Fern Testing

We had a similar situation with PPMP that was JC-accredited.  While a formal log is not required, most inspectors will ask for evidence of documentation of the patient result.  The problem becomes, how do you know who was tested to be able to pull up an example?  I would check with your EPIC contacts to see if any sort of audit lot could be produced.  We have that for Cerner; not sure if there is a similar option with EPIC.

Hi,

I am hoping EPIC will find a way to extract the fern test.  I am faced with challenges in the providers completing the log sheet.  The L&D Manager mentioned why are we keeping the log sheet and I thought she had a good point.

Stacie

How do your Providers document the result of the test currently as that will be the key as to how you will get a report or if it's possible.

Our clinic docs are supposed to use a specific lab order code and document in the enter/edit activity in Epic. Then we are able to pull a report for that order code.

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The challenge with physician documentation for us was always to get them to actually use the designated electronic form for resulting.  Since so much of what they do is in the form of dictated notes, their reflex was just to put their testing results there, and not in the designated electronic form.

  I can recall one inspection where the inspector was stomping around demanding that someone show her an example of a PPMP result, as the physicians were giggling at the request, trying to recall patients who might have had a test, and me of course caught in the middle.  Oh, the things we do for POCT!

We have done EXTENSIVE work with EPIC to train providers to order and document their microscopy tests on their own.  We are still using a paper log also, since there is no computer in the microscope room.  We also have written an internal Epic competency documentation for providers that covers the direct observation piece of the 6 elements of competency.  We use this along with a CBT to cover all 6 elements.  We also have a report that is pulled from Epic and one that is pulled from Healthstream.  When the two reports are "married", all required competency documentation is there.

Of course, the providers were not happy with the process of entering their own results or with having to do competency, but due to citations, we had no choice. 

Our system isn't perfect, but we feel it is much better than what we had.  It stills needs a few tweaks here and there but overall, it is working. 

Good luck to you all...THIS project has been the hardest one in my entire POC Career!

It's really an awkward position to be in for a POCC.  And it's hard to argue the logic that physicians certainly do things that are far more complex, that don't require nearly as an elaborate means of demonstrating competency.  I feel very fortunate that PPMP has left my area of responsibility due to some administrative restructuring.  I think I would have to think long and hard before taking a position again that required PPMP oversight unless it had very firm administrative support.  I think I'd insist they be on their own CLIA certificate if at all possible, and let them deal directly with their own regulatory issues.

Sonia,

How was your EPIC team able to create an internal EPIC competency form?  I am highly interested in doing something similar.

Our physicians documents Fern Testing under their provider notes.  The Medical Director does not think providers would follow through with putting in an EPIC order and resulting, so we have to continue with our patient log.

Thank you all for your responses!  Yes, PPMP is a challenge. Luckily, all I have is Fern Testing as far as PPMP but they want to bring in wet mounts...

Stacie