Although we are still on all-paper inpatient orders, we’ve had our medications in Epic (“Apex” at UCSF) since February via pharmacist order entry. One of the go-live tasks is to get all the non-medication orders for current inpatients in to the system. We’re doing that with a “Cutover Kardex” completed by a group of specially trained nurses overnight last night. Its an extension of a typical Kardex in that it standardizes the written structure of all the existing orders so they resemble how those orders will appear in Apex. This morning at 0600, the physicians and NPs will begin signing off on the cutover Kardex, which is then handed over to the crew of 40 cutover nurses who will enter these orders in to the EHR in the background. Over the course of today and overnight new orders will continue to be written on paper, and the cutover crew will periodically sweep these up and enter these in to the system in the background as well.
In this way, when CPOE goes live at 0700 Saturday morning, all the patients’ current orders will be in the system, and the physicians’ and NPs’ first task in CPOE will be to review and confirm their completeness.