Informal Poll on Corrections and whether or not to send T11 message to remove bad document

[Chris_Haugsness]

We are at a cross roads and I wanted to see what other facilities have decided to do when it comes to Doc Corrections and the ability to remove a badly indexed image from a patients chart in Epic.

If a document were indexed to the wrong person, said document would be sent to our corrections queue and then re indexed.  When that indexing happens we have two options.

1. Submit a T11 message to Epic to remove the image from the incorrect persons chart

2. Don't submit a T11 message, which will leave the image on the incorrect person chart but adds an overlay stating FILED IN ERROR, and leaves a note stating the same fact.

What does your organization do?  Some want the chart to continue to show the document because it's possible that document could have been used in a decision regarding the incorrect patient's care, and it's nice to be able to refer back to within Epic.  Others want as clean a chart as possible in Epic, and therefore want the incorrect image removed from the incorrect patient's chart.

Other things to keep in mind are ROI requests, and making sure the incorrect document doesn't make it out.

[#2]

In our organization, we remove them from the chart.

[Eric_Stewart4]

In the current organization that I am working in - they have opted for the "FILED IN ERROR" approach; for the same reason you offer in #2 above.

[Chris_Haugsness]

Eric,

Are you using the ROI module within Epic along with the dll from OnBase that pulls scans into the release?  If so, are you taking any steps to ensure a filed in error document doesn't make it into the release?

Thanks

Chris

[Julia_Tabaj]

 HI Chris,

In the past the services team has used both ways during implementations. Recently, our best practice has been to send the T11 and reindex the document, with relinking the Filed In Error document type as optional. We moved to this as best practice due to some places in our integration where overlays may not appear. The EpicCare Link integration has the OnBase image is rendered in the Epic Acordex viewer, which currently does not display overlays. In Epic 2014, the same would happen with any inline or image thumbnail viewing through the Image Retrieval API. Also with the Image Retrieval API, OnBase documents in MyChart can be set to auto release certain results to patients, and if the document was Filed in Error but never reclassified in Epic, this could potentially cause a wrong result to display to the wrong patient.

Those are just a few of the reasons that we are opting to send the T11s as a standard during our services engagements. That said, sending a T11 to remove doesn't have to be the end of the document in Epic. If required, a T02 could be sent relinking the document that was just removed but now classified as Filed in Error so that it still is actively a part of the chart where it was incorrectly linked. There are still a few options there.

I hope that this helped clarify a bit what we are currently doing in Healthcare Services. If you have any questions or need any further follow-up feel free to reach out to me.

Thanks,

Julia Tabaj

Lead Technical Consultant, Global Healthcare Services