Physician (Provider) Inbox

Covered in this topic:

Inbox - Patient Desktop

Inbox - Main Desktop

Note for Senior Medical Students

How to sign-off Inbox items

Right-click Options

The Physician (Provider) Inbox is used to review/sign orders and view results.

The Inbox contains all review items, unauthorized orders for co-sign, and orders placed on behalf of the specific Provider by other healthcare professionals, such as Nurses or Pharmacists. It is recommended that Providers check the Inbox every 8 hours, or sooner for higher acuity patients, to keep up to date. Of special note is the Sign Inactive Orders section, which contains orders that will not be active until co-signed. 

Inbox information for patients is found in two keys areas:

Patient Desktop > Shortcuts menu > Inbox

Main Desktop > My Inbox Across Patients

Inbox – Patient Desktop

From the Patient Desktop, Patient Shortcuts menu, click Inbox. The information displayed will be only for the currently selected patient, relevant to the currently logged in Provider.

The Inbox is divided in two sections.

1. Summary Grid

This contains a count of items organized by Kardex group / rows. The column headers indicate the following:

Criticals/Abnormals-shows a count of critical or abnormal results

Review Results-shows a count of results that need to be reviewed

Orders-shows a count of orders that need to be reviewed

ASO Orders-shows a count of ASO (Automatic Stop) Orders that are due to be renewed. If an order is not renewed within the reminder time frame, it will automatically be discontinued.

Note: ASOs do not apply to medication orders at this time.

Results to Complete-not in use at UHN and should always be empty. If you notice an order under this column please contact the Help Desk.

Results to Sign-shows a count of results that need to be signed

The columns are static and the rows will vary depending on the types of items available for review on the patient. Click on a row or column to filter items displayed in the Summary Details List below the grid. Click All in the top left corner to reset filters.

2. Summary Details List

These are organized in sections, similar to the column headers in the Summary Grid with the addition of:

Sign Inactive Orders-this lists unauthorized medication orders input by a Medical Student, or a direct order entered by an APN that is not covered under a Medical Directive.

Column Headers in the Summary Details List are as follows:

Category-includes ASO Renew, Results to Sign, Review Results, Sign Inactive Orders, Sign Orders (also listed in the teal category headers)

Kardex-identifies the Kardex grouping

Event Time-shows the time the result or order was entered into the system

Procedure-displays the name of the procedure or medication

Order/Result Information-displays the order or result information. Note: only four lines of text will be visible. Hovering over the result will display the rest, if longer than four lines.

Stat-indicates any STAT orders

Type-indicates order type such as new, hold, change, etc…

Status-shows the status of the order or procedure such as complete, active, unsigned verified, etc... Critical items will display as red with an exclamation mark. Abnormal items are bold and underlined. Combinations of both also appear.

Provider-shows the provider who generated the order

Indicators-appear for order advisories as red exclamation mark (!) and for order instructions as pound symbol (#). For more information on Advisories, click here.

Note: Click on a column header to sort by those items.

Inbox – Main Desktop

My Inbox options found on the Main Desktop enable Providers to review details for the list of all their assigned patients as well as orders placed on their behalf for any patient. This Inbox view provides similar options and functionality as the Patient Desktop Inbox.

1. From the Main Desktop, Patient List tab, under My Inbox Across Patients, click on Inbox – My Active Patients. The other Inbox options allow you to select a subset of your patients (e.g., Inbox - My Active IP/EP Patients, Inbox - My Active Ambulatory Patients).

Note for Senior Medical Students:

The Main Desktop option is found under Pt Selection, Sr Med Student Inbox.

Note: Both Inboxes function in a similar manner. The Main Desktop Inbox has three additional functions that assist with sorting through multiple patient lists.

Filtering Options

Filters can be applied by selecting one or more options. Click the Update List button at the bottom when making changes.

Note: The Nursing Unit filter works only with one selected Facility at a time.

Two ways to Sign-off Inbox Items

Inbox box items can be signed-off from either the Main Desktop or Patient Desktop.

Items signed-off in the Inbox are electronic acknowledgement that the information has been reviewed. This is captured in the system audit trail. Once items are signed-off, they will be cleared from the inbox. Historical items can be found in Chart Review, even after they have been signed-off.

Signing-off an order will remove it from the Inbox of all other responsible Providers. However, signing-off a result will remove it only from your Inbox, and will remain in the Inbox of all other responsible Providers for that patient.

There are two different methods to acknowledge and sign information in the inbox.

Note for Medical Students:

Orders entered by Sr. Medical Students will be received in the responsible provider's Inbox, who can then co-sign the order. Orders must be signed-off using the Detailed Sign, by clicking the Edit button.

Summary Sign-Sign/Review button

Use Summary Sign for discontinued orders to review normal results.

1. Select an item to review.

Note: To select multiple items, hold the Ctrl key on your keyboard and select items from the list.

2. Click on the Sign/Review button. The item will be removed from the inbox and your electronic signature is captured in the audit trail for this item.

Detailed Sign-Edit button

Detailed Sign allows you to review full order details, avoiding potential errors when not fully viewed, and provides additional options to Reject/Discontinue orders, or Renew ASOs. Additional review options will appear such as Trends, Reference Ranges, and Report Query.

1. Select an item to review.

Note: To select multiple items, hold the Ctrl key on your keyboard and select items from the list.

2. Click the Edit button.

Details for the item are now displayed with various transaction line prompts specific to the item selected.

Choose options include (some are not pictured above):

Yes - to sign-off the order

No - to not sign-off the order and keep it in the Inbox

Enter Comment - to add a comment to the order

Reject/Discontinue - to cancel the order

Instructions - to edit the instruction field where applicable

View Advisories - to view advisories any override comments when the order was placed

Renew - to renew ASO orders

Accept Final Review - to sign-off on a result

Additional Review - to access other result review options such as Trends, Ranges, or Report Query

Note: Orders from the Sign Inactive Orders must be signed-off before becoming active. The orders from the Sign Orders section are already active.

Note: The Select All button should be used with caution as too may selected orders may freeze EPR. Also, clicking Select All then Sign/Review will electronically sign all the orders without having fully reviewed order details.

Right-Click Options

Right-clicking on an item provides the following four options:

Edit - to access Detail Sign options

Sign/Review - to perform a Summary Sign on the item(s)

Trend - (for results) access a table of trended results for similar items, such as CBC

Review Previous Results - (for results) access previous results for the patient without having to go to Chart Review

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