Maestro Tips

MAESTRO TIP: NEED TO TRANSLATE A MYCHART MESSAGE?

You can request same-day translation of a MyChart message using these simple steps!

1. 1. Log in to Epic
  2. Go to In Basket
  3. Click on New Message drop down
  4. Click on Request PtMsg Translation
  5. Type or cut/paste your message where *** appears
  6. Click Send

An interpreter pool will receive and complete your request. Requests received outside of normal business hours will be done the next business day.

MAESTRO TIP: WHERE’S SEARCH?

Where’s Waldo? Looking for the Search field? It’s hidden in column banner on left, under alerts and above COVID vaccine status! (Pro tip: Want to see if Social Work has engaged with your patient regarding a particular need? Type “LCSW” into the search and relevant notes should come up.)

MAESTRO TIP: UPDATED DOC VAX LIST

Thanks to DOC Pharmacist Holly Canupp for updating the DOC Vaccine pref list to match our current floorstock! Click here for DIY tipsheet on how to update Order Pref Lists

MAESTRO TIP: USE .INTERP SMARTPHRASES TO DOCUMENT

- .INTERPRETER: Use to document level of interpretation used
- .INTERPAVAIL: Use if patient’s preferred mode of interpretation was inaccessible

MAESTRO TIPS: MEDICATION REVIEW, COST SHARE ESTIMATOR

- How to med rec like a pro(vider):
  Reconciling Medications, Outside Clinical Info
  Be sure to use to see what patient has told DOC Nursing they are taking/not taking & need more of
- Using rx estimator tool:
  Medication Patient Cost Estimating ToolNote: You need to be on Duke wifi or VPN to access

MAESTRO AMBULATORY TEACHING CHECKLIST 2022-2023

Checklist of Maestro competencies for encounter efficiencies and In Basket management.

DON’T PUT IN THE WRONG ECG ORDER

ECGs done at DOC should be ordered as “Clinic Performed” NOT “Ancillary.” The latter will NOT be visible to DOC Nursing (won’t change dot to blue, etc.) and can result in delays. There was an SRS earlier this month due to this error; please be aware for future ECG orders. Thanks! UPDATE: A ServiceNow ticket was placed to flip order to ‘Clinic Performed’ automatically, hopefully fixing things.

Pro tip: Use DOC Provider Favorites pref list to order common and commonly confused clinic orders!

ORDERING MEDICAL SUPPLIES, EQUIPMENT?

Please remember that Carolyn Lawrence and Christy McDonald in DOC Medical Records when they reach out to you for orders for incontinence supplies and other durable medical equipment (DME), these need to be entered as “GSE” orders(NOT anything that looks like a medication; see example below). Pro tip: Can’t find what you’re looking for? Enter “Generic Supply Order” and write in what you are ordering for your patient. You can even save these to Pref Lists. Thanks!

MAESTRO CARE THERAPY PLAN UPDATE

Changes to the Therapy Plan feature in Maestro Care were released June 1. Here is a tipsheet on how to navigate the new changes when ordering outpatient infusions for patients: Treatment Therapy Plan Update

DD3: OUTPATIENT MAESTRO FL2 FORM

Maestro-integrated electronic FL2 form used for inpatient is now available for outpatient use! See the FL2 Long and Short Forms Maestro Quick tip here.

GRAM STAIN ORDERABLE CHANGE

Gram stain is often ordered incorrectly and accounts for a HUGE number of canceled tests in the Microbiology Lab. Being mostly a redundant order given that cultures already include it, it has been discontinued. For vaginal specimens for Bacterial Vaginosis, please order instead:

- - Bacterial vaginosis Gram stain – LAB3230
    The test itself and result interpretation remains the same.

PRESCRIBING SMARTER

Thanks to Caroline Sloan and Larry Greenblatt for these pro tips!

- - New Estimate tool in Maestro can show you what patient out-of-pocket costs may be when ordering meds (see blue box at top of Sign Orders inset):
  - Remember the NC Medicaid drug list changes; and will likely change again in 2022. Google “NC Medicaid PDL” for latest.
  - Medicaid patients can get 90 day fills for same copay as 30 day ($3 brand or generic)! Save money, time, gas, COVID exposures and go for 90!
  - Medicaid will pay for delivery. Mainly independents (e.g., Gurley’s, Josef’s) will do this; they can also do pre-packaged med boxes/pill packs. See Holly Canupp, Catherine Snyder if you need help switching patients over.
  - Medicaid is still also paying for automatic BP cuffs, scales, and pulse oximeters. Ask your attending for details.

MAESTRO CARE UPGRADE TOOLKITS

Click here to learn more about the Maestro Care Upgrade Toolkits which were developed to help end users prepare for the April 2022 Maestro Care upgrade. These toolkits contain slides with numerous updates and enhancements within Maestro Care. Note: You have to be signed into Duke Box for link to work.

LIKE SEEING YOUR OWN PATIENTS?

Use the “For:” field exclusively for scheduling return to PCP (hopefully yourself), and SKIP that useless “Return in:” box. Write in: “<reason for return> in <x> to <y> months with PCP Dr. ____ (or Julia/Val).” Pro tip: Build in speed buttons; see Dani Zipkin to show you how! Remember, only YOU can prevent medical homelessness.

CLOSING THE LOOP ON CALLS

Get a Patient Calls/Internal Comm message in your In Basket? Use “Encounter” activity to open it directly (instead of creating a new Orders Only):

Also, be sure to route these back to sender once action is taken, to close the loop. Copy “P Duke Outpatient Clinic Front Desk” for scheduling.

DEATH E-CERTIFICATES NOW REQUIRED

As of May 1, 2022, the State of NC will no longer accept paper death certificates. All death certificates must be filled out electronically using a new system called NC DAVE (North Carolina Database Application for Vital Events).

See the electronic death certificate tip sheet and presentation in the DOC Toolbox for more detail.

Email NCDAVESupport@duke.edu for questions, support.

WANT AN EZ BUTTON? ADD DOC FLOORSTOCK TO YOUR PREFS

Want an easy way to order meds in clinic? From Epic menu, go to Tools/Patient Care Tools/ Pref List Composer; then at bottom click ‘Copy User,’ type in Holly Canupp and find ‘Clinic-Administered Medication.’ Here is a link. Then when ordering, click circles (“tadpoles”) by order box and your pref lists will open, including this one. Thanks, Holly!
Pro tip: Add ‘Immunizations’ while you are at it.