Requiring Action – How to Clear Items and Who Can Sign Off (by Item Type)

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Overview

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What is Requiring Action?

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Who can clear items in Requiring Action?

• Provider Level Users can sign off on most clinical items by default.
• Staff Level Users can clear certain items (such as letters and some office messages) and can sign off on others only when a provider has granted them delegate permissions.
• Authorized Delegates are Staff Level Users explicitly configured by a provider to sign on their behalf for specific item types.

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Workflow Instructions

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Lab Results

• Practice Home queue: Reports
• Patient chart: Requiring Action (if unsigned)

• Any Provider Level User can sign off on electronic lab results, even if they are assigned to a different provider
• Staff Level Users can sign off if they have been delegated sign-off permissions by a provider

• Click Sign Off (Provider Level User) or Sign off on behalf of provider (Staff Level User with delegation)
• Optionally, click Sign Off & Send to patient or Sign Off & Send to provider to attach the report to a Patient Letter or Provider Letter

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Imaging Reports

• Practice Home queue: Reports
• Patient chart: Requiring Action (if unsigned)

• Provider Level User (ordering provider or any provider in the practice)
• Staff Level Users with delegated sign-off permissions

• Click Sign Off (Provider Level User) or Sign off on behalf of provider (Staff Level User with delegation)
• Optionally, click Sign Off & Send to patient or Sign Off & Send to provider

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Faxed Documents

• Practice Home queue: Reports (after filing from the Fax Inbox)
• Patient chart: Requiring Action (if assigned for sign-off)

• Provider Level User assigned to the document
• Staff Level Users can sign off if delegated by a provider
• If the document was filed with File on behalf of Provider checked, no sign-off is required and the document goes directly to the Chronological Record

• Click Sign Off (Provider Level User) or Sign off on behalf of provider (Staff Level User with delegation)

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Office Messages

• Practice Home queue: Office Messages
• Patient chart: Requiring Action (if addressed to you) or Outstanding Items (if waiting on others)

• Provider Level Users can sign any Office Message thread, even if they are not a recipient
• Staff Level Users can click Mark Complete only if the thread contains no Provider Level Users
• Premium EHR users may configure Staff Level Users as Office Message Delegates to sign on behalf of providers

• Sign Off – for Provider Level Users or Staff Level Users designated as Office Message Delegates (Premium EHR)
• Mark Complete – for Staff Level Users when no providers are on the thread
• Acknowledge – for recipients after a provider has signed and sent a final reply; all other recipients must acknowledge to dismiss the item

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Refill Requests (Rx Requests)

• Practice Home queue: Rx Requests
• Patient chart: Requiring Action

• Provider Level User assigned to the request
• Authorized Rx Delegates (Staff Level Users) can address non-controlled substance refill requests on behalf of a provider
• Controlled substance refill requests can only be addressed by the Provider Level User with EPCS credentials

• Click Approve, Approve with modifications, Change Number of Refills, Deny, or Deny & add reason for standard refill requests
• For controlled substance requests: click Deny or Renew (which opens a new prescription form requiring EPCS authentication)

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Unsigned Visit Notes, Notes, Letters, and Orders

• Practice Home queue: Draft Notes, Draft Letters, or Draft Orders
• Patient chart: Requiring Action

• Provider Level Users can sign all draft clinical documents
• Staff Level Users can send Letters
• For Orders, Referrals, and Letters: Staff Level Users with appropriate delegate permissions

• Complete the document and click Sign or Sign & Close

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Patient Letters and Provider Letters

• Practice Home queue: Patient Letters or Provider Letters (when a response is received)
• Patient chart: Requiring Action (when a response is received or action is needed)

• Provider Level Users
• Staff Level Users (for Patient Letters and Provider Letters)
• For Referrals: Staff Level Users with delegate permission

• Reply, Sign, or Acknowledge for Provider Letters or Referrals
• Reply & Sign Off or Reply, Sign Off & End Conversation to close the thread

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Quick Reference Table

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Related Articles

• Requiring Action & Open Items Queues – Managing open action items for your patients
• Practice Home Guide – Checking for requiring action items
• Office Message Feature Guide
• Patient Chart Guide – Annotate and eSign Clinical Reports and Documents
• Staff Permissions & Staff Delegates Guide