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EPIC tips update
Contributors: Amanda Ball and Cynthia Beaulieu
The AACN Digital Technology and Innovation (DTI) Committee developed this resource as a practical guide for clinicians using Epic in neuropsychological practice. The topics below highlight workflow strategies and Epic functionalities that can improve efficiency, enhance documentation, and support clinical decision-making, including keyboard shortcuts, chart navigation, flowsheet utilization, automated reporting tools, and documentation of social determinants of health. We hope these suggestions help you make the most of Epic’s capabilities to support patient care and clinical documentation.
Keyboard shortcuts:
Use Your Keyboard to Select Options on the Screen
| Shortcut | Action |
|---|---|
| Alt+underlined letter | Perform the action of the associated button. Often one letter within a particular button name appears underlined. If so, use that letter as the shortcut for the button. For example, in the Wrap-Up activity, the V in the Print AVS button is underlined. Press Alt+V to activate the button and print the After Visit Summary. |
| Spacebar | Select the button or option that currently has the focus. A dark border appears around buttons or options that currently have the focus. |
| Date and Time Conventions | |
| t Today. | Use this to indicate today’s date. You can also use this as a relative date. For example, for today’s date, enter “t.” For tomorrow’s date, enter “t+1.” |
| w-Week. | Use this for relative dates. For example, for two weeks ago, enter “w-2.” |
| m-Month | Use this for relative dates. For example, to for five months from now, enter “m+5.” |
| y-Year. | Use this for relative dates. For example, for one year ago, enter “y-1.” |
| n-Now. | Use this to indicate the current time. You can also use this for relative times. For example, for 30 minutes from now, enter “n+30” |
| Shift+click | Select a continuous range of entries from the list. While holding down Shift on the keyboard, use your mouse to select an upper and lower bound. All entries between your two selections are highlighted. For example, use this technique to select rows 1 through 12 in a list. |
| Ctrl+click | Select two or more individual entries from the list. While holding down Ctrl on the keyboard, use your mouse to select each entry. For example, use this technique to select rows 1, 7, and 12 in a list. While still holding down the Ctrl key, click an entry again to clear it. |
| Navigate In Basket With Your Keyboard | |
| F5 or Alt+E | Refresh In Basket. |
| Ctrl+Shift+M | New Patient Message. |
| Delete or ALT+N | Mark Message as Done. |
| Ctrl+R | Reply to the selected message. |
| Ctrl+Shift+R | Reply All. |
| Ctrl+F | Forward the selected message. |
| Alt+H. | Chart |
| Ctrl+Shift+K | Mark as New. |
| F3 | Toggle Folder Navigation. |
| Ctrl+[ | Select Previous Message. |
| Ctrl+] | Select Next Message. |
| Alt+Shift+(period) | Select Next Folder Section. |
| Alt+Shift+(comma) | Select Previous Folder Section. |
| Alt+Shift+Left Arrow | Move up through the folder list. |
| Alt+Shift+Right Arrow | Move down through the folder list. |
| Ctrl+Enter | Display Report for Selected Messages. |
| Ctrl+K | Show Available Links. |
| ALT+H | Review Chart for the Patient. |
Flowsheets:
The use of flowsheets in Epic provides a standardized and efficient method for tracking behavioral, cognitive, and mental health symptoms over time and for making screening data easily accessible to the patient’s care team. Entry of data into flows also allows visualization of data to identify trends for patient care. While the specific flowsheets available vary by organization, many commonly used behavioral health and mental health screeners are built into Epic and can be administered during in‑person or telehealth encounters. These flowsheets allow clinicians to document patient responses directly within the electronic medical record, supporting longitudinal review and clinical decision‑making.
Many common screeners are available through the Epic Community Library. If you cannot find a flowsheet within your Epic environment, your institution informaticists may be able to locate an existing flowsheet in the Library. This reduces the time needed to build and validate a new flowsheet. Keep in mind that the availability of a scale, questionnaire or test is dependent upon copyright. Permission to incorporate some instruments directly into Epic may require permission and/or licensing fees. The incorporation of any permitted copyrighted scale is then restricted to the specific Epic site and is not available in the Library. Common instruments that are within the public domain, can frequently be located as flowsheets in the Library or built into your system by your institution informaticists.
In addition, Epic functionality such as DotPhrases and SmartLinks enables structured integration of flowsheet data into clinical notes and reports. DotPhrases can be configured to automatically pull relevant flowsheet scores, trends, or completion dates into documentation, reducing redundancy and supporting consistent interpretation and reporting. When used thoughtfully, this approach enhances efficiency, improves clarity in clinical communication, and helps ensure that symptom monitoring data are appropriately reflected in assessment, treatment planning, and follow‑up documentation. This approach allows clinicians to reference flowsheet‑derived scores and longitudinal trends directly within the results section of Epic documentation, supporting clearer communication of symptom severity, change over time, and clinical significance.
Commonly found relevant flowsheets in EPIC include:
| Flowsheet Name | Epic Short Name |
|---|---|
| Patient Health Questionnaire-9 | PHQ-9 |
| Generalized Anxiety Disorder-7 | GAD-7 |
| Columbia-Suicide Severity Rating Scale | C-SSRS |
| Ask Suicide-Screening Questions | ASQ |
| Suicide Risk Assessment | SRA |
| Suicide Risk Level | SRL |
| Mental Status Examination | MSE |
| Behavioral Health Assessment | BHA |
| Mood Disorder Questionnaire | MDQ |
| Brief Psychiatric Rating Scale | BPRS |
| Edinburgh Postnatal Depression Scale | EPDS |
| Violence Risk Assessment | VRA |
| Behavioral Risk Assessment | BRA |
| Restraint and Seclusion Monitoring | R/S |
| 1:1 Observation (Safety Companion) | 1:1 OBS |
| Confusion Assessment Method | CAM |
| Cognitive Status Assessment | COG |
| Functional Activities Questionnaire | FAQ |
| Alcohol Use Disorders Identification Test-C | AUDIT-C |
| Drug Abuse Screening Test | DAST |
| Substance Use Screening | SUS |
| Clinical Institute Withdrawal Assessment for Alcohol | CIWA |
| Clinical Opiate Withdrawal Scale | COWS |
| PRN Behavioral Medication Effectiveness | PRN-BH |
| De-escalation Interventions | DE-ESC |
| Behavioral Escalation Pathway | BEP |
| Vanderbilt ADHD Rating Scale | VAND |
| Strengths and Difficulties Questionnaire | SDQ |
Consider building your summary score data table into a flowsheet in Epic. Flowsheet data can be made to autopopulate into your reports or be incorporated directly into clinical documentation using Epic DotPhrases. By inserting flowsheet data or a preconfigured DotPhrase into a progress note or report, clinicians can automatically populate the note with relevant flowsheet information, such as screening scores, response patterns, or dates of administration. This allows structured assessment data to be clearly documented without manual transcription and supports consistency across notes and providers. Also, your data are now available for visualization of trends to assist with patient care and for future reference with re-assessments and data modeling.
Example sentence with DotPhrase usage:
For example, entering a DotPhrase such as .PHQ9 or a locally configured behavioral health DotPhrase can automatically pull the most recent PHQ‑9 score and item responses from the flowsheet into the note, where they can then be interpreted and integrated into the clinical assessment.
Epic Tip: Documenting Social Determinants of Health (SDOH) & Z Codes
Why this matters
Social determinants of health (SDOH) such as housing instability, food insecurity, and financial strain can affect overall well-being, neuropsychological test performance, and treatment adherence. Additional SDOH factors include insurance coverage, access to healthcare providers, cultural and linguistic considerations, and transportation barriers. These factors can influence healthcare access, quality of care, and health outcomes. Documenting relevant SDOH helps provide clinical context and support care coordination. Clinicians may use SDOH information documented by other team members (e.g., social work, nursing) or patient-reported information available in the medical record. Consider SDOH when interpreting cognitive concerns, patient engagement, and environmental stressors that may influence presentation and test results.
How to find SDOH information in Epic
SDOH information may be accessed and documented in multiple locations within Epic, including Social History, SDOH screening tools/questionnaires, Flowsheets, social work or case management notes, nursing documentation, and other patient-reported information. The specific location and workflow may vary by organization and Epic configuration.
- Check Social History or Flowsheets for completed SDOH screenings.
- Check Chart Review > History > Social Determinants (availability may vary by organization and Epic configuration).
- Look for SDOH-specific visual indicators, such as the SDOH wheel or umbrella icon, where available.
- Be aware that some organizations use facility-specific templates, SmartPhrases, flowsheets, or other Epic tools to document SDOH information.
Document in your note
- Include relevant social factors in the psychosocial or assessment section
- Note when these factors may affect testing, engagement, or follow-up
Add Z codes (ICD-10)
Use Z55–Z65 codes when social needs impact care. Code block is titled “Persons with potential health hazards related to socioeconomic and psychosocial circumstances”
- Common examples:
- 9 – Problems related to education and literacy
- 0 – Homelessness
- 4 – Food insecurity
- 2 – Lives alone
- 3 – Acculturation difficulty
- 0 – Relationship distress
Include when clinically relevant
- Use Z codes when social factors affect:
- Test interpretation & validity
- Attendance/adherence
- Treatment planning
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