Using CST Cerner for Virtual Visits

For CST Cerner live sites, CST Cerner remains the electronic health record for documentation of telehealth and virtual patient visits.  If your clinical area/clinic currently registers and schedules patients for ambulatory visits and documentation is currently performed in CST Cerner, these functions extend to virtual encounters.  Virtual visits should be captured appropriately in CST Cerner as this provides for better statistical tracking of usage, correct charge capture, and archiving of documentation.

Regardless of what telehealth/virtual platform you use, the patient encounter should be scheduled in CST Cerner in order for you to document into the electronic chart and for the encounter to be captured for hospital reporting.

Scheduling Clerk or MOA with Scheduling Privilege:

An outpatient or pre-outpatient encounter can be flipped to a telehealth encounter:

• At the time of the virtual visit, the scheduler/MOA should “check-in” the patient by changing the pre-outpatient encounter to an active encounter (telephone consult, etc.)
• If the provider and/or clerk are off-site this may require additional coordination.

A new telehealth encounter can be created:

• If no pre-outpatient encounter exists, it can be created, or a telehealth encounter can be created immediately prior to the expected virtual visit – by a scheduling clerk or MOA with scheduling privileges. Instructions here.
• Future clinics should continue to be scheduled in the usual way (by creating pre-outpatient encounters).

Clinician/Provider:

Virtual visit can be conducted through whichever modality is most appropriate for the circumstances (telephone, Skype for Business, Facetime, Zoom, etc.).  See PHC Med Staff website for information on different platforms.

• Ensure you are using the correct Telehealth Encounter (for the specified date and clinic location – as the patient may have multiple encounters of this type) – using your “Ambulatory Organizer” will help you by selecting the correct encounter.
• Verbal consent to use telehealth is required as some platforms maintain their servers out of the country.  Consent should be documented in the note.  An autotext („telehealth) is available in dynamic documentation to facilitate this consent.
• Conduct your interview/assessment of the patient.  Document using the same forms, document templates as you use in the usual outpatient setting. 
• When signing/saving your dynamic documentation, you may change the Document Type to “Televisit Note” in order to have the document filed distinctly from the outpatient clinic notes.  This is optional and based on your preference, but you are encouraged to do so, as you will be able to better differentiate which visits were seen in person versus virtually. Quick Reference Guide available here.

Report to the scheduling clerk which patients were seen virtually so that they can “complete” the encounter in Cerner.

Print PDF Requisitions with Remote Access

Ordering laboratory tests in future state gives Providers the ability to place one-time and recurring lab orders on a future visit. Once the future lab order(s) have been signed, a Cerner-generated Outpatient Laboratory Requisition approved by the Ministry of Health is set to automatically print out at the Patient's Location. However, within a remote virtual health workflow, providers or associated clinicians may utilize a Print to PDF solution enabling them to print or save a copy of the Cerner-generated Outpatient Laboratory Requisition when working remotely. For instructions, click here.