Beacon Exam Flashcards
(107 cards)
1
Q
What is Beacon?
A
Beacon is Epic’s medical oncology application.
2
Q
Where is Beacon used?
A
Beacon is used in hematology, BMT, radiation oncology, and gynecological oncology.
3
Q
What does an organization gain by using Beacon?
A
- Increased patient safety with integration
- A single electronic medical record
- Standardized treatment and patient care
- Automated AJCC Cancer Staging
- CPOE for chemotherapy and oncology orders
- Ability to meet the documentation requirements of certifying organizations, such as AJCC
4
Q
What is oncology?
A
Oncology is the area of medicine that deals with the diagnosis and treatment of cancer.
5
Q
What are the phases in a cancer treatment timeline?
A
- Consult and diagnosis
- Staging
- Treatment
- Maintenance and Long-term care
6
Q
Describe the consult and diagnosis phase of the cancer treatment timeline?
A
This is where the oncologists determine what kind of cancer a patient has, their prognosis and treatment options.
7
Q
Define prognosis.
A
The likely outcome or course of a disease; the chance of recovery or recurrence.
8
Q
Describe the staging phase of the cancer treatment timeline?
A
oncologists and pathologists document how advanced a patient’s cancer is, report tumor information to registries, and recommend treatment options.
9
Q
Describe the surgical treatment phase of the cancer treatment timeline?
A
Cancer surgery attempts to completely remove localized tumors or reduce the size of large tumors so that follow-up treatment by radiation or chemotherapy will be more effective. Can also be done as a diagnostic procedure.
10
Q
Describe the radiation therapy phase of the cancer treatment timeline?
A
Radiation therapy uses x-rays, gamma rays, and other sources of radiation to destroy cancer cells. The goal of radiation therapy can be curative or palliative, and it is often used in conjunction with other treatments, most often surgery and chemotherapy.
11
Q
Describe the chemotherapy phase of the cancer treatment timeline?
A
Chemotherapy treatment uses chemical agents to interact with cancer cells to eradicate or control the growth of cancer.
12
Q
Describe the Blood and Marrow Transplant phase of the cancer treatment timeline?
A
This is a therapy that replaces diseased bone marrow with highly specialized stem cells that develop into healthy bone marrow. This treatment is only used for certain types of cancer.
13
Q
Describe the maintenance and survivorship phase of the cancer treatment timeline?
A
Survivorship is designed to ensure the continued medical observation to monitor the health status of the patient, detect any recurrence of cancer early and provide ongoing therapy.
14
Q
What is an oncologist?
A
A physician that specializes in the treatment of cancer.
15
Q
What is an oncology fellow?
A
A fellowship is the period of medical training that a physician can undertake after completing a specialty training program.
16
Q
What are NP/PA’s allowed to do for oncology treatments?
A
- Be part of the care team
- Assist with new patients/consults
- Order routine chemotherapy
- Perform invasive procedures
17
Q
What does an infusion nurse specialize in?
A
They specialize in care of patients receiving IV infusions, chemotherapy infusions, IV hydration, and blood products.
18
Q
What is an OCN?
A
A nurse with an additional certification in the proper administration and handling of chemotherapy.
19
Q
What does an oncology pharmacist do?
A
Oncology pharmacy specialists recommend, design, implement, monitor, and modify pharmacotherapeutic plans to improve outcomes in patients with malignant disease.
20
Q
What does a patient navigator do?
A
Patient navigator’s help guide the patient through their plan of care and typically work with the entire treatment team including physicians, nurses, social workers, dietitians, chaplains, cancer researchers, librarians, psychologists, complementary-medicine providers, etc.
21
Q
What are the integrated workflows that Beacon shares with other apps?
A
- Rooming
- allergies
- home medications
- history - Charting
- Notes
- Problem list (diagnosis)
- Dual mode order entry - Discharge
- After Visit Summary (AVS)
- Patient Instructions
- Level of Service - Inpatient MAR
- Barcode medication administration
- Flowsheet documentation
- Blood administration
22
Q
What functionality does Beacon typical own?
A
- Treatment Plans/Protocols
- Chemotherapy ordering
- Protocol (PRL) Best Practices Build
- Outpatient & inpatient infusion workflows - Oncology-related Therapy Plans
- Therapy Plan scheduling - Cancer staging
- Oncology history
- Radiation Oncology
- blood and Marrow Transplant
- Multidisciplinary Tumor Board
- Tumor Genomics
- Advanced Preparation
23
Q
What are Protocols?
A
Protocols are tools that contain recurring medication, procedure and related orders, organized into a day and cycle structure, which spans the entirety of the oncology treatment/
24
Q
What are Treatment Plans?
A
A treatment plan is a system generated, patient level tool that can be customized to fit the patients needs.
25
What's an encounter?
Any contact that the patient has with your organization.
26
What's an episode care?
An episode is a series of related encounters grouped together in order to consolidate and centralize documentation related to an ongoing condition. Automatically created when a new treatment plan is created.
27
What is a group of related encounters called?
An episode
28
What are the differences between a Protocol and a Treatment Plan?
A Protocol is a standard regimen intended to treat a specific kind of cancer. A Treatment Plan is a customized, patient-specific version of the regimen.
29
What are the two options that appears for staging information?
1. Enter staging information
| 2. Mark as Not Needed
30
Describe the Oncology History Section.
The oNcology History activity gives clinicians a central place in the patient's chart to document information about the patient's oncology care, such as diagnoses, treatments like chemotherapy and surgery, and outcomes.
31
What type of cancer staging references does Beacon support?
1. American Joint Committee on Cancer (AJCC)
2. FIGO staging
3. Free text staging
32
What does the provider need to do in order to access the Staging Activity?
Enter a cancer diagnosis on the problem list and click Enter Staging Information
33
Why is it important to add the cancer diagnosis to a patient's Problem List within Epic?
This is the only way to access the staging information, and there are many other parts of a patient's cancer treatment that rely on having the diagnosis on the problem list.
34
What are the two types of staging?
Clinical and pathologic staging.
35
Describe a protocol.
A standard regimen that becomes a treatment plan when it applied to a specific patient.
36
What activities are included in Treatment activity?
1. Treatment Plan
2. Consent Forms
3. Supportive Care Plans
4. Therapy Plans
5. BMT Treatment
37
Does a treatment plan weight have to be entered for a nurse to release the orders?
Yes
38
What system level defaults can a provider override?
1. Specify the weight and BSA to use for medication dosing
2. Specify the correction factor used when calculating adjusted weight
3. Specify the warning threshold for differences between the weight or BSA used to calculate doses in the treatment plan
39
What is the prescription cycle also known as?
Bonus cycle or Cycle 0
40
What are therapy plans used for?
Therapy plans are used for standing orders that occur repeatedly, over time and that need to cross encounters.
41
Can a patient have more than one active therapy plan?
No
42
What is the master file for treatment plan?
TPL
43
How can you see the contents of a protocol before choosing to for your patient?
Click the preview icon
44
Can you associate a treatment plan with a diagnosis that is not already on the patient's record?
Yes
45
Why would it bee helpful to enter the patient's current height and weight before creating the new treatment plan?
When you accept a treatment plan for a patient, you can see the dosing of any meds that need to calculate based on the patient's body surface area. To assign a treatment plan weight, the provider will need the patient's current BSA.
46
At what levels of a treatment plan can orders be signed?
The whole cycle, a specific day of a cycle, order categories, or specific orders.
47
How are Therapy Pans different from Treatment Plans?
Therapy plans are built around a list of orders and use relative intervals to specify when each order is due, whereas treatment plans are built around cycles and use specific calendar dates. Therapy plans are quicker and easier to set up, and more flexible. Therapy plans can continue indefinitely, while treatment plans have very rigid structures and have a very clear end date. Therapy plans do not include oncology-specific tools like treatment plans, and therapy plans do not require a Beacon license.
48
What is the significance of prior authorization, and what happens if a patient does not have authorization in time for their infusion appointment?
The prior authorization workflow ensures that a hospital contacts the patient's payer and confirms they will pay for treatment. If a patient does not have authorization before their treatment, their treatment could be delayed.
49
What is the 1st step in the outpatient infusion visit overview?
1. Check the Schedule Ahead of Time
| - Confirm signed orders
50
What is the 2nd step in the outpatient infusion visit overview?
2. Infusion Visit Prep
- Check reports
- Document dosing weight and BSA
- Check lamb results
- Release remaining treatment orders
51
What is the 3rd step in the outpatient infusion visit overview?
3. Pharmacist Verifies Meds
| - Verify, or duel verify, necessary medications
52
What is the 4th step in the outpatient infusion visit overview?
4. Medication Administration
- Administer pre-medications
- Administer chemotherapy
53
What is the 5th step in the outpatient infusion visit overview?
5. Complete the Treatment day
- Schedule upcoming appointments
- File charges
- Complete the treatment day
54
What are the two reasons for the visit-to-visit weight change alert?
1. The weight entered could be an error.
| 2. We want the user to be aware of any significance change in weight.
55
What are the two types of alerts for significant weight change?
1. Significant weight change since the previous visit
| 2. Significant weight change from the Treatment Plan weight
56
Define Synopsis.
Synopsis is a powerful review took that allows clinicians to visually compare data in both a flowsheet and graphical format on the same screen.
57
What is visible in the Rx Sidebar report?
Current medication for the patient as well as information about interventions and the Snapshot report.
58
What is visible in the Order Details display?
Dose, route, frequency, information about the treatment plan and prior authorization.
59
Why is the inpatient MAR used in Beacon?
It provides additional functionality that is important for infusion nurses such as medication barcoding, documenting start and stop times and providing an hour by hour view for administered meds.
60
What does each column in the MAR represent?
A 1-hour block of time.
61
What does each row in the MAR represent?
A different medication.
62
What appears at the intersection of a row and column?
Due times for medications with scheduled administration times.
63
How are medications sorted in thee standard Inpatient MAR?
They are sorted alphabetically.
64
How are treatment plan medications sorted on the MAR?
In the same order they are listed in the patients treatment plan.
65
Describe the concept of double-checking the "rights"?
Giving the right patient the right medications with the right dose via the right route at the right time for the right reason followed by the right documentation.
66
Why is it important to document the correct stopped time for infusion?
There are implications for billing and intake and output.
67
From which activity or activities can the nurse release Treatment Plan orders?
The nurse can release orders from either the Treatment Plan navigator section or the Treatment Plan Manager.
68
What information is available too the nurse in the Synopsis activity?
Vitals, Lab results and medication doses/administration information.
69
How can the nurse tell whether or not to hold treatment?
Check the results against the Treatment Conditions order in the treatment plan.
70
What icon displays on the treatment plan to indicate the orders are released?
Green check mark with an arrow.
71
How many days' orders can we release at a time, as seen in the Treatment Plan Manager and navigator sections?
Only the current day's orders can be released.
72
True or False. A patient typically needs only one follow-up visit after their oncology treatment is complete.
False. Survivorship follow-up visits can last years, oftentimes decades! A patient is monitored for lingering side-effects of treatment as well as cancer recurrence.
73
With whom is the oncology treatment summary shared?
The patient and/or patient's caregivers, the patients care team, the patients PCP, etc.
74
Why might a user put a treatment plan on hold?
If the patients condition suddenly deteriorates, or otherwise the oncologist is unsure of when the patients treatment will continue and wants two wait until there is more information to proceed.
75
True/False: During a treatment day transition, the same user who adds/removes orders must also edit orders and finish the treatment day transition.
False, the two steps of transitions of treatment may be performed by two different users and the ability to do each step is controlled by security points.
76
Which two formulas are used to determine the AUC dose of carboplatin for a patient?
Calvertt formula and a creatinine clearance formula (Cockroft-Gault by default)
77
Which two items can an oncologist override to manually determine the AUC does of a medication for a patients?
Serum creatinine and glomerular filtration rate.
78
An oncologist is viewing the treatment plan in a navigator for a patient and is trying to quickly determine how the dose of an AUC-based medication is being calculated by the system. The oncologist has voiced frustrations that she has to open the order composer of the medication in order to see the dose calculations. What can you do as the administrator to easily display the dose calculations for the oncologist without them having to open the order composer?
In a profile for the oncologist you can set the 'Show dose calculations in navigator section?' to Yes.
79
How does the rule of specificity impact how the system searches for medications and procedure settings?
The system starts at the most specific level, Procedure Record (EAP), then checks the Procedure Category (EDP) and finally the most general System Definitions (LSD) level for each settings.
80
How are clinic appointment request orders and infusion visit orders different?
Clinic requests do not rely on medication duration for scheduling purposes, while infusion visits do. They also generate different types of visits, clinic requests are office visits and infusion visits are Oncology TX visits.
81
What are treatment conditions orders used for?
Treatment conditions give information to the provider or nurse on what conditions the patients needs to meet before they can go on with the treatment day.
82
What should the display items be for a Treatment Conditions order? Summary items?
Comment is the most important display and summary item listed in the OCC.
83
Can order groups contain orders that have different order categories? How?
Yes, by specifying the order category in the order itself.
84
How can you define an overall order category for an order group?
In the default category field, define the overall category for the order group. Note that this only applies to orders added after you've specified that default order category. If you had added orders before filling in the default category, you would need to specify the category for those orders individually.
85
What is the difference between basic and single selection modes?
Basic mode end users do not have a choice; all orders added by the protocol builder will appear in the treatment plan. With single-select, users can select one order from many to be included in the treatment plan; if the group does not include a default selection no orders will appear in the treatment plan until a user selects one.
86
What is the basic structure of a protocol?
Cycles contain days which have order groups (which contain orders) or individual orders.
87
In the Protocol Builder, how are different orders organized? How does this differ from how they are organized in a Treatment Plan?
Orders are organized by order groups, not order categories like a Treatment Plan.
88
True or False. An order group can contain orders that fall into different order categories.
True
89
How do you make an order group in a protocol required?
Click the selection mode link on the Order Group header, and choose required. For suggested order groups, choose Recommended.
90
What is the difference between cancelling and deferring a treatment day?
Cancelling means all of the orders contained in that day are no longer able to be released or acted upon, whereas deferring means you want to keep those orders but have them happen a few days later, to allow the patient to recuperate.
91
What is the difference between cancelling and deleting a treatment day?
Cancelling a treatment day shoes that the day was intended to be given, but will not be completed for clinical reasons. Deleting a treatment day is usually done because of error or at the beginning of the treatment plan modification process.
92
When would you defer a treatment day?
For clinical reason such as treatment parameters not met.
93
Where in the treatment plan manager can you see all the changes made to a treatment plan over time?
In the History view of the Treatment Plan Manager. Click Add/Remove Views on the toolbar and then select the check box for History.
94
How can one provider quickly sent treatment plan information two another provider?
Route the treatment plan.
95
How do protocols differ from treatment plans?
Protocols are the template for chemotherapy treatment built by analyst and are diagnosis-specific. Treatment plans are applied to the patient, modified for patient and are date-specific.
96
While editint a patient's treatment plan, you realize you do not want to keep the changes you have added since you last saved the Treatment Plan. How could you most easily edit the Treatment Plan to reflect what you would like to see?
A. Click Undo
B. Click Last Saved
C. Click Restore
D. Close the treatment plan without saving
C. Click Restore
97
```
Which of the following can be done in the Treatment Plan Manager?
A. Drag and drop an order
B. Copy and paste a day
C. Sign orders
D. Release orders
```
A. Drag and drop an order
B. Copy and paste a day
C. Sign orders
D. Release orders
98
```
Which activity allows oncologist to modify multiple treatment days at once within the Treatment Plan?
A. Treatment Plan navigator section
B. Order Review
C. Treatment Plan Manager
D. Springboard Report
```
C. Treatment Plan Manager
99
You are getting ready to build order groups and protocols and need to create new order categories before you begin. To create new order categories you must:
A. Edit the appropriate category list
B. Edit the appropriate procedure category
C. Edit the appropriate Order Group
D. Edit the appropriate ERX and/or EAP record
A. Edit the appropriate category list
100
True or False: An order group can be reused in multiple protocols.
True
101
Protocols can be suggested to users based on:
A. A best practice advisory
B. A diagnosis in the chart
C. The research study the patient is enrolled in
D. Being a favorite of that user
A. A best practice advisory
B. A diagnosis in the chart
C. The research study the patient is enrolled in
D. Being a favorite of that user
102
True or False: Treatment plan medication orders appear in the pharmacy verification queue as soon as they are released.
True
103
There was a problem with a pic line and the nurse would like to push back the due times of the remaining medications. She's already started administering pre-meds.
True or False: The nurse can click the Adjust Treatment Start Times button to move the due times of the remaining medications.
False.
104
True or False: Staging information can be routed automatically to an Inbasket pool for an organization's tumor registrar.
True
105
True or False: A Treatment Conditions order needs to have Comment appear as a display item to users in the Treatment Plan.
True
106
```
What lab value is required in order to automatically calculate AUC-based dosing of carboplatin when using the Cockroft-Gault formula?
A. Potassium
B. Blood glucose
C. Serum creatinine
D. Platelets
```
C. Serum Creatinine
107
True or False: When modifying an existing therapy plan on a patient's chart, it is possible to reactivate orders that had previously been removed or were originally left unsigned.
True. In the Therapy Plan navigator, a wrench button allows you to view removed orders. From there you can also easily reactivate them.
