What are Hidden Results?
Team Workflow
Process Steps
General validation of Transaction(s)
Assign Different Types of Transactions in Results
Log your Actions
Common Issues - Troubleshooting/Investigation
Update the Template (if applicable)
Related Articles
Instructions for reassigning transactions/results that cannot be signed off in its current state
What are Hidden Results?
Transactions/Results are downloaded as Labs, Scans and Dictations that cannot be signed off in its current state since they do not appear in the system for the intended recipients. This can occur for a number of reasons. A Hidden Results Report was created to generate a list of these transactions.
The SA team will email the VCH PCC EMR TEAM when the report is ready.
Team Workflow
The person on support is accountable for completion. If there is a large volume of results (roughly 20+) or it is an unusually busy support day, they are welcome to ask others on the team for help. The only urgencies to correct are abnormal results; These must be done by end of day. If the person attending the Hidden Results is unable to complete it by end of work day, they should contact the next support person or email the team to let them know some will carry forward to tomorrow. They should also offer to help with the next day's report.
Process Steps
- Find the file with today’s date located in this folder: \\vch\departments\PCAC_EMR\01 - PCCEMR\01-Reports and Data Extracts\Reports\Operational\PC2747HiddenResultReport\Report
Note: the Hidden Results query is run from the backend off of EMR_Reporting which is one day old data. - Navigate to the spreadsheet with the current date and open the password protected spreadsheet (speak with other analysts to obtain the password).
- Open the HiddenResultsReport
- Log on to EMR Production using Sys-Admin account (Caution: Do not use Citrix)
- Open Medical Record, using the Client File Number or PARIS ID from the spreadsheet, search for the transaction in EMR Results view. (Tip: Keyboard Hotkey - Press CTRL + ALT + semicolon to go directly to results)
- Look for the matching Display Date and Transaction Data Type to find the hidden result.
- To check or change the Assigned Clinician and/or POS, right click on the transaction and select Set Properties.
General validation of Transaction(s)
- A Clinician and not an admin account (few exceptions for when a CSC/CA can sign off results).
- The assigned Clinician is not setup as Read Only (RO) account and has an Active status
- Clinician’s grants match the POS they belong to, especially for receiving the transaction (Note: If there is a mismatch of grants and POS memberships, correct it).
- If unsure which primary Clinician(s) or POS should be assigned (ie: Clinicians with similar names) assign the transaction to the next Clinician CC’d or the Clients MRP (Shown in the Yellow banner).
- You can check the Transactions Ordering Provider or relevant CCs by clicking on the Information tab of the transaction.
If no MRP or clinic is listed:
- Click on Encounters on the left menu and expand the top section where it shows date, find a recent Clinician.
- On the right, you will find the Encounter with the most recent Clinicians name; update accordingly.
Tip: If you need to access People and Places, please use the Support Environment to avoid impacting Production. Opening People & Places will lock other users out from this area.
Assign Different Types of Transactions in Results
a. Edit your View filters (optional) to show the POS, Ordering and Assigned Provider columns:
b. for Pathology results, transactions should be assigned accordingly to one or more of the following criteria's (in order):
- Client’s MRP (shown in the yellow banner) at their main POS
- Ordering Provider at OPs main POS
- CC’d recipients listed in the information tab (in order of CCs at their main POS)
If none of the above are found, go to Encounters Notes and see who the last contact was with (MD, NP, RN).
- If there are no Encounter notes, go to Alter Client / Booking and try to find a recent contact there.
- If still no EMR providers found, assign to Clinic’s medical lead – refer to Clinic Contacts spreadsheet. Email them to make aware why this result was assigned to them.
c. If the transaction/result is a Transcription/Scanned Transcription Document:
Currently, the Transcriptions are assigned to the Clinician who had created the Transcription and they are considered as the Ordering Provider. Transcriptions should be reviewed and signed by the addressed Clinicians.
Assign them accordingly in the following order:
- Dictated for at the bottom of the transcription (if the name is a family physician) at their main POS
- CC’d to – in order of CCs at their main POS (if the ordering provider is listed, skip to the next one)
- Client’s MRP
- If still no EMR providers found, check the Encounter note for MD/NP entries. If there is no MD/NP entries, assign to Clinic’s medical lead – refer to Clinic Contacts spreadsheet. Email them to make aware “why” this result was assigned to them.
d. Assign all transactions (pathology and transcriptions) older than 6 months to SD-PHY-ADM at PEN. (Email Stan so he knows to attend to these.) Note: since Stan is no longer working with EMR team, this process is currently under review with CIS leadership. Interim workaround is to notify Mai and Richmond about the transactions that are older than 6 months and they will connect with the appropriate CIS group to get them processed.
ADDENDUM: Follow the same steps above (d) to ALL Unsigned Transactions resulting from the routine inactivation of dormant users. SAs will send a team notification when this script is going to be run. Filter spreadsheet by Assigned Clinician Inactive column = Yes.
e. For inactive duplicate clients follow these instructions: https://imitspccs.zendesk.com/hc/en-us/articles/360057265472
f. For all others (both inactive clients and inactive clinicians), assign as per the following criteria:
|
Pathology: |
Transcription: 1. Dictated for at the bottom of the transcription (if the name is a family physician) at their main POS 2. CC’d to – in order of CCs at their main POS (if the ordering provider is listed, skip to the next one) 3. Client’s MRP 4. If still no EMR providers found, check the Encounter note for MD/NP entries. |
If no provider found based on above criteria, assign it to SD-PHY-ADM at PEN (Email Stan so he knows to these)
(Reviewed & updated March 4, 2021 by Stan, Serina, Teresa, Janet)
Log your Actions
After processing each hidden result, you will need to update the spreadsheet with information corresponding to the columns.
1. Update the following 4 columns:
- Cleaned up By (this will be used to record the name of the person doing the cleanup)
- Cleaned? (Y/N) (If N, leave brief explanation in comments section on why it wasn’t changed)
- What was done/Comments (this will be used to record what cleanup is done)
- Additional Feedback (Optional: add any other additional comments under here which are usually not related to the result fix, like fixing the associated clinician account)
2. Save the spreadsheet.
3. Once all reviewed/fixed, send an email to EMR team saying that the cleanup was done.
Common Issues - Troubleshooting/Investigation
1. Clinician’s main POS is inactive – has other active POS available
Check the yellow info banner for the client’s PC or Alt POS. If the clinician is working at one of these clinics, assign to the clinician at this POS.
2. Clinician only belongs to an inactive POS
Go to the Encounter history of the patient and find the latest time the client was in an active POS and the clinician. Set the clinician & the POS accordingly. If there are no recent Encounters or Bookings, assign to clinic medical lead. Email them to let them know why the result was assigned to them.
3. Clinician has a Read-Only account
Another clinician has to be assigned to the result (we are looking at ways to add Read Only to the clinician name)
4. Clinician is inactive
Another active clinician has to be assigned to the result.
5. The assigned POS may be an active clinic in Profile EMR, but they could also be no longer in use and are slated to be inactivated.
To make sure the assigned POS is active, use the list found here: \\vch\departments\PCAC_EMR\01 - PCCEMR\04-Org Charts & Contacts\Contact Info
List inactive clinics
6. The result is already signed
Don’t make any changes but do monitor the next day. If it is still in Hidden Results report, make changes as required. Leave a comment. Also note that results should not be signed by a CSC/CA (unless part of CPS). If this is the case, we need to follow up with the clinic to see if this was done in error.
7. There is no result on the reported date, but there is a result within a day or two
Check for unsigned result, double check the information on the spreadsheet, if information matches, then process the result. If no matching result found, may have already been signed and no further action needed. Leave a comment.
8. Results showing Anomalies
In any case of seeing a large list of Hidden Results it should noted for any anomalies related to a clinic or particular user. We would try to remediate any abnormal results and discuss these remaining hidden results at the next daily team huddle. These anomalies may require more investigation into the cause e.g. changes in configuration that requires a rollback or a different type of remediation would be required.
9. Transactions/Results Forwarding
EMR has a Transactions/Results forwarding feature where users are able to reassign transactions as part of their workflow, however the feature does not prevent users from incorrect assignment of results to clinicians who don’t belong to the POS. If the transaction history indicates a user had previously actioned it prior to showing up again in Hidden results, contact that user to have them correct the issue or determine the best course of action.
10. There is no PARIS ID listed
Login to the clinic (MS) and look for the result with the associated file number
Update the Template (if applicable)
If the Hidden Results template needs to be updated in any way (ex. add new temporary instructions, change column orders, etc.) make sure to contact the System Administrator team first. Since the Hidden Results are pulled using an automated script, any changes to the template could affect how the script runs.