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Lytic Therapy for Pulmonary Embolism (PE)?



The PEITHO trial published this week in the New England Journal of Medicine compared standard therapy vs. systemic fibrinolytic therapy for intermediate-risk PE. In the study, the use of fibrinolytic therapy reduced the primary endpoint of hemodynamic decompensation (including a drop in systolic BP <90 mmHg for at least 15 mins) but increased the risk of intracranial hemorrhage by a ratio of 10:1 (P <0.003). The editorialists recommend a conservative approach for PE using intitial anticoagulation and rescue fibrinolysis for refractory hemodynamic decompensation.



Just A Reminder...



In order to use the Physician Portal with later versions of Internet Explorer (Versions 10 & 11), you must add the Portal URL ( to Combatibility View. This is located under Tools.



If you are having issues with viewing charts under the Med Rec tab, check to make sure you have not loaded a later version of Java. Portal will accept versions of Java 1.6_22 up to 1.6_45. However, it will not work with any versions of 1.7x. You can uninstall the 1.7x version, then log back into Portal, click in the Med Rec tab, and install the correct Java version.



The new AFib Order Set is now available through the HOME Tab of the Physician Portal. In addition, the order sets have been placed in the nurse's stations in the following units: Neuro, NIC, 5S, 4S, ICU, Intermediate, and in the ED Admitting Physician area. 


Attention: Primary Care Physicians



Write the specific date & time of your Heart Failure patient's follow-up appt in the order sheet. Use these Transitional Care Management (TCM) codes for the visit.


99496, TCM:  Medical decision-making of high complexity during the service period, face-to-face visit within 7 calendar days of discharge. As much as $230.90 if you meet the requirements.


99495, TCM: Medical decision-making of at least moderate complexity during the service period; face-to-face visit within 14 calendar days of discharge. As much as $163.91 if you meet the requirements.



Feedback is important. See improvements to the Change in Level of Care workflow which will be available on Thursday morning at 9 AM.  New video on eCafe will help you navigate the improvements step by step "http://mrhsswss02/Clinical/eCafe/default.aspx” .  Click on the NEW eCafe MedsTracker VIDEOS 


We heard you .  Remote portal access to online orders will be available Thursday (12/19) at 8 AM.  You'll see 2 Online Orders Tabs.  Use Online Orders REMOTE tab when accessing from your desktop icon at home, office, or mobile device.  Use Online Orders IN-HOUSE CITRIX tab when working in the hospital or when logged in remotely through CITRIX. For more details, check out the OnLine Orders Important Notice.  If there are no medications present on the Admission Tab, providers should check with the nurse to verify home meds are available for reconciliation or select OVERRIDE to pull in the partially completed home meds in  Online Orders/Meds Tracker.   For users that want to access Online Orders remotely, you will need to access the Portal through Citrix. These procedures can be found on the HOME tab of the Portal. The files are Physician Citrix Receiver Setup for Android Devices; Physician Citrix Receiver Setup for Apple iDevices ; Citrix Receiver Setup for Apple Computers; Citrix Web Access Setup for Windows PC.  Check out the eCafe Website to get a quick refresher on how to access Online Orders "http://mrhswss02/Clinical/eCafe.


If you have issues or questions concerning the Physician Portal, please call 402-5228 during the hours of 6:00 a.m. and 3:00 p.m. If you have issues after 3:00 p.m., please call 812-0498




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Dear Physicians:


 Florida Blue Townhall Meeting


Date:  Wednesday, April 23

Time:  6 pm - 8 pm

Location:  Auxiliary Conference Center

RSVP:  671-2589




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Med–Surg LOS Spotlight

Week ending Mar 23 :                           4.99

Month to date thru Mar 23:                    5.24      

February 2014:                                     5.25

FY 2014 (Oct - Feb)   YTD:                4.93 

                                  Target  4.50 

Average LOS February 2014:              41.5 Hours     

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