ABSTRACT
Data and Documentation ● Produce a Summary Record of Care ● Present Ad Hoc Views of the Health Record ● Manage Patient History ● Manage Patient and Family Preferences ● Manage Patient Advance Directives ● Manage Consents and Authorizations ● Manage Allergy, Intolerance, and Adverse Reaction Lists ● Manage Medication Lists ● Manage Problem Lists ● Manage Immunization Lists ● Interact with Guidelines and Protocols for Planning Care ● Manage Patient-Specifi c Care and Treatment Plans ● Manage Medication Orders as Appropriate for her Scope of Practice ● Manage Non-Medication Patient Care Orders ● Manage Orders for Diagnostic Tests ● Manage Orders for Blood Products and Other Biologics ● Manage Referrals ● Manage Order Sets ● Manage Medication Administration ● Manage Immunization Administration ● Manage Results ● Manage Patient Clinical Measurements ● Manage Clinical Documents and Notes ● Manage Documentation of Clinician Response to Decision Support Prompts ● Generate and Record Patient-Specifi c Instructions
● Manage Health Information to Provide Decision Support for Standard Assessments ● Manage Health Information to Provide Decision Support for Patient Context-Driven
Assessments ● Manage Health Information to Provide Decision Support for Identifi cation of Potential
Problems and Trends ● Manage Health Information to Provide Decision Support for Patient and Family
Preferences ● Interact with Decision Support for Standard Care Plans, Guidelines, and Protocols ● Interact with Decision Support for Context-Sensitive Care Plans, Guidelines, and
Protocols ● Manage Health Information to Provide Decision Support Consistent Healthcare Manage-
ment of Patient Groups or Populations ● Manage Health Information to Provide Decision Support for Research Protocols Relative
to Individual Patient Care ● Manage Health Information to Provide Decision Support for Self-Care ● Interact with Decision Support for Medication and Immunization Ordering as Appropri-
ate for Her Scope of Practice ● Interact with Decision Support for Drug Interaction Checking ● Interact with Decision Support for Patient Specifi c Dosing and Warnings ● Interact with Decision Support for Medication Recommendations ● Interact with Decision Support for Medication and Immunization Administration ● Interact with Decision Support for Non-Medication Ordering ● Interact with Decision Support for Result Interpretation ● Interact with Decision Support for Referral Process ● Interact with Decision Support for Referral Recommendations ● Interact with Decision Support for Safe Blood Administration ● Interact with Decision Support for Accurate Specimen Collection ● Interact with Decision Support that Presents Alerts for Preventive Services and Wellness ● Interact with Decision Support for Notifi cations and Reminders for Preventive Services
and Wellness ● Manage Health Information to Provide Decision Support for Epidemiological Investiga-
tions of Clinical Health Within a Population ● Manage Health Information to Provide Decision Support for Notifi cation and Response
Regarding Population Health Issues ● Manage Health Information to Provide Decision Support for Monitoring Response Noti-
fi cations Regarding a Specifi c Patient’s Health ● Access Healthcare Guidance ● Interact with Clinical Workfl ow Tasking ● Interact with Clinical Task Assignment and Routing ● Interact with Clinical Task Linking ● Interact with Clinical Task Tracking ● Facilitate Inter-Provider Communication ● Facilitate Provider-Pharmacy Communication ● Facilitate Communications Between Provider and Patient and/or the Patient
Representative ● Facilitate Patient, Family and Care Giver Education ● Facilitate Communication with Medical Devices
This list of competencies came from the Direct Care components of the HL7 EHR System Functional Model. In some cases functional statements were not changed as they can also serve as competencies. For example, the HL7 EHR System Functional Model statement of “Access Healthcare Guidance” was unchanged, except for the preamble that applies to all Clinical Information Management Competencies, as “Using an EHR, the nurse can: Access Healthcare Guidance.” The HL7 EHR System Functional Model statement of Communication with Medical Devices was changed from “Communication with Medical Devices” to “Facilitate Communication with Medical Devices” to make it a Clinical Information Management Competency.
