Recent changes to eStar outlined

Below is an overview of some recently implemented changes within eStar, as well as some that are coming soon.

Medical Assistants and Medication Removal

Beginning May 9, Medical Assistants (MAs) can now remove medications from the medication lists within eStar. This change will provide a more consistent workflow between MAs and nurses when performing intake, as well as a more consistent view to clinicians of changes that have been made.

MAs can remove medications from the medication list for the following reasons:

• Patient-reported medications:
  • Patient reports no longer taking the medication
  • Erroneous entry
  • Patient request via My Health at Vanderbilt
• Provider-prescribed medications
  • Duplicate medication
  • Course of therapy completed
  • Old prescription (expired) and patient no longer taking
  • Replaced by new therapy or dose (alternate therapy)
  • Patient request via My Health at Vanderbilt

MAs should NOT remove medications for the following reasons. Instead, the medication should be marked as “not taking” and/or flagged for review.

• Patient-reported medications
  • The medication is placed on hold
• Provider-prescribed medications
  • Non-adherence (non-compliance)
  • Patient is not taking the medication, but should be
  • Patient is unable to afford the medication
  • Medication availability issues (such as on back order)
  • Patient reports taking differently than prescribed
  • Patient experiences side effects
  • The medication is placed on hold

All colleagues should remember:

• Obtaining a medication history is the process of identifying the most accurate list of all medications a patient is taking and should be taking
• When obtaining a medication history, to assume all medication lists are inaccurate
  • To verify the medication list in eStar by discussing with the patient or caregiver
• To always provide a reason for removing medications

Sample Prescriptions in eStar

On April 26, the "Sample" button was removed within the routing selections available when writing a prescription. Applicable to all clinicians who order sample prescriptions, the change was made to clarify options for both ordering clinician and the receiving pharmacy,

To e-prescribe the medication to the appropriate pharmacy, clinicians should now select "Normal," click Notes to Pharmacy link, and enter “Please dispense as a sample prescription”. A Tip Sheet entitled "Writing a Prescription for a Sample" is available in the Learning Home Dashboard or Hubbl for more information.

Canceling a Lab Order

On May 1, a new orderable within Orders navigator will allow a clinician to request to cancel a lab test for a lab specimen that has already been collected. This new item creates necessary documentation for the Lab.

This change has been made because the VUMC Lab requires a clinician’s written/electronic order for canceling lab tests.

• If specimen has not been collected, cancellation of lab test may be performed within eStar (label may have been printed)
• If specimen has already been collected, cancellation of lab test may only be requested within eStar (only lab staff can actually cancel the test from within lab system)
• If lab test has already been received in Lab and/or resulted, clinician must speak with lab staff via phone (5-LABS) for additional information regarding billing
  • Cancelation request must be in eStar to serve as documentation

A Tip Sheet entitled “Requesting the Cancellation of a Lab After Specimen Collection” is available within the Learning Home Dashboard or Hubbl for more information.