Purpose Sutter Community Connect Downtime Procedure To ensure that all users and IT staff are aware of the procedures to be used during an outage, and that all users and IT staff are aware of the communication plan for downtimes and outages. Pre Requisites (Practice to have on hand and available in the event of downtime) Reports (generated from Epic, see below) Blank Registration form (included in this document, make copies as needed) Payment log (included in this document, make copies as needed) Blank Ambulatory Encounter Downtime Form (included in this document, make copies as needed) Reports All Practices should print the following reports nightly (after the phones have been switched to exchange) to ensure that the practice is prepared for any unexpected downtime the following day: Department Appointments Report (DAR) Wait List Report Notification IPS will notify all Practices via e mail notification when an unexpected downtime occurs. This notification will include e mail communication with each Practice s designated Super User. The Practice Super User will notify Practice staff of the downtime. If the Epic system fails, please have staff contact the designated Super User & Office Manager (if the Office Manager is not the designated Super User). The Super User will contact the SHIS Service Desk for updates & information. Users should check the IT Service Center status line by calling 916 855 5830. The status line will describe the problem, the next update and the estimated time of repair. If the user suspects a problem and it is not listed on the status line, a new ticket should be generated with the IT Service Center. A Message of the Day will be posted in Epic with Planned Downtime information. The first message is posted 3 days prior to the downtime and will display only once on first login. The night of the downtime at 8:00 pm, the message will appear each time the user logs in. Each practice must establish a downtime process for obtaining/accessing any patient clinical patient information (ie, pull patient charts). In some cases, a SRO (Shadow Read Only) server may be available during EPIC downtime. If one is available for your use, the information will be included in the notification from IPS. The SRO is view only and users cannot edit any records. Users will access SRO by logging into Hyperspace using the same procedures as they would use to log in as usual. The banner at the top of Hyperspace will be burgundy in color. Upon notification that Epic is back up, users must log out of Hyperspace and then back in to access the live system. Page 1 of 11
Check In Using a single printed copy of the Department Appointments Report (DAR) (or other method to ensure multiple schedulers do not overbook open slots): Note all patient arrivals on the schedule (by writing an A or other notation) Write in name and DOB, MR#, or other identifier of all add in patients Note all patient no shows (by writing a NS or other notation) Note any other schedule changes, being as specific as possible Record all co pays (and/or payments) on a standard payment log, as well as each encounter form. If you are hand writing encounter forms, include all of the following information: Patient s full name MR# or DOB Date of Service MD name Diagnosis and/or ICD9 code (s) Co pays and/or Payments received Financial Class and Insurance Company Copy all insurance cards (front and back). Include Subscriber Name, Subscriber DOB, Patient Name and date copied. All new patients must complete a registration form & have current phone number noted on encounter form. Check Out If payments are made at check out, document on a standard payment log, & document on all encounter forms. Appointments For all non urgent appointments, explain to patient that the scheduling system is down; depending on Practice policy, practice staff can ask patient to call back in the next day or two to schedule their appointment or take name and phone numbers to call patients back when Epic is up. For urgent appointments, (needing to be seen in the next day or two) practices should take name and phone numbers of patients and call them back to schedule their appointment as soon as the system is back up. Staff may also add urgent appointments to the single weekly master schedule, so multiple schedulers do not book appointments for the same time. Clinical Patient Documentation Document patient encounters on Ambulatory Encounter Downtime Form. Page 2 of 11
Give patient paper prescriptions, lab orders and radiology orders. (Be sure to maintain a supply of the appropriate paper requisition forms for downtime.) Complete progress notes (included with Ambulatory Encounter Downtime Form). Keep all completed Ambulatory Encounter Downtime Forms in central repository for input after system is back up. When the EPIC system is back up! If using SRO, log out of Hyperspace then back in. Organize all paperwork for input. Enter Data (in priority order). 1. Update all schedules off hard copies with written notations. 2. Run a new schedule and compare against hand written copy to ensure no appointments are missed. 3. Update all registrations (must be done before any charges are posted). 4. ARRIVE ALL APPIONTMENTS. Very important step, as after 3 days these appointments will be marked No Show by the system. (If this happens, you will need to edit the appointment from the schedule to avoid affecting your patient s no show stats.) 5. Open encounter and enter information into patient chart. Ambulatory Encounter Downtime Form will be handled according to clinic policy (may be scanned to an individual encounter, if clinic policy supports scanning.) Use order class of historical if available when entering the downtime patient data. Route the Downtime encounter to the Provider for approval. 6. Provider resolves each Downtime encounter. Provider reviews/signs Lab and Medication orders, then closes the encounter(s). 7. Cancel/No Show appointments as appropriate. 8. Call back any patients needing appointments. 9. Run an Encounter Form Control PB Encounters with missing charge report and check for any omissions. 10. Batch and enter all charges. If a bill cannot be automatically generated, it will be hand written with the patient s name, DOB and account number. 11. Batch and post all payments collected. 12. Patient co payments If the Cash Drawer is not available, handwrite the patients name, account number, appointment time and amount collected. 13. Batch and enter those payments into the cash drawer. Page 3 of 11
Patient Information Sutter Community Connect Epic Downtime Registration Form Last Name First Name Middle Name Alias or Maiden Name Sex Birth Date Social Security # Marital Status Street Address City State Zip Home Phone Work Phone Cell Phone Religion Language Need Interpreter? Ethnicity Race Employer Name Employment Status Retirement Date (if applicable) Occupation Emergency Contact Name Emergency Contact Number Relationship to the Patient Primary Care Provider Name Primary Care Provider Phone # Referred? Yes No Referred By Name/Phone # Guarantor (Person Responsible for Bill) Last Name First Name Middle Name Alias or Maiden Name Sex Birth Date Social Security # Marital Status Street Address City State Zip Home Phone Work Phone Cell Phone Religion Language Need Interpreter? Ethnicity Employer Name Employment Status Occupation Race Insurance Information Primary Insurance Insurance Company Name Group Number Subscriber ID Copay Subscriber s Name Social Security Number Birth Date Sex Relationship to Patient Subscriber s Employer Name Subscriber s Employment Status Home Phone Work Phone Secondary Insurance Insurance Company Name Group Number Subscriber ID Copay Subscriber s Name Social Security Number Birth Date Sex Relationship to Patient Page 4 of 11
Subscriber s Employer Name Subscriber s Employment Status Home Phone Work Phone Data entered into Epic Insurance card scanned Driver s license/picture ID scanned Sutter Community Connect Epic Downtime Payment Log Checks Invoice #/DOS Amt Paid Reference # Patient/MRN Total: Charge Invoice #/DOS Amt Paid Reference # Patient/MRN Total: Cash Invoice #/DOS Amt Paid Patient MRN Page 5 of 11
Total: Sutter Community Connect Epic Downtime Encounter Form Pt Name: Birthdate: Provider: MRN: Phone# Encounter type: Vitals Height: Weight: Temperature: Location: BP: Location: Pulse: Resp: Reason For Visit/Chief Complaint/Reason for Call : Allergies : Pharmacy Name: Phone: Fax: Current Medications: If additional space is needed, attach a separate sheet of paper. Dose/Disp Nursing Notes By/Call Taken By: If additional space is needed, attach a separate sheet of paper. Page 6 of 11
Episode: Type: Date Noted: Page 7 of 11
Pt Name: MRN: History: (Medical; Surgical; Social; Family; Specialty; Problem List) Immunization/Injection Orders & Documentation Route, Site, Lot #, Manufacturer, Exp. Date, NDC, VIS Date Dose Given by: New/Refill Medication Rx: Dose Disp Refills Procedures/Orders and Consults/Referrals: Document results on a separate sheet Future/ Standing Details/Comments Assoc d Dx# Referring/Auth Provider Page 8 of 11
Provider Signature: MA/Nurse Signature: Page 9 of 11
Pt Name: MRN: Diagnoses: Level of Service: Follow Up Instructions/Disposition: Provider Charting: Dictated Documented Progress Note: (Please write legibly) RECOVERY INSTRUCTIONS When EpicCare is available, access the provider s schedule, select the patient and begin transferring data from the Encounter Downtime Form into the Visit Navigator. The Encounter Downtime Form will be handled by local policy. Scanning of this form is Page 10 of 11
required only if Epic documentation is scribed for the treating provider or nurse. If scribed, the encounter documentation should be scanned. Page 11 of 11