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OPA & Order Set Requests

Order sets, SmartSets, and OPAs (OurPractice Advisories, Epic's pop-up alerts) are maintained through one process: an IT Service Request for intake, and Epic Round Table for everything after. This page covers what you need to know as a requester or reviewer.

Full policy and procedure

The complete Order Set and OPA Governance document (Part A policy, Part B procedure, roles, decision rights, and review cycle) is available here: Order Set and OPA Governance → Version 1.0. Approved by the Provider Advisory Council September 17, 2026, and by the Pharmacy and Therapeutics Committee and the Medical Executive Committee October 13, 2026. The official policy is on the Freeman Policies and Procedures site (Freeman network only).

Three rules to remember

Every request starts in ITSM.
If it is not in Round Table, it is not getting built.
Owners decide; analysts build.

How to submit a request

Open an IT Service Request at fhsitsm.saasit.com ↗ and choose the request type: New Order Set or SmartSet; Order Set or SmartSet Change; New OPA; OPA Change or Retirement.

Include:

Your specialty and department
The name of the existing set or alert, or the proposed name and clinical purpose for a new one
One paragraph on what should change and why
Whether a new medication, dose, or route is involved (yes, no, unsure)
The clinical owner, if you know who that is
Urgency: routine, or patient safety with a one-line reason

Do not list every line-item change in the ticket. You will enter those in Round Table once your review period opens, so you write them once.

Order set request form: Order Set Request ↗

OPA request form: OPA Request ↗

What happens next

Triage within five business days. The Clinical Informatics team checks scope, whether a similar set or alert already exists, whether it should be a set, panel, or SmartSet, which approvals apply, and whether there is enough detail to proceed. You get a reply either way.
Assignment. The Epic inpatient or outpatient lead assigns an orders analyst and, if medications are involved, a pharmacy analyst.
Round Table review period. The Round Table Coordinator role is shared by the Informatics team and the Pharmacy Clinical Coordinator; one of them opens the period and you are added to the set or alert in Epic Round Table. Enter your changes as comments on the specific order or panel, with order name, dose, rate, frequency, and priority where they apply. Ad hoc periods are short, typically two weeks.
Owner approval. The clinical owner for the specialty approves or rejects each comment. Every thread ends in a clear decision before build starts.
Build and validation. Analysts build in the non-production environment. Reviewers validate and document any issues by reopening the comment in Round Table.
Release. Changes go live on a published release date. Off-cycle releases are limited to patient safety.

The pharmacy rule

P&T reviews any order set that contains medications, plus anything else the Pharmacy P&T Coordinator chooses to take there.

Two requests get mixed up, so be clear which one you are making. Adding a medication to an order set is an order set change: submit it in ITSM, and it goes through the Round Table review process with pharmacy and P&T review of the medication content. Adding a medication to the formulary is not an order set change: it does not go through Round Table, but it does go to P&T. If a medication is not on formulary yet, P&T has to approve it before it can be built into a set. If you are unsure which one you need, mark unsure and the Pharmacy P&T Coordinator decides.

Order panels

An order panel is a small reusable group of orders that can sit inside several order sets. Panels use the same request path as order sets: submit the order set request in ITSM and say it is a panel. A panel gets its own Round Table review when it affects more than one order set, since the change carries into every set that uses it. A panel used inside a single set is reviewed with that set. Panels are not on their own periodic review cycle; they are reviewed when the sets that contain them are reviewed, or whenever someone requests a change.

OPAs

New alerts and material changes go to the Decision Support Committee before build. It meets monthly or every other month and votes electronically between meetings for urgent items. Requests to retire an alert that reduce burden without safety risk can be approved electronically. Thirty days after release, firing and override rates are reviewed.

If you are asked to be an Owner or Reviewer

Owners approve or reject reviewer comments and submit the set to builders. Reviewers leave comments and respond to others. Be specific: name the order, the dose, the frequency. Answer questions in your thread; the build team does not chase answers. Owners do not close review periods; builders do.

Timing and the go-live calendar

Through October 23

Only safety fixes and go-live readiness.

October 24 through December 31

Change requests only, with shortened review periods, prioritized by patient safety and then by volume.

January 1, 2027

The first scheduled periodic review month opens, with every set and alert on a published three-year cycle.

Target from review close to release is 60 days.

Communication and education

IT posts the release notice to every discipline the change touches, not providers only: physicians, APPs, nursing, pharmacy, and ancillary teams. Your department teaches its own staff what changed and why.