FirstNet Provider Training

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FirstNet Provider Training
Presented by Kim Olney RN, Senior IT Trainer
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Instructions

• View the Computer Based Learning Module

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• Action buttons are located at the bottom of each
  screen when completing a module through Ascension
  Health University
• The functionality of each button has been listed
  below.
• Please use the buttons to navigate through the
  module.

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Objectives

• Upon completion of this CBL the learner will have
  a basic understanding of how to
• Navigate the FirstNet Patient Tracking List
• Look up Results
• Place Basic Orders
• Prescription Writing Process
• Depart Process

• NOTE
• Please remember this module demonstrates Cerner
  functionality only.
• Consult your Clinical management team with any
  questions you may have about clinical workflow or
  daily operations.

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Introduction

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

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• From your desktop, click on the BIEHR Icon

Click on the FirstNet Prod Icon
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Enter your User Name and Password. (passwords are
case sensitive)
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Click Yes to be an Available provider.
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• Provider Role Default Relationship fields
  Click on the drop-down arrow and choose the
  appropriate role/relationship.
• Associated Provider Color click on the box to
  open the window choose a color and click Ok.
• Place a checkmark in the box next to Available
  Reviewer.
• Click OK

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Click on the Physician tab for your site.

• BMC Physicians
• PIPP Physicians
• WBIMC Physicians
• LM Physicians

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Click on a patient row then click on the Assign
Provider Icon to assign yourself as the provider
for that patient.
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Title Bar
Menu Bar
Overview of Patient Tracking List
Tool Bar
Tracking List Icons
Links to chart sections

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

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Tracking List Columns

• Left to right
• The first column has star indicators for abnormal
  or critical lab results.
• A blue arrow pointing to the pt. row.
• Bed number the patient is assigned
• Aacuity
• Name Last, First and (pre-arrivals)
• Age/gender (pinkfemale, bluemale)
• LOS-length of stay
• Allergy (hover over icon to see allergy
  information)
• Latex allergy

• Continued
• Chief complaint why they are being seen.
• Lab/Rad columns (functionality discussed next
  slide)
• Orders
• MDattending doctor initials
• RNs initials,
• MLP initials
• RES initials
• PCP primary care provider
• Comment and Isolation fields.

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Hovering over an Icon or field will produce a
drop-down with information pertaining to that
field.
Yellow Starabnormal lab results
Red Starcritical lab results
Double left click in the Lab or Rad column will
open the Quick Flowsheet.
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Quick Flowsheet
Double clicking in a Radiology field will open up
the report.
Clicking on the Review button will mark results
as reviewed and closes the window.
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The abnormal/critical star will fall off after
you have marked reviewed.
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Opening the Patients Chart
To open the patient chart click on the yellow
folder icon. Choose the section you want to
access.
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The Demographic banner

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

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Key sections of the Menu

• Menu
• ED MPage Summary
• Document Viewer
• Documents-Provider
• Documents-Other
• Orders
• Medication List

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ED MPage Summary

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

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Document Viewer

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

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Documents-Provider

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

NOTE Documents-Other are specific to
non-provider roles (RN, RT, PT, OT, Dietary, MSW,
PCA etc.).
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Customized View for Orders and Medication List
Windows
Click on Current then click on Customize View
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Custom View Set-UpBefore

• Highlight the selections from the Available
  columns list.
• Click Add

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After

• Now arrange the list in the Selected Columns
  section by using the arrows to the right.
• Use the drop-down arrows for the fields at the
  bottom of the page, make the selections as seen
  here.
• Click OK

NOTE Must be done for the Orders window and the
Medication List window to view to be appropriate.
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Advanced Filters
Setting Advanced filters for the Order window
will allow you to see all non-medication orders.

• Click on Displayed All Active Orders
• Change Display to All Active Non-Medications
• Click Apply

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Order Entry

• The Add Order window is where orders are searched
  for and added to the orders scratch pad.
• Most orders for FirstNet are on the Homepage or
  in the folders on the homepage.

Click the Add button

• Click on an order (CBC with Diff), then click Done

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Order Sentences

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

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

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Order Details
.
This is the Orders Scratch Pad. This lists all
the orders entered and allows you to add or
change order details prior to signing.

• To start entering the order Details click on the
  desired order to highlight it.
• (repeat process for all orders).
• Review the order and click Sign.

Note A next to the order indicates required
information must be entered before signing the
order.
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• When done, the entered orders will be in the
  Processing status.
• To complete the process, click on the Refresh
  button.

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Depart Process

• When ready to discharge the patient click on the
  patients row. Then click on the Depart button at
  the top of the window.

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The Depart Process window has 2 sides.

• The Left side is the menu. Sections highlighted
  in yellow are required.
• The Right side is the Patient Summary (what is
  printed and sent home with the patient).

Click on the pencil icon to open the
sections. Lets start with Meds/Prescriptions...
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Prescription Writing

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

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Click on a medication to fill in the Details for
that medication, repeat for each medication.
NOTE Before you sign you must choose a printer.
See next slide.
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Adding/Selecting Printers
Click on the dropdown arrow next to the Send To
field.
Click on Other
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Apply to set to All Pending Default Always
treat my
When at BMC, LEE or PIPP all the Rx printers for
that site are in separate folders. Open the
folder for your site and choose your printer.
(You may right click on the printer and add it to
your favorites) See the next slide.
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When at WB IMC the Rx printers for that site are
in the BORGESS AT WOODBRIDGE HILLS folder. Click
on the name of the folder, the printers will
display on the right side and choose your
printer. (You may right click on the printer and
add it to your favorites) See next slide.
NOTE RX printers all end in_rx (you also might
need to grab and drag the column to the right to
see the RX printer.)
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Setting a Default Printer

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

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Sign and Print
All pending RXs will print upon signing
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Patient Discharge Instructions and Follow-up

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

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

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

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• Who provider, organization/clinic or Free-text
• Quick Picks when other choices arent
  appropriate.
• When hours, days weeks etc.
• Where Address and phone for provider.
• Comments Predefined/editable.

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Provider Search

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

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

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

Sign Save Cancel
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• Review the Patient Summary
• Sign/Close

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• Now the House Icon will appear in the To Do
  column. (Indicator the patient may be discharged
  by the nurse).

• At the end of your shift, click on the Provider
  Check-Out Icon.
• Click OK

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Exiting the application

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

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• For any questions concerning this or any other
  Cerner provider issues, please call Provider
  Support at 226-7303 8am-5pm Monday-Friday
• After hours, weekends and holidays leave a
  message, we
• will get back to you next business day
• For urgent matters, call the Helpdesk at
  (226-5386).

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Conclusion

• We hope this Computer Based Learning course has
  been both informative and helpful.
• Feel free to review this course until you are
  confident about your knowledge of the material
  presented.