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  • 1.  Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-16-2024 14:49

    Hello,

    For the institutions that use EPIC, do you allow the MAs to click "Mark as Reviewed" after updating the home medication list.

    It is a provider responsibility to perform the medication reconciliation but I'm trying to seek clarification if it's within the scope of the MA to click that button if a provider will review that list after.

    Thank you!

    Cindy



    ------------------------------
    Cindy Phan, MSN, RN
    Clinical Nurse Educator- Ambulatory
    UCI Health
    Orange, CA
    714-456-7131
    ------------------------------


  • 2.  RE: Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-19-2024 09:46

    Hello,

     

    I am not sure about your state guidelines but here in Michigan our MAs can.

     

    Ashley Rosa, MSN, BSN, RN

    Manager Ambulatory Care Management

    Bronson Healthcare Group
    Michigan

     




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  • 3.  RE: Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-19-2024 13:47

    The board's response opened up more questions for me:

    Can non-credentialed medical assistants – and by extension, lay-people –enter orders into the electronic health record (EHR).  What entries can such workers make, if any?

    For all these objectives except computerized provider order entry, anyone can enter the information for something like blood pressure, or height/weight. But when it comes to CPOE (computerized physician order entry), the information either must be entered by a licensed health care professional- and must be done prior to any action being taken on the order – or it must be entered by a [credentialed] medical assistant.  You can't have a lay person who enters that, somebody goes through and just clicks a button.  You must have the actual licensed health care professional or [credentialed medical assistant].

    As of January 2013, only credentialed medical assistants have been permitted to enter medication, radiology, and laboratory orders into the EHR to count toward the Meaningful Use of thresholds under the Medicare and Medicaid EHR Incentive programs.

    According to Meaningful Use 2 – core measure 1, any licensed healthcare professional can enter orders into the medical record for purposes of including the order in the numerator for objective of computerized physician order entry (CPOE).

    The order must be entered by someone who could exercise clinical judgement if the entry generates any alarms about possible interactions or other clinical decision support aids.  This necessitates having the Computerized Physician Order Entry (CPOE) occur when the order first becomes part of the patient's medical record, and before any action can be taken on the order.

    The Centers for Medicare and Medicaid Services (CMS) did not specify any particular credentialing agency for medical assistants but did say that the credentialing would have to be obtained from an organization other than the employing agency.

    Many working medical assistants have not graduated from an accredited program and thus are not eligible to sit for a certification examination offered by some agencies.  The American Association of Medical Assistants (AAMA), the certifying agency for medical assistants, says these individuals are not eligible for certification by the AAMA, but they may be eligible for certification through other agencies. 

    According to CMS, a non-certified individual, such as a scribe, is not qualified to enter these orders in the computerized provider order entry because there is not licensing or credentialing of scribes, so there is no guarantee of their qualifications for accuracy in such a position.



    ------------------------------
    Cindy Phan, MSN, RN
    Clinical Nurse Educator- Ambulatory
    UCI Health
    Orange, CA
    714-456-7131
    ------------------------------



  • 4.  RE: Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-20-2024 10:58
    Hi,
    So with this statement: The order must be entered by someone who could exercise clinical judgement if the entry generates any alarms about possible interactions or other clinical decision support aids. This necessitates having the Computerized Physician Order Entry (CPOE) occur when the order first becomes part of the patient's medical record, and before any action can be taken on the order.
    Does that mean to say that a certified MA can actually enter an 'actionable order' for the items mentioned, or just enter info. and 'pend' for provider signature?
    In NYS, our MAs (even if certified) can pend but not enter any actionable orders for tests or meds.
    They can enter meds onto a medication list, but the provider needs to confirm during the visit.
    Always trying to get clarity around this....


    Jaclyn S. Schindler, MPH, PMC, FNP-BC
    Senior Director, FGP Clinical & Nursing Operations
    NYU Langone Health
    One Park Avenue, 10th Floor, New York, NY 10016
    Jaclyn.Schindler@nyulangone.org<mailto:jaclyn.schindler@nyulangone.org>
    (646) 276-3005




  • 5.  RE: Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-21-2024 10:35

    Hello Jaclyn,

     

    Have you taken a look at the American Academy of Medical Assistants (AAMA) - https://www.aama-ntl.org/medical-assisting/what-is-a-medical-assistant#?

     

    You can search "Scope of Practice for Medical Assistants under Texas Law" at the web site above so I would imagine you could search the same for any state.

     

    I know what our MA II staff can do here in my clinic area and that includes giving flu shots but no by mouth medications or injectable antibiotics. They can ask the family if the patient is taking a medication and mark it as "taking" or "not taking". Our providers are responsible for putting a new med in the patient record (EPIC). Nurses can pend the request for refills to the physician after documenting last seen date and verifying that the pharmacy is requesting the same med, same dose as original. Our MAs cannot draw labs. I took a look at a school for MAs and found their list of what they say is allowable in TX. I figured a college would know since they are teaching the MAs here in TX. Here's what it says:

     

    Standard of Care for Medical Assistants: The Duties and Responsibilities of Medical Assistants in Texas 

     

    The standard of care refers to the level and type of care an average, prudent, similarly qualified medical assistant would provide in similar circumstances. It serves as a guide to ensure that all patients receive consistent, competent, and safe care. 

    According to the American Association of Medical Assistants (AAMA), medical assistants in Texas are expected to perform a range of clinical duties under the supervision of a licensed healthcare provider. These include the following:

    ·        Taking and recording vital signs 

    ·        Recording patients' medical history

    ·        Drawing blood for tests 

    ·        Administering medications as directed 

    ·        Assisting physicians in minor surgical procedures 

    ·        Collecting and preparing laboratory specimens. 

    In addition to clinical tasks, medical assistants are often responsible for administrative duties that include the following:

    ·        Scheduling patient appointments 

    ·        Managing the physician's calendar

    ·        Maintaining medical records 

    ·        Billing and coding for insurance purposes 

    ·        Answering phones and providing patient assistance 

    ·        Coordinating with other healthcare professionals

    Other Ethical and Legal Guidelines Medical Assistants Must Follow

    Medical assistants are expected to do the following to uphold the standard of care: 

    ·        Remain within the scope of their training and competencies to ensure patient safety and welfare.

    ·        Use equipment and perform procedures following established protocols. 

    ·        Document all medical records and notes accurately and promptly to ensure they reflect the true nature of patient care and comply with legal standards.

    ·        Ensure patient information remains private, following the Health Insurance Portability and Accountability Act (HIPAA). 

    ·        Provide care to all patients regardless of age, gender, race, or socio-economic status. 

     

    I hope this helps!! Rhonda –

    Chair – AAACN Staff/Patient Education SIG

     

     

     

    Rhonda Edwards, BSN, RN, AMB-BC, CPN

    Texas Children's Hospital                                          

    Spina Bifida Nurse - Clinical Care Center 

    Office #: 832-822-3317                                                           

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  • 6.  RE: Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-19-2024 10:01

    In my experience, the MA will mark medications as reviewed as a form of communication to the provider  indicating that a medication reconciliation was performed, updated and is accurate.  This saves the provider time.  The provider would then address any concerns during the visit and mark as reviewed.  Ultimately, it is the provider that is responsible to review the medications with the patient.  In EPIC,  the last person to "Mark as Reviewed"  is the one that appears as the "last  reviewed by".



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    Tammi Viancos BSN RN
    UT Southwestern
    Irving TX
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  • 7.  RE: Medication Reconciliation- Can MA Mark as Reviewed in Epic

    Posted 08-19-2024 13:46

    Thank you Tammi for your response.  Does your organization have a policy specific to this or this is just taught?



    ------------------------------
    Cindy Phan, MSN, RN
    Clinical Nurse Educator- Ambulatory
    UCI Health
    Orange, CA
    714-456-7131
    ------------------------------