Order? I hardly Know Her!
Users ordering a Basic Metabolic Panel from the inpatient order composer do not see the "Daily" frequency button. They can still select it via the picker, but it does not appear as a quick-select button. Other frequency buttons display as expected.
Go to the Lab Blood Orderable EDP
- Check that "daily" is a button option
- Verify that the OCC and EAP are not overriding daily as an allowed frequency.
Cardiology physicians cannot see the Cardiology Provider Care Team system list in Patient Lists. The system list was built and released. Patients placed on the cardiology care team via consult order are not visible to the team. Other specialties' lists appear to be working.
After technologists complete EEG exams and click "Mark as Ended," neurologists report they cannot find the studies to interpret them. The technologist-side workflow (Snapboard scheduling, check-in, End Exam documentation, Mark as Ended) is completing without error. The breakdown is occurring somewhere between Mark as Ended and the neurologist's ability to access and close the interpreted study. The exact failure point has not yet been identified.
Ask the reporting neurologist: does the study appear on the Reading Work List at all?
Verify the Reading Work List report is configured to show the study and that the report's Study Status filter includes the relevant statuses
Engage the interfaces team to trace whether the message is being sent and received with PowerScribe.
Confirm with the interfaces team that incoming transcription messages are processing correctly and check the interface message log for filing errors
When nurses attempt to select a specific attending physician as the ordering provider for inpatient orders, the provider does not appear in the search results. The provider exists in the system and can be found in the Provider Editor. Other providers at the same facility are searchable without issue. The provider reports they can log in and access patient charts normally.
Open the provider's SER record in the Provider Editor activity (Clinical Administration → Users, Providers → Providers)
Navigate to the Proxy Provider Information screen and check I SER 34920 — Inpatient Ordering Provider — this field is likely set to No or is missing. Set it to Yes (or leave blank, which defaults to Yes)
Also confirm the provider's SER record is linked to an EMP (user) record — a provider without a linked user record cannot be selected as an ordering provider for inpatient orders even if I SER 34920 is set correctly
A bed planning order is producing a parent order plus unlimited daily child orders. Standing Order Information shows 99999/99999 remaining occurrences with interval "Urgent." Staff are seeing duplicate orders cluttering Active Orders.
Identify the EAP record tied to the bed planning order
Determine if this change should be made at the procedure category (EDP) level if other orders are affected
Set Default Frequency to "Once" and restrict Allowed Frequencies accordingly
Confirm whether existing live orders need to be manually discontinued and re-ordered post-fix
Neurology consultants report that patients disappear from their Provider Care Team patient list as soon as the consult order is marked complete or discontinued
Infection preventionists report that positive MRSA culture results are not appearing in the Infection Control Find Results Reporting Workbench report used to drive their daily IP workqueue. Results are filing correctly from the lab interface and are visible in the patient chart. The issue is that the Bugsy surveillance report is not capturing them, so IPs are missing MRSA cases that should be under review.
The MRSA lab result definition is either missing, not enabled, or not correctly mapped to the components filing in Avera's system
Open the Lab Result Definition Editor in Hyperspace and search for the MRSA lab result definition — confirm it exists, is enabled for user selection, and has the correct procedure, organism, or component criteria configured.
Physicians at two specific inpatient facilities (Avera Marshall and Avera Gregory) cannot be selected as medication authorizing providers when placing inpatient orders. The same providers authorize orders correctly at other Avera facilities. The providers' SER records appear intact and they have inpatient ordering privileges. The problem is location-specific, not provider-specific — multiple providers are affected only at these two locations
Because the issue is location-specific and affects multiple providers identically, the problem is almost certainly in the authorized locations configuration on the SER records rather than individual provider privileges
Open a representative affected provider's SER record and check the authorized locations section: I SER 8209 — Authorized Locations Grouper and I SER 8205 — Individual Locations — confirm whether Avera Marshall and Avera Gregory are included, or whether a locations grouper was used and those two facilities were omitted from it
Also check I SER 8212 — Authorizing Provider Filtering Rule — if a patient context rule is restricting authorization at these locations, the rule criteria may be excluding patients admitted to those facilities
Check I SER 8210 — Meds Authorizing Provider is set to Yes for affected providers — medications and procedures require separate authorizing flags and it's possible the meds flag was missed during provisioning for providers intended to work at these satellite facilities
Certain procedure orders are not completing transmittal after being signed. The issue does not affect all departments or all order types — some orders route correctly, others appear to stop mid-process. No consistent error pool entries. Staff have not identified a clear pattern in which orders are affected.
When a consult order is placed, the patient appears in the consulting team's Provider Care Team patient list (the rounding/follow-up list) but does not appear in the New Consults system list. Consulting physicians are missing new referrals because they only monitor the New Consults list for incoming work. This is affecting multiple specialties. The consult order is being placed correctly and a provider team is being assigned.
We are not using the "New Consults" List for our workflows
The sepsis nurse screen advisory (3040000300-Base Sepsis Standard - Nurse Screen) is appearing correctly. When nurses answer Yes to the suspected infection question, the sepsis status is not advancing to "Positive Screen" and the provider alert advisory (3040000302-Base Sepsis Standard - Alert) is not firing. Lactate auto-ordering is also not triggering. The workflow is breaking between the nurse screen response and all downstream actions.
Confirm the flowsheet row is correctly linked in the advisory's follow-up action and that it is released
Verify the sepsis status field is correctly configured in Storyboard and that the status value "Positive Screen" is a valid category value in the sepsis status item
Check whether an older Sepsis Standard or care-path-based advisory package is still released alongside the current advisory set — conflicting released advisories from packages 250901 or prior editions of 307512 can interfere with status transitions; unreleasing outdated advisories may be required
Confirm the auto-lactate advisory (3040000304) is released and its triggering criteria reference the acknowledgement flowsheet row from the nurse screen
Validate the provider alert advisory criteria are evaluating sepsis status = Positive Screen and are not being suppressed by a competing exclusion criterion
Clinicians report that when placing inpatient orders, the authorizing provider field is automatically populating with the patient's attending provider rather than the logged-in ordering physician. Users are having to manually clear and correct the field on every order, which is creating significant friction and risk of orders being attributed to the wrong provider for billing. The issue affects all order types and appears system-wide for inpatient encounters.
In Text, navigate to Clinical Administration → Management Options → Profiles (LPR) and open the profile used by inpatient ordering clinicians
Follow the path Procedure, Scheduling, Task → Cosign, Acknowledgment → Order Provider Defaulting screen
Check I LPR 8541 — Procedure Authorizing and I LPR 8542 — Medication Authorizing — the first entry in the defaulting hierarchy is likely set to 5-Attending Provider rather than 2-Current Provider
Also confirm I LPR 8315 — Use provider defaulting is set to Yes and I LPR 8316 — Always display providers form is set to No (displaying the form automatically while also using defaulting creates redundant friction)
Infection rules are not firing for MRSA surveillance orders placed post-cutover. Investigation suggests that net-new LRR component records built for Bugsy are not referenced in the standing orders, SmartLinks, or PAF columns — existing references still point to the old foundation components. Scope of affected records is unknown.
No patients are appearing on any Provider Care Team system lists across all specialties post-cutover. Consult orders are being placed and provider teams are being selected in the order composer, but the assignment is not persisting to the treatment team — meaning the patient never gets placed on the care team list. The issue is system-wide, not specialty-specific. New Consults lists are similarly affected where they rely on team assignment.
AND/OR
Confirm whether Default Relationship (I SER 34825) is set on individual provider records
Blood product prepare orders placed post-cutover are not reaching the blood bank system. Clinicians can place type and screen and prepare orders in Epic without error, but the blood bank has no visibility into any prepare requests. Transfuse orders are also affected — nursing is unable to complete the blood administration workflow because no units are being prepared. The issue appears system-wide across all blood product types (RBC, platelets, plasma). Type and screen results are still returning from the blood bank interface. This is a patient safety emergency.
Because type and screen results are returning, the blood bank interface is partially functional — the issue is specific to the outbound prepare order message not transmitting, suggesting a broken or misconfigured interface for outbound order messages rather than a complete interface failure
Immediately engage the interfaces team: confirm the outbound order transmittal interface for blood prepare orders is active, the queue number is configured, and the interface is pointed to the correct post-cutover blood bank endpoint
Open the order transmittal rule for blood prepare orders and verify the interface referenced in the Send directive matches the correct post-cutover interface record — a stale interface ID from the pre-cutover environment is the most likely cause
Check the order transmittal error pool for prepare order errors (error 522 — destination not found is common when interface records are misconfigured post-migration)
HIM is reporting that a large volume of inpatient H&P and discharge summary notes authored by residents, advanced practice providers (APPs), and medical students are being signed without triggering cosign requirements since go-live. The notes are completing without the Cosign Required checkbox appearing, no In Basket messages are being sent to supervising attendings, and no cosign deficiencies are being generated. This is a system-wide compliance failure affecting all inpatient units. HIM cannot track or enforce cosign completion on these notes because the deficiency mechanism never fires.
On the profile these APPs hit -- verify H&P and Discharge Summary note types are listed in I LPR 46000 (Note Type for Cosign) with I LPR 46010 (Requirement) set to Required and I LPR 46020 (Forward to In Basket) set to Required — if these entries are missing, add them
Confirm the feature set linked to the inpatient encounter context (I LPR 31400 / I LPR 31401) includes 1-Cosigning in I HFN 200
Check whether security point 28-Notes Cosign Required (Inpatient) should be set on the resident/APP/medical student security class — this enforces cosign on all note types for those users without needing note-type–level profile entries
Also confirm that attending/supervising providers have security point 42-Notes Cosign or 322-Can Cosign Others' Notes so they can act on notes forwarded to them