Physician Updates - MEDITECH Expanse

A report has been run for the YHC emergency departments to identify medications that are commonly administered as one times doses.

The pharmacy team is ensuring that all these strings have a ONCE ONE option to decrease the amount of clicks and changes required to commonly used medications in the ED. ED Order Sets that contain these medications will all be changed to ONCE ONE dosing as well.

These changes will be occurring over the next week, and are the beginning modifications required if 1Health is to look at future implementation of the ED Filter functionality within MEDITECH.

We are following up with each physician who participated in shadowing with a summary of what we heard, and current status / progress of issue they brought forward.

The spreadsheet documenting progress on all issues identified during shadowing can be found here: Link to spreadsheet

As per the 1Health Steering Committee on March 18, 2022, 1Health Yukon is putting LTC in abeyance until we have achieved a readiness level in Yukon Hospitals that more aptly supports a successful rollout to additional care settings. Long term care homes will come back up at that time, and include Whistle Bend Place.

There is no set date at the moment, we will work through how to roll back safely and map out workflows in advance - wherever possible, we will map out by provider type. Once we do have a plan, this will also be communicated.

Please see below for what a "reset" of 1Health Yukon means - more information to come - operating principles are to refocus, realign and restart.

An updated tips & tricks - physician edition is available here: Physician Tips & Tricks

The magnitude of change in implementing MEDITECH in YHC cannot be overstated, and has changed the way providers work. Now that the system is up, many of the more complex areas including admissions, transfers, phases of care and discharges need a review and confirmation of actual workflow – from the context of execution in an electronic environment as opposed to mapping paper to electronic.

• Click fatigue, alert fatigue, scrolling, user interface and experience – these were commonly brought forward, and there are many ways we can reduce clicks and alerts. Topics of flowsheets, widgets and personalized ordersets were reviewed as ways to immediately improve efficiency in accessing information and navigating the chart.
• There are many “quick win” opportunities for optimizing in areas of ordering, documentation and chart navigation, and reducing the number of clicks, and some have already been implemented or are in progress. The issues that do not have a clear option for resolution have been brought forward to MEDITECH.

• Overall, we captured and categorized 203 different issues - the tracking spreadsheet can be found here:

Physician shadowing sessions - issues captured - status of issues will be updated each Friday.

Week 2:

Note: zoom sessions will be opened at scheduled start time - if no attendees within 30 min, we will update the schedule and close the session.

Please contact Wendy Frappier (Wendy.Frappier@healthtech.ca) or Jennifer Potvin (jennifer.potvin@yukon.ca) if you would like to schedule time outside of what has been put forward in the schedule below, or rearrange accordingly.

March 7, 2022

March 8, 2022

March 9, 2022

March 10, 2022

March 11, 2022

Please be advised that beginning noon, February 21, 2022 lab results for LTC residents will be available in the MEDITECH EMR and will also flow through to the Plexia instance of ordering providers.

If you experience any issues with this adjustment, please contact Jennifer Potvin (jennifer.potvin@yukon.ca) or Justin Archer (justin.archer@healthtech.ca).

YHC Lab has confirmed that when lab are orders placed in the ambulatory section of the discharge plan subsequently print in the Outpatient Laboratory. The AAs then file them, and they are made available when the patient presents for collection.

When discharge medical imaging orders are placed, however, the imaging department receives a printout AND the orders also go to the hold queue electronically so appointments can be booked by the schedulers.

We can confirm these workflows are indeed working as expected, and patient outpatient tests ordered at discharge are being completed by the appropriate service areas.