General Updates       Ongoing Issues       Resolved Issues        

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Nov 17 2021

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2)  Preregistration delay

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As noted earlier, this will be some delays in preregistration for the ORs.  The admin has assigned an extra clerk to try and help with patient flow.  So hopefully the impact will be minimal.  

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1) Sorry about the delay in updates, I'm in the OR today!

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Nov 16 2021

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6)  Historical Link 

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The Historical Link back to the old meditech system is not working again.  

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5)  Connecting Ontario

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This is not working again.  

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4) ED tracker issue

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So the Expanse team has noticed that there have been issues with the ED tracker access.  For non-ED physicians, if you go into the tracker and sign up for a patient, you actually become the MRP for the pt and remove the pt from the ED physicians list.  This is obviously a HUGE issue.  

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They will likely need to remove access to the ED tracker for all non-ED physicians and build us our own "read only" ED tracker.  

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Will update the group when I hear more.  

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3)  Using "Inpatient Physician" login space

 

Some people have been having issues accessing the ED tracker and have been told to use one of the other logins options (OT physician, GH physician, MDH physician).  

 

Please do NOT use these other login options.  

 

If you do, you will not have access to the patients "Home Medication" list, and will not be able to reconcile the home meds when entering in orders.  

 

There are issues with the ED tracker (see above) that they are trying to address.

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2)  Progress notes/draft notes getting sent out

 

There was an issue where draft notes and progress notes were being sent out to physician offices.  As of 6pm last night this has been fixed.  Now only things such as consult notes/discharge summaries/operative notes etc are being sent out.  

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1)  Dictation Issues

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The dictation system is now working properly at all 3 sites.  

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Nov 15 2021

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10)  Elective Surgery Delays

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So it looks like they have pre-registered surgical patients up to Thursday.  As it is now, beyond Thursday, elective surgical patients may need to be registered on the day of surgery which will obviously cause significant delays.  Admin is working on this!

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9)  OTMH Dictation Issues

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Some people are finding that the dictation system at OTMH is now not functioning properly.  I am looking into this.  

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Update:  email came out from Anna Diab.  There is an issue with Bell Canada which is affecting our dictation system.  

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8)  Concern about patient stickers

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Some people have had concerns about patient stickers in ER and on the ward.  There has been no change in policy regarding stickers.  They should still be available in the ER as the sticker "strips", and as the "sheet" of stickers once the patient is admitted.  If you can't find any, just ask the unit clerk to print off more.  

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7)  Email Discharge Notifications

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Some surgeons have noticed that they are getting email notifications for patients that are getting discharged.  This should not happen.  If you are getting them, it is due to a setting in your account.  If you email me or call 8889, and we can get this stopped.  

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6)  Managed Transfer Routine

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There has been a lot of confusion around the Managed Transfer Routine and its use in entering postop orders.  I will try and make a video on this topic later tonight as it is a fairly complex issue.  It IS IMPORTANT though that postop orders be entered through the Managed Transfer Routine.  There are significant downstream sequelae that can occur if this is not followed.  

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5)  Diet orders not on Ortho Sets

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Somehow diet orders were missed on all the Ortho Sets.  This has now been rectified.  

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4)  Added a link to the PowerMic Mobile setup document

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3) HRM not working/Dictations not making it to MD offices

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Some people have noticed that hospital reports are not getting to our office EMRs.  This is a known issue and they anticipate that HRM will be functioning again by the end of the day.  

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2)  Admitting MRP

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There has been some concern about who is MRP when we admit patients.  There has been no change in this process.  When a patient is admitted, admitting will assign the surgeon as the "Admitting MD" and a hospitalist will be assigned as the "Attending MD".

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1)  Day 3...here we go!

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Good luck everyone.  First day of elective cases.  There is, as expected, delays in preregistration.  So be patient.  

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Nov 14 2021

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5)  Elective Surgery Delays

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It has come to my attention that there is a potential that cases this week may be delayed in preop registration.  Apparently their previous registration information was not transferred over to Expanse.  So our clerks will need to re-register these patients.  

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4)  Expanse training documents

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I have added the Expanse training session documents for our future reference.  

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3)  CT requisitions not getting to radiology

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Apparently there is still an issue with CT requisitions getting sent to radiology.  For now they recommend filling out paper reqs and faxing to radiology.  

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Update: this has been resolved. 

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2)  Dictation System at MDH and GH

 

This continues to be an issue.  Dr Carter and Dr Dalvi are looking into it.  For now, what we have to do is use the OTMH line (x6916).  Your ID will work properly on this system, but you need to indicate that your note is for a Milton/Georgetown patient. 

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1)  Welcome to day 2 of Expanse! 

 

Based on many of the questions and issues that came up yesterday, I have created several more instructional videos for you.  Dr Chin has also created a number of very useful videos for the hospitalist group that I have linked to as well.  

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Nov 13 2021

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11)  Accessing the ED tracker

Some physicians have been having issues accessing the ED tracker from the home button.  I have requested IT to look into this issue.  If you have this issue though, please call 8889 and let them know.  They will likely need to adjust settings on your individual account.  

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10)  Connecting Ontario

The Connecting Ontario link from Expanse does not work.  They are trying to figure out why.

 

Update:  this is now working 

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9)  Documentation

Assuming you are able to get into documentation, people are finding that if you create a note it is not showing up.  This is apparently part of the same problem as the labwork issue.  They are still working through this.  

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Update: as of 12:40 today all notes that are entered into the system are now showing up.  They are working to get the notes entered prior to this up into the system.  

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8) Dictation System

Apparently along with Expanse, we also got a new dictation system.  The extension to log into it in Georgetown is currently not working, so you have to use the external phone number.  

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Oakville: 6916 - 844-737-6978

Milton:  6917 - 844-737-6980

Georgetown:  6918 - 844-737-7315

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With the new system, when you enter in your ID it will also read back your name.  Make sure it reads back the correct name because some people have found that their ID does not link correctly with their account.  

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And finally, to end a dictation, press 5.  If you press 8, it will not give you a dictation number.  

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7)  Labwork

There is a delay in the bloodwork from showing up in Expanse.  For now if you need labwork urgently, you can call the lab and they can tube up a printed copy of the results.  

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Update: This issue has now been resolved. 

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6)  ED tracker not working

There is a design issue with the ED tracker.  It only shows patients that are waiting to be assigned to a ED doc.  So when we go to the tracker it is not going to show the patient that has been referred to you.  

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This is going to have to change and I've told the Expanse team this.  However, for now there are two workarounds.  

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a) Get the patients name from the ER doc and search for them.

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b)  When you get to the ED tracker, click on the "down arrow" next to the "More Lists" tab.  This will allow you to see all Outpatients and all Inpatients that are currently in the ED.  This is clunkly, so probably best to just make sure you get the name and go with option A.  

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5)  ED physicians admitting patients for surgeons

There was some questions from surgeons about whether ED physicians will still admit pts for us.  I spoke with Paul Healey.  He said that some members of their group think that specialists should be admitting their own pts now that we have access to orders from home.  This is more of an issue though for medicine subspecialists who have complicated orders.  He thought that for surgery pts, given that our orders are typically quite straight forward this should not be an issue.  

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4)  Historical Visits

All previous BW and imaging etc is supposed to be accessed via "Historical Visits" link on the right side bar.  This is currently not working.  

 

Again IT is aware and is trying to sort it out.  

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3)  Order Entry PIN issue

Some people have noticed that when entering orders the system does not ask for a PIN.  

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IT is aware and is working on it!

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Update: this now appears to be working.  

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2)   Documentation Issues

Some people are finding that they can't enter in any documentation. They are getting an error stating that an "electronic signature is not enabled."

 

The IT team is aware and is working on it.   

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Update: It now works for me...hopefully this has been resolved for everyone.  

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Update 2:  It is not working for me again and for a lot of other people...so it appears to be an ongoing issue.

 

Update 3:  It should be working now for most people.   

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1)   Creating a PIN.  

When you first log in to Expanse, you need to set a PIN.  

a) click on the "Menu" button in the top right.

b) click on "EMR preferences"

c) click on "Change PIN" at the bottom of the screen.

d) Enter your normal hospital password in the "Network Password" box, and enter a 4 digit numerical PIN.  

e) click on "Save" in the bottom right

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