| 以消息为中心 |
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| 病人预约申请 |
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核对病人是否符合要求 |
审核 |
1.16 (获取病人人口学信息Access patient demographic data),17.3 (审核别人医保是否合格Review display of patients’ insurance eligibility) |
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挂号人员 |
x |
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下达访前检验医嘱 |
医嘱 |
10.4(下达检验医嘱order lab study) |
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医师 |
x |
x |
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预约 |
执行 |
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挂号人员 |
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转诊到其他机构 |
医嘱 |
10.10 (下达转诊申请医嘱Order provider referral) |
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医师 |
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x |
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Refer to telephone consultation or secure messaging |
执行 |
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医师、护士 |
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| 急诊室信息流程 |
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告知急诊科ED病人即将到达 |
通知 |
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EMS急诊护理人员 |
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传输记录到救护车的run sheet |
创建 |
7.1(记录每次encounter的病程记录Document a progress note on each encounter) |
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护士 |
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口头报告病例给ER |
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EMS急诊护理人员 |
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快速挂号、确认病人身份 |
创建 |
7.8(Document encounter) |
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护士 |
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x |
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书写报告 |
创建 |
7.40(记录生命体征 vital signs); 7.41(记录体重weight) |
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EMS急诊护理人员 |
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将报告传输给ER |
传输 |
19.5(Transmit clinical summary) |
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EMS急诊护理人员 |
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| 药房消息处理 |
Intake |
Take message |
执行 |
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挂号人员 |
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核对Rx |
审核 |
1.10-14(访问既往多次就诊的药物过敏史、既往多次就诊的病史、正在服用的药物列表、药嘱、非药物过敏史Access medication allergy history over multiple visit, history over multiple visits, active medication list and supplements, medication order, nonmedication allergy history over multiple visits), 10.10(下达转诊医嘱Order provider referral), 20.4-11( 更新药物过敏、药物列表、药嘱、非药物过敏，下达药嘱Update medication allergy, medication list, medication order,nonmedication allergy, order for medication),17.3-9(病人保险合格的展示、检验结果的接收、收缩压、舒张压的变化、提供的患者教育等Review display of patients’ insurance eligibility, received clinical lab test results for user interface, changes in diastolic blood pressure/height/systolic blood pressure/weight,education provided) |
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护士、医师助理 |
x |
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x |
x |
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核对处方集 |
审核 |
17.10(审核电子处方集或者药物列表Review electronically formulary or preferred drug list) |
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护士、医师助理 |
x |
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x |
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Prior authorization Check |
审核 |
19.10-13(向医保传输保险合格核对信息、向医保查询合格性Transmit insurance eligibility check to private/public payers, eligibility queries to private/public payers) |
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医师 |
x |
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x |
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Routing to prescriber |
核对DDI |
审核 |
3.2(实时药物-药物禁忌提醒Alert for drug-drug contraindications(real time)) |
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护士、医师 |
x |
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x |
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用药变更 |
创建 |
10.1(下达药嘱Order(prescribe) medication), 10.5-7(下达常用药嘱和新药嘱Order medication as generic, new medication),20.6(更新药嘱列表Update medication list) |
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医师 |
x |
x |
x |
x |
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x |
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指导变更 |
记录 |
7.1(Document a progress note for each encounter) |
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护士 |
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x |
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获取预授权 |
接收 |
12.8-9(从保险机构收到电子格式的保险合格核对信息Receive insurance eligibility check electronically from private payers/public payers) |
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护士、医师助理 |
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x |
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Routing back |
联系药房 |
通知 |
19.6(传输电子处方Transmit electronic permissible medication order(prescription)) |
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x |
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联系病人 |
通知 |
9.1-2(告知病人随访和预防保健相关信息Notify patients for follow-up care and preventive care) |
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护士、医师助理、医师 |
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x |
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传输处方 |
传输 |
19.18-24(Transmit to other provider diagnostic test results/immunizations/medication allergy list/medication list/problem list/procedures performed, transmit to patient summary record from other providers) |
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医师、护士 |
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x |
| 与其他医师的相关消息 |
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Msg. intake or outreach to other clinician |
传输 |
19.18-24(Transmit to other provider diagnostic test results/immunizations/medication allergy list/medication list/problem list/procedures performed, transmit to patient summary record from other providers) |
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医师、护士 |
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x |
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x |
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商讨病例 |
执行 |
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医师、护士 |
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x |
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x |
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达成一致 |
记录 |
7.1(Document a progress note for each encounter) |
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医师、护士 |
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x |
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x |
| 术前阶段 |
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术前提醒病人相关信息 |
提醒 |
9.1-2(告知病人随访和预防保健信息Notify patients for follow-up care and preventive care) |
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医师、护士 |
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x |
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x |
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联系护士团队 |
通知 |
19.18-24(Transmit to other provider diagnostic test results/immunizations/medication allergy list/medication list/problem list/procedures performed, transmit to patient summary record from other providers |
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医师、护士 |
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x |
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x |
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联系麻醉师团队 |
通知 |
19.18-24(Transmit to other provider diagnostic test results/immunizations/medication allergy list/medication list/problem list/procedures performed, transmit to patient summary record from other providers |
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医师、护士 |
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x |
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x |
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电话确认 |
通知 |
19.18-24(Transmit to other provider diagnostic test results/immunizations/medication allergy list/medication list/problem list/procedures performed, transmit to patient summary record from other providers |
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医师、护士 |
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x |
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x |
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联系外科医生 |
通知 |
19.18-24(Transmit to other provider diagnostic test results/immunizations/medication allergy list/medication list/problem list/procedures performed, transmit to patient summary record from other providers |
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医师、护士 |
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x |
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x |
| 手术安排 |
预约手术 |
电话答复 |
执行 |
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护士、医师助理 |
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x |
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x |
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核对时段 |
审核 |
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挂号人员 |
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x |
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x |
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向pt确认 |
创建 |
9.1-2(Notify patients for follow-up care and preventive care) |
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挂号人员 |
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x |
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x |
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提醒病人 |
提醒 |
9.1-2(Notify patients for follow-up care and preventive care) |
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挂号人员 |
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x |
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x |
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安排手术人员 |
Review historical patient visits |
审核 |
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核对人员是否空闲 |
审核 |
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分配时间 |
记录 |
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