This document provides guidance for customizing and implementing various aspects of a MEDITECH CPOE system, including: 1. Standardizing naming conventions and formatting for orderables, medications, and order strings to follow industry standards and legal requirements. 2. Configuring order sources, reflex order sets, and evidence-based order sets from approved vendors. 3. Training physicians, nurses, ancillary staff, and pharmacists on using the CPOE system for tasks like placing orders, reconciling medications, and managing orders during downtime. Emphasis is placed on specialty workflows. 4. Coordinating go-live preparations across departments like registration and virtual beds in ED.

1. MEDITECH CPOE
Excel Healthcare Group
www.excelhcg.com

4. Dictionary Review
At least make considerations and have a style guide to follow
when making these changes

5. Order Sources
eMAR Quick Charge Ramifications:
If the order source is defaulted into PHA, then that order source will also default into
the Quick Charge routine for nurses.

6. Review OE Procedure Dict
• Naming conventions: Orderable name descriptions should
be spelled out completely since it is the legal name.
However when appropriate, in many name descriptions it
makes more sense to use the industry-standard
abbreviation or acronym.
Computerized Axial Tomography Scan of Head is the legal name for the
orderable commonly known as Head CAT scan but CT is the known
“Industry Standard”.
Example: CT Head wwo Cont
Example: CT Chest Abdomen Pelvis w Cont

7. Review Pharmacy Med Dict
• Trade Name field should be formatted as:
• Injectable and Bulk (If more than one concentration is available)
[Trade name] + [drug concentration] + [dose form]
• All others: [Trade name] + [dose form]
• Add special identifying information at end of the name (i.e.
PEDS, OR, ER, etc)
• Express suffixes that are part of the brand name (SR, SA, CR)
within both the generic name and brand name. Suffix should
immediately precede the dose form.
• (Example: Metoprolol Succinate 12.5 mg XL Tab ).
• Combination medications should contain strength of items at
end of name
• Example: Dyazide 50/25 Cap
• If more than one trade name for product, add additional trade
names to Generic Equivalent field.

8. Review Pharmacy Med Dict
• Pharmacy - Generic Equivalent
• Generic Equivalent can be used to add additional generic
or trade names, using naming convention described above
for Trade Name field.
• Trade names that you enter at the Generic Equivalent
prompt appear in lookups that are sorted by trade name.
• Utilize Generic Equivalent field for any Automatic
Therapeutic Interchanges.
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Example: Add “Atorvastatin Auto Sub to” as a
Generic Equivalent for
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Simvastatin, if Simvastatin is
automatically substituted for Atorvastatin.

9. Order Strings
• Review the format of the order strings first
• MEDITECH recommends using Joint Commission and ISMP
standards when building the frequency schedules, example: use
“daily” instead of “qd”.
• Medication orders should include common order strings.
(* Morphine might have many order strings, with variation in both dose
and route)
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Morphine Inj 1 mg IVP every 4 hours PRN
Morphine Oral Liquid 2 mg PO q2hp
Morphine PCA 50 mg/ 50mL 50 mg IV ONCE ONE
Morphine 30 mg IR PO Q2h2 SCH
• Frequency - The most common frequency is the default on the order
selection screen.
• *Note in Zynx all Frequencies are displayed and are not separated by
Category use. Frequencies should be standardized when possible.

11. Evidence Based Order Sets
Both of these vendors are approved by MEDITECH:
• Provation
• Zynx

12. Reflex Order Sets
There are three types of reflex orders you can build:
1. Suggested Order
2. Pre-requisite
3. Linked Meds

15. CPOE Training
We suggest grouping all the same type of clinicians into a training
to make it relevant to their practice.

16. Provider Training
• Explain process for Direct Admit and ED to Inpatient, if
pertinent to provider practice
• Place single medication order and protocol Order Set
• Add a single order to favorites and create a specialty
folder for it
• Explain difference with CPOE telephone orders/Verbal
Order, Written and Protocol
• Place an order for a consult, Diet
• Complete a Transfer & D/C an old Order Set
• Enter admission orders
• Adjust the Admission orders (register as, etc.)
• Initiate & Sign Order Sets – demonstration and explain
difference of the two

17. Provider Training
• Complete Medication Reconciliation – Admission,
Transfer
• Discontinue orders, discontinue O/S or complete
• Complete Discharge Process – discharge order, Depart,
D/C med rec
• Resolve order conflicts – alerts
• Demonstrate Proper Hand off/Chart Check
• Explain Downtime Process
• Physician Desktop – how are orders are signed or
refused
• Discuss process around your specialty area….as
pertinent (ex. ED, Med/Surg, Oncology, OB, NICU and
processes)

18. Nursing and Clinicians
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Train on Single Orders, Order Sets (O/S), any Order Sets related to their specialty, Transfusion
O/S, TPN O/S, Admit to venue Order Sets, identifying statuses O/S and how to discontinue if you
have too many Home Medications on the Med Rec when they print.
Emphasize looking to Initiate Order Sets when patients arrive from the Physician‟s office, ED or
the OR once the location is updated by Registration in the computer and looking for a completed
admission med rec or transfer if it pertains to the circumstance.
Train on Transfer orders (service or bed location), Transfer Med Reconciliation (where to find all
the med recs if completed before sending a patient anywhere)
Identify and train on the Med Rec process for the outpatient areas
Train on where to find orders.
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Discuss with ED & PACU – Process for discontinuing their O/S phase of orders before patient
goes to department or completing to obtain a „completed‟ status for the O/S.
Surgery areas & ED must be proficient on use of the eMAR.
Discuss looking for Provider Orders, and the use of „Notify Physician‟ orders
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For example: Where do I find my consults (case management, PT/OT, dietician) now that paper is gone?
Example: Provider Order – notify physician when pt arrives to department (nurse can complete this one time order
when task is complete)
Example: Notify physician if pt. BP <100 is continuous order (nurse does not complete since it is continuous and each
nurse needs to see this order)
Discuss Discontinuing orders/Order Sets within the proper workflow
Discuss receiving telephone or verbal orders
Discuss receiving telephone calls related to admission orders and med reconciliation process for
telephone orders

19. Nursing and Clinicians
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Discuss Downtime process for CPOE with clinicians, what their role is during a downtime and
where to find information, as well as what has to be placed back in the computer once the
application is back up.
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Discuss Status of Order Sets – physicians may have entered one twice, know to review both
and call the doc to cancel one that is hanging out there.
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Discuss importance of Documenting Home Medications correctly the first time in the OR,ED,
Admission so the physician does not receive an error message when doing reconciliation and
so that the meds print correctly for discharge.
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Discuss the importance of using the proper „Order Source Type‟ when placing orders
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Discuss what to do if a nurse orders a med as „Written‟ that should have been a „Telephone
order‟ that will need a physician signature in the messaging.
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Discuss the more complicated process if the order is entered, and completed with the wrong
Order Source Type. Discuss how to change or adjust as needed.
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Discuss readiness (day or night) to take orders if calling a physician: computer on, in patients
chart ready to take orders. Ideal is for physician to enter orders themselves, but you always
want to be prepared. Be collaborative rather than rigid.

20. Ancillary Departments
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Discuss Downtime process for CPOE with ancillary department and their role for
CPOE during a downtime.
Discuss how to look at a chart and review
Discuss any virtual beds needed for ED, and Rehab areas with registration if the
facility does not already have the process in place. If patient is in a virtual bed and an
order set is initiated it will go to the department the patient is expected to go to versus
if not in a virtual bed, it will fire the O/S orders to the Outpatient department.
Discuss with the auditors and registrars where to find order sets, and how to look up
orders on charts now that there is no paper. Walk through a typical workday where
each would use paper and identify where in the computer it will now reside.
Discuss with Pharmacists use of the messaging for communication
Discuss with Pharmacist Physician Order Management (POM) Order entry to assist
physicians and troubleshoot the POM side of ordering medications and online med
rec entry.
Discuss with Pharmacists when to use the appropriate order source type so that
proper routing to the ordering physician inbox can occur. This is also important for
CPOE statistics.

22. Contact us
www.excelhcg.com or 770-918-9083