• Notice: this SmartGroup includes multiple instances of the same procedure order—“Notify physician (specify”)—each with a different default comment. • Notice: you can select multiple options within this SmartGroup. • Notice: each item you select also appears on the Orders sidebar.
• Notice: again, this SmartGroup contains multiple instances of the same procedure—“POCT glucose.” In this SmartGroup, however, you can select only one of them.
• Notice: each of the options in this SmartGroup is a medication, with different default doses, frequencies, and admin instructions. • Is this SmartGroup single-select, or multi-select? Single _ • The display name of each order helps you decide which one you want, but after selecting it, the order name reverts to what you’d expect: <generic name> (<BRAND>) <form> <dose>
• Medications >> Insulin - Night Coverage >> insulin aspart (NovoLOG) injection • This is the same ERX record that you selected in the previous SmartGroup, but with different dose/frequency/admin instructions.
• Notice: all three orders are selected by default, with specific doses routes, frequencies, PRN reasons, and admin instructions.
□ 5. Expand the Concentrated Insulin (NOTE CONCENTRATION) SmartGroup. • Notice: unlike the previous examples, none of these orders have default values displaying.
□ 6. Select the “insulin lispro (HumaLOG) 200 unit/mL inj pen” item. • Notice: there’s no default value for dose, but there ARE default values for Route and Frequency. • If a SmartGroup doesn’t define a default value for a particular item (dose, route, frequency, etc.), the system will apply whatever default value is set in the ERX record (or EAP/EDP record for procedures).
• In this case, the ERX record has no default dose, but does have a route and frequency.
• Notice: even though there are two orders for insulin aspart (NovoLOG), you don’t get any duplicate warnings. That type of warning is suppressed in this Order Set.
□ 9. Pretend that time has passed and the patient’s condition has improved. Discontinue the insulin aspart (NovoLOG) injection 4-16 Units. • The system prompts you to discontinue the rest of the orders from the Order Set as well. If the patient is no longer getting corrective insulin they likely don’t need the supporting orders, either! • This happened because the corrective dose order for insulin was marked as a “keystone” order in the SmartGroup.
z1a Key Takeaways: Overview of Order Sets
• Order Sets are SmartSet (PRL) records.
• Users can search for and select Order Sets in:
o The Orders activity (alongside individual orders)
o Navigators (such as the Admission Orders >> New Orders for
• Order Sets can contain multiple sections:
o Sections divide up an Order Set and make easier to manage
o They don’t really control anything; they’re just for organization
• SmartGroup (OSQ) records are the building blocks of Order Sets.
• They contain the individual orders: Procedures (EAP records), Medication
(ERX records), and Order Panels (more on those in chapter 16).
• In the SmartGroup record, you can configure:
o Specific values (dose, route, frequency, PRN reasons, admin
instructions) for the orders they include
o Which orders (if any) are selected by default
o Whether a user can select only one order (single-select) or any number of orders (multi-select) from the SmartGroup
o Whether the SmartGroup is expanded or collapsed by default
o Whether users are required to select one of the orders from the
• A single SmartGroup can contain multiple instances of the same
EAP/ERX/Order Panel, each time with different values
• If a SmartGroup specifies a default value for an order, that value overrides
any default set in the ERX/EAP record.
o If a SmartGroup doesn’t specify a default value, then the default
value (if any) from the ERX/EAP record applies.
• Each SmartGroup can be used in multiple Order Sets.
o If you change a setting in a SmartGroup, that change will affect
every Order Set using that SmartGroup.
What’s the difference between a SmartSet and an Order Set? In EpicCare Ambulatory, SmartSets serve as templates for entire visits. They can include the reason for visit, the visit note, likely orders, prescriptions, diagnoses, follow-up, and level-of-service. Order Sets are just SmartSets that include only orders (usually inpatient-mode orders) and that are limited to appear in certain contexts.