Epic EMR training deck

Labs

Where do I find labs?

1. 1Open the patient's chart
2. 2Click Chart Review — the button at the very top of the chart, in the activity bar just above the patient banner
3. 3Select the Labs tab — it runs down the left side of the Chart Review screen
4. 4Results are listed newest first — double-click a row to open the full report
5. 5For trending over time, open Results Review and switch to the grid or graph view
6. 6Abnormal values show in red/blue; hover a result for the reference range

Tip: Results Review is the fastest way to compare several days of labs side by side.

Trend a Lab

How do I trend a lab value over time?

1. 1Open Results Review — it's in the activity bar at the top of the chart, usually next to Chart Review
2. 2Set the date range at the top (e.g. Last 7 Days or Custom)
3. 3Choose a display group such as Chem, CBC, or All Results
4. 4Click the lab name on the left to select the row
5. 5Click Graph to plot the value over time
6. 6Use Print or Copy to pull the grid into a note

Imaging

How do I find imaging or radiology results?

1. 1Open the patient's chart
2. 2Click Chart Review — the button at the very top of the chart
3. 3Select the Imaging tab — in the left-hand tab list, just below Labs
4. 4Click a study to read the radiologist's report
5. 5Click the image link (or Launch PACS / image icon) to open the actual images
6. 6Preliminary reads are labeled — check for a final signed report before acting

Cultures

Where do I find culture and micro results?

1. 1Open Chart Review at the top of the chart, then select the Micro tab — in the left-hand tab list, under Labs and Imaging (or Labs > filter Microbiology)
2. 2Click the culture to expand the report
3. 3Read Gram stain first, then preliminary and final organism identification
4. 4Scroll to the sensitivity panel for antibiotic susceptibilities
5. 5Cultures update over days — check the collected date and status (Preliminary vs Final)

Pathology

Where are pathology and biopsy results?

1. 1Open Chart Review — the button at the very top of the chart
2. 2Select the Pathology tab in the left-hand tab list (some builds file these under Labs or Procedures)
3. 3Click the specimen to open the full narrative report
4. 4Read the Final Diagnosis section at the bottom of the report

Orders

How do I place an order?

1. 1Open the patient's chart
2. 2Click Orders — it's in the activity bar on the left side of the chart, or along the bottom toolbar
3. 3Type the order name in the search box and pick the matching order
4. 4Fill in required fields — priority, frequency, indication, start time
5. 5Click Accept at the bottom right to add it to the basket
6. 6Click Sign Orders — bottom right of the basket; verify the green check appears

Tip: Orders sitting in the basket unsigned never reach nursing or pharmacy.

Order Sets

How do I use an order set?

1. 1Open the Orders activity
2. 2Click the Order Sets tab — at the top of the Orders activity, next to the search box (or search the set name in the order search box)
3. 3Open the set — pre-checked orders are the recommended defaults
4. 4Check or uncheck items and edit doses in the right-hand panel
5. 5Click Accept, then Sign Orders at the bottom right

Add-on Lab

How do I add on a lab?

1. 1Open Orders from the activity bar and search for the lab you want to add
2. 2Open the order details before signing
3. 3For an add-on to an existing specimen, set collection to Add-on / Lab Collect and reference the existing specimen
4. 4For a fresh sample, leave it as a new collection and set the collection time
5. 5Click Sign Orders at the bottom right, then call the lab to confirm the specimen is still viable

Tip: Add-ons are usually only possible within a limited window after the original draw (often 24–72h, shorter for chemistry).

Verbal Orders

How do I enter or cosign a verbal order?

1. 1Enter the order as usual in the Orders activity
2. 2In the Sign Orders screen, change the Order Mode dropdown to Verbal with Readback or Telephone with Readback — it's near the top of the signing window
3. 3Select the ordering provider from the lookup
4. 4Sign — the order routes to that provider's In Basket Cosign folder
5. 5To cosign: open In Basket (envelope icon, top toolbar) > Cosign Orders folder on the left > review > Accept

Stop an Order

How do I discontinue or modify an order?

1. 1Open the Orders activity and find the order under Active Orders
2. 2Right-click the order (or select it and use the buttons at the bottom of the screen)
3. 3Choose Discontinue to stop it, or Modify to change dose/frequency
4. 4Enter a reason if prompted
5. 5Click Sign Orders at the bottom right — the change is not live until signed

e-Prescribe

How do I send a prescription to a pharmacy?

1. 1Open Orders from the activity bar (or the Meds section of the visit navigator)
2. 2Search the medication and select the outpatient prescription
3. 3Set sig, quantity, refills, and dispense-as-written
4. 4Click the pharmacy field and choose the patient's preferred pharmacy
5. 5Click Accept, then Sign at the bottom right — enter your two-factor / EPCS token for controlled substances

Medications

How do I find medications or the MAR?

1. 1Open the patient's chart
2. 2For the active list, click the Medications activity — in the activity bar at the top (or Chart Review > Meds tab on the left)
3. 3For administrations, open the MAR activity from the same activity bar
4. 4The MAR is laid out by time — scheduled, PRN, and continuous infusions are grouped separately
5. 5Scroll left/right to see past doses and what's due next
6. 6Click a dose cell to see who gave it and when

Med Rec

How do I do medication reconciliation?

1. 1Open the Medication Reconciliation activity — from the activity bar, or inside the Admission or Discharge Navigator
2. 2Review each home medication and mark Continue, Modify, or Don't Continue
3. 3Add any missing home meds with Add Med
4. 4Resolve every row — unresolved rows block signing
5. 5Click Sign / Complete Reconciliation at the bottom

Give a Med

How do I document giving a medication?

1. 1Open the MAR activity from the activity bar and confirm the due dose
2. 2Scan the patient's wristband, then scan the medication barcode
3. 3Verify the five rights shown on screen (patient, drug, dose, route, time)
4. 4Enter any required fields — site, rate, pain score, vitals
5. 5Click Accept to file the administration

Tip: If a scan fails, use Override only per your facility's policy and document the reason.

IV Drips

How do I document or titrate an IV drip?

1. 1Open the MAR and find the infusion in the Continuous section
2. 2Click the active bag to open the administration window
3. 3Choose New Bag, Rate Change, or Stop as appropriate
4. 4Enter the new rate and volume, then Accept
5. 5Confirm the rate change appears on the MAR timeline

Notes

How do I write a note?

1. 1Open the patient's chart
2. 2Click Notes — it's in the activity bar at the top of the chart, usually the second or third button from the left, right next to Chart Review
3. 3Click Create Note (or New Note) — the button at the top left of the Notes screen
4. 4Pick the note type, then a template or SmartPhrase if you use one
5. 5Write the note — Pend saves a draft, Sign files it to the chart; both buttons are at the bottom of the screen
6. 6Use the Share/Route button to send it to another provider

SmartPhrases

How do I create or use a SmartPhrase?

1. 1In any note, type a period followed by the phrase name (e.g. .ROS) and press Enter
2. 2Press F2 to jump between the wildcards and fill them in
3. 3To create one: click the Epic button (top left corner) > Tools > SmartPhrase Manager > New
4. 4Paste your text, add SmartLinks with @ and wildcards with ***
5. 5Save — it's available immediately in every note

Tip: @ pulls live chart data (SmartLinks), . inserts your saved text, *** is a blank to fill.

Dictation

How do I dictate with Dragon in Epic?

1. 1Open the note and click into the text box
2. 2Press the record button on your mic (or the Dragon toolbar mic icon)
3. 3Speak normally and say punctuation out loud — "period", "new paragraph"
4. 4Say a SmartPhrase name to insert it, or "next field" to jump to the next wildcard
5. 5Press the mic again to stop, then proofread before signing

Tip: If accuracy drops, open Dragon > Manage Vocabulary to train problem words.

Cosign Note

How do I cosign or attest a resident's note?

1. 1Open In Basket — the envelope icon in the very top toolbar — and go to the Cosign Clinic Notes folder in the left-hand folder list
2. 2Open the note and read it
3. 3Click Addendum / Attestation and insert your attestation SmartPhrase
4. 4Click Cosign — the note is now billable and final

Fix a Note

How do I edit or addend a signed note?

1. 1Open the Notes activity — activity bar at the top of the chart — and select the signed note from the list on the left
2. 2Click Addendum (signed notes can't be edited in place)
3. 3Add the correction text and sign the addendum
4. 4For a note filed on the wrong patient, contact your Epic help desk to have it retracted

Admission

How do I admit a patient?

1. 1Open the patient's chart from the department or ED track board
2. 2Open the Admission Navigator — from the activity bar at the top or the navigator strip on the left (or Transfer/Admission activity)
3. 3Work top to bottom: place the admission order and set level of care
4. 4Complete medication reconciliation and the admission H&P
5. 5Add problems to the Problem List and set code status
6. 6Sign all orders — bed assignment happens once the admit order is signed

Discharge

How do I discharge a patient?

1. 1Open the patient's chart
2. 2Click Discharge in the activity bar at the top of the chart: the button sits right next to Notes and Orders and opens the Discharge Navigator — your discharge note and discharge activity sections are in the left-hand navigator panel, usually labeled Discharge Summary or Discharge Note
3. 3Work top to bottom through the navigator sections
4. 4Complete discharge medication reconciliation, follow-up, and patient instructions
5. 5Write or finalize the Discharge Summary note
6. 6Sign the discharge order and print the After Visit Summary (AVS) — the print button is at the bottom of the navigator

Transfer

How do I transfer a patient to another unit?

1. 1Open the Transfer Navigator from the activity bar at the top (or place a Transfer order from Orders)
2. 2Set the destination unit and level of care
3. 3Reconcile orders — Epic will ask which orders continue after transfer
4. 4Complete the transfer note or handoff documentation
5. 5Sign; bed management completes the physical move

Handoff

How do I do a handoff or sign-out?

1. 1Open the Handoff activity in the activity bar at the top (sometimes named Sign-Out or I-PASS)
2. 2Update the illness severity and one-liner summary
3. 3Fill in the action list / to-dos for the covering team
4. 4Update contingency planning ("if this, then that")
5. 5Click Accept — the handoff report is visible to the incoming team

In Basket

How do I message another provider?

1. 1Click In Basket — the envelope icon in the very top toolbar of Hyperspace
2. 2Click New Message at the top of the folder list and choose Staff Message
3. 3Search for the recipient by name, pool, or role
4. 4Attach the patient so the message keeps chart context
5. 5Type your message and click Send at the bottom right

Tip: For anything urgent use Secure Chat or a page — In Basket is not real-time.

Secure Chat

How do I use Secure Chat?

1. 1Click the Secure Chat icon — the speech-bubble icon in the very top toolbar (or the chat tab in Haiku/Canto)
2. 2Click New Conversation and search a person, role, or care team
3. 3Use Attach Patient so the thread carries chart context
4. 4Send your message — recipients get a live pop-up
5. 5Use Convert to In Basket if the topic needs a permanent record

Result Notes

How do I act on results in my In Basket?

1. 1Open In Basket (envelope icon, top toolbar) > Results folder in the left-hand folder list
2. 2Select the result — the chart snapshot opens on the right
3. 3Use the QuickActions bar: Result Note, Patient Letter, or Order
4. 4Write your comment and route to the pool or staff who will call the patient
5. 5Click Done to remove it from your folder

Chart Review

Where is Chart Review?

1. 1Open the patient's chart
2. 2Click Chart Review — the button at the very top of the chart workspace
3. 3Use the side tabs — Encounters, Labs, Imaging, Meds, Notes, Micro — they run down the left side of the screen
4. 4Check boxes next to rows and click Preview to view several items at once
5. 5Use the filter/date bar at the top to narrow a long list

Vitals

Where do I find vitals and intake/output?

1. 1Open the Flowsheets activity from the activity bar at the top (or the Summary sidebar for the latest set)
2. 2Choose the Vitals or I&O flowsheet group from the list on the left
3. 3Set the time interval at the top — hourly, per shift, or daily
4. 4Click a cell to add or edit a value, then Accept (green check, top right of the flowsheet)
5. 5Right-click a row to graph the value over time

Problem List

How do I add to the problem list?

1. 1Open the Problem List activity from the activity bar (or the Problem List section of the navigator)
2. 2Type the diagnosis in the Add Problem search box at the top
3. 3Pick the specific diagnosis — avoid unspecified codes when a specific one exists
4. 4Mark it Chronic and/or Principal Problem if applicable
5. 5Add an overview note if the team needs context, then Accept

Allergies

How do I add or update allergies?

1. 1Open the Allergies activity — from the activity bar, or click the red Allergies banner on the left-hand storyboard
2. 2Click Add and search the agent
3. 3Enter reaction type and severity
4. 4Mark Not on File / NKDA if the patient reports none
5. 5Click Mark as Reviewed so the banner clears

Code Status

Where do I set or check code status?

1. 1Check the storyboard — the patient panel running down the left side of the chart; code status shows near the top
2. 2To change it, place a Code Status order from the Orders activity
3. 3Select the status (Full Code, DNR, DNR/DNI, Limited)
4. 4Document the discussion in a Goals of Care or Code Status note
5. 5Scan advance directives into Chart Review > Media (left tab list) if they're on paper

Outside Records

How do I see records from another hospital?

1. 1Open Chart Review at the top and select the Care Everywhere tab in the left-hand tab list
2. 2Click Request Outside Records if none are loaded
3. 3Select the outside organization and open the encounter
4. 4Use Reconcile Outside Data to pull meds, allergies, and problems into the chart

Scanned Docs

Where do I find scanned documents and forms?

1. 1Open Chart Review at the top and select the Media (or Documents) tab in the left-hand tab list
2. 2Filter by document type — Consent, Outside Records, ECG
3. 3Click to open in the viewer
4. 4To add one, use Document Imaging / Scan or Import from the same tab

ECG

Where do I find EKG or ECG tracings?

1. 1Open Chart Review at the top and select the Cardiology / Procedures tab in the left-hand tab list
2. 2Click the ECG entry to open the interpretation
3. 3Click the image or Launch MUSE link to see the tracing
4. 4Compare with prior tracings using the date list on the left

Find Patient

How do I look up a patient?

1. 1Click the patient search box — the magnifying-glass field in the very top toolbar (or press Ctrl+Space in many builds)
2. 2Type the MRN, or last name comma first name
3. 3Pick the correct patient — verify name, DOB, and MRN
4. 4Choose the encounter you need, or select Chart Review for the whole record

Tip: Opening a chart you're not treating triggers a break-the-glass audit — always have a clinical reason.

Patient Lists

How do I set up my patient list?

1. 1Open the Patient Lists activity from the activity bar at the top
2. 2Under My Lists, click Create My List for a personal list
3. 3Use Available Lists to find your unit or service census, then Add to My Lists
4. 4Right-click a patient > Add to My List to build a rounding list
5. 5Use Properties to choose which columns display

Track Board

Where is the ED track board?

1. 1Click the Track Board activity in the top toolbar
2. 2Pick your department view at the top
3. 3Columns show room, chief complaint, wait time, and pending results
4. 4Click a row to open the chart; right-click for quick actions like assign provider

Schedule

Where do I see my schedule or appointments?

1. 1Open the Schedule activity (Ambulatory) or Snapboard (procedural areas) from the activity bar at the top
2. 2Set the date at the top left
3. 3Click a slot to open that patient's visit navigator
4. 4Use the status column to see arrived, roomed, and completed visits

Haiku / Canto

How do I use Epic on my phone (Haiku)?

1. 1Install Haiku (phone) or Canto (iPad) from your organization's app catalog
2. 2Log in with your normal Epic credentials and complete two-factor setup
3. 3Use the patient list or search to open a chart
4. 4Tap the chart tabs for results, notes, and meds; use the mic for dictation
5. 5Use Secure Chat and In Basket right from the app

Tip: Haiku shows most of the chart but a smaller order set — sign complex orders in Hyperspace.

Print

How do I print from Epic?

1. 1Use the Print button in the activity you're in, or the Epic button (top left corner) > Print
2. 2Choose what to print — AVS, note, results grid, or face sheet
3. 3Pick the printer from the list (printers are location-based)
4. 4Confirm the copy count and click Print

Wrong Chart

I documented on the wrong patient — what do I do?

1. 1Stop and do not delete anything yourself
2. 2Discontinue any orders you placed on that patient right away
3. 3Open the note and add an Addendum stating it was entered in error
4. 4Call the Epic help desk to retract or move the documentation
5. 5File the safety/event report per your hospital policy

Can't Sign

Why can't I sign my orders or note?

1. 1Look for red text or a red exclamation at the top of the signing window — that's the hard stop
2. 2Check for unfilled required fields (marked in red) inside each order
3. 3Resolve any Best Practice Advisory (BPA) pop-ups
4. 4Confirm you have an active encounter open, not a read-only chart
5. 5If it's a security issue, your template may not allow that order — ask a provider or the help desk

Frozen Epic

Epic is frozen or a window disappeared — what do I do?

1. 1Wait 30 seconds — Epic often recovers on its own after a server hiccup
2. 2Try the Epic button (top left corner) > Restore Workspace to bring back a lost window
3. 3Log out and back in; your unsigned work is saved as pended, not lost
4. 4If it persists, call the help desk and note the exact error text

Break the Glass

What is Break the Glass?

1. 1You'll see a pop-up when opening a restricted or confidential chart
2. 2Enter a specific clinical reason for access
3. 3Click Accept — access is granted and logged for audit
4. 4Only break the glass for patients you're actually treating

Personalize

How do I personalize Epic to work faster?

1. 1Star your frequent orders in the Orders search so they appear under Preference List
2. 2Use Epic menu > Tools > SmartPhrase Manager to build your own note text
3. 3Open Personalize on any activity toolbar to reorder columns and tabs
4. 4Set your default In Basket folders and note types in My Settings
5. 5Save filtered patient lists so your census loads in one click