IRIS Worklist - Frequently Asked Questions

Here are the answers to frequently asked questions about the IRIS Worklist.

GENERAL IRIS WORKLIST QUESTIONS

1. Who can see the IRIS Worklist and how do I access it?
   1. All users with existing permissions to IRIS Analytics will see the IRIS Worklist. The IRIS users displayed will continue to be based on the department permissions that the application users have access to. 
2. How long does an IRIS user stay flagged?
   1. An IRIS user will remain flagged and have an open review until the review is complete. 
3. Am I able to change a review status back (i.e., "In Review" to "Needs Review")?
   1. A review status operates unilaterally, meaning you are unable to move it back to a previous state. 
4. How do I manually open an IRIS review? 
   1. Select an unflagged user's card to open the IRIS User Detail Panel and select the "Move To" dropdown to assign a review status. 
5. I accidentally opened an IRIS review. What should I do? 
   1. Move the user to "Reviewed" with No Concern and document a note. 
6. Why am I unable to open the "Documentation" tab for a user? 
   1. A user is required to have an open IRIS review in order to access the "Documentation" tab and add notes. 
7. What are the different Review Outcomes? 
   1. After completing an IRIS review, you may select one of the following review outcomes to track what you determined: 
      • Policy Non-Compliance: failure to adhere to established hospital protocols, guidelines, or procedures. 
      • Diversion Suspected: suspicion that a healthcare professional is illicitly using or diverting medications intended for a patient. 
      • No Actionable Concern: minor deviations from protocol and no evidence of significant harm to patients or violations of regulations.
8. A provider has an overall red IRIS of 4.6 yet their flagged IRIS is yellow with a score of 1.5. When I examine his IRIS metrics they all appear to be green and yellow or have a low IRIS. Since this is the case, why is the overall IRIS still red? 
   1. The cut-off for a yellow IRIS score is 4.5, so anything above this score will be red. ControlCheck's logic scales the scores so that the top 1% of users will have a red IRIS. The hospital this user works for has about 200 users; as a result, you should expect at least two users to have a red IRIS. If there aren't two users that exhibit extreme outlier behavior, it's possible for a user with slightly unusual behavior to have a red IRIS. In this scenario when we examined this provider's top two metrics, variance counts and med trends, their metric scores were very high yellow scores. When configuring the overall IRIS these two metrics are weighted 5x more heavily than the other IRIS metrics.

IRIS REVIEW & CASES QUESTIONS

1. What is the difference between an IRIS Review and a Case?
   1. An IRIS Review is the initial assessment of the user's controlled substance handling activity and once "In Review" requires an application user to review concerning IRIS metrics before determining a review outcome. These reviews will be created and managed in the IRIS Worklist. If diversion cannot be ruled out or is suspected after completing an IRIS Review, a Case should be opened to collect appropriate evidence and create a collaboration space for multiple diversion committee members to share notes and findings.
2. Why is “Routine Surveillance” removed as a reason when I open a case from the IRIS Worklist?
   1. The IRIS Worklist reviews are intended to replace routine surveillance or monthly IRIS reviews that are currently being tracked in Investigations. Under the IRIS Worklist workflow, an investigation should only be opened if diversion is suspected or diversion cannot be ruled out from the observed behavior.
3. Who has the ability to open a case from the IRIS Worklist?
   1. If your hospital has Case Portfolio enabled then, only users with "Owner" or "Admin" cases access permissions can open a case from an IRIS review. 
4. Who has the ability to see Open/Closed Cases on the user card layout?
   1. Users with No Access to cases will not see any "Open/Closed Cases". 
   2. Users with Collaborator and Owner roles will see "Open/Closed Cases" that they specifically have access to. 
   3. Users with Admin and Viewer roles will see "Open/Closed Cases for all users.
5. An IRIS user has an open IRIS review and an open case. What should I review? 
   1. The open case should take precedence if diversion is suspected. In addition, the open IRIS review identified on the worklist should be assessed as well.
6. Can I assign more than one tag when conducting a review? 
   1. No, currently you can only assign one tag when conducting a review. 
7. Can I review the same provider more than once within the same month? 
   1. It depends on the current cool-off period. If it's 30 days, then users will need to wait a month to review the user. If the cool-off is shorter, then users can review the same provider more than once.

MANAGING IRIS WORKLIST WORKLOAD

1. Will the IRIS Worklist create more work for me and my staff? 
   1. We recommend that you review users with a high red IRIS only once a month, so this feature should not create more work for your staff. This feature was intended to create a more streamlined and efficient review workflow by offering:
      • real-time user risk identification
      • centralization of data
      • faster reviews for documenting and determining an outcome
2. How many IRIS users will ControlCheck flag for review?
   1. When the IRIS Worklist and User Flagging setting is enabled, the system will initially flag the top 1% of red hospital IRIS users as "Needs Review" so that you will know who has anomalous behavior and requires a review. As reviews are completed, the system will leverage the cool-off period to avoid the reflagging of a "reviewed user" and flag new red IRIS users outside the cool-off period. This means that after departments complete reviewing the initial set of flagged users, there should be fewer users being flagged in the future.

FEATURES NOT OFFERED IN IRIS WORKLIST

1. What IRIS 2.0 features are no longer available?
   1. The improvements and new features with IRIS Worklist solve many problems so we are removing the following older IRIS 2.0 features:
      • Custom Date Range filter - you will still have the ability to customize and view an IRIS user's metrics based on their flagged date range and the current date range (i.e. Last 30 days). 
      • Snooze User - this feature continues to be a low usage feature and the cool-off period setting helps prevent a "Reviewed" user from being flagged again based on a defined period of time. 
2. Is there a proactive notification for newly flagged users? 
   1. We do not support this functionality. 
3. Can I modify the review statuses, review outcomes, or reasons? 
   1. We do not offer any customization for these predetermined fields to help standardize IRIS reviews. 
4. Is there an export option for document notes and status updates for an IRIS review?  
   1. We do not support exportation on the IRIS Worklist, but PDF exporting notes is one of our near-term priorities.