
I can set it up for 24 hours but it looks for a collection within the
last 24 hours not pending, or active orders (labs terminology for
duplicate order) Select Order Checking Mgmt Menu Option: 8
Lab Duplicate Order Range Lab Duplicate Order Range
Duplicate lab orders date range may be set for the following: 1
Location LOC [choose from HOSPITAL LOCATION] 2 Service
SRV [choose from SERVICE/SECTION] 3 Division DIV [HOPI
Labs have to be ordered (credited to) a credentialed provider. If Completed
nursing place the order then the nurses name is often listed as
the ordering provider instead of the primary provider. It would be
nice to have an order check that asks about the primary
provider for labs when the ORELSE keys are used to order.
Because there will not be an updated version of Behavioral Duplicate
Health GUI, reliance on EHR for behavioral health charting will
increase. Because EHR has no group charting capability there
is a large deficit in EHR's usefulness for behavioral health
record keeping. David Taylor of EHR Deployment and
Implementation has indicated, "We (National EHR Training and
Deployment) advocate that BH Providers order medications
through EHR GUI." (EHR ListServ 12/13/06). Giving EHR these
capabilities will obviate the need for IHS sites to have a single
visit created incrementally in different systems with the visit-
related data ending up in two different data bases. It is our
understanding that the VA's Event Capture package would
provide group charting capabilities were it made available to
EHR. This would not only be greatly useful in BH but in
Diabetes Management, Dietetics, and other areas where group
medical services are called for. Could Event Capture--or some
other GUI-display program be implemented to give EHR group
visit/note generating capabilities?
Mary, On Hold
What do you think about a reminder to look for Patient
Education Goals that have been set?
Our providers and nurses set goals but remembering to look
and see if a goal is set is something that is not done
automatically. Having this feature would be beneficial! Our site
is part of the Chronic Care Collaborative and goals are being
used more and more. It is searchable in VGEN, so can there be
some Reminder logic written? Do you see this as a possible
enhancement request? I wonder if the VA has something like
When entering education topics for a visit, EHR does not allow Approved
you to enter the exact same topic more than once per visit.
This is an issue for inpatients, as their entire admission is
treated in some ways as one visit by EHR. We feel that it is
feasible for a patient to be educated on the same topic more
than once during their inpatient stay.
We can do last med or last med class, will we ever be able to On Hold
do last # of meds or med class? For example, I have a patient
who is currently on warfarin 2mg tabs (MoWeFr) *and* warfarin
3mg tabs (TuThSaSu). If I use the existing objects, I'll only get
one of them (whichever was filled last, even if by a
nanosecond). I really need a way to get both of the current
warfarin strengths in this object. This could happen with other
drugs, too (i.e. phenytoin).
There is no integration between the EHR and Pain Contract Closed
Management register. REQUEST THE FOLLOWING: "CASE
REVIEW DATE" and "NEXT REVIEW DATE" - develop and
OBJECT for tiu note writing and flowsheets AND as REMINDER
FINDING for cohort and resolution logic.
After reading the Suicide Reporting Form Component User Denied
Manual, I noticed that there is no information about what the
audit trail is when a user EDITS data. For example, what is the
reason the change is made, who made the change, date of
change, old value, new value, etc. I believe this information is
useful to understand if this form is working and from a training
point of view, what types of edits are occuring most.
One of my service units have seen a decrease follow up with Completed
Group B-Strep treatment for OB patients at 35-36 weeks. They
will like to use reminders as a means for alerting and ensuring
that patient get treated intrapartum. The resolution logic
available to me will not help with turning on this reminder at 35-
36 gestation. It will require a computer finding. The logic for this
finding would be that the system will calculate 35-36 weeks
gestational age from the EDC data entered in the reproductive
status tab within the EHR. It would also be beneficial if
somehow users (CACs) can manipulate this computer finding to
maybe create other reminders to turn on for different gestational
ages for the diffrent tests that the patient needs according to
their gestational stage.
We need the ability to embed reminder dialogues within Approved
templates. This has come up in multiple situations where this
abiltiy would reduce double documentation and improve GPRA
results. I realize this is a functionality that has not existed and
yet I have heard agreement from other sites in the Portland
Area how much this is desired. My personal opinion is this is
currently our most important priority.
1. For consistency, I think the Temperature field should accept #1 - Denied
".0" Currently, it accepts 99.1,99,2, etc, but if you want to enter # 2 - Approved
99.0, it makes you enter it as 99 without the decimal place. This
is confusing and frustrating for some users.
2. We are requesting that there be a way to document how
much oxygen a person is on when they document the O2
saturation in the vitals section. We are starting to enter vital on
inpatient, and the users are telling me that this is a very
important piece of info that needs to go right next to the O2 sat.
An O2 sat on room air vs 2L of oxygen is important for the
providers to know and they can't tell this by just looking at the
vital signs in EHR.
Providers would like to be able to add refills to existing Transferred
medication orders in EHR without creating a new order and
without filling the prescription. (ie patient has enough
medication, but needs refills to get through the next
Requesting the ability to add the same patient education code Duplicate
into an EHR visit twice.
You can document a patient education code into RPMS data
entry twice - assigning a different goal for each one, but you
cannot enter an education code into the EHR twice.
Why would you want to do this?
From Cece Butler: "It is easy to have more than one goal to a
Example: A patient who presents with constipation:
Goal increase fiber--eat 3 fiber foods everyday
Goal increase fluids--drink 6 cups of water everyday
All goals for nutrition or MNT
Example: A patient who presents with uncontrolled diabetes:
Goal avoid sugar beverages--change to diet beverages
Goal reduce fats--avoid fried foods
Goal portion control--reduce meal portions
All goals for nutrition or MNT"
Is there any progress on stuffing/choosing/entering the provider Duplicate
when entering patient ed in the reminder dialogs? This would be
similar to the skin test prompt (PXRM SKIN READER) which
(See attached image) See 11/27/07. The exam and patient ed
were entered via a dialog template. The provider was entered in
the exam (alcohol screen) but not patient ed.
I would love to see an additional column on the orders tab that Approved
says ordered by as well as provider. (see attachment)
Just as it does in RPMS
Select Order number: 48498
DEMO,PATIENT ADAM 14 Requesting location:
Date/Time Ordered: 11/06/07 10:31 By:
-Lab Order # 48498 Provider: ACKLEY,DAVID
That way the person placing the order could at least tell if it was
In Elko, NV(and PHN Depts across the nation), the PHNs do Closed
blood glucoses, cholesterol screening, etc., in the field. The only
place to record the values was to bury them in the PHN notes.
The problem with that is that the Drs do not see those values
and GPRA cannot capture the i.e. cholesterol levels. In the
current EHR system there is a lab package that is entered
through RPMS. The process of entering labs is a bit lengthy.
Elvira suggested that the PHNs have access to the lab package
to enter field screening labs. That was a good suggestion and
we are now doing that. The problem is: - it is very cumbersome
and time consuming to be charting in EHR then go into the lab
package and go through that whole lab entry process. [ In the
lab package, the PHN can sign off as the orderer (Provider),
and sign off on the reviewer of the labs. The PHN notes reflect
patient referral to the Clinic and further PHN f/u when labs are
abnormal.] Here is the idea... - Have a "PHN labs" section within
EHR - The PHN can document PHN labs without having to go
into the RPMS lab package. PHN notes and labs can be
documented within the same EHR program. - The PHN labs will
Our staff would like to see some sort of seperation on the Denied
Orders tab to make it easier to search (such as making a
seperate tab for lab orders, nursing orders, imaging orders, etc.)
Need HPV reminder similar to other series immunuzations. Completed
Tried to create locally but only 1st dose resolved, CONDITION
field does not appear to resolve 2nd dose.
Would like an "undo" button for EHR. Denied
I'm trying to make a dialog to document refusals of vitals. The Duplicate
nurse assistants frequently get patients who refuse, WT, HT ,
BP, etc. Going in and entering all these refusals through the
Personal Health component takes time. The PED refusal works
great for education refusals. I tried to build one but it didn't work.
Any chance of a Vitals refusal or similar item?
Our pharmacists would like to have the Display Outcome and Approved
Standard button added to the Pharm Ed button.
Add new annotation tool to lab results so that providers can add Approved
their comments to lab results
I have received numerous requests for a method to record Duplicate
othrostatic blood pressure or note when O2 Sat. is recorded that
the patient is on O2 or room air, etc. It would be nice to have a
column for method as well as range and units when recording
What I would like to see is an option to change the ordering Denied
provider when ordering labs. See attached document for more
Updating the ICD and CPT code changes in the pick lists is very Approved
cumbersome and time consuming. A simple search, find and
replace tool would make this task easier. The tool could search
for an obsolete code by code number and provide you with an
option to replace the code, edit the narrative, or delete the entry.
Learning health factor can be added now when entering Pt Ed Approved
EXCEPT when choosing pt ed topics from the Pt Ed pick lists
Request this feature be added
Forwarding notifications should do just that. Currently Approved
forwarding a notification merely copies it to another user. The
original recipient is forced to sign off on it anyway, even if they
never saw the patient.
EHR should not prompt providers to enter in an E&M code for Closed
colposcopy clinic visits. If they put one in, that would be an
error. There's no way to remove this prompt by clinic- only by
user or class. See below... Please add this option. Thanks.
EHOXQPC REQUIRES E&M CODE may be set for the
10 User USR [choose from NEW
50 Class CLS [choose from USR
Select PARAMETER DEFINITION NAME:
To plot percentiles on growth chart is almost nonfunctional On Hold
especially if child is less then 1 year of age. All of our
peds/family providers have converted back to paper now.
Need a way to be able to implement CDC's growth chart or to
be able to right click on be able to enlarge so providers can see
the percentile that the child falls in.
The AVA Add Edit Provider menu is (was?) a mainstay of how Denied
providers are entered. Unfortuantely, it has not kept up with the
changes in the medical field. There is no place to enter a fax
number, or a place to enter an NPI number.
The entry function for "Historical services" will not allow you to Approved
make an entry to the surgical history on the same day the
surgery occured. For sites that do not have an IHS hospital, this
forces you to have to put off the entry to the next day. This
should be fixed, as this has the potential to cause this sort of
entry to be missed.
We would like to see the patient's time of visit next to the Duplicate
patients name when using the clinic sort option on the patient
The Fort Defiance Med Error team recommends that the EHR Transferred
national group modify software to strengthen the safety of the
EHR medication ordering system. The first modification we
recommend is instituting a software program that sends an alert
to the provider when the provider writes an order that exceeds a
maximum dose for the drug in question.
The final modification we recommend is to have auto-inactivate
dates for time-limited prescriptions (for instance, when a
provider orders Amox for 10 days, the Rx should automatically
become inactive after 10 days, without requiring the provider to
go into the system and manually inactivate it at the next visit).
One thing I think that needs to be added to the new BEH menu Approved
created by medsphere in future EHR patches would be the
ability for CAC’s to see all the keys a user has. In my database I
added the XQLISTKEY option in my BEHOORKY MAIN menu
and this is how that menu option looks after the change.
DEMO HOSPITAL RPMS-EHR
Management Version 1.1
ALL Allocate OE/RR Security Keys
CHK Check for Multiple Keys
SHOW Show the keys of a particular user
This will allow CAC’s to have access to see all the keys that
user holds not just the order keys. In my opinion this will help
CAC troubleshoot problems without them having to contact IT
for a list of user keys or having to give the CAC’s access to site
manager’s key menu.
Education topics accumulate rapidly particularly with inpatient. Approved
Cumbersome tool with too much breakdown of education
details. Suggest that these topics do not display after X days, or
drop off with Patient discharge.
I found where it need to be updated so not to return the default Approved
for all services when doing a Group update of consult/procedure
request. In my opinion we should not have a default of all
services for this prompt since all services is a grouper not a
working consult so it would never need a be updated. Beside if
you try to use it to do a group update, it will not work. Look at
documents above. (this is from a training database no real data
used for the document). If you feel this need to get fixed, below
you will see how to fix it then send it out to the service units.
This is the option I want to change the default. (option is
GMRCSTSU) Select Consult Management Option: GU Group
update of consult/procedure requests
Select Service/Specialty: ALL SERVICES//
The routine that stuff this default is GMRCASV in this entry
ASKPRMPT ;Write the prompt and do the Read to get the user
text entered in X
↓Here ↓ Move this
I '$T S
I X'["^" S
When a provider (or nurse) places an order in ED or Urgent Denied
Care for another provider (such as the designated PCP) it would
be nice if EHR asked "Are you the Primary Provider for this
order". Very similar to the way it asks if you are not the
designated visit primary provider but try to place orders. That
way it reminds the provider to make the necessary change so
that the correct ordering provider is selected (such as for pre-
Principal Clinics created in PIMS can be selected by EHR Approved
users. These clinics are meant to be groupers and should not
be selectable. Users are picking these and writing orders, etc,
which then become hard to find because people are looking for
them in the wrong place. Thank you.
When scrolling/searching for a note title, titles of more than one Denied
word will display in the list multiple times. We are at the point
where we have so many different titles that it is getting really
confusing for our users. We are teaching them to set personal
preferences for note titles, but I would also like a parameter that
disallows the 'breaking up' of the note titles in the list. Thanks.
Sometimes I log into the incorrect division and have to close it Denied
out and log in again. I wish we can just change the division like
we can in RPMS from the toolbox.
A "Print Prescription" button on the medications tab would be Duplicate
nice. That way when providers write an order for a class II drug
or none formulary item they can print a standardized
prescription straight away to sign and give to pharmacy or the
This request is on behalf of the pharmacy NPC and PSG. Approved
Medication reconciliation is being performed in many different
ways. There are plans to include this information in the PWH;
however, programs also want other options to perform this
process through EHR templates. The PSG and NPC is
requesting the addition of multiple medication objects for EHR
templates that include all statuses (pending, active,
discontinued, expired, hold, suspense, etc) as well as chronic or
non chronic. It is also necessary to be able to include outside
prescriptions (from either the upcoming Non-VA meds or from
the pharmacy outside Rx option (AORX). Additionally, it would
be great if these objects could be adjusted by time (go back 10
days, 30 days, 6 months...). Thanks!
When setting up a vital entry template at the USR CLASS or Completed
SERVICE/SECTION level, settings are not holding. Vital
templates are only setting at System, Division and User levels.
The original intent of identifying the baby's mother was to Approved
provide a path for connecting the baby and mom at some point.
Is it possible to change the item so that is reads
mother/guardian's name needs to read mother's name, chart
number, or birth date?
Adverse drug rxns do not order check in real time in current Approved
Request enhancement/change autosign (immediate
participation in order check upon entry) entries AND order
check at SIGNING of orders rather than just at ENTRY of
orders to improve safety.
(Also CRID 412: When you enter NO KNOWN ALLERGIES, it
is immediately visible without signature in POSTINGS and
No know allergies enters the system without signature despite
request to “sign”)
When a provider uses the "Other" lab test option to order a lab Approved
test, all of the tests in file 60 are displayed. Would like the EHR
to allow only tests in file 60 that are marked as "Both" or Input"
to be seen in the list. This will keep the provider from ordering
Don't know if this was submitted already. Request to make the Duplicate
patient education pick list more user-friendly. User’s can’t see
the entire name, especially when the category is long and it cuts
off the topic. 1) Adding hover-help/mouse-over help, to show the
entire name (and long) education category and topic. - OR - 2)
Ability to increase columns, just like the ICD-9 and Superbill
picklists. A scroll bar appears when the columns are increased.
Users would like the ability to display multiple pap smear dates Approved
and results for individual patients. See attached email from
Modify Last PAP object to return Last # PAPs (i.e., last 3 PAPs).
Name: LAST PAP
Print Name: LAST PAP AND RESULT
National Standard: NO
Owner: CLINICAL COORDINATOR
Object Method: S X=$$LASTPAP^BTIULO2(DFN)
Description: Returns last pap smear date and result from
Women's Health package.
Additional Information: Add fourth parameter for the #; PGEN
doesn't allow secondary prompt; Last Pap call is a TIU call, a
programmer call (developed by Lori); should call new published
entry point that we created
Dr. Bieberly pointed out that he has a very difficult time Approved
managing inpt meds when pt are returning from surgery. On
the medications tab, it just says discontinued and the date, but
he doesn’t know if the med was discontinued for a reason prior
to surgery or just due to surgery. On the orders tab, it shows
obsolete order as a reason for d/cing and the date & time. It
would be nice if on the medications tab, it also showed the time,
not just date and the reason for dc/ing.
Another thing he pointed out is that it defaults back a number of
days, would be nice if inpt drugs defaulted to only this
hospitalization, with the ability to change the dates, which you
can already do.
I instructed Dr. Bieberly on how to change the date range now in
order to limit the # of meds & also what to look for on the orders
He has a valid point.
I do not know of any method that enables users to enter a Duplicate
refusal for colonoscopy in EHR. The only refusals I see that
providers are able to enter in EHR and which count toward
meeting the GPRA measure are refusal of guaiac lab test and
possibly barium enemas. The latter depends on which CPTs
are used, which are not listed. (It would be nice if the
corresponding CPT codes were listed along with the description
of the radiological exam.)
As soon as possible, it is important to enable providers to enter
refusals for colonoscopies so they may be counted toward
meeting the GPRA measure (Colorectal Cancer Screening),
particularly for this measure since I would expect it might have a
high refusal rate. Flexible sigmoidoscopies also count toward
meeting the measure. I do not know how common this
procedure is but they might need to be added, too. Please
contact me if you need a list of the codes that are counted for
these two procedures, as we are constantly updating our logic
and do not want to include them here in the event they change.
Issue: Providers frequently order screening labs for diabetes, Duplicate
lipid disorders, etc. There is currently no option for this in the
clinical indication drop-down menu. Providers want to have the
option of choosing "screening for" in the drop-down menu.
Currently, the choices are the from the problem list and
"Other..." (I apoplogize if I have already submitted this request!)
We would like to be able to "respond" to a notification just like Duplicate
responding to an email.
It would be nice to have BMI charts added for kids just like we Closed
do for height and weight as this number is age adjusted. Then
we can get a BMI percentile just like we can for height and
When a pharmacist edits asterick fields in the inpatient Approved
pharmacy package to correct an EHR ordered inpatient
medication prior to verifying, both the new order and the old
order appear on the Orders tab. The old order has a status of
dc/edit, but dc is an unapproved abbreviation and causes
confusion amongst other providers and nurses following the
patient. Can we change the dc/edit status to something else
like change/edit on the EHR display side. I emailed Carlene
McIntyre, and she seemed to think changing the EHR display
side may be better than attempting to change the RPMS
pharmacy package. I would like to submit this issue as an
enhancement request for consideration.
Dual order sort of the orders and medications tabs would be Approved
Currently, if you click on one column in EHR to sort orders, it will
only sort by that column. There doesn't seem to be any rhyme
or reason to the other columns. For example, if you group
orders by service, they are not in chronological order by start
date or alphabetical order by order, provider, or status. This
dual sort would especially be beneficial on the inpatient side
where orders are being followed more closely by nursing and
providers. Some providers use the All Orders-All Services
custom order view function to be able to see orders that are
both active and discontinued to be able to track the inpatient
admission orders better vs. Active only orders that just shows
the most recent and pending orders.
Same thing happens on the medications tab. It would be better
to be able to dual sort columns by clicking on 2 columns or
holding down your shift or control key when selecting the
columns to which you desire the sorting to apply.
For example, on the medications tab, the provider could click on
the medication column to put the medications in alphabetical
order then click on the last fill date in order to sort them by both
columns. Dual sort capabilities would especially be beneficial
with C-2 medications where no refills are allowed and a new
As reported by White River: For a given visit, you can’t use the Duplicate
same topic code more than once. That means if a pt returns
for a FU visit, and has not met a goal that was set at the
previous visit, you cannot note GNM and note an adjusted goal
set during that day’s visit.
As an example...
a patient sets a goal last week using the diabetes exercise
education code (DM-EX-GS-walk daily). The patient comes
back and says, I didn't walk every day, but I think I can walk
every other day. The clinician needs to document: DM-EX-
GNM (because they didn't meet the goal) then DM-EX-GS (to
set a new goal).
A better idea is to add a new goal status of "Goal Reset" to
address this issue.
Due to Joint Commission standard (MM.5.10.6) regarding Approved
documentation of first dose to new start medications, can we
add a "New Start" checkbox (either above or below the
Expected First Dose Now checkbox) for inpatient medications
ordered via EHR? This checkbox would act like a comment
that the provider has added to the script when processed and
will print on the RN and pharmacy order service copies. We
would like for providers to be able to assist pharmacy and
nursing in identifying new start medications so that we can
become more compliant with the current standards. Thought
about adding this to each drug orderable item in our pharmacy
package as patient instructions but cannot separate from other
needed comments (i.e. for pain) and this would be a lot of work
with lots of meds.
Can we add in a new "New Start" checkbox to inpatient
medication EHR quick orders? I believe all inpatient sites will
need to have this in order to assist in becoming compliant with
Joint Commission standards.
Currently, there is no way to enter data for the PHN mneumonic Transferred
via EHR. Would like a new object so users can enter this,
prompts are as follows:
MNEMONIC: PHN Public Health Nursing Form
ALLOWED VISIT RELATED ONL
LEVEL OF INTERVENTION: ?
TYPE OF DECISION MAKING: ?
L LOW COMPLEXITY
M MODERATE COMPLEXITY
H HIGH COMPLEXITY
Answer must be 1-200 characters in length.
NSG DX: ?
Answer must be 1-200 characters in length.
SHORT TERM GOALS: ?
Answer must be 1-200 characters in length.
LONG TERM GOALS: ?
Answer must be 1-200 characters in length.
Could the vim/EHR code be altered so that we have an In Process
additional option for opening popup windows. Either add a
popup3 or modify popup2 so that we can have either modal or
modeless popup object windows. That would allow us to have
objects such as notes open and still allow us to reference other
It is wonderful to be able to document infant feeding choice Closed
now, but it would be great data if we can do it other than real
time. Ex: If a baby is one year old now, but mom breastfed for
the first 6 months, then swtiched to formula, there is not way to
capture that the baby WAS breastfed for 6 months if the baby
had not been seen at that time. This would be a great addition
to the epidemiological data IHS is trying to capture through the
new Infant Feeding Choice selection in RPMS/EHR.
I’ve found that there are a lot of cool things you can do with the Duplicate
program launcher button. Say for example, I’m on the progress
notes tab and I want to take a quick look at the immunizations.
Instead of having to leave the progress notes tab to search for
the immunization object, you can click on a program launcher
button that will open up the immunization object into a window
on top of EHR. When you’re done, just click on the X to close
the immunization object window. This is the line of code you’ll
put in the EXENAME box of the program launcher button dialog;
ns) This works for all the objects, you can get the program
identifier from the EHR Technical Manual. Just add the program
identifier after, ($VIM.popup2, ). The last part just after the
program identifier is the title of the window that you’ll open up.
You can name it whatever you want. ? If you prefer using Menu,
the line of code can also be inserted into the Menu.
Unfortunately this only opens up the object in a modal window,
so you won’t be able to click outside the popped-up object
window. It would be great if the programmers would give us a
I have had providers here request the ability to use their control Denied
key and pick multiple pov's off the historical list or problem list at
the same time.
Need to include (1)injection site (2) where placed left or right Approved
arm (3)lot number (4) dosage.
This is already available in RPMS this needs to be included in
the EHR if you want providers to use EHR instead of RPMS.
When our PHNs perform immunization clinics they need to Denied
record them as "Current" so that they can account for the Lot#
amd Injection Site but they also would like to change the
location to the actual place where the clinic was held, such as
"Jeddito Dental Clinic". The only way you can do this right now
is to record the immunization as "historical" or go into the roll-
and-scroll and make the appropriate edits.
Can you add the "Location" box to the "Current Immunizations"
entry area as an option.
Add functionality to copy communications. Right now the text Denied
pops up in a yellow box, but you can't select the text to copy.
Using COPY TO NEW ORDER for an active med creates a On Hold
duplicate med order. This action does present the "Duplicate
Order" box to the user. (This DOES occur if user enters a new
order). This leaves 1 pending and 1 active order for a given
medication. During the pharmacy processing the duplicate med
order is discontinued. The provider notes are usually written
PRIOR to pharamcy filling the pending meds. The medication
reconciliation is then incorrect in the note (see attached).
Ideally, duplicate orders should trigger the presentation of the
"duplicate order" box regardless of how order created.
Dialog to send a user generated notification is very unfriendly to Approved
use. It's so unfriendly, requiring so many clicks. It lacks
appropraite defaults, like a default to today's date and time.
Choosing a user to send to requires going to another screen.
And the default to send it to myself is unreasonable: most of the
time, I don't send a notification to my self. For comparison, see
how much easier to use the dialog to assign an additional signer
Requesting a way for EHR to capture patient's signatures in Closed
association with consent forms.
Ideally, something like how ScriptPro Central has a signature
pad and captures the signature when a patient signs that they
are picking up medication.
Would it be possible to add intake and output measurements to Duplicate
the vitals measurement panel for inpatient's use?
When entering a historical PPD through EHR, you cannot enter Approved
the date it was administered vs. read, and you cannot document
who did the initial injection, vs who read it, vs who documented
it (current user). In addition, the view in the Imm package is
misleading. It says that the user both administered and read it
was the user who documented it in EHR.
The ED has always used the "Face Sheet" in the Patient Closed
Registration package to send with a transferred patient. I have
placed the "Health Summary," and "Patient Wellness Handout"
on the GUI for easy access but I am unable to attach the "Face
Sheet." Can this be added?
Add the ability to override a health maintnenace reminder (or Denied
enter anoverride for EHR reminders) similar to what can be
done in PCC data entry.
Move the prompt for "Date/Time of Note:" before the prompt for Denied
"Progress Note Title" OR add a prompt for "Late Entry" that you
click and it jumps to the "Date/Time of Note" prompt and opens
Justification: Providers forget to change the date of the note to
the correct date when creating late entries. It is time-consuming
to fix these errors and if left uncorrected, the notes are out of
chronological order making it hard to locate the visit note. If
they were prompted to click a box at the very beginning of the
new note box for "LATE ENTRY" and it took them directly to the
calender, then they would be reminded they need to change the
date OR the "Date/Time of Note" prompt could be moved to the
beginning as a reminder to select before selecting a note title.
Nursing staff has requested additions to the list of family Transferred
planning methods found in EHR. They would like:
When the user tabs around EHR while in a sensitive patient, it Denied
does not log what they have viewed. In the roll-n-scroll, it
captures package activity and on the EHR side, it only captures
Vuecentric. It would be ideal to know where a user went within
a patient chart, especially now with all the issues coming up in
the media with users going into patient records.
Some things require single click, while others require double Denied
click. (single click the plus sign, but double click the work) It
kind of bugs me, and others have commented on it too. It
would be nice to have it more uniform.
The users should be able to remove the primary provider if Denied
another provider is listed for the visit. The GUI should just
automatically switch the primary provider to be the next provider
down on the list. Currently this process takes too many clicks.
Providers keep getting a message when entering ICD codes Transferred
directly asking "If they want to truncate the narrative". We see
this a lot with the diabetes codes and it can get annoying. It
would be nice if the provider narrative field could be increased
from 80 characters so that it could accomodate the ICD lists
loaded in the system.
We would benefit from an area in health factors or exams on Denied
the wellness tab in EHR to put screening for street drugs
use/abuse. Our nurses screen for this regularlly, but no place to
document this. Thanks.
Nursing had a couple of request for the Wellness tab. Under Transferred
Personal Health/Reproductive History they would like to know if
partial hysterectomy, full hysterectomy and tubaligation could be
added. Surgical sterilization is what they have been choosing,
then adding a note the CC/PROBS tab, below the chief
complaint. - Under Health Factors, can drinking occasionally be
added? Also, where would they enter Vision and Hearing Tests?
Under the Vitals tab, when entering vitals, there is an option to
enter vision corrected and vision uncorrected, but this does not
allow them to enter the information they have. They are also
putting this information under CC/PRBS. Do they need to enter
it under a note?
We, the physicians, request a patch to give the ability to turn off Approved
the notifications for inpatient blood glucose values. These
notifications are numerous and crowd our notifications. Some
physicians receive up to 100 per day. The results are often 1-3
weeks late, also! We urge you to make this available for us as
soon as possible.
Can the visit lock be activated when the coder answer Yes - this Approved
record is complete -
Example: provider completes the visit, signs the visit, coder
codes and completes the visit and answers yes to is this visit
complete, visit crosses over to 3rd party if a billable visit, this is
when the visit lock should lock the visit, even if the visit lock is
set at 30 days the visit is completed as above, before the 30
days, visit should lock when coder answers the question yes.
I would like TIU Template Data Object created for, 1) Pending Approved
Lab Orders, 2) Chronic Meds that have no refills left, and 3)
We, the physicians, request a patch to give the ability to turn off Duplicate
the notifications for inpatient blood glucose values. These
notifications are numerous and crowd our notifications. Some
physicians receive up to 100 per day. The results are often 1-3
weeks late, also! We urge you to make this available for us as
soon as possible
Could we add a choice in the printing options to be able to print Approved
the inpatient medications?
Until the fields are available in EHR, can the TIU Birth Completed
Measurements object be modified to only display those that you
can enter in EHR? For now, it is somewhat unusable in a note
because the apgar, complications, and type of delivery fields will
always say "unknown" especially on a first visit like a weight and
color check for newborns before data entry would even have a
chance to fill in these fields from reading a note.
Request that there be a way to indicate on Vital Signs whether Duplicate
they were administered Lying, sitting or standing. It would be
easiest for the nurse or other provider to annotate this on the
VITALS tab, right at the top in the same box as the date and
time. It could just be a drop down box that says LYING,
SITTING, STANDING and they choose which one.
Prior to V1.1 I had the ability to add diagnosis codes multiple Completed /
times to same pick list with different narratives. We still need to Approved
be able to do that. In many cases one ICD-9 Code can cover
several different narratives. In addition, providers have unique
preferences in the way narratives are worded. For example,
One provider wants 780.4 worded "dizziness" another wants it
worded "vertigo". I do not wish to nor have the time to create
unique pick lists for every provider according to their
preferences. I realize that when duplicates are used in a pick
list, and one diagnosis is selected, all the other common codes
are "checked" as well and this sometimes causes panic among
the providers, but I usually only have to explain what is
happening to the providers once and they ignore this in the
future. We have learned to live with this in the first version. Can
this be a site specific parameter - to allow duplicate ICD-9's or
to disallow? Associations: Love them! I still cannot associate
health factors or exams with a CPT - I submitted that in a
separate Feedback. Would like to see added: 1. Ability to
associate a CPT code with a second CPT code. Some coding
We'd like to be able to check off BOTH V65.49 AND V68.1 for Denied
our pharmacy POV when using the PharmED button. Can you
change the radio buttons to checkboxes? Thanks.
The recent patch removed the maximize button on the Denied
templates and it is time consuming and cumbersome to have to
drag the corners of the screen to maximize the template. I
would like to request that the maximize button be returned to
the templates. Thank you!
As you all well know exach year new CPT or ICD-9 codes are Duplicate
added or deleted. If your pick-lists for CPT or ICD-9 codes using
these inactive codes, you would have to go through all your list
to find the inactive one. Needless to say this is very time
consumming. There is an option within the RPMS EHR order
menu (SRO Search/Replace Orderables ) where I can serach
all my quick order for inactive tests or meds and repoint the new
test or med to that quick order. I am asking to create this same
functionality within the GUI. I know that these super-bills and
pick-list are created in the GUI and more then likely are stored
somewhere within the GUI files. If the developer can delelop a
button (similar to the query button) within the superbills or pick-
list dialog that when it is selected, the system will search the
pick-list then search the CPT or ICD-9 RPMS files for these
same codes and if the inactive field is true, then it can either
stop the query and ask user to either replace or delete the
inactive code inside the GUI lists then after this is done it
continues the query where it left off. Or do the query then
provide the user with a list or report of all the inactive codes plus
Many requests have been made by providers to include the Duplicate
PIMS Check-in time for viewing when selecting a patient by
clinic within the patient selection window of EHR. This would
assist in prioritizing patients.
At my site, I set up a process so that referrals go to a CHS Approved
consult; when the results come back, we scan it in, attaching it
to the consult. This generates a consult completed notification,
but it just disapprears when you double click on it. In order to
promote a paperless environment, I would like a signature from
providers that they have seen the consult. They would only sign
it if they acted on it.
Right now, we route documents to the providers prior to
scanning since their initials and the date on the paper mean that
they have seen the document.
While documenting patient education for each pov, it would be Approved
very nice to be able to high-light as many education
descriptions/categories as we want, at the same time.
As i am sure you know, at this point only one of these can be
selected at one time, the number of minutes is entered, then
you have to select the next one, and so on.
Recently during a AAAHC review, the reviewer asked me how a Approved
provider can check to see that another provider has seen
(signed off) a lab or imaging report. I know I can go into RPMS
and track who signed off on the notification, but it would be nice
if others could see this in the GUI. It would be nice be able to
see this at the bottom window of the lab tab.
Need to be able to print multiple visit summaries by a range of Approved
dates. Also need to be able to customize the selection to
exclude or include certain service categories, clinics, locations,
Also, add a function to Radiology report print to be able to print
a range of radiology reports or all radiology reports in the
system. Tis would be similar to the LDIS and LSUM print
functions in the lab package.
It would be nice if the above print enhancements could be
added to both the EHR and RPMS. If added to the EHR,
access could be limited to HIM staff or House Supervisor staff.
Justification: For release of information purposes, sometimes
patients or attorneys request the entire medical record. Going
in and printing each visit summary one at a time is time
consuming. We would also like to be able to exclude lab only or
x-ray only visits from the range of printed summaries because
we use the LSUM function to print all labs in the system and
don't need these to be duplicated through visit summaries.
It would be nice to have a "Newborn Hearing Screen" as part of Approved
the Birth Measurements under Personal Health as this is usually
performed prior to the baby's discharge (or soon after) and
seems like a logical place to find the information. Would be
especially nice it this information also recorded the appropriate
CPT code automatically.
Add ability to import more than one TIU template file at a time… Approved
Now you have to do it one by one…
I sent a template with buttons via listserver that gave the Duplicate
providers the ability to enter data into the different RMPS
packages without leaving the note tab. Draw back is if they have
activated a template, the "buttons" will not "work" until they close
that template. I request the following enhancement From e-mail:
However I know that the ability to minimize the template was
removed, but if somehow this functionally was return. Then the
provider can minimize the template, go to the buttons above
and enter data, then go back to his template and finish the
notes. In addition to the minimizing function, we would need the
ability for that template to get new data, like a refresh button
somewhere in that object, so that the template would contain
the latest If this could be done, you will have a lot of happy
providers eager to use EHR. Providers are frequently “losing”
there notes trying to go to other tabs. This is especially true with
new providers using the system.
We need to be able to designate a patient's primary care Approved
provider in EHR, rather than backing out and going to RPMS.
This should be easy to do, such as a button on the top task bar
w/ either free text, or preferably dropdown of choices of medical
providers to designate. This should be done soon. This inability
to designate PCP is slowing down our ability to adopt
Innovations in Planned Care (and more sites are joining) as well
as our ability to make maximal use of iCare.
My coders are informing me that the CPT code for the PPDs Approved
includes the needle and syringe, yet the package is adding
separate codes for the needle and syringe and injection. They
are needing to manually remove these each time. We can set
the package so no CPT codes come across, but we would
really like to be able to set this per vaccine or skin test to avoid
issues like these. Any information you can provide to assist us
in fixing this problem will be appreciated.
I don't remember whether I asked for this before, but I would Duplicate
like to be able to import more than one template at a time by
selecting all of the ones I want to import from the filesystem
(selecting multiple files using shift and Ctrl) and import them into
a folder in one operation.
So, for example, I want to filter the output of all meds to meds Denied
that are expired or get a single value from Reproductive history--
I don't want the whole object. An example of how this is
implemented is the Unix utility grep.
For medication quick orders, if the pharmacy put something in In Process
the MESSAGE field (drug enter/edit in the rx package), it is
supposed to pop up when the provider selects the quick order.
However, the message only appears if the provider EDITS the
quick order. It would be nice if the message appeared always,
not just when the QO was edited. Thanks.
The communication tab is a helpful assest to have for EHR. Denied
One suggestion is to be able to look back at at least 5 old
messages. At our clinic we use it to communicate to pharmacy
when pt is here for medications. However if you x out of the
note you can not look back at the note to verify which patient is
here for medications. It would be great to have at least 5
messages stored to review messages.
When "Copying to New Order", one must choose one of three Approved
locations for meds to be picked up. Please allow sites to set one
of these three to default, in our case "window".
When clicking "refill" for a chronic med, the refill disappears. It Approved
needs to be displayed in bold like new orders. When refilling
meds for a patient on multiple drugs, it's easy to lose track of
which ones have been refilled or not. Either the patient doesn't
get an intended drug, or it wastes patients', providers' and
pharmacy time to call me and ask if I really didn't want to refill
something the patient's been on forever.
Our Nurse Executive has requested the possiblity of associating Denied
Treatment Protocols or Practice Standards with a chief
complaint diagnosis. For example: If the nurse selects "Patient
reports chest pain" from the chief complaint builder the nurse
would be prompted with the protocol to give the patient an
aspirin. This would act merely as a reminder that the protocol
exists. She then would enter policy orders as appropriate.
Also, this could possibly be an electronic file for protocols with
functionality to document yearly review and approval status for
A CPT modifier can indicated, e.g., that a mastectomy is In Process
unilateral rather than bilateral. If I want to test for that in
reminders, now I can't.
The nurses have asked for more specific options in the In Process
reproductive status window to separate "surgical sterilization" to
include BTL and hysterectomy. Patients apparently are getting
frustrated when the nurse keeps asking them for their last
menses when they had a hysterectomy.
Also for RCIS as well as EHR - How about a post 1985 or so Denied
word processor that consistently justifies across lines when
things are inserted, spell checks, etc.
Because all new admissions to the hospital require that the Denied
patient be screened for MRSA, would like an alert to appear in
EHR (GUI) when patient is admitted indicating they have not
already been screened for MRSA for that admission. Alert
should inactivate when MRSA lab test is ordered on Orders
Could you consider three more OE/RR print fields for the next Approved
patch where you are putting the PROVIDER DEA on? These
would make formatting the Controlled Substance prescription
look much better.
This information is currently available on the Print Format
Webex, but requires Fileman programmer access to complete.
So is dangerous This puts all of the Patient Address information
on one line. (Mary gave me this a couple of years ago)
Select OE/RR PRINT FIELDS NAME: ADDRESS OF PATIENT
NAME: ADDRESS OF PATIENT//
DEFAULT CAPTION: Address//
EXAMPLE ENTRY: 504 Smith Drive//
CODE FOR SETTING VARIABLE: S
No existing text
The other three are for items from the FACE SHEET that come
from the Patient File.
The first would be for the information from item #9, Street
Address [Line 1] The second one - item #12, City: and # 13
The third one – item #14, Zip Code. Team panel (green) on Denied
Modify the display in the Primary Care
the Patient/Visit toolbar to not only display the Team/PCP but
the Women's Health Team/PCP and possibly the DMS provider
as well (if there is room). The prompt to add/edit the WH
provider is already present in the UPC (Update Primary Care
Provider) option in PIMS. What you enter there does not
display in GUI, however. What you elect as a site to display in
this panel should be controlled by a parameter which gives sites
latitude to display information relevant to their operation.
It would be nice for providers to be able to designate within EHR Duplicate
the primary care provider in order to build patient panels. We
should be able to do this by clicking on the Green Box.
It would be helpful to be able to create a To Do List with links to Deferred
The most practical way to navigate a pick list today is to scroll it. Transferred
However, many pick lists are large enough that it would be
helpful to include a sort of easy to access search functionality. I
would model such functionality on Windows Explorer or Gnome
Natulius file browser.
Due to the age, lack of interface with other RPMS packages, Transferred
and it's ability to meet JC requirments for measuring staffing
statistics the Nursing Acuity System needs to be upgraded.
The package has a lot of potential because it meets a JC
requirement and can be used to calculate the necessary
statistics with minimal data entry because most of the
information can be pulled from data already available in PIMS.
One of the missing components in the EHR patient charting is a
standardized patient assessment for each inpatient shift. If an
EHR component could be created to enter the inpatient
assessments, this data could be used to calulate the staffing
statistics together with information entered in the roll and scroll
about nurse staffing levels per shift (like it already does). The
EHR patient assessment component could possibly be a vitals
measurement if it is programmable. This would also allow for
charting of the assessments.
The reports (available through the roll and scroll) should include
the ability to define date ranges. We would only need the
staffing statistics reports if the assessment was performed and
available through EHR.
Plus, please fix all the bugs!!!!
Is there a way to add fields for defaults into the inpatient order Transferred
file for medications so that when a doc uses the "transfer to
outpatient" option, defaults can be set for things like day supply,
pick up location, refills, chronic flag, etc?
Dear RPMS Enhancement Team, In Process
A recommendation to the reproductive health tab – would be to
note that menses has not begun and the date it begun.
It the button had a yes/no functionality – that would be blank
until selected no and the date would be defaulted by the date it
was checked NO.
There would be a box for the date menses began with a
calendar and the selection of the date would automatically
check the box YES.
We need to have medsphere create print formats for the CNII Approved
narcotics that will bring in patient's address, prescribing
provider, institution address, dea# and NPI number. There has
been discussions on the listserve about the DEA requirements
for CNII narcotics. There have been other discussion here at
Area about JACHO stand on hybrid environemnts. One service
unit that I know of has been warn about having hybrid EHR
environment and the impact this has on patient care. If we are
to continue with the EHR inscentive, we need to electronicalize
all and every form. So it would be prudent to start with creation
of print formats for provider's DEA, precribing provider, NPI,
patient address (the address needs to look more like an
address then just a single string of street, city and zip code),
and institution address. I am not sure if the provider does not
have a dea# then will the institution DEA number be sufficient?
Don't know, but it might be a good idea to create print format for
institution DEA. The CAC's can then use those print formats to
create their own RX footer or header. You can also have
medsphere create a sample CNII footer that if the CAC does
Continuing with the need to eliminate hybrid EHR Approved
enviroment....Efforts are being made for the EHR inpatient
deployment, but we are lacking any good nursing package. Hopi
is using the acuity system but this package has its problems
and no developer assign to it. Then we have the problem with
I&O's. Where are nursing going to document their I&O's, dietary
count, restraints checks, 24 hours order checks, etc. Inpatient is
run by nursing, so we need a nursing package that will address
We are using the REAP (Rapid Eating Assessment for Patients) In pre-CCB
screening questionnaire. It is done yearly so when we document discussion
it via template, it would be nice that it would immediately
populate the screening exam section under the Wellness tab.
That way we would not have to look through all the notes to find
out when it was done so that it will not be repeated more than
once a year unless the physician requests it.
In the EHR, the ability to order is governed by order keys Approved
(ORES, ORELSE, ORMAS) but because there are multiple
categories of items that can be ordered, this creates problems
for many sites including ours. I (as CAC) have been asked to
turn on the functionality to "restrict requester" so that nursing will
not inadvertently order meds or labs but then they are not able
to order consults, which our facility allows. I'd like to see an
additional category of keys, or some other way to set the system
so that we can restrict ordering of each category of ordering--
lab, radiology, consults, nursing, etc. this will also impact the
ability of the nurse to request a refill on behalf of the patient (a
refill that already exists)--it cannot currently be done with the
restrict requester function turned on but some facilities allow
Although this is nice in theory, it is not fully functional in that I Approved
cannot actually change (or even see) all of the information to
make the allergy actually work--most especially the VA Drug
class code. Without that data, the order checks do not always
work and creates a hazardous situation where we think we are
protected but in fact are not. We are able to see and edit this
data when verifying allergies on the RPMS side. Can the
verificatin through the EHR be enhanced, or can the feature be
allowed to be turned off? it gets really annoying getting the pop-
up window on the patient, even though I have already verified
the allergy on the RPMS side for that session.
Presently we have the ability to enter data into the RPMS while Denied
providers are writting their notes in the form of reminder dialogs.
Problems with this is that creating reminder dialogs takes time
and are not as easy as creating TIU notes. I don't know if this is
available in the VA but it would be nice if we can create the
majority of the TIU template as a regular template then we can
attach reminder dialogs strategically thorugh out this template
so that providers can create the consult, or enter education,
enter diagnosis, etc while they are constructing their notes. How
the system is set now, reminder dialogs can not be attached to
a TIU template. Providers have to be taught to click on their
note template, then if they want to use a dialog, they need to
paste that template, then go back and select the dialog. Enter
the data there and hit ok again and maybe go back to the
template and finish the note. This is easy for those more
experience provides but for the average person, it can be
confusing. If we can attach these dialogs as we built our TIU
templates, then I think it would greatly help the provider.
Specially ER/urgent care providers. Just a thought....
Dr. Cullen has requested that the Community Alerts regarding Approved
Suicidal Behavior and CDC Nationally Notifiable Diseases is
displayed in the EHR and "the first time a user logs on to
Is it possible for a user to change the default sign ins when we Denied
go to a outside facility? When I travel to my secondary (outside)
clinics, I have to remember to switch to that clinics outside
siteand not hit the default to my local site every time I log in...I
accidentally signed into the primary site EHR record several
time when I was out the satelite clinic...Some of the patients get
seen at both sites and it would be very easy to chart
inadvertently on the Primary site EHR when seeing someone in
at the satelite clinic.
It would be nice if I could go into a set up screen and change
my default to outside facility and the clinic for the time I was
there, and then switch it back 1 time when I got back to my
home area. If this is not possible, it should be brought up to the
programmers to make this possible as I believe it is going to be
a source of significant error in the EHR environment with
traveling physicians going to other EHR sites, especially if every
one sets this default up differently!
When entering a Pap Smear refusal through the Personal Approved
Health component, the logic looks for "PAP SMEAR" in the Lab
File 60. If local test is not named "PAP SMEAR" search and
Refusal entry fails.
Suggest that this be made a locally editable parameter so that it
can match the local Lab file.
See attached document for screenshot examples.
The eye glass prescription is only entered on the RPMS side. In Process
And a prescription is needed and the only way to pull the
prescription over is the use of EYE care HEALTH summary out
of PCC and that is not real time and useful in the EHR
An ideal solution is to have it in the personal health history so
the tech or eye MD can enter it and generate an electronic
Request from the pharmacy PSG to ADD the time pharmacist Duplicate
verifies a prescription in the GUI. Currently no place for this in
I believe this was a feature in the late deceased 1.0 version. In Process
If you left-click on an order, then move the mouse while holding
the left mouse button, you were able to select multiple orders or
meds; whatever your mouse swooped on. Now you don’t have
that option: you have to use CTRL or SHIFT with the mouse
buttons to select adjacent items. Would this feature be
Request from the pharmacy PSG: The new Print button on the Duplicate
Med tab (CCHIT) will allow a provider to print a copy of the
outside script (e-prescribing) but not work for in-house scripts.
The PSG would like to be able to print a CII medication using
this method with the provider's DEA number and perhaps a note
stating that the medication was filled "in-house" to meet federal
and state requirements of maintaining a prescription for
controlled substances for a minimum of 2 years.
Presently the patient education is found in education format. Transferred
For most providers when they ask to see if a patient has pick up
meds they look at the notes. However the patient education
note by pharmacy does not put an addendum to the visit to
know what meds have or have not been picked up. Please
make changes to keep providers up to date on pt compliance.
This situation applies to a pharmacy WITHOUT 24 hour Denied
coverage. In the inpatient setting, a medication is ordered
electronically by the provider during non-pharmacy hours. The
medication is verified and co-noted by the nursing staff and a
MAR is printed. None of the pending orders give administration
times for continuous orders (i.e. BID=0600-1800; Q24H=1200).
When pharmacy arrives in the morning and finishes the pending
orders, then the administration times appear when the MAR is
re-printed. Pre-EHR, nursing staff utilized RPMS to enter
orders and MAR would print correctly. Any suggestions other
than 24 hour pharmacy?
I had a request from one of my service untis to see if we can Duplicate
change the demophraphical display of patient's age in the
patient selection objects to display months for patients under 2
y/o. If you click on the ppatient detail button in that object, the
age is displayed correctly in months. See attachement:
Currently, there is only a labor-intensive and restricted access Approved
process for a site to verify that certain notifications from the
EHR have actually been processed, and not just deleted due to
age. This can be a significant issue in terms of meeting
requirements for accreditation (JCAHO, etc.) as they often want
documentation that we have followed our policies, for example if
we say all labs are signed off by the provider we need to be able
to show this. We need to have canned reports or an easier way
to see that these have been processed.
Our radiology tech has mentioned the IHS policy for x-ray In Process
exams specifically states that if the patient says she is not
pregnant, "How is the client certain she is not pregnant? The
answer given should be included on the x-ray requisition". On
EHR orders, the ordering provider isn't prompted to put in this
answer anywhere. It might be nice to have either the LMP
automatically print on the x-ray requisition, or a free text box
appear prompting the ordering provider to state how the patient
is certain she is not pregnant. Attached is the IHS policy, see
top of page 2, item #3.
Would like a notification created from the mailman bulletin Transferred
APCL DIABETES REG NEW CASE
The EHR Vuecentric framework currently has a "The license on Denied
this host will expire on..." popup that appears for all users
beginning 30 days before expiration. This is proving to be
bothersome and even confusing to many users. Since most end-
users have no control over the license installation, and the
license patch has historically not released 30 days before
expiration, I suggest changing this message to a parameter that
can be set at the User, Class, Division, and System levels. This
would allow it to be in place for CACs and other IT folks who
need to be aware of license expiration without adding to the
plethora of popup messages that end-users are experiencing.
It would be nice if the "Visit Diagnosis" component would Denied
automatically open (pop-up) if someone tries to write a progress
note without first selecting a POV.
Providers are requesting an option that we could turn on for a Deferred
mandatory notification to be sent for missing notes for the
We need to have the ability to designate which groups of Duplicate
notifications can be forwarded to our surrogates when we are
on leave. At our facility it would be ONLY lab and radiology
reports, but other facilities might have other needs, such as
scanned-in consultant's notes. It clutters up the surrogate's
notifications screen when notifications for things like missing
E+M codes or about missing notes are going to the surrogate.
The Pharmacy PSG is requesting a Medication Possession Approved
Ratio (MPR) as a calculated field in the outpatient medication
section of the EHR.
As our Social Services department moves forward with EHR Denied
they would like to be able to enter the "Activity" and "Number of
people served" into EHR. At this time they are having to go into
the roll and scroll to enter this information although EHR
captures the remainder of their encounter information.
We believe that it would be helpful to have templates have a Duplicate
minimize button that would allow us to exit the template to seek
information from other parts of the record without losing our
place. We also believe it would be nice for providers who go in
and out of templates if the template that was being used would
remember the information marked previously when it is brought
back up. It is sometimes awkward to have to go back to the
printed note to figure out where in the template we had left off.
We believe that there should be built into one of the tabs an In Process
area for permanent registration of social history such as patient
lives in a abusive household, patient is a single parent, patient
has had multiple legal problems, patient is in foster care, patient
has sibling with autism, etc.
Nurse aides would like the ability to document "unable to Transferred
screen" when unable to take certain measurements (height or
weight) from those who are wheelchair bound. Currently,they
have to document unable to screen as a refusal in the Personal
I would like to request an exam be added. We do a screening Transferred
called CHAT. Its a checklist for autism in toddlers.
It would be nice if the Order Component had a tab for each Denied
service instead of all in one list.
When viewing / printing the Appointment Actions component Approved
details the form that EHR takes you to is the "Visit Summary"
which is data entry / coder friendly but EHR was supposed to be
for providers and nurses so I would like the details to show the
"Visit Brief" summary which would work better for providers and
nurses. Data entry and coding staff can access the visit
summary through PCC as usual.
Nurse requested the option of selecting "pregnancy" as a Denied
contraindication reason to a vaccine.
I noticed that pressing F1 to get the help menu while entering Completed
the patient weight in the vitals entry component, it doesn't tell
the user how to enter in pounds and ounces for peds patients.
(putting a space indicates lb oz.) Can that line be added to the
help dialog box?
1. Would like to have an automatic notification for the infection Completed
control nurse each time a "flagged" microbiological organism is
2. Would like to have an automatic notification for the infection
control nurse each time a laboratory threshold of "positive" is
Is there a way to ensure that all fields for a given visit are Duplicate
completed. This is like an immediate error check instead of
getting the notifications?
Request that a done button that had the following function. In Process
1.When pressed it provides the provider with the missing
information needed to complete the visit. Thereby decreasing
notificaiton and having providers try to remember from memory
information from a visit that may have took place several days
ago. this should increase billing more complete visits and not
have missing E&M codes, or use of 9999codes etc.
Since having to print prescriptions for CII drugs we would like an Duplicate
easier process to do this such as a "Print Prescription" button
on the medications tab, and/or on the Orders tab.
The Med Tab needs to display stop time in addition to date for Approved
inpatient meds. (This has already been done in Medsphere's
I meant to request that Start date/time also be displayed on the
Med Tab for inpatients.
Our Providers have requested a change on the signature box. Denied
Often they will start their note when seeing the patient. They will
use the option “Save without signature” order the patients lab
work and plan to complete the note when the lab work is
completed. The problem is that when they click the signature
tool to sign the lab orders it brings the note into the box as well.
The providers then end up signing the note they wanted to save
and then compete when the lab results returned. They would
like to see the default changed so the provider needs to check
the items they want to have their signature applied to, not have
the default of all items checked.
We are requesting that Not Found a Service Category be added Completed
to EHR for PHN to use this category when patients not found at
Some kind of one line message under the PCP name in the Approved
green box say that there are more providers to view, such as:
“Click to see more providers”
Request to modify: Duplicate
Encounter Context Configuration
Temporarily Override Visit Lock for User option so that when
you do an unlock you are asked the date you wish to relock it?
It could be set at that time or if left blank then you would have to
go back in and relock it...much like the surrogate setting works
in the EHR.
Dean has a good suggestion. Pregnancy status entered into the In Process
reproductive history component can trigger an automatic POV
and order checks for providers and pharmacists when ordering
... screen so that users won't be confused about what dialog is Approved
We love the patient record flags just wish they were Denied
The coders at my facility perform internal audits on each other. Transferred
Right now we have to run a complicated fileman report to find
visits that each coder has audited. It would be nice if there was
some kind of predefined report to specify a date range, service
category, clinic code and visit auditor. Or possibly just add visit
auditor as an option in VGEN.
Display the CAGE Health Factor questions on the screen (along Approved
with guidance on scoring) - same with PHQ2, PHQ9, CRAFFT,
AUDIT and AUDIT-C Measurments. Displaying the actual
questions and the "scoring key" would provide the user with
guidance on using the tool. Display in a way that is similar to the
Patient Education Outcome & Standards functionality currently
available in the EHR. See the email string from Dr. Elaine Miller
(Aberdeen) and others below.
For Imaging orders, san the "status" column on the orders tab Approved
be made to mirror what is actually in the radiology package?
Currently EHR shows "scheduled" as the status, when the
status in the radiology package is actually "examined."
EHR should allow users to select patients from iCare panels Approved
through the patient context selection dialog. I'd envision another
bullet in the list called "iCare Panels". Selecting this bullet would
expose a drop-down list of iCare panel names available to that
user (ones she created or ones shared with her). There are two
API that iCare uses for this. the way I understand it is that
BQIGETPANELLIST is called first to bring back the list of
panels available to that user, and then when they select a panel
name the BQIGETDFNBYPANEL API brings back the patient
names in that panel. Panels are easy to create in iCare and
users clearly need to access those same panels in EHR.
When a provider chooses a patient using the default clinic and In Process
today and the patient hasn't been checked in yet its not easy to
tell. The visit box shows the time the appointment is made for. I
would like to see the visit box show a message that the visit isn't
checked in yet or is not available yet.
I would like to request group visit entry functionality be added to Duplicate
It would be very helpful to automatically open up a comment or In Process
addendum field when being sent a document to sign as an
additional signer. This would allow a plan or response to be
entered - possibly with a functionality that would allow a return
to the first signer for review.
It is important! And the RPC call and the routine wouldn't take Approved
too long to write... ----- The only way to do this is RPMS. Send it
as a enhancement if you think this is important.
________________________________ From: Electronic
Health Record on behalf of Marianne Sebastian Sent: Tue
9/9/2008 10:00 AM To: EHR@LISTSERV.IHS.GOV Subject:
notification to med rec to pull chart Just wondered if anyone is
using EHR to request charts to be pulled by medical records for
nursing? If so, how are you doing so and can you make it print
to a designated printer? We are currently using RPMS to
request charts but providers/nurses would prefer to do this in
we would like to be able to remove a line within a complex order Approved
when entered in error. This functionality would apply to the
provider entering a long complex order on the fly. i know this
functionality works in the quick order wizzard - is it possible to
apply this option to the providers option when building their
own? thanks, lm
Nursing would like to have the functionality to enter an Approved
immunization when it is clicked in the forecaster window of the
Immunization object. Example...forecaster shows Tdap due.
When nurse clicks on Tdap currently nothing happens.
Suggestion to have it open the Tdap entry window as if the
nurse had cllicked "Add" and then chosen Tdap from the
available vaccines list.
Can we add a way of recording the size of cuff used, i.e., adult, Duplicate
large adult, child?
Teaching and education issue... Need it to be consistent. Approved
if they have a question for you. Attached is an example of a Duplicate
... rather than having to go to RPMS to do it. Maybe an idea for Duplicate
the scheduling GUI if not deemed EHR appropriate.
Allow for an amount less than 1 as a quantity for quick orders. I Completed
can mention three examples: Ativan 2mg/ml a 1mg dose =
0.5ml, HPV single dose = 0.5ml, Regular insulin 10 units subq
now = 0.1ml. Currently, these quantities can be entered by the
provider or the pharmacist in the order dialog or RPMS, but they
cannot be entered in the quick order setup. This change would
increase the convenience for providers and pharmacists of
having the correct dose for each new order already entered. As
is, there is greater risk of an incorrect dose which could then
result in medication errors.
See attachement. It should be red. Approved
Saw a comment about a tickler file on the EHR Listserv and In Process
thought this would be a very useful enhancement. Here is the
original message I posted earlier about making "tickler" file
functionality in CPRS. I have finished this, and use TIU Text
Objects. This means it could be used in any CPRS without any
modifications needed. How to use it: ========== 1. Drop a
Tickler template into one's note in CPRS. This will look
something like this: ======= [TICKLER MESSGE] =======
#DUE#: <----- to be edited.
================================ Message: ... 2. Sign
the note. 3. When the due date/time arives, then an addendum
will be added to the note, and an alert is created to this
addendum noting that a signature is due. It is at this point that
one can see whatever message was put into the tickler, and do
what ever follow up is needed. 4. When done, sign the
addendum. The final note might look like this *** ACUTE
MEDICAL ISSUE VISIT Has ADDENDA *** 09/03/08 (423) 123-
4567 ======= [TICKLER MESSGE] ======= #DUE#: 9/3/08
@ 3:20 pm ================================ Message:
... /es/ KEVIN S TOPPENBERG Family Physician Signed:
I know that one of the features we are going to have is being Denied
able to send electronic prescriptions to pharmacies via
Surescripts or other portals. I want to ask the converse
question: Are we planning on being able to receive electronic
prescriptions from Outside Providers? (yes, not a lot of IHS
pharmacies do that; but we do).
Modify the patient context display on the Suicide Reporting Approved
Form. The current "demographic banner" at the top of the form
is a holdover from the IHS Patient Chart application and is kind
awkward. It is not a standard convention.
I would like a report that gives just the number of consults in a Approved
timeframe. I would like it to have the number broke out with the
number completed, pending, dcd etc but I dont need the list of
patients with it.
Is it possible to separate the Active Medications and the Approved
Pending Medications in Patient Data Objects? We often have
our Active Outpatient Medications Patient Data Object in the
SUBJECTIVE area of our progress notes. Providers usually
document POV, Superbill, and Order Meds, Labs, etc. prior to
creating their note for everything to pull into the note. Pharmacy
usually reviews the providers note prior to releasing medications
during their clinical review of medication therapy. Hence, a lot
of times the medication orders that providers ordered via EHR
show up as pending in the providers progress note, and orders
are duplicated under pending. The total medications also is
inaccurate [as in the example where the patient is only on 8
meds but total medications counts 15.] Providers have
asked if there is a way to separate the Active Outpatient
Medications from the Pending Medications. They want the
patients current active medications to be in the SUBJECTIVE
section of their note and the pending medications to be in the
PLAN. Pending Medications currently also show up in the
PLAN with the Todays Orders Patient Data Object, but this
The Joint Commission requires the use of two patient identifiers In Process
when providing patient care/services. Is it possible to add a
radio button on the "Pharm Ed" pop-up option to check to
document that two patient identifiers were used by the
pharmacy when services were provided? For the radio button,
the wording could read, "Two identifiers verified" Thanks.
I may write multiple orders, e.g. med renewals/changes but only In Queue
sign one or two of those orders, e.g. chapparone or for an EKG.
I leave the meds to be signed later since Pharmacy staff would
like a signed note before filling meds, whenever possible. The
problem occurs when I do my note, and sign. The orders that
are waiting to be signed do not automatically pop up w/ the note
for sig. It requires a separate step - often forgotten until a
notification arrives! - to go back and sign the other orders. Can
everything thats pending just come up at the same time? Thx
When selecting patients the display does not display the MR In Queue
with the patient name. For patients with multiple duplicates [i.e.
Joe Yazzie in Navajo] one has to go to each patient to find out
what their MR is before choosing the right one. It would be
quicker if the name, DOB and MR all displayed.
The VUA [View a Users Alerts] menu item in the TIUM should Denied
also be accessible through the EHR menu, EHRBEHNOTVUA
as this is a logical place for CACs to find the information that
they are often need. This would be nice as a national
enhancement so that local changes will not be overwritten.
Would like spirometry to be added to vitals. Approved
As an ambulatory Urgent Care setting, I need to always denote In Queue
the patients: 1. Mode of arrival [ambulatory, carried,
wheelchair], 2.a Triage aqcuity system 1-5 in number to denote
on all patients. Can we have this added either to the chief
complaint section or as a measurement [which it isnt] but do not
know where else it would go.
I find it very distracting and in fact quite useless to have all vital Duplicate
sign values recorded to 4 significant digits. There is really no
basis or indication for doing so. The added characters in each
value actually reduce ones ability to focus on what the value
truly is. Please give strong consideration to removing the
added program that ends up calculating these temperatures,
weights, heights, and BMI to the 4th significant digit.
CPRS v27 has that functionality. Its faster for documentation. Approved
I believe CPRS v26 had that functionality. I dont know the Duplicate
business rules it followed, but in any case thats for SMEs to
decide. I would encourage having the ability for pharmacists,
nurses, and providers.
You will want to do that if you have an approximate date and In Queue
need to satisfy the Forecaster. the only way around it is to
delete the immunization and start all over. We should be able to
edit that field and the Location as well in the edit box. See
Vitals that need to be added: orthostatic BP, route of temp. Transferred
taken and Ishiharas color blind test.
Remove unreleased pharmacy orders that were a carry over In Queue
Individual tabs for orders, ex: nursing, labs and radiology. Duplicate
medication profile is cumbersome to read when you want to In Queue
look at "what the patient in currently taking". Current meds
would include active medications and expired medications--
meds having just expired, but patient still taking. Having the
discontinued meds in there confuses the picture. Is there an
option to have a tab like the chronic only or active only, that
would screen out the discontinued medications --leaving expired
and active. Thanks
I have a service unit that uses T-sheets and EHR in the ER. Completed
The providers that work in this ER also works in outpatient
department. This parameter is set to either class or person.
They would like add clinic so that when the provider works in the
ER, then they will not get the notification for and E&M code but
when they work in the outpatient they would get the notification.
The T-Sheet already contains the E&M code for that ER visit.
Sometimes we need to change a Progress Note to a Discharge In Queue
Summary that was written in the wrong place [provider seleced
Family Medicine Title under progress notes to write a discharge
summary]. Change title will only work within a class and not
between classes. Need something that will move a document
from one class to another.
I saw this snapshot of the new pediatric growth chart in the Completed
DOD's AHLTA. It looks significantly better than ours in terms of
functionality and usability. Is there work currently going-on
through IHS as far as growth chart improvements? It would be
great to take ours in this direction.
See attached screenshot. Denied
In EHR v1.1, only holders of the ORES key can discontinue In Process
expired meds. Can this functionality also be given to holders of
the ORELSE and OREMAS keys. There are instances when a
holder of the ORELSE key might need to dc and expired med
by policy or even need the ability to do it by a verbal or
1 - BMI calculation on the triage tab is for adult only and does Completed
not calculate for pediatric population 2 - temperature on triage
table indicates oral only and does not give a choice of indicating
that it is a rectal temperature
It would be nice to have a "Refusals" prompt created that would In Queue
record the appropriate refusal infomation in the Personal Health
component of EHR.
Attempted to submit with attachment, not sure it worked - this is Duplicate
the second attempt without the attachment. Request the ability
to add appointment date/time after the patient name in the
"Patient Selection" window. Currently we can get the
appointment date/time if we change the "List Appointments for"
option to "Past Week", "Past Month", or if we select any date
range other than current date in both to and from fields, it would
be helpful if we could select "To" and "From" for today and the
date/time would show. That way, those that don't like the feature
could just select "Today" in the "List Appointments for" menu
and they would get the names without the appointment times.
Orders cannot be printed from EHR Orders tab [using File, Duplicate
Print] to local Windows printer...only able to print to RPMS
printers. Other tabs [ie Notes, Labs, etc] allow printing to both
local printers and remote RPMS printers. This is becoming an
issue with the requirement to print Class II narcotic prescriptions
for hardcopy wet signature and for printing outside prescriptions
to send to other pharmacies.
When visits are to be relocked, it would be helpful if the visit ID Transferred
was also listed. Sometimes a patient can have several visits
listed for a given day. - Setting Use to override visit lock for a
user. for User: STEWART,KELLY A - Select Visit to unlock: ?
Visit to unlock Value --------------- ----- SEP 30, 2008@16:40
YES Answer with VISIT VISIT/ADMIT DATE&TIME, or VCN, or
VISIT ID Do you want the entire VISIT List? N [No]
Users [myself included] often almost click on the "toggle" or "all" In Queue
button in Broadcast on the communication menu, instead of
clicking on "send". These buttons are not necessary, anyway,
since users can simply hold down the shift key and highlight all
users if they want to send a message to everyone. Also, the
shading on the message recipient is so light, we have to inspect
the screen carfully to see who the recipient is. My request, then
is to either: 1] increase intensity of highlight color 2] Reduce size
or disable the "All" and "toggle" buttons 3] Increase the size of
the "Send" button to draw user's attention to that. 4] Relocate
the "All" and "toggle" button to a less prominent location to
make it not so tempting to click. 5] Maybe rename the "toggle"
button to "Surprise Party" :]
Users would like to have "Hysterectomy" added as a drop-down Duplicate
box choice in the reproductive history [see attached] so they can
stop asking when their last LMP was.
Clinicians at Claremore Indian Hospital have requested that the In Queue
ICD pick list in the POV search tool be formated to have the
same sequence presentation as the ICD search tool in the
Laboratory Order medical justification. The alphabetic
presentation of the ICD pick list in the Laboratory Order "Other"
justification is more usable for the non-coder.
I would like to request and EHR enhancement that allows you to Denied
multipurpose accession from EHR and AWE from EHR. We are
a multi-divisional facility and use these functions outside the lab
setting, e.g. nurses, providers, diabetes, etc... We have many
facilities that use this function by providers to create their labels
to print for drawing purposes, often times done by them. It is an
awful inconvenience to have to switch from EHR to RPMS to
complete and order to print bar code labels. This is requested
by our providers Thanks
In order to help us meet JC requirement NPSG.03.04.01 it In Queue
would be nice if we can print a medication label from EHR that
providers can use when transferring meds from one container
to another, such as the use of syringes.
we are unable to erase demo patient notifications. It feels good Denied
to have all notifications taken care of and these really have no
bearing on patient care. Why can't we erase these notifications
even once we have done what they ask? what can be done
I am running reports under consult management so I can keep Completed
my consults under control. When I run a report for pending or
completed consults for my clinic it gives me the name of the
patient and the last four digits of their social. It would be sooo
helpful if it would give the name of the patient and the chart
number instead of the social. Please take into consideration. :]
I do quarterly chart audits and am the only therapist at this In Queue
facility. If I get a consult in March, I usually don't schedule the
patient until June. When I do my chart audits I need to find the
date I completed the Evaluation not the date the consult was
written. It would be helpful to have a report for WHEN the
consult was completed in June instead of the fact that the
consult was completed and the consult is from March. Thank
Many EHRs are achieving a higher level of decision support by In Queue
integrating vendor-provided healthcare information into their
system through the use of "infobuttons." We pay for two
programs that both have infobutton capability: Micromedex and
Up-To-Date. An example of an infobutton that would be of
tremendous benefit to RPMS-EHR users would be a link to
specific drug-drug interactions [Micromedex has a VERY nice
lookup for this] that could be accessed from a button attached
to the current pop up we get [the one that tells which drugs
interact, but doesn't describe the interaction or severity of it].
This type of functionality may prove to be a cost-efficient way to
build robust decision-support into our existing EHR.
Providers would like to customize exam screening result prompt In Queue
fields to their specific entries. For example, the IPV exam result
field would only contain NEGATIVE, PAST and PRESENT when
entering exams through reminder dialogs.
Notification enhancement requests: In Queue
- Dual Sorting of notification columns.
- Add option to save notifications as info only after review [sign
and save OR view and keep] to use as clinical reminder to
follow-up [i.e. abnormal labs/imaging results].
- Default NOW for new scheduled notifications rather than
having to pull up calender and select now with several clicks.
- Add REPLY option to scheduled notifications with copy of
previous message to keep conversation thread going until
- Add list of message recipients identified for scheduled
notifications so that sender can assure proper selection of
desired recipients and recipients can tell who all received same
notification for communication and case management
- Add REPLY on instant messaging notification so that you don't
have to go back to the notification tab to respond and remember
who sent you the instant message.
- Add minimize functionality to instant message popup to be
reviewed at provider's convenience.
[Instant messages often disappear before being able to read,
get stuck back behind EHR, or have to be closed prematurely.
All these instances could result in the instant message being
forgotten about and no response sent.]
- Add option to "Add comment" to progress notes [similar to
Creating a new HS object for patient's mother and father's In Queue
name would be helpful. Identified on page 2 of the Pt Reg
package: 8. FATHER'S NAME : 9. MOTHER'S MAIDEN NAME
: Thank you.
Inpatient pharmacy staff would like the Patient's Diagnosis to be In Queue
printed on the following report:
IV Menu Option [PSIV] -- Supervisor's Menu -- Management
Reports -- Patient's on Specific Drugs.
I sat down with pat and edited the header and footer for the In Queue
report tab. We felt we did not need to have repeated items in
the header as well as in the footer. Below are our edits. Thanks.
for header: CIAVUTIO DEFAULT HEADER [for dicatated and
patient centric reports] ==[ WRAP ]==[ INSERT ]=======<
Patient-centric reports =====[<PF1H=Help ]==== &c&f
for the CIAVUTIO DEFAULT footer I took out the S^specify
==[ WRAP ]==[ INSERT ]=======< Patient-centric reports
=====[ <PF1H=Help ]==== &u Page &p&r&e &u
WORK COPY ONLY &rPrinted: &d &t
We were unable to document an historical Penicillin allergy on In Process
an elderly patient who was told by the military that he was
allergic to Penicillin. The patient had allergy testing and had no
known reaction to enter. It would be nice to have a way to
document an allergy from allergy testing and not an actual
We released a new version of the RPMS Immunization In Queue
Package [Version 8.3], and added a new field called "VFC
eligibility" that is associated with each shot a patient receives.
This information is required by many state immunization
programs, and by capturing it in RPMS we are saving sites a lot
of paperwork. Unfortunately, for sites using EHR, this field is not
available. Because VFC eligibility is determined at the time the
shot is given, it makes sense to have this field in EHR so that
providers can complete it without having to go out of EHR.
Please add print format for provider license and NPI number. Duplicate
I would like to request that an enhancement be in place that In Queue
would automatically notify the ordering physician that a med
was not pick up by the patient and it was returned to stock. A
notification that gets triggers and gets sent to the ordering
provider when a medication is returned to stock via the
Sorry if this is already reported... Can we add the ability to edit In Queue
an existing problem list note? The current functions available
are "add note" and "delete note". Providers would benefit from
being able to edit existing entries instead of having to delete
them and add a new one.
Unable to add Transaction to the Superbill Association even In Queue
though information is in Version 1.1 Please see attachment.
Suggest that the Interpretation field from File 60 be displayed in In Queue
Lab Result Notifications in EHR. This is most often used for
important lab range result information...particularly for
therapeutic drug levels. Sample from File 60:
INTERPRETATION: Therapeutic levels: Drug Dosage: Trough:
Peak: 500 mg BID 3.1-10.0 ug/mL 10.0-25.0 ug/mL 1000 mg
BID 4.9-37.1 ug/mL 30.0-40.0 ug/mL 1500 mg BID 7.0-34.0
ug/mL 36.1-70.0 ug/mL
The business owners of the RPMS Suicide Reporting Form In Queue
[SRF] are requesting two changes to the following fields 1]
Lethality [inactivate] and 2] Behavioral Act [inactivate two values
and add four others].They are also requesting that all fields on
the SRF be mandatory but not forced. These changes have not
yet been made to the SRF in PCC and AMH but when they are
released to the field they will need to be followed as soon as
possible by the changes to the EHR SRF component. See the
attached for more details. Thank you.
Currently there is a logic check in the EHR RenewMed dialog In Queue
that restricts refills to a range of 0 to 11. The Pharmacy PSG
approved a change in the pharmacy package to a maximum of
15 refills within a 1 year period so that certain types of
medication will not run out of refills prior to the 1 year legal limit
[OCs, inhalers, topical ointments, etc]. I'm requesting that the
dialog be changed to 15 so that it corresponds to what is in the
Enhancement requests x2 for the Release Orders to Service In Queue
Box. 1. RN enters order in physician name – clicks ACTION ?
Release without signature – 2. The Release Order to Service[s]
box displays ? default size is small and this “hides” the Nature
of Orders. 3. The user must remember to use scroll bar to
see/change the Nature of Orders defaults. [See first 3 screen
shots below] This is A. Not user friendly and B. An easily
forgotten step contributing to errors with nature of order [sites
audits] ENHANCEMENT REQUEST: 1. The Nature of Order
should be listed first [at the top of the box]. Below that have
“The following orders will be released”. [See preferred display
screen shot] 2. Increase the default size of the Release Order to
Service box for better visualization of all fields [when using the
Hand and Pen signature icon the box size is larger – see final
In using EHR for Inpatient purposes--when ordering meds using In Queue
the transfer from inpatient to outpatient, need a way to default
the pick up status to window.
Enhancement Request for Nature of Order display When RN In Queue
takes a telephone order from a doctor the RN must do a verbal
read back of that written order to the doctor. The RN also
documents “verbal read back done” with that order. Sites and
surveyors audit this. Currently e.h.r. does not easily capture this
information. [RN enters a note stating this [easily forgotten and
makes audit trail convoluted]. This information could easily be
captured by incorporating it with the order entry process. For
Nature of Order make the following change: Telephone to
Telephone/verbal read back done or Telephone/Verbal R/B
done or Telephone/VRB done [depends on spacing issues]
Verbal to Verbal/Verbal repeat back done, or similar If the
change is approved there are 2 places the Nature of order
displays to the user when entering the order: 1. Release Order
to Service[s] – when using Action – Release without signature 2.
Review/Sign Changes – when using Signature icon. I would
anticipate the change will display in the Reports - Order
Summary etc? [Thereby satisfying audits]
Billing requires a provider signature for all orders. When nurses In Queue
enter standing orders for a test they are prompted to select
"Policy", "Telephonic" or "Verbal" or "Hold until signed". All of
these will generate a reminder to a provider to sign the order
EXCEPT policy. Can we modify the program to generate a
reminder and allow providers to sign these as well so they can
The drug/alcohol screening only includes the CAGE for alcohol In Queue
and no screen for drug use. Can we add a drug screening
component V65.42 to include uses, does not use, in
counseling? And then change the name of the CAGE to alcohol
screening and not Drug and Alcohol Screening.
When entering historical data of some sort, it would be In Queue
wonderful to not have to choose a specfic date. For example-
Patient says that they had a hysterectomy 30 years ago,
sometime in the June. Right now you have to choose an actual
day, month and year. What if no one knows? We'd like to be
able to put in an approximate date when the situation arises.
I believe that notifications for unsigned notes is somewhere In Queue
hard coded. Frequently service units are seing that note are not
getting signed by the provider and they are not able to send that
visit out due to this. Since the notification dealing with unsigned
notes can not be manipulated so that a notfication can get
forward to a supervisor if not sign within a specified time frame,
HIM personnel has to manually check the VUA menu or the
management to see if providers are signing there notes within
reasonable time. I think that if the CAC can select the unsign
note notification and have that notification automatically forward
to a supervisor or backup reviewer after whatever timeframe it
is agreed upon by all parties, it would make this process a lot
easier to monitor for HIM. I am requesting that TIU notifications
be part of the notification list that we have access to under the
notification menu option. Please let me know if this will be
worked on or not so I can get that information back to my
service unit. thanks
Would like the ability to setup certain CPT codes with multiple In Queue
quantities. This would save providers extra clicks. CPT: L3050
PATIENT NAME: DEMO,PATIENT VISIT: FEB 23,
2009@08:52 PROVIDER NARRATIVE: Foot, Arch Support,
Removable, Premolded, Metatarsal, Each PRINCIPAL
PROCEDURE: NO QUANTITY: 1 EVENT DATE AND TIME:
FEB 23, 2009@16:29:02 ENCOUNTER PROVIDER:
JOHN,KAREN M CPT SHORT NAME [c]: FOOT ARCH SUPP
PREMOLD METAT For example, our Podiatrists always issue 2
for the following CPT codes: L3050 S0395
When you click on the blue box [patient] and then you have Duplicate
ways of viewing your patients, If you choose clinic and this
displays what patients are in that clinic for whatever day you
specify [Alphabetically]it would be nice if they were listed by
appointment and their appointment time [like the VA does]
Notes Projected Release
Working as designed--Radiology
package setup issue
Mouse wheel is fixed in v1.1. This
could make the scroll bar a non-issue.
Not sure if it's possible (or easy) to
move the scroll bar to the left side.
Transferred to PCC Data Entry
Subcommittee on notifications will
determine second request
This will need to be done locally
Transferred to CIMTAC as a PCC
This is a training issue
BHS patch 1
Could cause trouble--a CPT code that
drops in to PCC when the order is
placed is likely to get billed even if the
order (procedure) is never carried out.
Students should get NO keys - this
forces a cosigner to be identified.
Students should highlight the
cosigning provider in blue or gray
when selecting the visit so that the
cosigner appears in the visit box. This
will place the orders under the
cosigning provider's name and should
prompt for an electronic signature
from the provider to sign off on the
EDR is on its way and RPMS Dental
Package will be phased out
Because notifications are handled at
the kernel level, the LOE is considered
to be prohibitive in the short term
Transferred as a Health Summary
request (not EHR)
Transferred to PCC Data Entry
Subcommittee on notifications will
There is a suitable workaround in
This is really a national Health
Information Management policy issue.
Working as designed
Not supported by Lab PSG
On hold until RCIS becomes part of
Actually wanted to link diagnosis
(available in v1.1)
Transferred to the Pharmacy PSG
Transferred to the Pharmacy PSG
See CRID 418
Cannot be site-specific; supporting this
would be too difficult
This will need to be done locally
EHR v1.1 patch 3
See CRID 329
Need to make the Duplicate
Order Order Check mandatory.
See CRID 252
On hold until changes are made to
On hold until Reminders v2 comes out
Merged with CRID 346
Out of scope--not EHR
Beta strep screening is in the Prenatal Prenatal Module
Module at 32-36 weeks.
#1 - not allowed to have trailing zeros
due to National Patient Safety Goals
Transferred to the Pharmacy PSG
See CRID 355
Entered as a problem report
Will be addressed with the EHR Point
of Care Lab result entry component.
You can already sort by the service
and create a custom view.
HPV is in Reminders patch 1005. Reminders patch
LOE too high
Entered as a problem report
See CRID 373
There is currently a work-around and
implementing this enhancement could
cause numerous other problems.
Working as designed--setup issue
Waiting on current development
regarding charts displaying in the GUI
Out of scope--not EHR
See CRID 329
Transferred to the Pharmacy PSG
This is a training issue
This is a training issue
LOE too high
Printable prescriptions are being
included as part of the CCHIT
EHR v1.1 Patch 1
See CRID 388
See CRID 311
See CRID 290
Should be included in new Well Child
See CRID 355
Transferred to PHN project as they're
currently working on many
It will be available in the Prenatal
Module (both PCC+ and EHR) which
is now in alpha test.
See CRID 418
Can already keep the control or shift
key depressed and right click at the
same time to add several historical dx
or problem list entries over to the Visit
Working as designed
The CCB feels that communications
should only be used for simple quick
messages, and don't think it should be
used for more (e.g. sending patient
IHS is looking into using iMed Consent
for this issue. It is not currently
considered an enhancement to EHR
as it is a separate project.
See CRID 273
We will soon have the ability to change
A change has been approved to make
it easier to sort by visit date.
Transferred to PCC
Cannot be done
This is how Windows works
Could cause confusion as to who is
listed as the primary provider
Transferred to PCC
Can already use CAGE and will soon
be able to use CRAFFT
Transferred to PCC CCB
See CRID 451
This should be fixed in the most recent
See CRID 373
#1 - Completed in v1.1 patch 1
#2 - Approved
The Pharm Ed button was not
designed to be used this way.
Double-click title bar to maximize
See CRID 389
See CRID 329
Approved, pending changes made to
See CRID 418
See CRID 457
Too sophisticated of a request to put
out to the general public.
Notifications should be used in this
A solution was approved that should
cover the stated issue.
Too difficult to do on a national level.
TIU notes currently expose the RPMS
text editor, so would not be possible
without a major re-write.
This appears to be a local policy and
could possibly be remedied with a
There is only so much information that
can fit in the PCP box. You can click
on the box to get the other provider
Combined with CRID 460
This might be better suited to the web-
based version of EHR that should
come out in the next 1-2 years.
Search function already exists but with
glitches. This has been transferred to
a problem report.
Transferred to the Nursing Acuity
Transferred to the Pharmacy PSG
Medsphere says this is not technically
feasible at this point.
Doubtful that this can be done.
See CRID 308
Transferred to the Pharmacy PSG
The CCB does not concur with this.
Transferred to Diabetes Program
There will be no more pop-up
messages for Licensing file.
Cannot require a POV before starting
the note, due to different types of
It was decided that this is too difficult
for now. It may work in the next
generation of EHR.
See CRID 277
Can already be done in the BHS/BH
See CRID 418
Entered as a problem report
Transferred to PCC CCB
This is actually an Immunization
package issue, but was also denied.
This can be addressed through the
community alerts in iCare.
See CRID 505
This is a training issue.
Transferred to PCC CCB
See CRID 373
See CRID 322
See CRID 460
Will be in a future patch.
Will be included in a future patch
Transferred to PCC CCB
See CRID 380
This can already be done.
This will be included in the upcoming
Well Child Module.
Works as designed.
See CRID 329
Transferred to PCC CCB
See CRID 488
Suggested setting up a label printer to
work with the EHR so that when you
order a lab test you get a label.
See CRID 329