CRIS for Prescribers

This web page is for Prescribers at the NIH Clinical Center who have questions or seek information about the most effective ways to use CRIS.

Spotlight: QuickNotes

QuickNotes (known to some CRIS users as SmartPaste) is a new feature in CRIS designed to help write clinical documents. To learn more, QuickNotes User Guide (1.04 MB).

Spotlight: Discharge Note

Beginning September 1, 2010, conditional discharge orders will no longer be available in CRIS. Instead, Prescribers will enter a discharge progress note which automatically generates a discharge order. To learn more, New Discharge Process (304 KB).

Spotlight: RESEARCH, BLOOD ORDER FORM

Beginning July 6th 2010, the Research, Blood order will be enhanced to provide better definition and tracking of specimen tubes used for research draws. This includes designating specific tube types by means of the order for any of 9 tube types.

Please refer to DLM Website http://intranet.cc.nih.gov/dlm/index.html for further instructions on ordering Research, Blood test in CRIS.

Spotlight: New Discharge Process

The Clinical Center has been working on processes to improve communication with patients and their outside physicians. In support of this initiative, the Medical Record Department will begin sending a new discharge package to patients' authorized outside physicians following discharge from an inpatient admission beginning September 1^st, 2010. Learn more (89 KB).

Spotlight: RADPACS

PACS is Changing...
PACSWEB to become RADPACS! On March 3rd, all pacsweb connections were redirected to the new V11 PACS (radpacs)*. Pacsweb users will now have access to the same PACS client used by the Radiology Department and will be able to log on with their NIH credentials. Macintosh users will have to access the new PACS via Citrix.

Spotlight: Radiology Scheduling Changes (beginning January 2010)

MRI: If you are scheduling a patient for multiple MRI scans that require an injection of Gadolinium contrast media, their appointment times may be combined together to eliminate the need for multiple injections.

CT: If you are scheduling a patient for a CT scan that requires them to drink oral contrast, their appointment time will be for the duration of 1 hour and 20 minutes. The 60 minute CT dose appointment will immediately precede the CT scan appointment for the following CT scans: CT Abdomen, CT Abdomen and Pelvis, CT Chest and Abdomen, CT Chest Abdomen and Pelvis, CT Pelvis.

For more information:
http://intranet.cc.nih.gov/radiology/schedule.html NIH Staff Only

Spotlight: Signed Protocol Consents in CRIS

Signed protocol consents are available in CRIS. The protocol consents must have been signed by the patient on or after May 1, 2009. To access the signed protocol consent, select the Protocol Info tab. Select the signed protocol consent you wish to view. It will be labeled Patient Signed Consent in the Item Detail column. Paper copies of protocol consents signed on 5/1/09 or after need to be sent to the Medical Records Department (MRD) for scanning and filing. Upon MRD receipt of the signed consent, you will be able to view it in CRIS within 24 to 72 hours. If you are not able to view a signed protocol consents in CRIS for patients who have met the criteria of a signature date of 5/1/09 or later please contact: The Help Desk at 301-496-8400.

Spotlight: Copy and Paste in CRIS/SCM

On February 3, 2009, the Medical Executive Committee (MEC) passed policy MAS M09-1, Utilization of Copy Functionality for Documentation within CRIS:

• Providers are responsible for adhering to the policy which can be found at http://internal.cc.nih.gov/policies/PDF/M09-1.pdf (37 KB).
• DCRI cannot guarantee copy and paste functionality will work smoothly within CRIS. It is highly dependent upon the operating system/workstation or Citrix client in use.
• To copy information a user can right click and select either copy from the short cut menu or "Ctrl" "C" on the keyboard.
• To paste information a user can right click and select paste from the shortcut menu. If this does not work use "Ctrl" "V" on the keyboard.
  
• A user can copy information from a structured note (SN) in SCM and paste it into the following:
  • A free text note in SCM
  • A Word document
  • A specific observations in SCM; however there is limited by the number of characters available for that field.
• For Excel spreadsheet: if you copy from SCM to an excel spreadsheet on the desktop some of the content is lost/ missing data due to formatting issues.
  

Reminder, per policy:

• Providers are responsible for the complete content of their documentation, whether the content is original, copied, pasted, imported, or reused.
• If any information is imported or reused from a prior note, the provider is responsible for its accuracy and medical necessity.
• If the provider uses information from a prior note, he/she must reference the date of the original note.

Spotlight: Mandatory Progress Notes in CRIS

The Medical Executive Committee voted recently to require that all progress note documentation be completed in CRIS effective March 1st, 2009 (rather than handwritten or typed outside of CRIS).

CRIS currently provides several different progress note templates in both free text and structured note formats which may be utilized to document in patients' medical records.

If you have any questions regarding CRIS progress note documentation or have a need for a new/modified template specific to your program, please contact Tricia Coffey in the Medical Record Department via email (tcoffey@cc.nih.gov) or on 301-594-7410. Ms. Coffey can assist with coordinating training for you/your colleagues if necessary.

Spotlight: Tamper-Resistant Prescriptions at NIH

To comply with the new CMS law, all take-home medication prescriptions written as 'Not Required for Study' under the Take Home Medications session type, will print on tamper-resistant paper in the Outpatient Pharmacy. Reference (49 KB).

You will no longer need to print/reprint the prescription to the location at which the patient is located; the prescription will print directly in the Pharmacy.

SIGNATURE & SIGNATURE FORM

Your electronically scanned signature will print on the paper prescription if it is on file. If your signature is not on file, you will have to come to the Pharmacy to sign the prescription.

Your Credentialing Coordinator will contact you to have your signature put on file. Additionally, if needed, access a copy of the signature form (42 KB). Follow the instructions to complete and submit the form.

CONTROLLED SUBSTANCES

All controlled substances will be filled by the Outpatient Pharmacy and therefore the patient will not receive a paper prescription.

IMPORTANT NOTE - Prescriptions for Schedule II Controlled Substances will continue to require a signed requisition form. The hard copy order requisition will print out at the assigned patient location noted in CRIS. The signed copy is required to be delivered to the pharmacy prior to medication dispensing.

ORDERS PLACED 'ON BEHALF OF' A PRESCRIBER

Take Home medication orders, 'Not Required for Study' (not filled by the NIH Pharmacy) entered 'On Behalf of' a prescriber are not permitted.

WHY USE TAMPER-RESISTANT PRESCRIPTIONS?

The use of Tamper-Resistant Prescriptions was initiated on October 1st, 2008 by the Clinical Center in order to comply with the Centers for Medicare and Medicaid Services (CMS) law. The law was intended to fight Medicaid fraud and abuse. All written Take Home prescriptions for outpatient medications NOT REQUIRED FOR STUDY (prescription filled off-campus) must be written on tamper-resistant paper.

Spotlight: Prescriber On-Line Training

Prescriber CRIS training is available online. Advantages of this new format include:

• 24 hour access to course material
• Remote access (outside of DCRI Classroom and/or NIH campus)
• Optional completion prior to arrival at NIH
• Enhanced online tutorials
• Self-paced

For more information, refer to Spotlight for Physicians or the CIO Newsletter-April 2008 Special Edition (55 KB) on this website.

Spotlight: CRIS Prescriber Registration and Training Process

CRIS Prescriber Online Training (517 KB)

Spotlight: Signature Manager

Did you know you could sign multiple orders for multiple patients at one time in CRIS?
Learn more.

Spotlight: ATV System (Admission, Travel, and Voucher)

The traditional "Form 54" used in MIS is being replaced with a new web-based system known as ATV that functions independently of CRIS. The system will help standardize the enrollment of patients in protocols. Key points to know:

• Access is password protected and corresponds to your regular network ID and password
• Protocol status and consents will be confirmed and maintained by Medical Records (i.e., providers can?t add or modify patient protocols directly in CRIS)
• Protocols and status will be viewable in CRIS on the Patient Info tab under? Health Issues?
• For more info on the ATV system, go to http://cris.cc.nih.gov/news/form54.html

Spotlight: CRIS Access

For details on CRIS access, go to http://cris.cc.nih.gov/access.html

Spotlight: Practicing with CRIS

CRIS online training tutorials are available at http://cris.cc.nih.gov/cristraining/cbt.html
To practice using CRIS with fictitious patients, go to https://cccasper.cc.nih.gov/Citrix/scd/default.htm

1. Log on using your NIH credentials.
2. Select the CRIS Practice folder.
3. Click the CRIS PRACTICE icon.

     For Prescribers: Name: prescriber01 Password: aaaaaa
     For other Staff: Name: chart01 Password: aaaaaa

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