Getting Started with Epic: Patient Lookup and Break the Glass

Patient Lookup

Find Existing Patients

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  • To look up a patient’s record in Epic, open the Patient Lookup activity for the desired activity.

1. The Search for a Patient window opens.

2. The Extended tab enables users to search for patients from an external system.

3. Enter the Name/MRN and at least one additional patient identifier. This can be the Sex, Birth date, or SSN (social security number).

4. Click Find Patient.

5. If the patient does not exist in Hyperspace, click Create New Patient.

6. Click Accept.

7. If a patient is located, they will display in the Results tab.

8. The wrench icon is used to adjust the default view between the Results or Recent Patients tabs.

9. Patient demographics matching the searched criteria are displayed in bold in the grid and are highlighted green in the report.

10. If the correct patient is displayed, click Accept.

Create a New Patient

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  • When using Patient Lookup, if an existing patient cannot be located, users will need to create a new patient record in Hyperspace.

1. Click Create New Patient from the Search for a Patient window.

2. The Create a Patient window displays when either of the 'create a new patient' hyperlinks are selected, and patient name details are editable.

3. When all details are entered, click Create Patient.

Duplicate Matching

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  • If the system returns potential duplicates for the patient the user is searching for, it will alert the user. Not only will the system return potential matches, but the Create a Patient window will also display a warning message in the Results section.
  • If all the information in the demographics synopsis matches the patient, select it even if the patient MRN is not from the current Service Area (SA). Do not create another, duplicate patient. In this case the user must Break the Glass to create an MRN for the current Service Area and make the record available to their staff.

Users often try to avoid breaking the glass on a patient even if it looks to be the correct patient. If a user has identified that it is a match, Break the Glass

1. When users click on a patient, they may be given a warning and shown lists of similar patients that are not within the current service area.

2. To view the previous patient selection, click Back to Search.

3. Removing the Service Area from the Service Area field will open a larger list of potential matches outside of the users current Service Area.

4. If the user discovers that the patient does exist but is not part of their service area, as indicated by the presence of an Enterprise MRN (aka E-number), the user will need to Break the Glass. Break the Glass instructions will be listed in a latter portion of the document.

5. When a patient is registered as a new patient and a portion of the demographics match an existing patient, the Potential Duplicate Records warning will open in the bottom half of the window. The new patient details are on the left, and the potential duplicate patient is on the right.

6. The items highlighted in green mark the similarities between the new and existing patients.

Patient Chart Advisories

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  • To ensure users are selecting the correct patient and noting changes in patient records, additional Patient Chart Advisories have been added that display alerts when there are unresolved overlays, incomplete merges, FYI flags for Identity Theft, or a patient marked as Known Non-Duplicate (KND).
    • PCA Unresolved Overlay Advisory [19220] - Note that information may be missing or incorrect in this record due to a Patient Unmerge or contact move (moving an encounter from one patient to another).

 

  • PCA Incomplete Merge Advisory [19291] - The patient is currently involved in a merge that is not complete.

 

  • PCA Marked as Known Non-Duplicate [84819225] - to alert the user that patient is Marked as a Known Non-Duplicate such as, twins or Sr. vs Jr.

 

Provider Patient Lookup

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  • When clinicians use the My Patients checkbox in Patient Lookup, the search results include patients for whom they:
    • Are currently the PCP or on the care team.
    • Have had an encounter within the last two years.
    • Have authored or cosigned a note in the last two years.
    • Have been on the treatment team for the last two years.
  • The information will display on the Your Recent Interactions card in the search results:

Break the Glass

Overview

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  • Break the Glass (BTG) is a way to get into the record of a patient that has already been seen at another hospital so that you can “share” the patient and the patient’s records.
  • The Break the Glass functionality is designed to notify the Epic user if they select a patient that does not currently have a record in their organization.
  • Users can expect the Break the Glass window to open when they select a patient that displays with an Enterprise Medical Record Number (MRN).
    • This is indicated by the MRN appearing with an <E>, for example <E5125220>. 
  • If you have verified it's the same person who already has a patient record at another hospital, it is crucial that the Break the Glass process is completed. 
    • If you do not and instead create the patient as New, this creates a duplicate patient record, which will cause issues with continuity of care.
Step-by-Step Instructions

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1. To Break the Glass, select the patient from the Search for a Patient window.

2. The Break the Glass window will open.

3. Choose a reason using one of the speed buttons. Typical reasons include:

a. Coordination of Care: Use for general care when the patient will not be transferring their PCP to the current service area.

b. Specialty Services: The patient is coming to the current Service Area for Specialty Services, but the patient will not be transferring their PCP to the current service area.

c. Temporary Care: Use for one time only general care when the patient will not be transferring their PCP to the current service area.

d. Transferring Patient Care: Use when the patient will now have their PCP and primary location within the current service area.

  • If the user selects this option, they will need to update/change the patient’s primary location and PCP once their registration record is entered.

e. Visiting Patient: Use when a person is visiting from outside of the geographic area.

4. Enter your Epic password to authenticate and click Accept.

Employee Break the Glass

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  • When an employee attempts to open a patient’s health record that is also an employee of their organization, Break the Glass will trigger.
  • The break the glass reason will display “You are attempting to access an employee record. Please verify that this access is appropriate before proceeding.”
  • Employee Break the Glass will not fire when:
    • The end user accessing the record is the patient's current PCP.
    • The patient has an appointment "today."
Breaking the Glass in Error

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  • If you broke the glass in error, please submit a ticket with a request to un-Break the Glass for the patient.
    • Include the MRN that was assigned to the patient.
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This article provides an overview of key clinical areas within the Epic application. This is intended as a starting place for newly hired clinical/support staff. Please refer to your clinical leadership for workflows specific to your center.