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1 Intra-op Implants Setup and Support Guide Epic 2015 Last Updated June 21, 2015 Epic Systems Corporation 1979 Milky Way Verona, WI Voice: (608) Fax: (608)

2 Your Responsibilities for Safe Use This documentation will help guide you through the available software configuration options so you can decide the right configuration for your organization. Of course, safe use of the software in any configuration requires you and your users to use good judgment and perform certain responsibilities, including each of the following: enter information into the software accurately and completely; read information displayed on computer screens accurately; validate all configuration decisions; confirm the accuracy of critically important medical information (e.g., allergies, medications, relevant histories, problems, lab pathology results, radiology results) presented by the software, just as one would with paper records; actively report errors or suspected errors discovered in the software to both Epic and affected personnel; thoroughly test the software to ensure it s accurate before using it; and use the software only according to standards of good medical practice. You also are responsible for training your personnel and other users to perform these responsibilities. Not performing any of these responsibilities may compromise patient safety. Table of Contents Implants... 4 Implant Entry Activity... 6 Choose Implant Window... 7 General Implant Information Form... 9 Charge Information Form Tissue Information Form Implant Dates Form Implant Dates 2 Form FDA Notifications Form Implant Groupers Form Edit Trail Form Implant Group Entry Activity Implant Group Entry Activity Implant Tray Entry Activity General Information Form Pool Information Form Building Implant Groups and Trays Build an Implant Group Build an Implant Tray... 39

3 Add an Implant Tray to a Procedure Record Setting Up Barcodes for Tissues Create a Barcode Configuration Record Create a Mapping Table Enable Your New Configuration Records Setting System and Location Definitions for Implants Set System Definitions for Implants Set Definitions for Implants at the System or Location Level Configure a Warning for Incomplete Implants During Charge Review Task Steps Show Anesthesia Staff as Quick Buttons if They Routinely Insert Implants Task Steps Check for All Implants Associated with a Patient Task Steps... 58

4 Implants You create a record in the Implants (IMP) master file for each implant used during surgery. It's possible to create implant records in two ways: In Log Entry. On the Log Entry activity's Implants form, you have the option of selecting an existing implant or creating a new implant. If you create an implant in Log Entry, you can later access its record using the Implant Entry activity. In Implant Entry. The Implant Entry activity enables you to create an implant prior to its use during surgery. The implant is then available for selection in Log Entry. When you select an existing implant, the information that you've already entered in its record (such as its serial number) is added to the log by default. Regardless of which method you use to create implant records, you can associate these records with surgical inventory (SUP) records, which minimizes manual data entry. For example, if your facility often implants a certain type of artificial knee, you can use the Inventory Entry activity to create a surgical inventory record for this item in which you enter such information as the item's manufacturer and supplier, as well as cost and charging information. When you create a record for a particular artificial knee of this type, this information is entered by default into the new record. You then only need to enter information that's specific to this particular implant, such as its serial number and lot number. When you post a log in which an implant has been implanted, explanted, or wasted, the system automatically updates the implant's record with the log's date and ID number so that, from within Implant Entry, you can easily see the logs in which these actions occurred. Section Overview This portion of the guide is divided into the following sections: Implant Entry Activity. This section contains detailed information about the forms that you see in the Implant Entry activity. Implant Group Entry Activity. This section contains detailed information about the Implant Group Entry activity. Implant Tray Entry Activity. This section contains detailed information about the Implant Tray Entry activity.

5 Building Implant Groups and Trays. This section contains instructions for building implant groups and trays. Setting System and Location Definitions for Implants. This section contains instructions for performing administrative setup related to implants. Intra-op Implants Setup and Support Guide 5

6 Implant Entry Activity Epic 2015 The Implant Entry activity enables you to access records in the Implants (IMP) master file. Recall that you create a record in this master file for each implant used during surgery. Further recall that you can create implant records either ahead of time (using this activity) or during the surgery (from within Log Entry). No matter which method you use, you can review and edit implant records using Implant Entry. To access this activity, navigate to Admin > OR Administration > Implants > Implants. You can also access this activity by clicking the Implants toolbar button on the standard Log Entry toolbar. 6 Intra-op Implants Setup and Support Guide

7 Choose Implant Window The Choose Implant window allows you to select the implant record you need to edit and uses a number of filter options to do so. To search for an implant, first select one of the following options: Implant type. This option enables you to search by implant type. Inventory item. This option enables you to search using the implant's associated inventory item. Implant specs. This option enables you to search using the implant's model number, serial number, or lot number. Once you've selected an option and entered the appropriate information, click Find to see a list of implants that meet your search criteria. If you know the name of the implant record you want to access, simply enter this name in the window's Choose implant field and click Find. To create a new implant, type a name in the Choose implant field and then click New. Choose Implant Window Intra-op Implants Setup and Support Guide 7

8 Choose Implant Fields and Buttons Implant type Select this option to search for an implant by type. Inventory item Select this option to search for an implant using its associated inventory item. Implant specs Select this option to search for an implant by its model, serial, or lot number. Model no. After selecting the Implant Specs option button, enter the model number of the implant you are searching for. Serial no. After selecting the Implant Specs option button, enter the serial number of the implant you are searching for. Lot no. After selecting the Implant Specs option button, enter the lot number of the implant you are searching for. Choose implant If you know the name of the implant record you want to access, enter it here. Note that this field is filtered by which of the options (Implant type, Inventory item, or Implant Specs) you select. New Click New to create a new implant record. Find Click Find to have the system search for a matching implant based upon the information that you have entered. 8 Intra-op Implants Setup and Support Guide

9 General Implant Information Form The General Implant Information form enables you to enter basic information about an implant, including its type, size, status, manufacturer, supplier, cost, and serial number. If you create an implant that is linked to an inventory item, information entered in the inventory item's record appears on this form by default. General Implant Information form Implant Information Section Implant Name (I IMP.2) The name of the implant. Click Edit to change the implant's name. Edit/Lock Click Edit to modify the name of the record. When you click Edit, the record name field is enabled and the button's name changes to Lock. Intra-op Implants Setup and Support Guide 9

10 When you have made the necessary modifications, click Lock. The record name field becomes read-only and the button changes back to Edit. Abbreviation (I IMP 60) The implant's abbreviation. Enter free text. Status (I IMP 90) The status of the implant. Select from a list of statuses such as Implanted, Destroyed, or Returned. The status of an implant is updated automatically when a log is posted in which the implant's status changes. Inventory item (I IMP 440) The inventory item with which the implant is associated. Select from a list of inventory items of the type Implant. Editing the information in this field will update the Inventory item field in all logs that include the implant, including logs created in the past and logs that are posted. Type (I IMP 70) The implant's type. Select from a list of types such as Pacemaker or Valve. SMDA? (I IMP 100) Enter Yes or No to indicate whether the item is affected by the Safe Medical Devices Act. Size Enter the implant's size, if applicable. This is a free-text field. Active? (I IMP 110) Indicate whether the implant is currently active. Enter Yes or No. Pacemaker rate (I IMP 490) If the implant is a pacemaker, indicate its rate. This is a free-text field. 10 Intra-op Implants Setup and Support Guide

11 Inventory location (I IMP 160) The inventory location at which the implant is kept. Enter a location. Tissue? Whether the implant is a tissue, or biological implant. Enter Yes or No. If Yes is entered, another prompt appears so you can indicate whether the tissue is autologous (from the same patient). Enter Yes or No. Pass-Through Code (I IMP 520) The implant's pass-through code. Enter free text. Laterality The laterality at which the implant was implanted in the patient. Description (I IMP 40) Enter a free-text description of the implant. Comments (I IMP 180) Enter free-text comments about the implant. Supply Information Section Manufacturer (I IMP 80) Identify the implant's manufacturer. Supplier (I IMP 120) Identify the implant's supplier. Model/Cat number (I IMP 130) Enter the implant's model number or catalog number. Serial number (I IMP 140) The implant's serial number. Enter free text. Intra-op Implants Setup and Support Guide 11

12 Lot number (I IMP 150) The implant's lot number. Enter free text. 12 Intra-op Implants Setup and Support Guide

13 Charge Information Form Charge Information form Charge Information Fields Chargeable? Whether your organization charges for this implant. Select this check box to charge for the implant. Cost per unit Enter the implant's cost. Charge amount Enter the amount that the patient will be charged for the implant. Charge code The Procedure (EAP) code that you want to send to the Charge Router for this implant. FT charge code This field enables you to specify a charge code that is not stored in the Procedure (EAP) master file for this implant. Custom programming must be done for your facility if you intend to use this field. Markup % The override markup percentage used to charge for the implant. Enter a percentage. Intra-op Implants Setup and Support Guide 13

14 Tissue Information Form The Tissue Information form allows you to enter additional, tissue-specific information for implants that are considered tissues. Tissue Information form Reception Section You can use the fields in the Reception section to document information about when and from where the tissue was received. Preparation Section You can use fields in the Preparation section to document specific details about the tissue implant, how it was prepared, and when preparation began and ended. 14 Intra-op Implants Setup and Support Guide

15 Implant Dates Form The Implant Dates form enables you to collect dates for a number of important events related to an implant, such as the dates on which it's implanted, explanted, wasted, recalled, and/or loaned. Note that information can appear on this form by default based on what's documented in logs. For example, when you post a log that documents the implant's implantation, the log's date and number are entered in this form's Implant Dates section automatically. Implant Dates form Dates Section Date received (I IMP 200) The date the implant was received by your facility. Enter a date. Intra-op Implants Setup and Support Guide 15

16 Manufacturer notified on (I IMP 210) The date that the manufacturer was notified that the implant was received. Enter a date. Expiration date (I IMP 190) The date on which the implant expires. Enter a date. Implant Dates Section Date implanted (I IMP 220) The date on which the implant was implanted. Enter a date. When the log that documents the implantation is posted, the log's date appears by default in this field. Manufacturer notified on (I IMP 240) The date on which the manufacturer was notified that the implant was implanted. Enter a date. Time implanted The time at which the implant was implanted. Enter a time. Implanted by The surgeon or physician who implanted the implant. Enter a surgeon or performing physician. Implant log no. This field displays the ID number of the log that documents the implantation. When this log is posted, its ID number appears by default in this field. Explant Dates Section Date explanted (I IMP 250) The date on which the implant was explanted. Enter a date. 16 Intra-op Implants Setup and Support Guide

17 When the log that documents the explanation is posted, the log's date appears by default in this field. Manufacturer notified on (I IMP 270) The date on which the manufacturer was notified that the implant was explanted. Enter a date. Time explanted The time at which the implant was explanted. Enter a time. Explanted by The surgeon or physician who explanted the implant. Enter a surgeon or performing physician. Explant log no. This field displays the ID number of the log in which the explanation is documented. When this log is posted, its ID number appears by default in this field. Wasted Dates Section Date wasted (I IMP 243) The date on which the implant was wasted. Enter a date. When the log that documents the implant's wastage is posted, the log's date appears by default in this field. Manufacturer notified on (I IMP 245) The date on which the manufacturer was notified that the implant was wasted. Enter a date. Wasted log no. (I IMP 244) The ID number of the log in which the implant's wastage is documented. When this log is posted, its ID number appears by default in this field. Reason wasted (I IMP 246) The reason that the implant was wasted. Select from a list of reasons. Intra-op Implants Setup and Support Guide 17

18 If the reason that the implant was wasted is entered in the log, the reason appears in this field by default. Loan Dates Section Date loaned (I IMP 280) The date on which the implant was loaned. Enter a date. Manufacturer notified on (I IMP 300) The date on which the manufacturer was notified that the implant was loaned. Enter a date. Loaned to (I IMP 290) The location, person, or facility to which the implant was loaned. Enter free text. 18 Intra-op Implants Setup and Support Guide

19 Implant Dates 2 Form Implant Dates 2 form Implant Dates 2 Fields Date returned (I IMP 310) The date on which a loaned implant was returned. Enter a date. Manufacturer notified on (I IMP 320) The date on which the manufacturer was notified that the implant was returned. Enter a date. Date destroyed (I IMP 330) The date on which the implant was destroyed. Enter a date. Manufacturer notified on (I IMP 340) The date on which the manufacturer was notified that the implant was destroyed. Enter a date. Date recalled (I IMP 350) The date on which the implant was recalled. Enter a date. Intra-op Implants Setup and Support Guide 19

20 Patient notified on (I IMP 360) The date on which the patient was notified that the implant was recalled. Enter a date. Date infected The date at which the implant became infected. Enter a date. Surgeon notified on The date on which the surgeon was notified about the infection. Enter a date. Date out of service The date on which the implant was marked as being out of service and left in the patient. Enter a date. Date patient expired (I IMP 370) The date of the patient's death. Enter a date. Manufacturer notified on (I IMP 380) The date on which the manufacturer was notified of the patient's death. Enter a date. 20 Intra-op Implants Setup and Support Guide

21 FDA Notifications Form The FDA Notifications form enables you to document FDA notifications related to an implant, including the date on which notification occurred, the reason for such notification, and free-text comments about the notification. FDA Notifications form FDA Notifications Form Date FDA notified (I IMP 390) The date on which the FDA was notified regarding the implant. Enter a date. Intra-op Implants Setup and Support Guide 21

22 Reason for notification (I IMP 470) The reason that the FDA was notified. Select a reason. Comments (I IMP 480) Comments about why the FDA was notified. Enter free text. 22 Intra-op Implants Setup and Support Guide

23 Implant Groupers Form Many of OpTime's administrative activities, including Procedure Entry, Inventory Entry, and Implant Entry, contain a Groupers form that enables you to view the data that's stored in particular items in Chronicles. You use the System Definition Entry activity's Grouper Settings form to configure your Groupers forms. Implant Groupers form Intra-op Implants Setup and Support Guide 23

24 Groupers Forms OpTime's Groupers forms enable you to view and edit any items that you specify. We recommend that you use these forms to populate items that are not otherwise editable in Hyperspace. 24 Intra-op Implants Setup and Support Guide

25 Edit Trail Form The Edit Trail form tracks changes that users have make to an implant's record. The particular fields for which changes are tracked in this form are defined for each facility in the Applications (E2G) master file. Edit Trail Form Edit Trail Items Show/Hide Detail Click the Show Detail hyperlink to expand all of this form's entries. Intra-op Implants Setup and Support Guide 25

26 When you click Show Detail, the hyperlink's name changes to Hide Detail, which allows you to collapse all of the entries. Expand/Collapse Either an Expand (+) or a Collapse (-) button appears to next to each user's name to expand or collapse the information about that user's changes. User Displays the users who have made changes. Date Displays the date on which the user edited an item. Time Displays the time at which the user edited an item. Item Displays the items that the user edited. Line Displays the lines within the items that the user edited. Old Displays the value that the user deleted (if any). New Displays the value that the user entered. 26 Intra-op Implants Setup and Support Guide

27 Implant Group Entry Activity Epic 2015 The Implant Group Entry activity enables you to access records in the Implant Groups/Trays (IMT) master file. Implant groups are collections of individual inventory items. Implant groups are also the components of implant trays. For example, you might create a group composed of screws and include this group on multiple trays. To access this activity, navigate to Admin > OR Administration > Implants > Implant Groups. Intra-op Implants Setup and Support Guide 27

28 Implant Group Entry Activity Implant Group Entry Activity Implant Group Entry Fields and Buttons Record name The name of the record that appears in record lookups in administrative activities. Edit/Lock Click Edit to modify the name of the record. When you click Edit, the record name field is enabled and the button's name changes to Lock. When you have made the necessary modifications, click Lock. The record name field becomes read-only and the button changes back to Edit. 28 Intra-op Implants Setup and Support Guide

29 Display name The name of the record that appears in Hyperspace. Active? Determines whether the record is considered active and can be used. Enter Yes or No. Filter by Locations Determines the locations at which this record can be used. Enter the locations in the table. Inventory Items Enter the inventory items that this record uses. Intra-op Implants Setup and Support Guide 29

30 Implant Tray Entry Activity Epic 2015 The Implant Tray Entry activity enables you to access records in the Implant Groups/Trays (IMT) master file. Implant trays are collections of implant groups and can also contain individual inventory items. You might create trays that contain the inventory items used for a particular procedure or group of procedures, or for a particular type of inventory item, such as screws. To access this activity, navigate to Admin > OR Administration > Implants > Implant Trays. 30 Intra-op Implants Setup and Support Guide

31 General Information Form The General Information form allows you to document details about your implant tray, such as the included implants and the implant tray's shelf code. General Information Form General Information Form Fields and Buttons Record name The name of the record that appears in record lookups in administrative activities. Edit/Lock Click Edit to modify the name of the record. When you click Edit, the record name field is enabled and the button's name changes to Lock. Intra-op Implants Setup and Support Guide 31

32 When you have made the necessary modifications, click Lock. The record name field becomes read-only and the button changes back to Edit. Active? Determines whether the record is considered active and can be used. Enter Yes or No. Alias (I IMT 4) Enter any synonyms you want to use when searching for your implant tray record. Bin location (I IMT 70) Enter the bin location for the tray. Filter by Locations Determines the locations at which this record can be used. Enter the locations in the table. Shelf Codes (I IMT 80) Enter shelf codes for the bin location. Inventory Items Enter the inventory items that this record uses. Left Column Groups Enter the implant groups you want to appear in the left column of the implant tray. You can use the arrow buttons to reorder implant groups within this column or to move them from the left column to the right column. Right Column Groups Enter the implant groups you want to appear in the right column of the implant tray. You can use the arrow buttons to reorder to implant groups within this column or to move the groups from the right column to the left column. Edit group Click Edit group to access the Implant Group Entry activity for the implant group you selected. The form contains two Edit group buttons, one for left column groups and another for right column groups. 32 Intra-op Implants Setup and Support Guide

33 Preview Click this button to preview the implant tray you have built. Intra-op Implants Setup and Support Guide 33

34 Pool Information Form The Pool Information form allows you to perform conflict checking for your implant tray by creating or editing a scheduling pool. You can create or specify a single system-level pool for conflict checking anywhere in your system and multiple location-level pools for conflict checking in any of your OR locations. If you choose to create a pool, a default pool name appears in the Create Pool window. The default pool name is assigned by the system using the format "[Implant tray name] pool - SYSTEM" for system-level pools and "[Implant tray name] pool - [location name]" for location-level pools. You can change this default name by entering text. Once you have entered a name and the system searches to make sure that a pool with that name does not already exist, the Edit Template activity opens so that you can create the template for the pool's availability. Once a pool has been added to the System level pool field, you can edit the template of that pool by clicking the Edit Pool button. For location-level pools, you must specify the location in the Location column and then the pool in the Pool column of the location-level table. Like the system-level pools, you can create and edit implant tray pool templates using Create pool and Edit Pool buttons directly below the location-level table. When you create a pool, a provider record is created. The template is then associated with that provider record. A new provider record is created every time a new pool is created. Implant tray pools differ from other pools in that they are of a new type, Implant Trays. This value is stored in the new Resource Pool Type item (I SER 5001). When you create records from within the Implant Tray Entry activity, they are automatically marked as implant tray records. In addition, with implant tray pools, you specify pools in the Implant Tray Entry activity instead of in your system or location definitions. 34 Intra-op Implants Setup and Support Guide

35 Pool Information Form Pool Information Form Fields and Buttons System level pool (I IMT 120) Enter the pool that you want to use to conflict check your implant tray at the system level. Location If you want to conflict check your implant tray at the location level, enter a location. The pool entered in the corresponding Pool field will be used to conflict check your tray at this location. Pool Enter a pool that you want to use to conflict check your implant tray when it's scheduled at the location in the corresponding Location field. Create Pool This button allows you to create a new scheduling pool and opens the Template Editor for your pool so that you can create a template. If you create a pool using the Create Pool button beneath the System level pool field, your pool is automatically entered in this field. If you create a pool using the Create Pool button benath the location level pool table, your pool is automatically entered in the first open Pool field of this table. Intra-op Implants Setup and Support Guide 35

36 A default name for your pool is created using the format "[Implant tray name] pool - SYSTEM" for system-level pools and "[Implant tray name] pool - [location name]" for location-level pools. Edit Pool Selecting a pool and clicking this button allows you to edit that pool by opening the pool's template in the Template Editor. 36 Intra-op Implants Setup and Support Guide

37 Building Implant Groups and Trays Epic 2015 This section contains instructions for building implant groups and trays and adding them to procedure and procedure preference records. Intra-op Implants Setup and Support Guide 37

38 Build an Implant Group You can use the Implant Group Entry activity to group a set of inventory items. You might choose to build a group for a certain type of screw. You can then easily add this group to multiple implant trays, reducing the time that it takes to build the trays. Groups also provide a visual distinction in trays to help you more easily locate an item. Build an Implant Group 1. Navigate to Admin > OR Administration > Implants > Implant Groups. 2. When the Implant Group Selection window appears, enter a name for your group. Press TAB, click Cancel, and then click New. 3. When the Implant Group Entry activity appears, enter a display name. 4. To limit this tray to specific locations, enter those locations in the Filter by Locations field. 5. Enter inventory items in the Inventory Items list. 6. Click Accept. 38 Intra-op Implants Setup and Support Guide

39 Build an Implant Tray You can use the Implant Tray Entry activity to gather groups of inventory items and individual inventory items into one convenient place. You might build trays that reflect actual, physical trays that your facility uses. You might also build "virtual" trays of related items, for example, a tray for a total hip replacement. Build an Implant Tray 1. Navigate to Admin > OR Administration > Implants > Implant Trays. 2. When the Implant Tray Selection window appears, enter a name. Then press TAB, click Cancel, and then click New. 3. When the General Information form of the Implant Tray Entry activity appears, enter Yes in the Active? field to allow its use. 4. To restrict this tray to specific locations, enter those locations in the Filter by Locations field. 5. In the Inventory Items field, enter those inventory items that should appear in the tray, but that don't appear in this tray's groups. 6. Enter groups in the Left Column Groups and Right Column Groups fields. 7. To edit a selected group, click the Edit Group button associated with the group's column. 8. Click Preview to view the layout you've currently configured. Click OK when the warning appears that your data will be saved. 9. Peruse your layout; then click Close. 10. To rearrange the order of your groups, use the up and down arrows that appear to the right of each column. 11. To move a group from the one column to the other, click the right or left arrow buttons that appear between the columns. 12. If you want to create a scheduling pool to conflict check your implant tray when it's scheduled, navigate to the Pool Information form. If not, skip to step If you want to conflict check your tray at the system level, enter a tray in the System level pool field, or click Create Pool to create a new pool and edit its template. If you want to conflict check your tray at the location level, enter each location at which you want to conflict check your tray in the Location column. Intra-op Implants Setup and Support Guide 39

40 14. For each location that you entered, enter the pool that you want to use at that location in the corresponding field of the Pool column. 15. Click Accept. 40 Intra-op Implants Setup and Support Guide

41 Add an Implant Tray to a Procedure Record You can specify implant trays in procedure and procedure preference records so that the tray automatically appears in Case Entry and Log Entry when the case or log looks to that record for information. Add an Implant Tray to a Procedure Record 1. Access a procedure or procedure preference record (Admin > OR Administration > Procedures). 2. Select the Instruments/Implants form and enter an implant tray in the first available row of the Implant Tray field. 3. In the corresponding row of the Merge field, enter Merge to merge this tray, or Duplicate to duplicate it in the case or log when this tray is present in another procedure or procedure preference record that the case or log uses. 4. Click Accept. Intra-op Implants Setup and Support Guide 41

42 Setting Up Barcodes for Tissues Epic 2015 Nurses in your OR and Cardiology departments can use barcodes to quickly enter information about implanted tissues from external tissue tracking systems. Documenting tissue information using barcodes helps you better comply with regulations requiring the documentation of the chain of custody for all implanted tissue. To setup barcoding for tissue documentation, you need to create a barcoding configuration record in the Inventory Barcodes activity. This record tells Epic where to store each value contained in a barcode when it is scanned. If you need to map values from a barcode to category values in an Epic item, you might also need to create mapping tables for those items and include them in your barcoding configuration record. Once your records are complete, you can specify those records in System or Location Definitions to enable them. Note that this framework currently only supports the GS1 format for barcodes. If you are interested in using another format, contact your Epic representative. 42 Intra-op Implants Setup and Support Guide

43 Create a Barcode Configuration Record To begin configuring tissue barcodes, you need to create at least one barcode configuration record. 1. In Hyperspace, click the Epic button and follow the path Admin > OR Administration > Inventory Barcodes. 2. Select the Create tab and enter a name for your new barcode configuration record. 3. In the Barcode parsing method field, enter GS1, unless you've contacted your Epic representative about another barcode format. 4. For each piece of information you'd like to store from the barcode, populate a row in the Custom Mappings table as follows: a. The Application Identifier column should contain the GS1 identifiers for the pieces of implant information included in the barcode. b. The Target column should contain the Epic item or Identity ID to which each piece of data from the barcode should be stored. c. Only use the Mapping Table column if you need to map values from your barcode to category values in an Epic item. For instructions on creating and adding a mapping table, go to the next section. d. Select the SUP check box if you want the system to look up and associate a corresponding supply record when the barcode is scanned. Intra-op Implants Setup and Support Guide 43

44 Create a Mapping Table If you need to map values from an item in your barcode to values in an Epic category list, you should create a mapping table and associate it with the corresponding items in your barcode configuration record. 1. In Hyperspace, click the Epic button and follow the path Admin > Interface Admin > Translation Tables. 2. Select the Create tab and enter a name and ID number for your new table. 3. In the direction field, enter Incoming. 4. Enter information about the Epic item you want to map to in the fields of both the Source and Destination sections. 5. In Destination column of the table on the right side of the screen, enter the Epic category values you want to save. 6. In the Source column, enter the corresponding values stored in your barcodes. 7. Once you've completed mapping your values, exit your record. 8. Click the Epic button and follow the path Admin > OR Administration > Inventory Barcodes. 9. Enter your mapping table in the row that contains the corresponding item. 44 Intra-op Implants Setup and Support Guide

45 Enable Your New Configuration Records Once you've created your barcoding configuration records, you can enable them by entering them in your System or Location Definitions. 1. In Hyperspace, click the Epic button and follow the path Admin > OR Administration > System Definitions or Admin > OR Administration > Location Definitions. 2. Go to the Barcode Scanning form. 3. List your barcoding configuration records in the Supply and Implant Barcoding Configuration Records field. Intra-op Implants Setup and Support Guide 45

46 Setting System and Location Definitions for Implants Epic 2015 This section contains instructions for performing administrative setup for implants. Administrative tasks include specifying which inventory item types are considered implants at your facility; indicating whether implants will be filtered from Log Entry pick lists; and selecting the method that the system will use to name implants that are created in Log Entry. Navigating to the System and Location Definition Entry Activities To access the System Definition Entry activity, follow the path Admin > OR Administration > System Defs. To access the Location Definition Entry activity, follow the path Admin > OR Administration > Location Defs. 46 Intra-op Implants Setup and Support Guide

47 Set System Definitions for Implants You can only perform the following task in your system definitions. Enter Supply Types Considered Implants The Surgical Inventory master file's TYPE OF ITEM item (I SUP 200) contains a category list in which you enter all of the inventory item types used at your facility (e.g. Catheter, Packing, etc). In your system definitions, you then indicate which of these types are considered to be implants. If you opt to filter implants off of Log Entry pick lists, the system uses the information that you enter here to perform this filtering. 1. Open the System Definition Entry activity and navigate to the Supply Types form. 2. In the Supply types considered implants table, enter the supply types that are considered implants at your facility. Intra-op Implants Setup and Support Guide 47

48 Set Definitions for Implants at the System or Location Level You can specify the following information either for individual OR locations or for your entire facility. Recall that location-level settings take precedence over system-level settings. Determine Whether a Log's Implants Table is Populated Automatically Supply types that are considered implants can be automatically placed on a log's Implants table when a log is created for a case that includes these items on its pick list or when a procedure (and its pick list) is added to a log. 1. Open either the System or the Location Definition Entry activity. 2. Navigate to the Settings 3 form and enter Yes or No in the Auto-populate implant table? field. Determine Whether to Filter Implants From the Log Pick List Supply types that are considered implants can be automatically removed from logs' pick lists. If you opt to perform this filtering, users cannot manually add implants to the Log Entry activity's Supplies and Drugs form. 1. Open either the System or the Location Definition Entry activity. 2. Navigate to the Case/Log Entry Pick Lists form and enter Yes or No in the Filter off implants? field. Determine How to Decrement Implants' Balance Records You have the ability to specify the balance record that is decremented when a log in which an implant has been used is posted. 1. Open either the System or the Location Definition Entry activity. 48 Intra-op Implants Setup and Support Guide

49 2. Navigate to the Settings 3 form and find the Decrement supplies in the picklist considered implants? field. If you enter Yes in this field, the balance records for items on a log's pick list that are considered implants are decremented when a log is posted. If you enter No in this field, the balance records for items in a log's Implants table are decremented when a log is posted. Enter an Extension Record to Default Implant Model Number You can use an extension record to create default model or catalog numbers for new implant records. For information about standard extension records available for entry in this field, see this guide's OR Location Definition Entry Activity section. 1. Open either the System or the Location Definition Entry activity. 2. Navigate to the Settings 3 form and enter an extension record in the Programming point to default implant model number field. Specify Implant Name Default Criteria You can specify the criteria used to create default names for new implants. You have four standard options: Inventory Item-Serial Number. The implant's name, followed by the letter "S" and the implant's serial number. Inventory Item-Log ID. The implant's name, followed by the word "Log" and the ID number of the log in which the implant is used. Serial-Log. The serial number of the implant, preceded by the letter "S," and the ID of the log in which the implant is used, preceded by the word "Log." Model-Log. The implant's model number, preceded by the letter "M," and the ID number of the log in which the implant is used, preceded by the word "Log." 1. Open either the System or the Location Definition Entry activity. 2. Navigate to the Settings 3 form and find the Log entry implant name default criteria column. Intra-op Implants Setup and Support Guide 49

50 3. Enter the criteria you've selected, in your order of preference, in this column. If the system has enough information to generate a name based on the criteria you've specified in this column's first row, then the name is generated. However, if the system does not have enough information to generate a name based on such criteria, it attempts to generate a name based on the criteria you've entered in this column's second row. Map Actions to Statuses You can map implant actions to statuses when you use custom actions and statuses to ensure proper billing and that the implant record's status is updated at log posting. If you do not map actions to statuses, the system maps them as follows: Implanted = Implanted Explanted = Explanted Wasted = Wasted 1. Open either the System or the Location Definition Entry activity. 2. Navigate to the Settings 2 form and find the Implant Action column. Enter the actions from the Surgical Log master file's Implant Action item (I ORL 6010) to which you want to map statuses. 3. In the Implant Status column, enter the status from the Implant master file's Status item (I IMP 90) for each row's corresponding action. Specify Site Quick Buttons from the Base Procedure You can help nurses document implants more quickly in the Intra-op Navigator. Information from the case and quick buttons can appear automatically in the Implants navigator section. The first time a nurse opens an implant in the navigator, the following things occur to make documentation easier: The laterality and the primary surgeon listed in the case appear by default in the Laterality and Implanted by fields, respectively. Quick buttons that correspond to the surgical sites listed in the procedure appear next to the Site field. Quick buttons, such as Implanted, Explanted, Wasted, and others, appear when a clinician opens any incomplete implant. 50 Intra-op Implants Setup and Support Guide

51 If the nurse opens a second implant in the same case, the values selected for the Laterality, Implanted by, and Site fields from the first implant appear by default in those fields. If she makes changes to this second implant and opens a third implant, any documentation values from the second implant appear by default in that subsequent implant. In this way, a nurse can quickly document multiple implants for one case, as she might need to do during a total knee replacement procedure, for example. Implant trays can also have quick buttons that appear by default and work in the same way as the Site field's quick buttons. The following implant tray fields have quick buttons: Default site Default laterality Default implanted by To allow site information from a procedure to appear automatically in an implant, you can map that information and determine which quick buttons should appear by default in your OR System Definitions. Task Steps 1. In Hyperspace, navigate to the Settings 4 form of OR System Definitions (Epic button > Admin > OR Administration > System Definitions). 2. In the Procedure Site column, enter a site that's listed in a procedure, such as Arm. 3. In the Implant Site column, enter an implant site that corresponds to that procedure site, such as Radius. 4. Continue to fill out the table in this way until all procedure sites used in your procedures are mapped to all appropriate implant sites. 5. Click Accept. Specify Whether an Implant Action Counts as Used or Wasted You can now define whether a particular implant action counts as Used or Wasted in a new mapping table. This change helps you better track whether implants are used or wasted over time. Intra-op Implants Setup and Support Guide 51

52 Note that the actions you map here don't affect whether implant actions count as Used or Wasted in your existing reports, including the Wasted Supplies and Implants Crystal Report (Wasted_Supplies.rpt). Task Steps 1. Log in to Hyperspace and follow the path Epic button > Admin > OR Administration. 2. Select either System or Location Definitions and go to the Report Definitions 2 form. 3. In the Implant Cost and Usage table, enter a list of Implant Actions that you want to correspond to Used or Wasted. For example, enter an action of Implanted and associate it with Used. 52 Intra-op Implants Setup and Support Guide

53 Configure a Warning for Incomplete Implants During Charge Review Epic 2015 Intra-op Implants Setup and Support Guide 53

54 Task Steps 1. Go to Epic button > Admin > OR Administration or Invasive Labs > Charging > Charge Settings and open your charge settings. 2. On the Implants form, enter one of the following in the Incomplete implants field: a. Error. An error message appears when a charge poster tries to post a log containing an incomplete implant. This error also appears in the Charges to Be Sent print group. b. Warning. A warning appears when a charge poster tries to post a log containing an incomplete implant. This warning also appears in the Charges to Be Sent print group. c. Ignore. No charges are generated for an incomplete implant when a charge poster tries to post a log containing that implant, and the charge poster doesn't see anything indicating that. This is the default value. 54 Intra-op Implants Setup and Support Guide

55 Show Anesthesia Staff as Quick Buttons if They Routinely Insert Implants Epic 2015 When a clinician documents an implant, the only available quick button for the Implanted by: field shows the surgeon or performing physician's name. While this behavior is appropriate for the vast majority of organizations, you might have unique workflows in which other types of staff insert the implant. For example, if your staff typically document a central line as both an LDA and as an implant, an anesthesia clinician might insert the implant. To let you make quick buttons available for anesthesia staff, you can configure a profile setting. Intra-op Implants Setup and Support Guide 55

56 Task Steps 1. Open your profile record and select History, Problem List, Implants. Go to the Implant Tracking and Documentation Details screen. 2. Enter Yes in the "Show buttons for anesthesia staff?" field. 56 Intra-op Implants Setup and Support Guide

57 Check for All Implants Associated with a Patient Epic 2015 You can create rules that evaluate whether a patient has a specific implant or type of implant. For example, you might create a rule for use in BestPractice Advisories that warn clinicians when certain implants are within one year of their expiration date. You can use rule property Implants in rules that have a patient context. This property returns information about all of a patient's implants. Intra-op Implants Setup and Support Guide 57

58 Task Steps Create a patient context rule using property Refer to the Create or Edit a Rule topic for more information. If you want to create a BestPractice Advisory that uses your rule, refer to the Build a Basic BestPractice Advisory topic and use the Other Criteria Form to enter your rule as a criterion in your advisory Epic Systems Corporation. All rights reserved. Certain information contained herein is confidential and must be treated accordingly. After Visit Summary, Analyst, ASAP, Beaker, BedTime, Break-the-Glass, Breeze, Cadence, Canto, Care Elsewhere, Care Everywhere, Charge Router, Chronicles, Clarity, Cogito ergo sum, Cohort, Colleague, Comfort, Community Connect, Country Connect, Cupid, Epic, EpicCare, EpicCare Link, Epicenter, Epic Earth, EpicLink, EpicOnHand, EpicWeb, Haiku, Healthy Planet, Hyperspace, Identity, IntraConnect, Kaleidoscope, Light Mode, Lucy, MyChart, MyEpic, OpTime, OutReach, Patients Like Mine, Phoenix, Powered by Epic, Prelude, Radar, RedAlert, Region Connect, Resolute, Revenue Guardian, Rover, SmartForms, Sonnet, Stork, Tapestry, Trove, Trusted Partners, Welcome, Willow, Wisdom, With the Patient at Heart and World Connect are registered trademarks, trademarks or service marks of Epic Systems Corporation in the United States and/or in other countries. Other product or company names referenced herein may be trademarks of their respective owners. U.S. and international patents issued and pending.