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Cerner: Resident Workflow Using Cerner Message Center
The Resident Workflow using Cerner Message Center was designed to allow a non-signing user, such as a Resident, to start a report in OpNote then send to the signing Surgeon for review and sign out via the Cerner Message Center.
Configuration
Client/Cerner:
Client must create an SR with Cerner to enable the scope patient\Communication.write for their Millennium R4 FHIR configuration.
mTuitive OpNote:
- Enable Resident Workflow: Check the box to enable to Resident workflow in Message Center
- Resident Workflow Topic: Free text. This is what will appear in the subject line of the message sent to the surgeon in Message Center.
- Resident Workflow Message Priority: Select Routine or Urgent. If Routine is selected, the message will appear in the surgeon's Messages Inbox. If Urgent is selected, the message will appear in the surgeon's Priority Items Inbox and will be tagged with a High priority in red as illustrated below.
- Resident Workflow Payload: This is what appears in the body of the message and can be customized for the customer. In this example, we have entered the following:
A synoptic report for Patient <%MRN%> is ready to review and sign in mTuitive OpNote. <%BR%>Click "Chart" on the toolbar and select "mTuitive" to launch the mTuitive platform. <%BR%>Report submitted by <%USERLASTFIRST%>.
Note the following tags in bold above:
- <%MRN%> — OpNote report Patient MRN
- <%BR%> — Line break in the message
- <%USERLASTFIRST%> — Name of Resident who forwarded the report to the surgeon for review and sign
Workflow
Resident
- Resident launches OpNote from within the patient record in PowerChart
- The only required field in OpNote is the Name of Surgeon. This tells OpNote who to send the message to in Message Center. If this field is not completed, the Resident will not be permitted to submit the report for review.
- While the Resident may see the message Please complete all required fields. Incomplete required fields are marked in bold, the Resident does NOT need to complete the normally required fields. The Resident will be permitted to Submit for Review where it will then be the responsibility of the signing Surgeon to complete the required fields for sign out.
- Resident completes what can be done and clicks Submit for Review, followed by Submit for Review in the Actions panel.
Surgeon
- Surgeon received new message in Cerner Message Center. In this example, the message was sent with a Routine priority so it appears under InBox General Messages.
- Surgeon clicks on message to read the message.
- Subject: This value is determined by the OpNote configuration field 'Resident Workflow Topic'.
- Document: The default document type is Phone Message/Call. As per Cerner, a new document type cannot be created and used by the Resident Workflow. This document type is where Cerner determines where to save this message, if the Surgeon choses to save the message to the patient record. In this example, if the Surgeon saves the message to the patient chart, it will be saved where Phone Message/Calls are saved on the patient record.
- <Add Text>: This is a Cerner feature on incoming messages. It allows the surgeon to enter text into the message before saving the message to the patient record.
- mTuitive OpNote needs review: This is hardcoded in the mTuitive program and cannot be changed.
- 490248563: This is the patient's MRN number and will be different for each patient. The value is determined by the <%MRN%> tag in the OpNote configuration field in 'Resident Workflow Payload'.
- PWmTuitive, MD 2, Cardio: This is the Resident who sent the message. The value is determined by the <%USERLASTFIRST%> tag in the OpNote configuration field 'Resident Workflow Payload'.
- Surgeon clicks on Chart, and mTuitive to open the patient chart. In this example and test system, click on mTuitive - OpNote Test - Edge. This will different at each site, depending on what the site has configured in the Cerner Table of Contents (TOC) for the mTuitive application.
- OpNote launches. Surgeon clicks on Review and Sign to open the report, complete, review and sign out. Note, the report currently has a status of Unsigned Operative Report, and the Surgeon's name is on the report.
- Surgeon reviews report for accuracy, completes any required fields not already completed by the Resident, and clicks Review and Sign, followed by Sign in the Action panel on the right.
- Signed report will land on the patient chart under the customer defined location, usually the Documents tab.