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DOH Enrollment Instructions

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Nov 2020 UPDATE:
Patients can now receive Insulin via DOH. This is a significant change from prior years. Patients should be counseled that they will no longer receive Insulin in clinic (or mailed to them). Instead, just like most other prescribed medications, patients will be picking up Insulin from the employee pharmacy. They can also pick up alcohol swabs and pen needles from the pharmacy, however glucometers, glucose testing strips and lancets must still be picked up in clinic. To enroll, all patients must complete a NEW 2021 DOH income attestation form--including patients who signed forms in 2019


DOH Enrollment Instructions:

  1. CMs print DOH forms in Spanish and English. During morning announcements, please remind all clinicians to complete 2020 DOH attestations.
  2. TSs include DOH enrollment as an item on the sign-in (part of "Health Maintenance" tab) and hand out DOH forms during rounds. They can look at columns X & Y on the Master Patient List to see if a patient needs this included.
  3. Seniors fill out DOH forms with patients. Most importantly, forms must be signed by the patient! At the end of clinic, chronic care seniors should upload the form into the media tab on EPIC (see instructions below) as well as emailed to Sharon Barazani.
  4. TSs confirm with seniors during sign-out that the DOH form completed and if not already done, mark on the Master Patient List (Columns X & Y).
  5. Labs TSs upload signed and completed forms into the media tab on EPIC (see instructions below) AND email them to Sharon. Using your phone camera is acceptable as long as the photo is clearly legible and NOT blurry. No filters necessary. Alternatively, you can use the clinic scanner (recommended!) or free app like TinyScanner, which we highly recommend. Also please mark on the Master Patient List (Columns X & Y)

This should be finished by Sunday 11:59 PM.


Using EPIC Haiku to Upload Enrollment Forms:

  1. Go to App Store.
  2. Search “Haiku”.
  3. Download “EPIC Haiku & Limerick” (you don't have to be on campus to do this).
  4. Go to your phone settings, scroll down to see Haiku, enter the following (settings might be in different location for Android):
    • Server: epicsoapproxyprd.mountsinai.org
    • Path: interconnect-haiku-prd
  5. Go back to the Haiku App.
  6. Log In with your EPIC username and password.
  7. On the bottom right of the screen, press “More”.
  8. Press “Search”.
  9. Search for the particular patient via MRN/name/DOB/etc.
  10. Next to the patient’s name on top of the screen, there will be a small camera icon. Press that, and choose “capture clinical media”.
  11. Allow Haiku to access your camera/microphone.
  12. Take a photo of the signed DOH document. Make sure the form is legible and please do NOT upload blurry photos.
  13. Write “2021 DOH Consent Form DD/MM/YY” in the description and save.
  14. Also, send a picture of the form to Sharon Barazani. Please include patient's name and/or MRNs in the email.
  15. After uploading to EPIC and emailing Sharon, shred any physical copies or light them on fire--as long as you dispose of the forms in a HIPAA compliant manner.
  16. Last step! Please mark on the Master Patient List (Columns X & Y) that the DOH form has been completed with the upload date.

Thank you!!

for general DOH info, click me