Recent changes within 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

Long-Term Medications

As of May 9, certain medications will be marked as “taking long-term” by default. This change is being made as long-term medications need to continue to display on the Medication List even if the medication has reached its End Date.

The default duration for these long-term medications will be set to one (1) year and default to 90 days for fill (except for controlled substances).  Certain controlled substances are now marked as long-term by default, but their existing default Duration and Days/Fill, such as 30 days, remain in place.

Long-term medications display on the Medication List with a pushpin icon. Medications not intended for long-term use may be indicated by a clinician by deselecting the “Mark Long-Term” check box.

Removal of Department Specialty from Referral Orders

To improve the referral /hospital follow-up orders process by ensuring display of more accurate referral lists, the “Dept specialty” field will removed from the referral orders process on May 11, 2018. Currently, when a user places a referral order and selects a department, the “dept specialty” field appears. However, the picklist that auto-populates within the “Dept specialty” picklist does not match VUMC’s provider specialty list. This means that incomplete and inaccurate provider lists were appearing in provider selection (“To provider”) field.

With the change, the “Dept specialty” field will be removed, so more extensive provider selection lists appear in “To provider” field (“To dept” field will remain and will limit provider search to that department).