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How to check what charts are open after clinic day:

  1. Log into EPIC under the “EHHOP” department
  2. Click on “EHHOP” in the bottom left pane and on the clinic date on the calendar
  3. When you see the schedule, click twice on the “chart” column (this is just to sort the chart list)
  4. Open charts will now appear at the top of the list. Any chart that does not say closed in that category means it is open.

How to see which attending saw a particular patient so that you know who to email:

  1. Open the chart by double clicking
  2. Assuming the chart is still open, you should see Visit Navigator open
  3. If the chart has actually been closed, a dialog box will pop up when you double-click, giving you the option to either add an addendum or review the chart. In this case, the chart is closed so you don’t need to do anything.
  4. In the open chart: click on Chart Review (on the blue pane on left) → Notes
  5. Click on the Student Note written for that patient on the day in question, and scroll down to the bottom. Make sure the student note you’re looking at was written by the senior clinician (or sometimes, attending) that saw the patient, and NOT the teaching senior (because the TSs will write their own student notes as well, but that’s not the one you want).
  6. The attending that saw this patient will be listed as having reviewed this Student Note.
  7. If the note says “accepted by Dr. X”, that means the note has been signed, but if it says “required by Dr. X”, the student note needs to be co-signed by the attending, as well.

How to figure out what the attending needs to do before he/she can close the chart:

  1. First, remember that only the attending who saw the patient can/should close the chart. Medical students cannot do this.
  2. In the chart, click on Close encounter in the blue pane on the left. If that button isn’t there (it sometimes isn’t), click on More Activities → Close encounter
  3. Do not try to sign the chart; this will close it, and will be a big problem.
  4. When you hit close encounter, you may see a list of items under “Recommended Items”. These are the things that the attending needs to do before the chart can be closed; so each item may or may not show up depending on whether the attending has already done it or not. They are:
    -Reason for visit
    -Level of service
    -Primary diagnosis
    -Additional encounter note (ie: the attending’s progress note)
    -Sign all orders
  5. Email the attending (give the patient’s initials and MRN) and request that they close the chart, specifying which of the above items needs to be done before they can close the chart.
  6. If you’ve emailed the attending a few times with no response (and the chart is still open), send Dr. Meah an email and request that she send the attending a friendly reminder.
  7. Remember: no medical student should be closing the chart, including you as the CM and the clinician that saw the patient. If you’re having trouble, email the Chief CM.