I know someone recently asked about future t.inj in another thread. I’m creating my own to not hijack that one and to also give more context into the workflow we use…had used.
As far as I could remember, eCW trainers instructed customers who needed “future imm/t.inj ordering” to add the order into the progress note, leave the order as pending, and then go back into the order (through the main imm/t.inj section) at a later point in time to update the initial order as administered and add documentation.
This worked great until around (if I remember correctly) 2017-2018 when one of the Version 11 builds introduced a new itemkey called LockImmunizationForLockedNote for patient safety reasons. With this itemkey enabled, the imm/t.inj order would lock (gray out) and become uneditable once the progress note that the order is associated with is locked. Because the imm/t.inj order itself does not have a locking function, it made sense to me that eCW would update their programming to have the order lock with the progress note so that data would not change…except that this killed the “future imm/t.inj ordering” workflow. I was fortunate that I was able to get an override to have this itemkey disabled at my previous and current organization and was able to continue using this workflow until the latest version update (we took 11.52.153.16 at the end of August) when I hit a brick wall. I have been told that I will not be able to have this itemkey disabled anymore.
Furthermore, a new checking mechanism was added (not sure if It’s an itemkey) that prevents a progress note/telephone encounter from being locked/addressed if there is a pending imm/t.inj order. All orders now need to be marked as administered or not administered before a progress note or telephone encounter can be closed out. This completely kills the “future imm/t.inj ordering” workflow as I know it because a future order would always be pending until the patient comes back at a later time.
I am waiting for eCW to provide a new workflow that works in an enterprise environment. It seems like others are using procedure orders as a workaround because locking a procedure is independent of locking a progress note. But, I see many flaws doing it this way that can lead to mistakes.
I’m not sure if there will be any new suggestions or ideas from those on this forum. I’ll keep ya’ll posted if eCW comes back to me something other than asking me to add it onto eCWideas!