EPIC AMB 400 Specialist Exam Study Guide: Questions and Answers - Prof. Smith, Exams of Nursing

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Describe the most efficient way to have the same question appear for all the diagnostic imaging procedures. - ANSWER Link the procedure category for those imaging tests to the question. If you list Glucose as a Result Component in a procedure record, how does that affect the user who results this test? - ANSWER In Enter/Edit Results, the user sees the component by default, thus saving documentation time. In the procedure category for Lab Sent Outs, two buttons are set up for CLASS. However, when users order the iron assay (a procedure linked to this category), four buttons display for CLASS. Explain why. - ANSWER The system searches for details using the procedure hierarchy, so it finds the four buttons defined in the iron assay procedure record and displays them. Users complain that when they order diagnostic imaging tests for ANY patient, the question "Is the patient pregnant?" appears. What setup is wrong? - ANSWER The linked question record should have been limited to females of an appropriate age.

There is a lab test for which you have specified a default order class. For this order, you want to hide the CLASS field in the order composer so users do not change the class. Describe how to do this. - ANSWER Create an OCC record that does not include the CLASS as a display item, and link the procedure to that OCC. True or False: The Additional Order Details display item can only be set up in an OCC record that you link to System Definitions. - ANSWER False What context is OCC? - ANSWER Ambulatory Context What is Controlled? - ANSWER Term to specify if field should be required or recommended. What else can meds and procedures contain? - ANSWER Instructions, questions (LQL), add'l items What is EAP? - ANSWER Procedures Orderable procedures must be linked to what in order for them to be looked up in order entry? - ANSWER Procedure Category What is determined in the procedure/ procedure category? - ANSWER Buttons, default order status, default order class, what should be available.

Where are the buttons entered in a procedure/procedure category? - ANSWER Outpatient order composer buttons selection screen What and where determines what order classes are available? - ANSWER Procedure/procedure category and under 'Allowed Order Class Section' What procedure name is seen by end users? - ANSWER Order Display Name Where can free text fields be added to orders? - ANSWER OCC LQL Questions- what should be entered for free text? - ANSWER Response type: Text If questions are linked to a procedure and its category, what happens? - ANSWER Both sets of questions appear (even one question more than once) from both levels If questions should only not be displayed from both the procedure and the procedure category, what can be done? - ANSWER This can be overridden so that only procedure- level questions display. What are primary display items? - ANSWER OCC Procedure details

What are secondary display items? - ANSWER Show Add'l details Order class buttons and the default order class are chosen from what section? - ANSWER "Allowed order classes" True or False: If a value has not been listed as allowed, this cannot be listed as a button or default value? - ANSWER True Procedure Category Setup for OCC - ANSWER Ambulatory context - > Your AMB POCT Orderables OCC Additional Outpatient Order Details Context - > AMB Point of Care Additional Order Details Procedures Link to a Result Component are listed as what? - ANSWER Orderable and Performable Procedures Link to a Result Component are linked where? - ANSWER Lab and Result Entry Information Screen Procedures Link to a Result Component and a type is specified where? - ANSWER Default Specimen Type (Ex. =Blood) Procedures Link to a Result Component and the sources available are located where? - ANSWER Procedure Specific Specimen Sources Screen (Ex Arm, Left (43); Arm, Right (44) )

True or False: Referral display items can change based on the selected order class. - ANSWER True What is the context of the OCC that includes the "pointer" referral display item? - ANSWER Ambulatory A physician requests that dynamic display items be set up for a medication based on the frequency (4 times daily versus 2 times daily). Will you be able to do this? - ANSWER No. Dynamic setup is only for referral procedures. OCC-Referrals are linked where - ANSWER Procedure category under the order composer configeration screen What for referrals can change display items? - ANSWER Class How many OCCs are needed for referral procedures? - ANSWER 3 What are the 3 contexts needed for dynamic referral procedures? - ANSWER - Ambulatory context; Internal referral- ambulatory context; - external-referral - ambulatory context; (can also use 4th of incoming referral when organization receives faxed referrals from external providers) What contexts are needed for non-dynamic referral procedures? - ANSWER ambulatory context; referral- ambulatory

What is Referral information for OCC? - ANSWER Display item for OCC record; tells system to check the linked referral context OCC to determine which referral-based item to display What is needed for an Internal referral-ambulatory OCC? - ANSWER Ordering type: Procedure; Ordering Context: Internal Referral-Ambulatory; Display Items What is needed for an External referral-ambulatory OCC? - ANSWER Ordering type: Procedure; Ordering Context: External Referral-Ambulatory; Display Items True or False: In order to document a historical immunization, you must have a procedure record. - ANSWER False True or False: Questions can be linked to a procedure or an immunization. - ANSWER True What is the abbreviation for immunizations on the immunizations activity? - ANSWER LIM Where are order-specific questions linked? - ANSWER in the Procedure record; Questions are LQL Where are the immunization activity-specific questions linked? - ANSWER in the Immunization record; Questions are LQL

What field in the procedure record is the immunization activity record linked? - ANSWER "Link to immunization" field If you are building a procedure record to link to an immunization record, what should you build first? - ANSWER Immunization record What number should you use for the Procedure Record for the immunization procedure? - ANSWER IMM ID (id of immunization from record) What is included in the LIM Record? - ANSWER Synonym 'flu'; on typical values screen - dose amount '.5', dose unit 'mL', Manufacturer 'Abbott Laboratories'. Do you link the procedure record to the immunization record or vice versa? - ANSWER Does not matter How many times can an immunization record be linked to procedures? - ANSWER Several times How many times can procedure records be linked to immunization records? - ANSWER Once What question LQL options are available? - ANSWER Prompt/Notes; Multiple/Single Response; Age; Gender Restrictions; Types of Responses; Rule-Based Filtering; Custom Values; Buttons; Check boxes; Radio Buttons

Does the system prompt LQL's for immunizations that are patient-reported? - ANSWER Nope, the system suppresses these default values. What are the two types of preference lists? - ANSWER Preference List Editor (EPD) and Preference List Composer (LPF) Preference List Composer includes what? - ANSWER Medications, Procedures (labs, referrals, etc) Preference List Editor includes what? - ANSWER Diagnoses, Reason for Visit (chief complaint), LOS What is a simple list of choices, no overriding? - ANSWER Preference List Editor Why use a preference list? - ANSWER No dealing with procedure categories, can be personally specified. Who builds a user preference list? Who builds a system preference list? - ANSWER User preference list- user; System preference list- project team Where are preference lists linked: - ANSWER Profile under Outpatient Orders Preference Lists

Can allow user preference list at 3 levels: - ANSWER user; EpicCare Security Class; System Def Disable Preference Lists on user level - ANSWER in user security under user settings under enable preference list, next to procedures to 'off' Build a CAM preference List - ANSWER List type 'meds', Sub Type: Clinic-Administered Medications; Ordering Mode: Inpatient (this is for CAM meds) Describe SmartSets and sections - ANSWER SmartSets (library) - one name; Sections (books); SmartSet Subsections (chapters) - called SmartGroups; SmartSet items (material in chapters) - frequently used items, can be chosen by default) SmartSet Subsections are called what - ANSWER SmartGroups (OSQ) What is the Smart Set Record abbreviation? - ANSWER PRL How should Smart Groups be built? - ANSWER with similarly purposed items, so it can be reused w/ other SmartSets The system can suggest SmartSets based on what? - ANSWER Reason for Visit, Past Surgical History, Problems, Dx, or Encounter Department Specialty SmartSets can suggest what? - ANSWER Notes, dx, follow up, Reason for Visit, Documentation

What should be checked if Smartgroups can be used in multiple SmartSets or Order Sets? - ANSWER Use as building block How to build SmartGroups? - ANSWER Name; General form- display name; check 'use as building block'; Enter synonyms; Configuration- add item- choose what you are adding (ex SmartText); Specify SmartText (Gen Artery Disease), Specify Filing Type (progress note/tele documentation), Specify display text (Artery disease); Check item to autocheck item (or no); Test Release; Close Record SmartGroup Test Release- - ANSWER Contact remains editable- only users with proper security can view and use; otherwise have to release and create contacts SmartGroup Retire- - ANSWER if should not longer be available; if belongs to a SmartSet, just hidden in production SmartSet Build- - ANSWER Name; Configuration- add section; enter name and Accept; keep on highlighted section- add Smartgroup; Save and Accept (this automatically marks SmartSet as Test Released) BPA Criteria - ANSWER Evaluate patient data - (also called Best Practice Adversaries (LGL) )

BPA SmartSet Sugestion - ANSWER Non-patient data like encounter type, department or provider type, not used as often BPA SmartBase - ANSWER Controls or Restricts when SmartSet OR INFO WITHIN SMARTSET should display - Restricts SmartSet, Section, or SmartGroup from showing True or False: A BPA Criteria record can be used to suggest a SmartSet based on patient information. - ANSWER True A SmartSet is suggested when a reason for visit of Pelvis Injury is enteref for Mary. However, when that same reason for visit is entered for David, that SmartSet is not suggested. This is because the _______ is linked to both a Criteria record for chief complaint and a ________ record that restricts the SmartSet to females. - ANSWER SmartSet / SmartSet Base True or False: Settings an orderable SmartGroup's panel type to 'Medication' means that it can only contain medication orders and can be added to preference lists that have been designated for medications. - ANSWER True Providers have asked you to limit a section within a frequently used SmartSet to only appear for pediatric patients aged 10 or younger. What must happen to accomplish this request. - ANSWER Create a BPA criteria record and enter the age range; Create a BPA SmartSet Base record; Link the BPA Criteria record to the SmartSet Base record; Link the BPA SmartSet Base record to the section.

True or False: A SmartGroup that contains orders can be configured with associated diagnoses before being specified in a SmartSet. - ANSWER False Providers would like a SmartSet for Smoking Cessation to be suggested when a patient is a current smoker. Because this is patient data, a BPA Criteria record must be created. However, there is no form in the BPA Criteria record which looks to a patient's smoking status. How could you accomplish this request? - ANSWER A CER rule can be created to identify if a patient is a current smoker. The BPA Criteria record would link to this CER rule. Then the SmartSet would link to the BPA Criteria record. An Expressed Lane must be _______ in order to open automatically in Express Lane? - ANSWER Released Which record type allows you to evaluate a patient's gender?

• ANSWER BPA SmartSet Base Link BPA Criteria (patient-specific data) in SmartSet - ANSWER On criteria form, in suggestions at top Link BPA SmartSet Suggestion in SmartSet (encounter department, encounter type, or provider type) - ANSWER On Criteria form, in suggestions field at top

What can be added to SmartSet suggestions and how many times? - ANSWER Can add more than one BPA criteria or BPA SmartSet suggestion criteria section suggestions Link SmartSet Base in SmartSet - ANSWER on Criteria form, on restrictions field near top Link SmartSet Base in Section - ANSWER In SmartSet- in SmartSet go to configuration; Click 'add section' (or edit section link); under section display name in restrictions box Link SmartSet Base in SmartGroup - ANSWER In Smartgroup, go to general tab, towards bottom in restrictions field SmartSet BPA Criteria Record - ANSWER Best Practice Advisory; Name, Record Type - criteria; general info- released; Add age restrictions (optional); Select desired criteria under pt criteria subform; save and close What naming conventions should be used for BPA Criteria, Reason for Visit, and SmartSet Base? - ANSWER CL (criteria locator) ; RFV (Reason for Visit); in SmartSet; BPA Criteria Record; Use SB (SmartSet Base) SmartSet BPA Criteria- what happens if more than one value is listed for 'include ________'? - ANSWER The system assumes OR logic

SmartSet BPA Criteria - what happens if values are added also to the '(and) include _______'? - ANSWER The system assumes AND logic SmartSet Base Build - ANSWER Best practice advisories; Name, Record Type- Base; General info- display text; Restrictions- encounter limitation inclusion- specify what department; potential triggering action field- outpatient; General info- released checkbox; Save and Close. Linking BPA's to SmartSet - ANSWER SmartSet; Criteria forms- suggestions- use BPA Criteria and BPA SmarSet Suggestions; Restrictions- add SmartSet Base (optional); Save and Close Associate Diagnoses automatically build - ANSWER Select Smartgroups, open and go to configuration, click dx associations and associate desired choices; click accept. Note: In order to auto associate, order items with diagnoses must be in SmartGroups or Parent SmartText already and saved first What are the levels of hierarchy? - ANSWER System Def, Service Area, Location, Department, Security Class, and Profile How do you use screen fast forward? - ANSWER Home; F9; 't' or 'i'; keyword or number

How do you link a profile to a department? - ANSWER Clin admin > facility structure > Departments > Units (DEP) > Dept # under 'Default Profile for workstation in Dept' True or False: You can add free text options to editor-based preference lists - ANSWER False To add an item to the preference lists of several users, what step should you take in the preference list editor? - ANSWER Click Advanced, filter on the types of lists you want to edit, and edit as needed. True or False: In a procedure preference list record, you must create at least one section to be able to add an item. - ANSWER True True or False: When you enter override details for a procedure in the Preference List Composer, users see those override details when they select that procedure from both the Preference List and Database Lookup tabs. - ANSWER False (Database Lookup tab does not look to preference lists) To Make a Preference List available to users in a particular department, link to this preference list in - ANSWER the profile to which their login department is linked Preference List Composer - ANSWER Medications and procedures (labs, referrals, etc) (things that need order composer)

How should you label the choices in the preference list composer? - ANSWER Mimic the summary sentence when labeling using the preference list editor because often the same medication is added with different doses, frequencies, and dispense of each med Where does the system preference list appear? - ANSWER On the facility tab, linked in facility structure. What appears on the database preference list tab? - ANSWER Orders on the procedure and medication master files Is the database preference list tab a preference list? - ANSWER Nope The browse and preference list tabs show what items? - ANSWER Profile-based and user preference list items Build preference lists- - ANSWER List type 'procedures'; subtype 'procedures'; Ordering mode 'outpatient'; must first add section; then finally orders How to add orders to sections created in preference lists? - ANSWER Click NEW ITEM each time In text, if multiple answers are given in a single value, what happens? - ANSWER The system sees these as a 'single' action and combines everything

The 'specified in a more general level' thing does not work with preference lists connected in the profile. Why? - ANSWER If even one preference list is added at a profile level, the system does not look at the system def level because a single answer is already given What does the preference list title do? - ANSWER Displays title users see on the browse tab of the search window. If left blank, the title is whatever the type column is (typically 'procedures') Using the preference list editor, how can one edit several lists at once? - ANSWER Click ADVANCED; enter List type; Check 'include all lists of this type' and click SEARCH AND ADD TO LISTING; Click ADD, DELETE, or REPLACE; Enter item and apply Preference list tune up activity - ANSWER designed to identify commonly used items not on a preference list and should be added and rarely used items that should be removed CAM Meds preference lists are linked where? - ANSWER On the clinic-administered medication orders preference list screen; type 'Clinic-administered medications'; List 'Link to a CAM preference list'; Title 'display title on list as seen on the browse tab of order search window CAM Preference list linking to a facility tab - ANSWER Under facility structure on 'outpatient facility preference list' field

How to hide the database tab in text in the profile? - ANSWER Under 'remove order types from outpatient database search results' enter 'disallow all' Express lanes use what to determine which Express Lane SmartSets to open? - ANSWER BPA Criteria or Smartset Suggestion Records; can also use CER rules CER Rule Examples - ANSWER BPAs; Patient Scoring Systems; Configuration Records; Status Boards; Follow up Work Queues; Account Payable Claims Express Lane build - ANSWER in SmartSet; go to Express Lane; Check 'use as express Lane SmartSet', Select 'Keep original structure' checkbox, click Release; Do you want to release this contact? popup- yes; Accept If more than one Express Lane SmartSet is suggested, what happens? - ANSWER users will be asked to pick one Order Panel Smartgroup build- - ANSWER Smartgroups; Name; display name; Check 'panel' checkbox; Configuration- add orders; Mark each item as pre-selected; Release and Close True or False: Orders that share a category within the same therapy plan must also share the same internal. - ANSWER False

What is the purpose of the Protocol Type field? - ANSWER Therapy plan activities and navigators can be configured to only display protocols of a certain type. Can a Therapy Protocol be edited after it has been released?

• ANSWER yes, but a new contact has to be created Therapy Plans are typically not used in inpatient settings - ANSWER Therapy meds include - ANSWER hydration, premeds, procedures, emergency meds, and therapy meds Patients can have how many active therapy plans of a given TYPE at a time? - ANSWER only one After a therapy protocol is assigned to a patient, what is it called? - ANSWER Therapy Plan Are therapy orders tied to a day? - ANSWER They are not tied to a day but calculated dynamically at the beginning of treatment based on intervals when they are last released What is duration? - ANSWER How long an order should continue. What does frequency determine? - ANSWER How many times an order is administered or performed on the day of treatment

Interval - ANSWER specifies when the first treatment should be administered and the spacing of subsequent treatments Epic allows multiple therapy plans to be assigned to each patient but what happens? - ANSWER The system considers it a single plan Where are Therapy Plans Built? - ANSWER Therapy Protocol Builder (PRL) To be a lead therapy plan provider what must happen? - ANSWER The SER must say yes to 'Treatment Plan Provider' and allowed types under allowed episode types (i.e. infusion treatment) How long a therapy plan's signed orders are controlled where? - ANSWER System Definitions True or False: InBasket classes are set up in the inBasket Class master file. - ANSWER False. They are values on a category list Describe how to create a new inBasket class that has these members: Dr. Mica, Dr. Seeger and Dr. Iron. - ANSWER Create a new value in category list EMP 450. In each of these user's user records, list that value. A pool named South Schedulers was created, but staff cannot find it when searching for it in the TO field in the InBasket.

What is one possible explanation? - ANSWER The registry has Status of INACTIVE There is an EMP 450 value of "Ped Nurses-South" and a Corresponding registry record named "south Pediatric Nurses." To send a pool message, enter P _______ in the TO Field. - ANSWER South Pediatric Nurses (this is an example that goes against Epic's recommendation of using the same name for the EMP 450 value and the corresponding registry name In which master file do you build an inBasket pool for East Urgent Care Nurses? In this pool setup, what master file will be searched? - ANSWER Registry master file: search User master file for members of that class What are the three processes for setting up an inbasket pool? - ANSWER 1. Create category list; 2. Create inBasket Registry Pool and link category list; 3. Add users to inBasket Registry Pool in User Security. What is a class message? - ANSWER All users get a copy of the one message More additional information in user security? - ANSWER Ctrl and Click to the item information How to create category for inBasket? (step 1) - ANSWER Search Category list maintenance; database- EMP, item- 450; Make up number and hit Go; Add title; Accept Note: users

must be assigned to it in order for it to be an option. in Production inBasket Build Pools (step 2) - ANSWER Open Registeries (HIP); Create record- name of pool; Status- active; Pool-yes; Pool used for- inBasket; Send message to- EMP; Selection item-Classification 450; Selection values- category list built in previous step; Selection linker - 2700; Message received by- EMP; If linked to departments is connected to a department, the system will auto check in the employee when logged in to the department; Accept Build Classes and Pools with import- list steps - ANSWER Export Data, Populate, Convert, Scan and Import Flowsheets started in which area? - ANSWER Inpatient Where are flowsheet tabs defined? - ANSWER Profile Settings Abbreviations for Template; Group; Row: - ANSWER Template (FLO): Group and Row (FLT) Row Flowsheet Build- - ANSWER 'R Name'; General form- display name; Row Type- data; Value Type- Custom List; Context - overtime; Check 'display all custom list options as buttons' and 'show abbreviation' (means show abbreviation only); Custom list and abbreviations; Save

Custom Calculation - ANSWER 'R Name'; Display name; Row Type - custom formula; Value Type- Numeric Formula; Context- overtime; Formula- custom formula row {x}+{y}+{z} (do not put spaces) Navigators based on - ANSWER Templates, topics ,and sections What is the Record Abbreviation for Navigator Configuration

• ANSWER VCN What is the navigator claw? - ANSWER CTRL+ALT+SHIFT, then F12, F10 We Rule is Connected from what to what? - ANSWER Profile to Navigator Order for Flowsheet Navigator: - ANSWER 1. Build Flowsheet; 2. Build Navigator (text); 3. Build Section Record (text); 4. Add Section to a Topic in Navigator Template (hyperspace); 5. Link Section to VCN (hyperspace) VCN Build - ANSWER Clin admin > Navigators > Navigator Configuration (VCN); Apply to section type - DOCUMENTATION_FLOWSHEET; Flowsheet Template ID; Action on leaving screen- file; Condensed on display mode- yes; start edit with all groups collapsed-no; allow details report popup-yes; all last filed value- yes; allow row info display- yes; enable copy forward- yes; exit

Create a Navigator- - ANSWER Clin admin > Navigators > Dup navigator > SEC_MR_FLOWSHEET; New name; continue with duplication- yes Epic creates navigator sections to be copied - ANSWER Navigator Template Editor - ANSWER Hyperspace; open navigator template editor- create new topic name; choose 'add section' and 'add navigator' from previous step; link to VCN on advanced tab What is the row type for groups of flowsheet rows? - ANSWER Flowsheet Group What may bring back text in clinical admin if accidentally deleted? - ANSWER F3 Preference List Editor- automatically creates list in alphabetical order- older functionality... never what? - ANSWER enter a specialty, overrides this for entire dept- always leave blank (same for security class) To manage pools, a user must what? - ANSWER Have security to manage and be a member of the pool Specialty comments vs family comments - ANSWER Specialty comments stay with the dept you are logged into; family comments cross encounters Look into SmartLinks Referencing Print Groups - ANSWER

.dblink(ept, 5) - ANSWER pull in by contact date - thinking record viewer; just go to database lookup Immunization activity - ANSWER auto pull in from state via batch job Occ Controls - ANSWER display items (question text), summary items (blue hyperlink) and controlled items (hard stop, yield, or no) build settings for lab order in procedure - ANSWER If procedure is chargable (active in hyperspace), page down to charge procedure record; link procedure to category on first page; outpatient default order class- clinic collect; default status- auto checks button; clinically inactive- no (must be in order to show up in hyperspace) Where are the buttons created for procedures - ANSWER order composer button selections II; under class-enter button names Synonyms can only be done at the procedure level - ANSWER OCC can also be set at system def level as a catch up just in case - ANSWER Procedure- amb focuses on orderable but if say performable, can attach a charge - ANSWER