CLN 200 Flashcards
What is Chronicles?
Epic’s database management system that stores information, including employee, patient, and medication records
What is the Epic term that uses the analogy of the filing cabinet?
Chronicles
What is the Epic term that uses the analogy of “file drawer?”
Master file
What is the Epic term that uses the analogy of “folder?”
Record
What is the Epic term that uses the analogy of “question?”
Item
What is the Epic term that uses the analogy of “answer?”
Value
What is a master file?
A storage entity in Chronicles used to organize a particular type of record
What is a record?
A specific individual in a master file
What is an item?
A prompt for a piece of information
What is a value?
The specific information recorded for an item.
What is a contact?
Tracks how the values for certain items change over time
What is the Epic term that uses the analogy of “contact?”
Dated sheets of paper
Define “chaining”
Using commas or semi-colon separators allows you to jump through multiple menus. Example: 11;1 or 11,1
True or False: Clicking with your mouse is useless in clinicial administraton.
True
How do you select a menu in Clinical Administration?
Type the number associated with that menu.
Within menus, typing this abbreviation returns you to the initial menu from a database prompt.
opt
Within menus, this keystroke returns you to previous the screen.
PAGE UP
This keystroke moves you to the next field on a screen within a record.
TAB
Within a record, this keystroke moves you to the field above or below the current field, or up and down in a list.
UP ARROW/DOWN ARROW
How do you move to the next screen of a record?
PAGE DOWN
How do you exit a record from any screen?
SHIFT+F7
How do you return to the last record you accessed during the login session?
=
Name the basic facility structure levels from most specific to most general
Bed, Room, Department, Location, Service Area, Facility
Name the two optional facility structure levels
Hospital Area and Place of Service
Define BED facility structure level
The most specific level. Admitted patients are assigned to beds, and it determines the hospital’s census.
Define ROOM facility structure level
Contains one or more beds
Define DEPARTMENT facility structure level
Areas that schedule or admit patients.
People log into departments
Name the four types of departments
ADT Units
Outpatient Departments
Hospital Outpatient Departments (HOD)
Virtual Departments
How are ADT units used?
For areas that admit patients to a room and bed
Examples: East Hospital Nursery, East Hospital Emergency
Do users schedule appointments with ADT units?
NO.
How are Outpatient Departments used?
For areas where patients are scheduled to see providers. Examples: East Clinic Family Medicine or East Clinic OB/GYN
How are Hospital Outpatient Departments used?
Both admitted and scheduled patients are seen in these areas. Patients return home or to the admitting unit.
Examples: East Clinic Radiology
East Hospital Same-Day Surgery
Define LOCATION facility structure level
A collection of departments that represents the actual building where people work. They can be hospitals or clinics.
Define SERVICE AREA facility structure level
Service areas are the business entities of the organization. They track revenue and accounts receivable. Can represent a geographical region, an affiliate organization, or your entire organization.
Define FACILITY structure level
Most general level. Refers to the entire enterprise or organization.
Define WORKSTATION facility structure level
Computers, printers, and fax machines need these records. Can link to various levels of the hierarchy.
Define HOSPITAL AREA facility structure level
An optional level that groups hospital units for census reporting. Hospital wings and floors are created as these records.
Define PLACE OF SERVICE facility structure level
An optional level that represents places outside your organization. Used to track where patients are sent and where providers are working.
Name the required levels of a hospital facility in order from most general to most specific
Facility, service area, location, department, room, bed
Name the required levels of a clinic facility in order from most general to most specific
Facility, service area, location, department, workstation
What is a category list?
A standard list of values for a specific item.
How do you find out the master file INI and item number of a category list?
CTRL+click
What is a Category ID?
The corresponding number for the category value. You can type this in place of the title or synonym.
How is the Abbreviation item from category lists used?
The short name for the title that appears on reports.
What does a category list’s Title capture?
The name of the value, which is displayed to end users.
Define category list Synonyms
Alternate names for the value. You can type these in place of the title or ID.
What does Release Range “no categories” mean?
You can edit all categories
What does Release Range “extendible” mean?
A range of categories; you can edit some categories (example: 1-3).
What does Release Range “all categories” mean?
This is a system-level category list. No categories may be edited.
Profile records configure what?
What you can see and do within individual activities.
Who or what needs a provider record?
Each clinician and scheduled resource at your organization.
Each non-affiliated clinician to whom your clinicians write or receive referrals.
Name examples of who/what would have a provider record.
Physicians, nurses, MRI machines
Who needs a user record?
Anyone who logs into Epic
A security class provides access to what?
Individual activities or other pieces of functionality
The role record determines what?
Where you find activities in Hyperspace.
What is the visible effect of a profile record?
Chart Review tabs, preference lists, default reports.
Name some example user records.
Clinicians, unit clerks, schedulers, front desk staff, biller, coder, administrator.
Name some example security class records
EpicCare Ambulatory, Cadence, InBasket
Example visible effects of Role
Layout and order of toolbars, menus, etc.
List the reasons why a provider record is needed.
To be lised as the referred to/from provider
To be scheduled with patients
To record credentials
To authorize orders
List the reasons why a user record is needed.
To log into the system
To record ID and password
To provide security to certain features
Elma Yorkstein is a unit clerk who logs in to Hyperspace and performs tasks in EpicCare Ambulatory, but she isn’t a clinician and doesn’t directly provide patient care. What record(s) does she need?
User
Marco Brown is an unaffiliated doctor who refers to, or gets referrals from, your organization, but he should not have permission to log in. What record(s) does he need?
Provider
Wenda Gurney is a nurse at your organization who provides patient care. She documents office visits in the system and is a licensed RN. What record(s) does she need?
User and Provider
The x-ray machine has appointments scheduled directly with it. What record(s) does it need?
Provider
In the Provider master file, this item indicates whether this provider can be listed as the referred from or referred to provider.
Ref Src Type
In the Provider master file, this item indicates whether the provider record is for a person, a resource (such as an MRI machine), or for a class.
Scheduling Type
In the Provider master file,this item indicates if this provider is employed by your organization.
Internal/Ext
In the Provider master file, this item indicates the department where a provider or resource is scheduled.
Department(s)
In the Provider master file, what does the License for Display item indicate?
The license that should appear after the provider’s name in any official documentation, such as MD, RN, or PT.
In the Provider master file, which item indicates whether a provider can be listed as the person responsible for a medication order?
Meds Authorizing Provider
Meds Authorizing Provider item in Provider master file indicates what?
Whether a provider can be listed as the person responsible for a medication order
In the Provider master file, which item indicates if this provider can initiate inpatient orders?
Inpatient Ordering Provider
In the Provider master file, which item indicates whether a provider can be listed as the person responsible for a procedure order?
Orders Authorizing Provider
In the Provider master file, which item indicates if this provider can initiate outpatient orders?
Outpatient Ordering Provider
Inpatient Ordering Provider item in Provider master file indicates what?
indicates if this provider can initiate inpatient orders.
Outpatient Ordering Provider item in Provider master file indicates what?
indicates if this provider can initiate outpatient orders.
Orders Authorizing Provider item in Provider master file indicates what?
whether a provider can be listed as the person responsible for a procedure order.
Using Epic’s analogy, what do the keys represent?
Security Points
Using Epic’s analogy, what does the ring of keys represent?
Security Class
True or false: Each application has its own security class. Users can only have access to applications for which you are licensed.
True
Name six layout items that the role record controls
- Default startup activities.
- Access to commonly used activities on the toolbar.
- Submenus under the Epic button.
- utomatically logging out or securing after a specified period of inactivity.
- The number of workspaces a user can have open at one time.
- How to determine the default login department.
True or false: A single role record is generally assigned to a single user.
FALSE. A single role record is generally assigned to a group of users.
Can a user log into Hyperspace without a role defined?
NO. Every user must have a role to log in. Without one, Epic cannot determine the layout of Hyperspace.
Name four pieces of information that must be attached to a user record.
- Shared security class
- User role
- InBasket security class
- Password information
Which user record form grants access to master files?
Chronicles Security
Which user record form controls access to activities that apply to multiple clinical applications; every clinical user needs this security class?
EpicCare Information
Which user record form determines the default login department and grants access to functionality that spans Epic’s applications?
Hyperspace/Shared Security
Which user record form grants access to the In Basket messaging system?
In Basket
Which user record form controls access to inpatient activities like the MAR and the inpatient Doc Flowsheet activity.
Inpatient EMR
Which user record form determines the assigned user role?
User Role
Which user record form allows for password modification
Basic Information
Which user record form determines the assigned provider record?
Provider/Hot-Key Information
Profile records configure what?
Options within an activity
List the profile levels in order of most specific to most general.
User
EpicCare Security Class
Department
System Definitions
Name two ways to look up a record in clinical admin
ID number
completion matching on record name or synonym
In clincial admin, how can you bring up the item information such as INI and item number?
Home/F8
What is hyperspace?
an integrated network of different Epic applications.
True or false: data is stored in Hyperspace.
FALSE. The system stores information in and retrieves information from Chronicles.
What is Clinical Admin?
a set of text-based menus that an administrator of clinical software often uses when working in a Reflection session for UNIX and Digital
True or false: Chronicles tracks changes to information over time.
TRUE.
For example, a record is maintained in Chronicles for each patient. Every time a patient makes a visit to a clinic or physician, the visit counts as a contact in that patient’s record.
There is only one record per patient, but there are many contacts in each record over time.
True or false: the contact with the lowest number is the most recent contact.
FALSE. The contact with the HIGHEST number is the most recent contact.
Describe the difference between Clinical Admin and Chronicles
Clinical Admin is a defined subset of master files.
Chronicles starting point is to open a specific master file.
How can you select a record when you can’t remember its name or ID?
Enter a “?” at the master file prompt, then enter Yes to see a list of records from the beginning.
How are Virtual Departments used?
Examples: East Hospital Business Office or East Hospital Respiratory Therapy
In which order does the system look to determine a user’s composite profile at login?
user> Security class> department> System (specific to general)
WHat two pieces of information would you need to know about the Allergy Reaction feild in order to add an item to this category list?
number and INI
True or False: Hyperspace does not store patient data
True
to find out the Master file INI and item number of a category list, what do you do?
CTRL and click in field
to acccess a category list in Category List Maintenance activity, what information do you need?
INI (master file) and item number
True or False: A category list can have only one synonym
False
Types of categories and messages: Customer, extendible, and system
Customer:No Categories fully editible; Extendible: range of categories, some or editible; System: all categories, not editible
what is the correcsponding MF INI:
security class, Provider record, Role, user record, Profile
ECL, SER, E2R, EMP, LPR
True or False: You link the provider and user records together from within the provider record
False (User)
True or False: Every Provider has a corresponding user record?
False
True or False: A provider can only place orders within the departments listed in her provider record
False (scheduling is limited)
True or False: By marking someone as an Inpatient Ordering Provider in his provider record, you are giving him the ability to enter orders in Order Entry
False (you are indication that this provider can be listed as the ordering provider. Security class gives access to enter orders)
True or False: Security classes are linked to a user from within the user record
true
what three security classes do nearly all clinical users need?
EpicCare, In Basket, Shared
What is the main purpose of a user record?
Stores ID & password, Links all of the security records together for a user (does not contain licensing information)
An employee needs both a user and a provider record, which do you creat first? Why?
Provider record then user, more effiient to link existing provider record when in user record
True or False: the profile controls the options on the main toolbar
False (role does)
Name one way Chart Review can be affected by you profile
any of the following: tabs end user sees, the order of tabs,default filter on Encounters tab, available reports
What user records are configured in Hyperspace?
User and Role
What user records are configured in Clin Admin?
Provider, security classes and profile
In which order does the system look to determine a user’s composite profile at login?
User> Security Class> Department? System Def (specific to general)
What two pieces of information would you need to know about the Allergy Reaction field in order to add an item to this category?
INI and Item number
True or false: The Departments field in the Provider record determines the user’s default login department.
FALSE. Default login department is defined in the user record.
Where does Provider Type (from SER record) appear in Hyperspace?
When creating a new encounter. The Provider Type column is in the Record Select window when searching for a provider for a new encounter.
How is External Name from the SER record used?
External Name appears in Hyperspace when a clinician marks a section as reviewed.
How can a user look up clinicians based on demographic and clinical information in their provider records?
Use the Provider Finder Activity
How do you access the Provider Finder activity?
Epic button > Tools > Provider Finder
True or false: if a user is not using Cadence functionality, a Cadence security class doesn’t need to be listed.
FALSE. Even if the user will not be using Cadence functionality, a Cadence security class must be listed in Cadence System for the user to be able to choose a department at login.
Describe where in text you duplicate a security class
Management Options > Utilities > Chronicles > ECL > Enter Data > Duplicate Classification
True or false: You cannot assign to a user (including yourself) a security class level higher than your own.
TRUE.
True or false: anyone who needs an Inpatient security class also needs an EpicCare security class.
TRUE. Not all security points are covered independently in these security classes.
When would an individual user record be linked to a profile record?
When the user needs profile settings specific to him/her.
When is a profile linked to an EpicCare security class?
To assign profile settings that are common to broad categories of users; e.g. all inpatient nurses or all radiology technicians.
When is a profile linked to a department record?
This is used mainly for users who might float among different departments or units and need different settings based on where they are working for the day.
What is the impact of linking System Definitions to a profile record?
This profile serves as the system default for everyone. Any setting not defined at a higher level profile will be found in the System Definitions level profile.
What is a composite profile?
The combined settings from certain profiles at each of the four levels (user, EpicCare security class, department, system defs)
Do profile settings give you access to Chart Review?
NO. EpicCare or Inpatient security classes grant access to Chart Review. Profiles define what you see within Chart Review.
How can you determine which Report IDs included in the Chart Review Encounter Reports?
Turn on the Report & Print Group Assistance report.
Epic > Help > Help Desk Reports > Report & Print Group Assistant
In Chart Review Tabs screen, what’s a trick to populate the default tabs?
Hit F6 to have all of the default tabs populate the screen. Then delete any that are not wanted, and press F7 to insert a row as needed.
Name some of the Chart Review settings that profiles control.
Available tabs, encounters that are filtered out.
Name some of the Patient Summary, Patient Lists, and SnapShot settings that profiles control.
The reports you have available and the default reports on the activity toolbar.
Name some of the Preference Lists settings that profiles control.
The system preference lists of medications and other orders that you search in Order Entry. You can have separate preference lists for inpatient and outpatient orders.
Name some of the Documentation Flowsheet settings that profiles control.
The default flowsheet buttons in the Doc Flowsheet activity, as well as the flowsheets preference list.
Name some of the Orders-related settings that profiles control.
Whether you can: search the entire database when placing orders, have verbal orders by default, have the ordering and/or authorizing provider appear by default when you place an order. Also, which types of orders require diagnosis association, and what validation programming points are checked when you try to sign an order (check for dupes, etc.)
Why would you configure settings at the System Default profile level?
- To make settings that are organization-wide
- To serve as the default for settings made at more specific levels.
- The more settings you can make in this profile, the fewer settings you have to make and maintain in more specific-level profiles.
Why would you configure settings at the Department profile level?
- These profiles change based on the department a user chooses when logging into Epic.
Why would you configure settings at the Security profile level?
To apply settings that apply to an entire group of users. Settings at this level override settings made at the department level profile.
Why would you configure settings at the User profile level?
When a particular specialty needs a unique set of preference lists. The user level profile is the most specific, so any settings made here will override the same settings made at a lower level.
True or false: Only an Inpatient security class can be linked to a profile.
FALSE. Only and EpicCare security class can be linked to a profile. You cannot link In Basket, Shared, Inpatient, Rx, Emergency Department, Obstetrics, Home Health, Radiant, or any other type of security class to a profile.
True or false: user-level profiles should NOT be designed solely for individual users.
TRUE.
How can you find out which profiles make up the composite?
In Hyperspace:
- Log in as the user for whom you want to know the composite profile.
- Epic button > Help > Help Desk Reports
- Double click “Session Information - IB Link” report
- Profiles and levels are listed under the EpicCare Profile Information header.
Why must a Cadence security class be listed in a user record?
A Cadence security class must be listed in Cadence System for the user to be able to choose a department at login.
Would a licensed physical therapist at your organization have a provider record? Why or why not?
YES.
The physical therapist has a license that should be displayed, and might be scheduled with patients.
Name three places in Hyperspace where a provider’s credentials will appear.
In the Allergies activity (or Allergies section of a navigator), where it notes who last reviewed the patient’s allergies.
In the Med Documentation section of a navigator, where it notes who last reviewed the patient’s medications.
In the History and Allergy sections of a navigator, where it notes who last reviewed the patient’s history.
In the Notes activity, next to the name of each note’s author.
A second year resident working in the hospital can place orders for admitted patients, but needs a sign-off from the patient’s attending provider. how would you set up the resident’s provider record to represent this scenario?
“Meds Authorizing Provider” and “Orders Authorizing Provider?” fields would be set to No, but the “Inpatient Ordering Provider?” field would be set to Yes.
True or false: by marking someone as an Inpatient Ordering Provider in their provider record, you are giving them the ability to enter orders in Order Entry.
FALSE.
You are indicating that this provider can be listed as the ordering provider for an order that someone enters into Epic. The security classes assigned to your user record give you the access to log into Hyperspace and enter orders.
What is the difference between making someone an authorizing or ordering provider?
“Authorizing provider” means that the provider can be legally and financially responsible for orders. It is not related to one’s ability to sign an order. Signing is based on security.
What are the major settings in a user record that determines what the user can see or do in Hyperspace?
Security classes - grant access to activities in Hyperspace.
Role - determines where the user will find activities in Hyperspace.
Profile - configures what options the user has within activities.
Name three settings that must be made before a user can log into Hyperspace
Possible answers: Status must be active Password must be assigned Role must be assigned Login departments must be enabled (via Cadence System screen, Resolute PB screen, or departments listed in your provider record)
What two types of security classes will every user of Epic need (not just clinical users)
In Basket security class and a Shared security class.
Which type of security class grants a user access to EpicCare Ambulatory functionality?
EpicCare security class
What types of security classes would a physician who uses the ASAP Emergency Department application need?
In Basket Shared EpicCare Inpatient Emergency Department
Why do all users need to be assigned a Shared security class?
The Shared security class controls access to functionality that might be used by any of Epic’s applications, including non-clinical ones like Cadence (scheduling) or Resolute (billing)
What is a Model security class?
A security class that is part of the Model system, designed by Epic to include the security points that would be needed by a given group of users.
You just removed the Problem List security point from the EpicCare security class to which a user is linked. When you log in as that user, he still has access to the Problem List activity. What might have caused this to happen?
One possible answer: Security changes don’t take effect unless Hyperspace is restarted. You didn’t exit Hyperspace completely and relaunch the application.
Your organization wants its hospital charge nurses to have administrative access to the Patient List activity (Inpatient security point 1 - Patient List Administrator). Otherwise, their access should be the same as that of other inpatient nurses (who use the Model IP Nurse Inpatient security class). How would you efficiently take care of this need?
Duplicate Model IP Nurse Inpatient security class and call the duplicate something like IP Charge Nurse. Add to the duplicate the desired security point. Link all of the charge nurses’ user records to this duplicate security class.
Where are Orders preference lists created?
In the Preference List Composer in Hyperspace.
True or false: An end user can choose to see encounter types in Chart Review that have been hidden for convenience.
TRUE. Uncheck the Default filter.
How can I define the default report buttons that appear for an end user in the Patient Summary activity?
List the reports that should be the default buttons in the Startup Buttons field on the Patient Summary screen in the profile.
When the physicians at your organization review an office visit encounter with a cardiologist, they want to see a different report than they see for most office visits. How could this be accomplished?
In the Chart Review Encounter Reports table, add another line for the contact type of Office Visit, but include a specialty of cardiology. Then list the special report under the Reports column.
True or false: You are limited to a single outpatient and a single inpatient orders preference list in any given profile record.
FALSE.
What are the four levels of profiles? What order does the system search them to create the composite profile?
User, security, department, system default. In that order.
What type of security class can be linked to a profile?
EpicCare security class
True or false: any profile record can be attached at any level.
TRUE.
The workflow engine is currently configured to control what three patient workspace views?
Activity tabs (to the left of patient chart)
More Activities menu
Navigators
True or false: configuring and assigning Workflow Engine Rules eliminates the need for assigning role and profile records to users.
FALSE. User and profile records contain many more settings that are not contained within the Workflow Engine and are still necessary for complete configuration.
“If” statement specifies what?
Which properties of the patient encounter apply to that rule.
Another word for “if statement” is…
Condition
Path to Workflow Engine Rules
Hyperspace toolbar > Build Tools > Workflow Engine Rules
True or false: Each property used in the Workflow Engine is defined by a property record in the Properties (LRC) master file.
TRUE.
The “then” statement does what?
Tells the Workflow Engine what to do if the rule matches the properties specified in the “if” statement.
Another word for “then statement” is…
Directive
What master file are rules linked to in order for the Workflow Engine to use them?
The most specific profile record for the user, in the Profile master file.
What are three aspects of a patient encounter than can be altered based on a rule match?
Override or Extend More Activities menu, Change default activity, Change available navigators.
Can more than one rule be linked in a profile record?
NO.
True or False: If the patient encounter does not match conditions in a Workflow Engine rule, the system looks for a rule in the next level of the profile hierarchy.
FALSE. Settings found in the Role and compiled profile for the patient encounter will be used. The system will not look for additional Workflow Engine rules at other levels in the profile hierarchy.
Name two types of directives that can be specified in a workflow engine rule.
Set ToolSet
Add Navigators
What does the Set ToolSet directive do?
Define the attributes for the clinical toolset.
What does the Add Navigators directive do?
Allows you to add activity tabs and a single navigator for a patient workspace.
What does the workflow engine do?
Configures the patient workspace to make it more efficient for the end user.
How do you access the Workflow Engine Rule Editor
From the Hyperspace toolbar: Build Tools > Workflow Engine Rules > Edit a rule.
How is it useful to create a new contact for a workflow engine rule?
- Allows you to track rule changes over time.
- Gives you the ability to create and edit new, unreleased contacts for released rules without affecting users until you are ready to release (activate) the new contact.
How can you get the section names from an existing navigator already available in Hyperspace?
Hold down CTRL+ALT+SHIFT, then press and release F12. Keep holding CTRL+ALT+SHIFT and press F10. Wait a moment while the navigator refreshes. Your navigator should now display the section names as below.
True or False: To create a navigator, you work in the following master files: Section, Topic, and Template.
FALSE. All three of these are different types of records in one master file, LVN (navigators).
Fill in the blank: A navigator topic record links to navigator _______ records.
section
Navigator hierarchy high to low
Template
Topic
Section
Define Section record
The smallest unit of the navigator. A record which contains programming that pulls patient-specific information into the navigator.
Path to access sections, topics, and navigators
Clinical Administration > Navigators > Navigators
What is a Topic record?
Groupings of individual sections.
What are the two main purposes that topics serve?
- Efficiency (can be reused in different navigatory templates)
- Organization: Topics segregate a navigator’s table of contents.
What is a template record?
It is what displays for the end user. The template record links the topics (and therefore sections) that appear to the end user.
True or false: only a topic record can be linked to a profile record or in the workflow engine rule.
FALSE. Only a template record can be linked to a profile record or in the workflow engine rule.
True or false: a template may sometimes be linked to only one topic.
TRUE.
True or False: a navigator template record can be linked to more than one topic record.
TRUE.
If you enter a caption of “Charting” in a navigator topic record, who will see that in Hyperspace and in what place will they see it?
It is what the end user sees as display text in their table of contents on their navigator.
