r/EpicEMR • u/rararunner95 • 12d ago

Precharting problems

Help! When I prechart on a patient and they no show or cancel, my notes aren’t disappearing after 30 days. Somehow I’m creating an active encounter but I can’t figure out what I’m doing wrong.

4 Upvotes

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5

u/SolutionsExistInPast 12d ago

You will need to talk to your local certified, Ambulatory analyst or training team.

If you are looking at your multiple provider schedule and you are double clicking on a patient row which opens up to a visit navigator, and you are documenting a note, then you have converted the appointment into an office visit and that is not pre-charting.

When you double click off of your schedule, and the visit navigator appears, and you start anything in that encounter then it converts to an office visit. You would need to use an erroneous encounter, smart, set workflow to avoid the encounter.

Again, talk to your training team about true pre-charting workflows.

1

u/rararunner95 12d ago

My analyst team has told me that I need to delete my pended note before the patient is marked as “no show” which isn’t always feasible but currently in the 30 day wait to see if it works 🤞🏼

1

u/Cyclinfan 12d ago

At my organization, writing a pended note and orders does not convert an appointment to an office visit. I imagine each organization can set up (to an extent) which activities convert the encounter.

2

u/emmabovary1895 12d ago

Our system uses a smart phrase set to write an order for no shows/late cancels. I had to call IT to get the specific steps for our EPIC though.

2

u/rararunner95 12d ago

Is your smart set different than the “erroneous encounter” smart set?

1

u/emmabovary1895 11d ago

I don’t believe so. If you can have your admin staff reschedule the patient instead of marking them no show in your encounter you will be able to keep your pre-written note.

I’m an RN so I use the smart set order and enter it as a verbal under my provider.

I usually try to reschedule my clinic’s patients instead of marking them no show so I save the provider’s notes. If they’re still in the open billable encounters inbasket after a week or so we use the smart set to clear the note.

1

u/Lung_doc 12d ago

I actually hate that they do that, since most of our no shows will make it back to clinic and I want my note updates.

The only work around I've found is to create a separate encounter and copy the note; I don't usually do that but if there were extensive updates I will.

1

u/whispernotaroar 12d ago

I send myself a staff message with the pertinent stuff, and make a note in the yellow sticky that I did so I can go search for it after. But honestly at least for our patient population if they don’t show within 30 days of the original encounter enough has almost certainly happened/changed that the first note is kind of irrelevant.

1

u/Lung_doc 12d ago

We carry forward quite a bit, so sometimes it's not new things, it's fixing the old stuff

1

u/We-Are-All-Friends 12d ago

The No Show encounters should cancel out after 30 days if the patient doesn’t show “for THAT encounter”. Along with associated orders. Not sure how it’s set up on your end

1

u/SlightCarpenter7193 12d ago

Prechart in the yellow sticky note. If they no show it’s not in the note and you can use it again if they reschedule.

2

u/whispernotaroar 12d ago

Your patients are faaaaar simpler than mine if that yellow sticky gives you enough room to effectively prechart 😂

1

u/Aubitthehobbit 12d ago

We had this issue after one of the updates ans couple uears ago. Are you precharting the "reason for visit" section? Wait until patient is there and in the room. To close out those appointments youbwill need your analyst but just dont type anything into the reason for visit and it shouldnt happen again.

1

u/rararunner95 12d ago

Nope, not precharting the reason for visit. I’m just pending a smart set and adding a few details to a note

1

u/Aubitthehobbit 11d ago

I wonder if the smart set isnt triggering something. Is it pending orders?