The VA Provider Digital Health (DHC) Committee meets monthly; members work to identify Cerner changes that would be most helpful to providers. VPSA provides sessional funding to the nine physician representatives on the committee for time spent in meetings and doing other committee work. The following is a summary of the committee’s May 14 meeting.

Goals of care

Goals-of-care documentation is a challenging workflow that requires the use of a powerform that is not intuitive. In a perfect world, users would have the ability to open a chart and immediately see goals-of-care information within one or two clicks. This would include the most recent goals as these usually evolve throughout hospitalization. The committee discussed the idea of using the banner bar with a section for advanced care plans or goals of care that could be selected to display relevant documents. A high-level priority is for goals-of-care conversations to be easily documented so that they fit with usual workflows as well as the ability to create goals-of-care documentation.

VA Associate Chief Medical Information Officer Dr. Stephen Van Gaal is connecting with the Lions Gate Hospital team to see how it is using goals-of-care documentation.

Patient portal

The committee heard about plans to include new items on the patient portal including the ability of patients to review their scheduled appointments, clinical results and related care documents. An e-form pilot is under consideration, as is one-way messaging initiated by clinicians. There is also interest in the ability to share education links with patients via the portal.

Go-live times for these items are in progress.

Cerner code update

Upgrades to change the current code to the 2025 version for M Pages, Millenium and other Cerner applications are expected to be released in the coming months. The Regional Digital Solution (RDS) team is assessing the changes and making configuration adjustments and will update learning materials.

RDS is currently testing to identify workflow changes that need to occur and communicating these to end users. This is a large upgrade that will bring about 21,000 enhancements in 6,400 code fixes.

Beta testing for Oracle for the AI Scribe feature

Dr. Van Gaal is reviewing the list of providers who work in VGH ambulatory clinics to identify supported specialty physicians and invite them to participate in an AI Scribe trial. Finding a cross section of providers working across these disciplines is a priority.

Verbal and telephone orders

There has been an issue in how VA approaches verbal and telephone orders. Medical Information team members are working with Professional Practice to come to an agreement on when telephone and verbal orders are (in)appropriate. The team is developing a list of such instances. They are aware that additional steps increase the risk of errors.

It is important that this work be patient focused and safe, while improving the learning environment by removing unnecessary steps and work for residents.

Roundtable discussion

VCH’s new Medical Director, Post-Graduate Medical Education, Dr. Kelly Lefaivre attended the meeting as a guest. She suggested the committee could benefit from learner representation. In the discussion that ensued, there was agreement that there is opportunity for collaboration between the committee and the PGME Learning Environment Committee. Once that group is off the ground, representatives could contribute by looking at issues and providing input.

Next meeting

The committee meets again on June 11. If you have an item you wish to be brought forward at one of these meetings, please contact Manager, Provider Strategic Initiatives & Engagement, Laura Mc Evoy.