When was the last time your facility reviewed the MEDITECH procedure build? Has it been since the original implementation or build? Is your operational philosophy, “If it isn’t broken, don’t fix it," or is it “Work smarter, not harder”? Let’s take a look at what optimizing orders in MEDITECH can do to help your healthcare organization improve efficiency.
What is optimization anyway? According to the New Oxford American Dictionary, optimization is “the action of making the best or most effective use of a situation or resource.”
When you’re in the middle of a project, making changes to existing procedures could cause delays so reviewing, editing, and improving orders during a project is not ideal. That’s why ongoing review and edits to procedure dictionaries is a good maintenance practice to establish.
How to optimize orders in MEDITECH
Below is a practical approach to help you improve the efficiency and accuracy of clinical orders.
Run a utilization report. Collaborate across departments to determine a reasonable time period to de-activate unused orders. For example, which procedures haven’t been ordered in the last six months or one year? Some of the reasons that a procedure isn’t ordered could be:
- Redundant order
- Workflow is obsolete
- Order is too difficult or requires too many clicks for a provider to enter
Check in regularly with your providers. Gather information from providers who have the highest percentage of utilization, and if changes are requested, take them to your change control board for approval.
Decide how to handle infrequently used orders
- Review these orders. Are the CDSs attached too cumbersome? Too many clicks? Is the procedure name not clear?
- Make sure any required queries are on page 1 of your CDS. If your CDS is too long, the provider will not want to scroll or go to the next page to answer a required query.
- Add aliases to your MEDITECH procedure such as Glycosolated HGB for a HGBA1C, CXR for Chest X-Ray.
- Consider putting these orders in a convenience order set with certain fields defaulted for ease of ordering.
Determine if there are underlying problems with the orders
- Check with departments such as nursing, lab, and radiology. Do they notice that certain orders fail frequently? Are nurses asked by providers to enter certain orders often?
- Spend some time reviewing orders through the eyes of a provider and check the following:
- Do mnemonics for queries and group response match Radiology and Lab orders?
- Review procedure names/mnemonics to ensure they do not have symbols. Many interfaces do not process ^^ or >> <<.
- Analyze the workflow for orders, especially for cumbersome ones. Can this information be found somewhere else in the EMR so it can be removed from this order?
- Review nursing versus provider CDSs. These should match. If a query is available, it should be available for both nursing and provider.
- For Lab/Mic orders, review the sources and descriptions to make sure they make sense. For example, “arm” should not be listed as a source for a stool culture. Many facilities use a pointer query that lists ALL sources and descriptions. Clean that up with assistance from your lab department.
Educate, educate, educate. As with any other change to the EHR, be sure to communicate and provide information to clinical staff about what’s new or different with ordering.
Why optimization matters
While optimization can be tough to prioritize, the payoff can mean providers enter more orders successfully and they save time doing so. Building optimization efforts into your IT operations will help you to be better prepared for EHR projects and will help strengthen your partnership with clinicians and providers in the long run.
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