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CLN104 Introduction to Clinical Tools – Key Facts

Introduction

  • Course: CLN104 – Introduction to Clinical Tools (May 2025 version; exams valid until Oct 20 2025)

  • Audience: Informaticists who bridge clinician needs & IT build teams; expected to know a clinical Epic app before class

  • Prerequisites – e-learns: MYC001, AMB001, CLNINP001 (optional), GEN601A

  • Class support: email CITraining@epic.com

    • Include companion name/chapter/page, environment (Study D, etc.), user ID, patient/MRN, troubleshooting tried.

  • Course agenda (08:30-17:00 both days)

    • Day 1 – Clinical Informatics overview, Profiles, Reports, SmartTools, Flowsheets

    • Day 2 – Tasks, Navigators & Workflow Engine Rules, Orders, In Basket, OPAs, Evaluations

  • Training materials versioning – always check All Training Companion Change Log and download the newest PDF.

  • Continuing Epic Education (CEE) & Proficient Self-Study: follow Epic U and Training Guide instructions.

Clinical Informatics Overview

  • Role of Clinical Informaticist

    • Translator among clinicians, builders, Operations, training

    • Goals: identify inefficiencies, design solutions, communicate across roles

  • Stakeholder groups & when to engage

    • Clinicians – 1:1 support, super-users, feedback on new projects

    • Builders – small aesthetic fixes, urgent build, use Sherlock logs & NOVA notes

    • Operations – large-scale workflow change, legal req., development roadmap

    • Training – issues solved by education (SmartUser, Thrive, labs, etc.)

  • Informatics ticket workflow

    1. Investigate (replicate in SUP/TST)

    2. Triage (scope, impact, effort, urgency, owner)

    3. Own or handoff (create project when similar tickets aggregate)

    4. Follow-up (close loop w/ requester)

  • Master-file cheat sheet (key clinical build files)

    • LRP report: “Displays info”, shareable, made of LPG print groups

    • LPR profile: “Options within activities”, ≥1000 settings, 6-level hierarchy

    • LOR workflow engine rule – MANSS (More menu, Activity tabs, Navigators, Sidebar, Storyboard)

    • LVN navigator: Template ▸ Topic ▸ Section, linked via LOR

    • FLO/FLT flowsheets (rows/ groups vs templates)

    • LTR tasks – clinical work list items

    • LGL OPA – patient-safety decision support (base + criteria records)

    • ORD orders – dynamic on sign (EAP + ERX defaults)

  • Data structure reference graphic included in workbook (Chronicles→Clarity-denorm)

Profiles (LPR)

  • Purpose: fine-grain configuration of clinical activities; over 1000 options on 300+ screens.

  • Examples of controlled items

    • Reports list & Chart Review tabs

    • Flowsheet template preference lists

    • Default order behavior (verbal, dx-assoc, validation)

    • Navigators & linked LOR

    • SnapShot default report, vitals units, Brain features

  • Six-level hierarchy (Rule of Specificity):

    1. User/User template

    2. EpicCare security class

    3. Login department

    4. Login location

    5. Service area

    6. System definitions

  • Compiling logic – item-by-item; more specific overrides more generic.

  • Session Information Report

    • Profile Compilation section lists consulted profiles (links visible when Report & PG IDs toggled on).

    • Compiled profile record shows final values.

  • Common tasks

    • Add flowsheet templates to preference lists (item 35150)

    • Brain profile editor → discharge banners etc.

  • Exam-style recall

    • Max 6 profiles per session

    • Identify settings via Record Viewer & profile comparison tool.

Reports (LRP) & Print Groups (LPG)

  • Report = ordered list of print groups; read-only patient data display.

  • Used in Schedule view, SnapShot, Summary, Storyboard sidebar, labels, navigator read-only sections.

  • Record structure: LRP ↔ multiple LPG.

  • User tools

    • In-chart: wrench to personalize report buttons & print-group order.

    • Report & Print Group Assistant (toggle via Session Information Report) reveals internal names & IDs.

  • Data Handbook – Print Group Encyclopedia: search by keywords, product, style; preview output.

  • Analyst considerations – linking report IDs into profiles (item 989 etc.).

SmartTools

  • Master files

    • HH1 SmartPhrase – user/system quick text (dot-phrase)

    • HHS SmartLink – pulls chart data (supports parameters & SmartBlocks)

    • ELT SmartList – click-n-pick options (single, multi, mutual exclude, labels)

    • ETX SmartText – documentation template restricted by Functional Type & pt factors

    • LQF SmartForm – interactive forms; SmartBlock (HHS) embeds SF in note.

  • Creating user SmartPhrase workflow

    1. SmartPhrase Manager → New User Phrase

    2. Pull in system phrase, modify, insert SmartLinks (e.g., .fname) & SmartLists.

    3. Save ⇒ HH1 ID appears; can Share With, Copy, Add to toolbar.

  • SmartLink categories

    • No parameters (e.g., .fname)

    • User-level parameters (e.g., .brieflab ) – help text on insert.

    • System-level parameters (analyst set in record; e.g., .risrsltadm lookback, narrative/impression).

  • Lab component IDs – obtain via Lab Component SmartPhrase Guide in Chart Review > Labs.

  • SmartTool Butler (.?) – search/filter preview links & phrases.

  • Community Library – import ETX, ELT etc. for reuse.

Flowsheets (FLO/FLT)

  • Structure: FLT template contains FLO groups; groups contain FLO rows.

  • Value types: Custom List, Numeric, BP, Patient Height/Weight, Temperature, Time, String, etc.

  • Cascade logic: trigger rows add more rows when “X/Exceptions” chosen.

  • Calculated rows – formulas or M-code; Braden Scale example (Score=Σ{i=1}^6 vi).

  • Copy Forward – department/profile/system definitions restrictions.

  • Row/Group management

    • Remove (rows w/o data), Complete (hide rows w/ data), Table of Contents hide.

  • Macros

    • Personal vs Public; can pre-populate WDL etc.; created from current column.

    • Macro Manager allows sharing, public flag, template scope.

  • Clinical Content Review tool – metadata on FLO/FLT, LGL, LPG, OSQ etc.

    • Owners, Reviewers, Discussion, Review Status; surfaced via GetSmart Metadata report.

  • Dashboards & SlicerDicer – Flowsheet Macro Usage, Flowsheets Explorer; analyze value counts, criteria slices.

Tasks (LTR) & Work List/Brain

  • LTR Task record defines task logic; linked to LTT templates and orders.

  • Common sources: Care Plans, Required Documentation, Order-linked tasks, MyChart pt tasks.

  • Brain vs Work List – discipline-filtered view; filter dropdown to show All Tasks.

  • Record Viewer comparison (item 140 Discipline) explains missing tasks.

  • Required Documentation management

    • Department-level LTT overrides System Def.; item 80 holds task list.

    • Dashboards: General Adult Nursing etc. display RD compliance.

Navigators (LVN) & Workflow Engine Rules (LOR)

  • LVN hierarchy: Template → Topic → Section.

  • Navigator Configuration record (VCN) controls section behaviour (Flowsheet embed, Report collapsed/expanded, Meds & Orders filters, Activity links).

  • Dynamic sections: Extension (LPP) + CER rule evaluate patient attributes (e.g., OB/Gyn status filtered by age/sex logic).

  • User customization – ellipsis ▸ Modify Layout (unless locked).

  • Workflow Engine Rule – patient workspace builder; directives for MANSS.

    • Workflow Engine Results report via Session Info > Patient Encounter Workspace.

    • Conditions with TRUE/ FALSE; Toolset shows navigators, activities, default tab, Storyboard.

    • Linked in LPR profile.

Orders

  • Order master files

    • ERX Medication (each strength/form)

    • EAP Procedure (everything non-med)

    • ORD dynamic record after sign (stores clinician overrides).

  • Ordering tools

    • OSQ Order Panel – small predefined bundle (orders only); users can create.

    • PRL Order Set – IP context, orders only; larger workflow.

    • PRL SmartSet – OP visit template; can include non-order items (dx, SmartText).

  • User activities

    • Create Panel: queue orders → Create Panel → defaults selectable/unchecked.

    • My Version of SmartSet/Order Set – customize defaults, deselect required items.

  • Preference Lists (LPF)

    • Types: User, Profile, Facility, Database.

    • Star order adds to user list via Preference List Composer OCC.

    • Copy User Lists vs Follow Users (updates propagate).

OurPractice Advisories (LGL) – Clinical Decision Support

  • Base record – display, importance, triggers (item 78), restrictions (item 380), follow-up (item 202), SmartSets (item 105), Ack reasons (item 4000), linked criteria (item 3000).

  • Criteria record – locator filters (item 75) evaluating diagnoses, meds, vitals, flowsheets, age etc.; include & exclude logic.

  • Alert record (ALT) – generated instance; seen in OPA Review.

  • Delivery modes

    • Navigator OPA section, Storyboard icon, pop-up, behind-the-scenes (tasks, In Basket).

  • Workflow: base + ≥1 criteria; triggers e.g., order signing, flowsheet rows filed.

  • OPA Review activity – patient specific: see actions, ack reason, logic path; hover text shows LGL & ALT IDs.

In Basket

  • Message Types (HIS) dictate folder, toolbar buttons (item 200), auto-advance, routing defaults.

  • Routing

    • Direct to user, pool, or dept via “To” logic; can route on Reply/Done.

    • Pools managed via Manage Pools; covering users via Attached & Covering Users.

  • QuickActions – context-specific buttons (Reply, Forward, Result Mgmt, Secure PM, Note).

    • Built per message type; user can create; analyst can build system QAs.

    • Options: prefilled recipient, subject, SmartText, mark done, file note, release to MyChart.

  • Personalization

    • Folder stars, order, auto-select first message.

    • Report tab wrench, QA toolbar drag/hide.

    • Action window defaults via action-window wrench.

  • Troubleshooting table – missing buttons, routing anomalies, auto-advance, etc.

Resources & Studying

  • Training Home – Important Dates, Resource links, In-Progress certificates.

  • Training Guides (Epic Community Member vs Consultant) – statuses, assessments, CEE.

  • Cert environment request via Training Home → Cert Environment Request; access.eu for EMEA.

  • Study environments refresh Friday 22:00 CT; can choose alt classroom sheet if work overwritten.

  • Key help contacts: CITraining@epic.com, UserWebSupport, E-Learning, Registrations, Exams, ContinuingEpicEducation.

  • Sample exams & projects with expiration across versions; All Training Companion Change Log.

  • Epic resources: UserWeb, Galaxy, weLearning, Community Library, Data Handbook, EHRN.

Formulas & Equations

  • Mean Arterial Pressure (MAP) calculation displayed in flowsheet note:
    MAP = DBP + \frac{SBP - DBP}{3} = \frac{[2 \times DBP] + SBP}{3}

Key Take-Away Matrix (Cheat)

  • Profiles – 6-level hierarchy, compiled per item (Rule of Specificity)

  • Reports – LRP of LPGs; Data Handbook for LPG search; assistant toggle via Session Info

  • SmartTools – HH1/HHS/ELT/ETX; .? Butler; parameterized SmartLinks; Community Library

  • Flowsheets – FLT/FLO; value types, cascading, macros; Clinical Content Review metadata

  • Tasks – LTR via orders/LTT; Brain vs Work List; RD LTT item 80 list

  • Navigators – LVN+VCN; extensions+CER dynamic; LOR linked in profile; Workflow Engine Results rpt.

  • Orders – ERX/EAP→ORD; OSQ panel, PRL set; user preference lists copy vs follow

  • OPAs – LGL base+criteria; OPA Review shows ALT; triggers; importance colors.

  • In Basket – HIS commands & routing; QuickActions personalize; pools/manage.