MD Orders
Assessment and Reassessment eDocs can be integrated with an MD Order to reduce duplicate documentation. As nurses complete their Patient visit assessments, they have the option to create an MD Order directly from within the eDoc. The assessment entered in the eDoc then flows into the MD Order. After the integrated MD Order is created, information continues to flow as the assessment is edited.
HHAeXchange does not support MD Order integration with revisits such as post-hospitalization follow-ups.
Because the Medications tab on the MD Order and the eDoc assessment are so closely matched, only one version exists in the integrated MD Order. The Medications tab on the eDoc assessment continues to be available and syncs to the Review tab on the integrated MD Order.
The Medications tab on the eDoc assessment syncs to the MD Order Review tab, even after the MD Order is created. This behavior differs from what happens when a medication is added or edited in the Patient Profile after creation of the MD Order, in which case the modifications do not sync.
When a Patient’s medication is added, edited, discontinued, or deleted in the eDoc or MD Order, the change syncs displaying in the Patient Med Profile page under Patient > Med Profile. When a medication is changed to a different one, then the new medication information replaces the older one. If deleted, then the medication is deleted from the Med Profile.
Information only syncs from the Patient’s Med Profile to the eDoc/MD Order one time; when created. If information is added or changed on the Patient’s Med Profile after the eDoc or the MD Order is created, then it does not sync to either the eDoc or MD Order.
Several columns on the Patient MD Order under Patient > MD Orders in the Medication and Review MD Order tabs provide better visibility for a physician or nurse to view to include a Comments column in the Medication tab.
Amount, Form, and Comments columns have been added to the Review MD Order tab.
Several sections of the MD Order are configurable such as DME and Supplies, Nutritional Requirements, and Safety Measures. The system uses exact (matching) text for the information to flow from the eDoc assessment to the MD Order in these sections.
Values that have been previously created, can now be inactivated in the Office Option Setup section of the Edit Office page under Admin > Office Setup > Office Edit. Therefore, a field that does not match a corresponding field in the assessment, can now be inactivated and replaced with a label that does match.
For example, in the following image, Rails is inactivated and replaced with Side Rails. Once saved, the custom MD Order field matches the text on the eDoc assessment DME and Supplies tab.
On the eDoc page Patient > Calendar > Visit Info, the following five new tabs are now available to integrate newly entered information into an integrated MD Order: Certification, MD Order-Demographics, MD Order-Others, MD Order-Order/Goal, and Review MD Order. Each of these tabs is covered in sections below.
For MD Orders, a Certification Period is required. When creating an MD Order via eDocs (Certification tab), click Add to apply a Certification Period directly or an existing Certification Period can be selected from this page.
To create a Certification Period, enter the Start Date and End Date fields (required, as denoted by the red asterisk) on the Patient Certification window.
The new MD Order tabs on the eDoc assessment are enabled and values from the assessment populate the MD Order.
The MD Order-Demographics tab is available on the eDoc assessment under Patient > Calendar > Visit Info as part of the Integrated MD Order feature. Nurses can enter information as needed via the eDoc assessment functionality. Details on this tab are pulled in from the Patient Profile when the integrated MD Order is created.
Details on the integrated MD Order–Others tab are populated based on details entered via the eDoc assessment. To ensure the consistency of information between the two documents, any value that is present on the eDoc assessment is disabled on the integrated MD Order even if not selected in the eDoc assessment. The nurse must always go back to the eDoc assessment to modify any MD Order value that is disabled.
For example, documenting the Prognosis on the Narrative tab of the eDoc, the same value is added to the MD Order.
On the MD Order, the fields are all disabled because the Prognosis section is updated via the eDoc assessment.
As with the MD Orders-Others tab, details in the MD Order-Order/Goal tab are populated based on the information entered in the eDoc assessment. Any Order/Goal values that are present on the eDoc assessment are disabled on the integrated MD Order (even if not selected).
Any custom-created sections on the MD Order-Order/Goal tab are available on the integrated MD Order; however, information does not flow from the eDoc assessment.
Providers can turn off the Orders/Goals mapping for Integrated MD Orders (primarily a configuration for LHCSAs) via the Agency Profile under Admin > Agency Profile. To disable the Orders/Goals integration with the eDoc, select the Turn off Orders and Goals Integration checkbox.
When this configuration is selected at the Agency level, the information from the eDoc does not sync to the Order/Goal tab of the MD Order.
