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RESOURCE AND PATIENT MANAGEMENT SYSTEM

RPMS Electronic Health Record


(EHR)

CAC Setup Guide

Version 1.1 Patch 3


October 2008

Office of Information Technology (OIT)


Division of Information Resource Management
Albuquerque, New Mexico
RPMS Electronic Health Record (EHR) v1.1 Patch 3

DOCUMENT REVISION HISTORY


Date of Location of Revision
Change Revision
Oct. 06 Medication Added this section
Counseling
Mar. 2007 Medication Added Medication Counseling to this section
Management
Configuration
July 2007 All sections All sections were updated to reflect the current version of
the EHR
Aug. 2007 Patient Chart Added Suicide Form to this section by describing the Patient
Component (in Centric option
Design Mode)
Aug. 2007 Enable Support for Corrected this to say that this feature should be set to NO
ChargeMaster Entry because this version does not support ChargeMaster entry
Nov 2007 Medication A new option “Maximum Allowable Days Supply” was
Management added for version 1.1, patch 1
Configuration
Nov 2007 BGO ENABLE This menu option was disable in version 1.1, patch 1.
CHARGEMASTER
ENTRY menu
Nov 2007 ART - Adverse This new option was added to the EHR Configuration
Reaction Tracking Master Menu.
Configuration
Nov 2007 Section 15.2 Added Default Filter for Problem List information
Nov. 2007 Section 10.2 Added Maximum allowable Days Supply information
Nov. 2007 Section 6.2.3.1 Added information about the prompts for Basic TIU
Parameters
Nov. 2007 Section 6.2.3.2 Added information about the prompts for Modify Upload
Parameters
Nov. 2007 Section 6.2.3.5 Added information about the prompts for Division -
Progress Notes Print Parameters
Nov. 2007 Section 6.2.4.1 Corrected information about Delete TIU template for
selected user
Nov. 2007 11.2.7 and 11.2.8 Added more information about the POV List and POV
Narrative Text parameters
July 2008 Added features of Version 1.1 patch 3

CAC Setup Guide i Document Revision History


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

TABLE OF CONTENTS
1.0 INTRODUCTION.....................................................................................................1
2.0 BASIC EHR SETUP...............................................................................................3
2.1 TIU Setup.....................................................................................................3
2.1.1 Document Definitions (Managers)...............................................3
2.1.2 User Class Management.............................................................4
2.1.2.1 List Membership by User (UCM2)..........................................4
2.1.2.2 Manage Business Rules (UCM4)...........................................4
2.2 CPRS Setup.................................................................................................5
2.2.1 Allocate OE/RR Security Keys....................................................5
2.2.2 Miscellaneous Parameters..........................................................5
2.2.3 Notifications.................................................................................6
2.2.4 Order Checks...............................................................................6
2.2.5 Quick Orders................................................................................6
2.2.6 Teams..........................................................................................7
2.2.7 Print/Report Parameters..............................................................7
2.3 IHS Setup.....................................................................................................7
2.3.1 Assign Keys.................................................................................7
2.3.2 Pick-Lists and Super-Bills............................................................8
2.3.3 Consults.......................................................................................9
2.4 Parameters.................................................................................................10
2.4.1 Setting Parameters....................................................................11
2.4.1.1 List Value for a Selected Parameter (LV)............................11
2.4.1.2 List values for a Selected Entity (LE)...................................12
2.4.1.3 List Value for a Selected Package (LP)...............................12
2.4.1.4 List Value for a Selected Template (LT)..............................13
2.4.1.5 Edit Parameter Values (EP).................................................13
2.4.1.6 Edit Parameter Value for a Template (ET)...........................13
2.4.1.7 Edit Parameter Definition Keyword (EK)..............................13
3.0 PATIENT CONTEXT CONFIGURATION (PAT)..................................................14
3.1.1 Ignore Aliases in Patient Lookup (ALS).....................................14
3.1.2 Allow Viewing of Demo Patients Only (DMO)...........................14
3.1.3 Set Logic for Patient Detail View (DTL).....................................15
3.1.4 Patient Selection Requires HRN (HRN)....................................15
3.1.5 Recall Last Selected Patient (LST)............................................15
3.1.6 Default Date Ranges for Patient Selection Dialog (RNG).........16
3.1.7 Team List Management Menu (TEA)........................................16
3.1.7.1 Overview of the Options.......................................................17
3.1.7.2 Options Usage......................................................................17
4.0 ENCOUNTER CONTEXT (ENC)..........................................................................19
4.1.1 Allow User to Create New Visits (CRT).....................................19
4.1.2 Days After Which Visit is Locked (LCK)....................................19
4.1.3 General Location for Outside Encounter (OTH)........................20

CAC Setup Guide i Table of Contents


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

4.1.4 Temporarily Override Visit Lock for User (OVR).......................20


4.1.5 Allow a User to be a Visit Provider (PRV).................................20
4.1.6 Visit Search Stop Date (STP)....................................................21
4.1.7 Visit Search Start Date (STR)....................................................21
4.1.8 Selectable Visit Types (TYP).....................................................22
5.0 SETTING UP A NEW USER................................................................................23
5.1 Provider Setup...........................................................................................23
5.1.1 CPRS Keys................................................................................23
5.1.2 User Class.................................................................................24
5.1.3 Parameters................................................................................25
5.1.4 Pharmacy Setup........................................................................25
5.1.5 BGOZ Keys................................................................................25
5.1.6 Electronic Signature...................................................................26
5.2 Other Users................................................................................................27
5.2.1 CPRS Keys................................................................................27
5.2.2 User Classes.............................................................................28
5.2.3 Electronic Signature...................................................................28
5.2.4 BGOZ Keys................................................................................28
6.0 TIU CONFIGURATION (TIU)................................................................................29
6.1 TIU Menu for Clinicians (CLN)...................................................................29
6.2 TIU Menu for Medical Records (HIS).........................................................29
6.2.1 TIU Maintenance Menu (TMM)..................................................30
6.2.1.1 Document Definition (Manager)...........................................30
6.2.2 TIU Alert Tools (TAT).................................................................39
6.2.3 TIU Parameters Menu (TPM)....................................................39
6.2.3.1 Basic TIU Parameters (TPM1).............................................39
6.2.3.2 Modify Upload Parameters (only for dictation sites)............40
6.2.3.3 Document Parameter Edit (TPM3).......................................42
6.2.3.4 Progress Notes Batch Print Location (TPM4)......................44
6.2.3.5 Division – Progress Notes Print Params (TPM5).................44
6.2.4 TIU Template Mgmt Functions (TTM).......................................45
6.2.4.1 Delete TIU template for selected user.................................46
6.2.4.2 Edit auto template cleanup parameters...............................46
6.2.4.3 Delete templates for ALL terminated users..........................46
6.2.5 User Class Management Menu (UCM).....................................46
6.2.5.1 User Class Definition (UCM1)..............................................47
6.2.5.2 List Membership by User (UCM2)........................................47
6.2.5.3 List Membership by Class (UCM3)......................................48
6.2.5.4 Manage Business Rules (UCM4).........................................48
6.3 TIU Parameters (PAR)...............................................................................49
6.3.1 Note Autosave Interval (AUT)....................................................49
6.3.2 Auto Cleanup Upon User Termination (CLN)............................50
6.3.3 Personal Template Access by User Class (CLS)......................50
6.3.4 Default Template for Document Type (DEF).............................50
6.3.5 Template Field Editor User Classes (FLD)................................50

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RPMS Electronic Health Record (EHR) v1.1 Patch 3

6.3.6 Allowed Personal Template Objects (OBJ)...............................51


6.3.7 Personal Template Access (PER).............................................51
6.3.8 Reminder Dialogs Allowed as Templates (REM)......................52
6.3.9 Verify Note Title (VER)..............................................................52
6.4 Create Templates.......................................................................................53
6.5 Template Options.......................................................................................53
6.5.1 Template Editor.........................................................................54
6.5.2 Template Creation.....................................................................55
6.5.3 Template Finishing....................................................................56
6.5.4 Template Importing....................................................................57
6.5.5 Template Fields.........................................................................58
7.0 NOTIFICATION CONFIGURATION (NOT)..........................................................61
7.1 Determine Recipients (DET)......................................................................61
7.2 Display Notifications a User Can Receive (DIS)........................................61
7.3 Erase Notifications (ERA)..........................................................................62
7.4 Flag Orderable items to Send Notifications (FLG).....................................62
7.5 Forward Notifications (FWD)......................................................................62
7.6 Notification Parameters (PAR)...................................................................63
7.6.1 Set Show All Notifications (ALL)................................................64
7.6.2 Send Flagged Orders Bulletin (BUL).........................................64
7.6.3 Set Deletion Parameters (DEL).................................................65
7.6.4 Providers that Require an E&M Code (EMC)............................65
7.6.5 Set Purging Interval (PRG)........................................................66
7.6.6 Priority Threshold for Popup Alerts (PRI)..................................66
7.6.7 Set Provider Recipients (PRV)..................................................67
7.6.8 Set Default Recipient Devices (RCD)........................................68
7.6.9 Set Default Recipients (RCP)....................................................69
7.6.10 Notification Sort Column (SRT).................................................69
7.7 Enable/Disable Notifications (PRC)...........................................................70
7.8 Display Patient Alerts and Alert Recipients (REC)....................................70
7.9 Enable/Disable Notification System (SYS)................................................71
7.10 Set Delay for Unverified Orders (UNV)......................................................71
7.10.1 Set Delay for Unverified Medication Orders (MED)..................71
7.10.2 Set Delay for Unverified Orders (ORD).....................................72
7.11 Set Urgency for Notifications (URG)..........................................................72
8.0 ORDER ENTRY CONFIGURATION (ORD).........................................................74
8.1 Delayed Orders Configuration (DOC)........................................................74
8.2 Key Management (KEY)............................................................................74
8.2.1 Allocate OE/RR Security Keys (ALL)........................................75
8.2.2 Check for Multiple Keys (CHK)..................................................76
8.3 Order Menu Management (MNU)..............................................................76
8.3.1 Create/Modify Actions (ACT).....................................................76
8.3.2 Enable/Disable Order Dialogs (DIS)..........................................77
8.3.3 Create/Modify Generic Orders (GEN).......................................77
8.3.4 List Primary Order Menus (LST)................................................78

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October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

8.3.5 Create/Modify Order Menus (MNU)...........................................78


8.3.6 Create/Modify Orderable Items (OIC).......................................78
8.3.7 Menu Parameters (PAR)...........................................................79
8.3.7.1 New Consult Dialog Default (CON)......................................79
8.3.7.2 Write Orders List (Inpatient) (INP).......................................79
8.3.7.3 New Med Dialog Default (MED)...........................................81
8.3.7.4 Write Orders List (Outpatient) (OUT)...................................81
8.3.7.5 New Procedure Dialog Default (PRO).................................82
8.3.7.6 Order Menu Style (STY).......................................................82
8.3.8 Create/Modify Prompts (PMT)...................................................82
8.3.9 Assign Primary Order Menu (PRI).............................................83
8.3.10 Convert Protocols (PRT)...........................................................83
8.3.11 Create/Modify Quick Orders (QOC)..........................................83
8.3.11.1 Namespaces for Quick Orders.............................................83
8.3.11.2 Laboratory Test Quick Order................................................83
8.3.11.3 All Other Labs Quickorder....................................................84
8.3.11.4 Outpatient Pharmacy Quick Order.......................................85
8.3.11.5 All Other Meds Pharmacy Quickorder.................................86
8.3.11.6 Outside Rx............................................................................86
8.3.11.7 Inpatient Pharmacy Quick Order..........................................89
8.3.11.8 Radiology Quick Order.........................................................89
8.3.11.9 Consults Quick Order...........................................................91
8.3.11.10 Nursing Quick Order............................................................91
8.3.12 Create/Modify QO Restrictions (QOR)......................................92
8.3.13 Create/Modify Order Sets (SET)...............................................92
8.3.14 Search/Replace Components (SRC)........................................93
8.3.15 Search/Replace Orderables (SRO)...........................................93
8.4 Order Check Configuration (OCX).............................................................94
8.4.1 Activate/Inactivate Rules (ACT).................................................95
8.4.2 Compile Rules (COM)................................................................95
8.4.3 Enable/Disable Order Checking System (ENA)........................95
8.4.4 Expert System Inquiry (INQ)......................................................95
8.4.5 Order Check Parameters (PAR)................................................95
8.4.5.1 Creatinine Date Range for Contrast Media Orders (CON). .96
8.4.5.2 CT Scanner Height Limit (CTH)...........................................96
8.4.5.3 CT Scanner Weight Limit (CTW)..........................................97
8.4.5.4 Set Clinical Danger Level (DAN)..........................................97
8.4.5.5 Enable/Disable Debug Message Logging (DBG)................98
8.4.5.6 Lab Duplicate Order Range (DPL).......................................99
8.4.5.7 Orderable Item Duplicate Order Range (DPO)....................99
8.4.5.8 Radiology Duplicate Order Range (DPR)..........................100
8.4.5.9 Mark Order Checks Editable by User (EDT)......................101
8.4.5.10 Enable/Disable an Order Check (ENA)..............................101
8.4.5.11 Creatinine Date Range for Glucophage-Lab Results (GLU)
102
8.4.5.12 Edit Local Terms (LCL)......................................................103

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October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

8.4.5.13 MRI Scanner Height Limit (MRH)......................................104


8.4.5.14 MRI Scanner Weight Limit (MRW).....................................104
8.4.5.15 Number of Medications for Polypharmacy (PLY)...............105
8.4.5.16 Order Checks a User Can Receive (USR).........................105
8.5 Order Parameters (PAR).........................................................................106
8.5.1 Disable Hold/Unhold Actions in EHR (HLD)............................107
8.5.2 Enable Clinical Indicator Prompt (IND)....................................107
8.5.3 Miscellaneous Parameters (MSC)...........................................107
8.5.4 Disable Ordering in EHR (ORD)..............................................110
8.5.5 Edit DC Reasons (RSN)..........................................................110
8.5.6 Set Unsigned Orders View on Exit (UOV)...............................111
8.5.7 Enable/Disable Order Verify Actions (VER)............................111
8.6 Print/Report Parameters (PRN)...............................................................112
8.6.1 Chart Copy Parameters (CHT)................................................112
8.6.2 Print Parameters for Hospital (HOS).......................................113
8.6.3 Print Parameters for Wards/Clinics (LOC)..............................113
8.6.4 Requisition/Label Parameters (REQ)......................................113
8.6.5 Summary Report Parameters (SUM)......................................114
8.6.6 Service Copy Parameters (SVC).............................................114
8.6.7 Work Copy Parameters (WRK)...............................................115
8.7 Order Reports (RPT)................................................................................115
8.7.1 Performance Monitor Report (MON).......................................115
8.7.2 Search orders by Nature or Status (NAT)...............................116
8.7.2.1 Nature of order...................................................................116
8.7.2.2 Order Status.......................................................................117
8.7.3 Unsigned Orders Search (UNS)..............................................117
8.8 Automatically Print Orders to a Service Printer.......................................118
9.0 CONSULT TRACKING CONFIGURATION (CON)...........................................120
9.1 Overview of the Options...........................................................................121
9.2 Tracking a Consult...................................................................................126
9.3 Finishing a Consult...................................................................................128
10.0 MEDICATION MANAGEMENT CONFIGURATION (MED)...............................130
10.1 Days of Medication Activity (ACT)...........................................................130
10.2 Maximum Allowable Days Supply (MAX)................................................130
10.3 Medication Counseling Configuration (MEC)..........................................131
10.4 Default Collation Order (ORD).................................................................131
10.5 Medication Report Configuration (PRT)...................................................131
10.5.1 Set Default Printers for Medication Reports (DEF).................132
10.5.2 Enable Printing of Sample Labels (LBL).................................132
10.5.3 Maximum # of Scripts per Page (MAX)...................................133
10.5.4 Enable Printing of Prescriptions (SCR)...................................133
10.6 Renewal Limit for Expired Meds (REN)...................................................134
11.0 MEDICATION COUNSELING............................................................................135
11.1 Pharm Ed Button......................................................................................135

CAC Setup Guide v Table of Contents


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

11.2 Medication Counseling Configuration......................................................136


11.2.1 Default Comprehension Value (DCMP)..................................137
11.2.2 Default Counsel Time (DCTM)................................................138
11.2.3 Default POV (DPOV)...............................................................138
11.2.4 Edit Disclaimer Text (EDTX)....................................................139
11.2.5 Education Topics (ELST).........................................................140
11.2.6 Hospital Location for Visit (HL)................................................140
11.2.7 POV List (PLST)......................................................................141
11.2.8 POV Narrative Text (PNL).......................................................141
12.0 LAB CONFIGURATION (LAB)..........................................................................143
12.1 Days of Lab Results to Retrieve (Cover Sheet) (CVR)............................143
13.0 VITAL MEASUREMENT CONFIGURATION (VIT)............................................144
13.1 Measurement Listed on Cover Sheet (CVR)...........................................144
13.2 Disable Triage Vitals Editing (DVE).........................................................144
13.3 Override Default Units (OVR)..................................................................145
13.4 Data Entry Permissions (PER).................................................................145
13.5 Data Entry Templates (TPL)....................................................................146
14.0 REPORT CONFIGURATION (RPT)...................................................................147
14.1 Print Formats (FMT).................................................................................147
14.2 Health Summary Configuration (HSM)....................................................147
14.2.1 List All Health Summaries (ALL)..............................................148
14.2.2 IHS Health Summary Configuration (IHS)...............................148
14.2.3 VHA Health Summary Configuration (VHA)............................150
14.2.4 Adding the Patient Wellness Handout.....................................151
14.3 Report Parameters (PAR)........................................................................154
14.3.1 Default Time and Occurrence Limits for All Reports (ALL).....154
14.3.2 Default Time and Occurrence Limits by Report (RPT)............155
14.4 System Display Parameters (SYS)..........................................................155
14.5 User Display Parameters (USR)..............................................................156
15.0 PROBLEM LIST CONFIGURATION (PLS).......................................................157
15.1 Disable Problem List Editing (DPE).........................................................157
15.2 Default Filter for Problem List..................................................................157
15.3 Include Personal Hist Problem w/Active (IPH)........................................158
16.0 POV CONFIGURATION (POV)..........................................................................159
16.1 Disable POV Editing (DPE)......................................................................159
16.2 Maximum Entries Shown in POV History (MAX).....................................159
17.0 PERSONAL HEALTH HX CONFIGURATION (PHX)........................................160
17.1 Disable Reproduction History Editing (DRE)...........................................160
18.0 PROCEDURE CONFIGURATION (PRC)..........................................................161
18.1 Suppress Confirmatory E&M Codes (CNF).............................................161

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October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

18.2 Disable CPT Code Editing (CPT)............................................................161


18.3 Disable Evaluation & Management Editing (EAM)..................................162
18.4 Suppress Emergency from E&M Codes (ERC).......................................162
18.5 Suppress Hospital E&M Codes (HOS)....................................................162
18.6 Enable Support for ICD Procedure Entry (ICD).......................................163
19.0 PATIENT EDUCATION CONFIGURATION (EDU)...........................................164
19.1 Disable Patient Education Editing (DPE).................................................164
19.2 Creating Patient Education Pick Lists......................................................164
20.0 EXAM CONFIGURATION (EXM).......................................................................168
20.1 Disable Exam Editing (DEE)....................................................................168
21.0 HEALTH FACTOR CONFIGURATION (HFA)...................................................169
21.1 Disable Health Factor Editing (DHE).......................................................169
22.0 IMMUNIZATION CONFIGURATION (IMM).......................................................170
22.1 Stop Immunization from Adding CPT Codes (CPT)................................170
22.2 Disable Immunization Editing (DIE).........................................................170
22.3 Stop Immunizations from Adding ICD Codes (ICD)................................171
23.0 ART CONFIGURATION.....................................................................................172
23.1 Enable Adverse Reaction Data Entry (ENT)...........................................172
23.2 Allow Adverse Reaction Verification (VER).............................................172
24.0 VUECENTRIC FRAMEWORK CONFIGURATION (FRM)................................174
24.1 Site Parameter Edit..................................................................................174
24.2 Show Current VueCentric Users..............................................................175
24.3 Startup VueCentric Framework................................................................175
24.4 Shutdown VueCentric Framework...........................................................175
24.5 Change Template Defaults......................................................................175
25.0 SPELLCHECKING CONFIGURATION (SPL)...................................................177
25.1 Enable Spellchecking Service (ENA).......................................................177
25.2 Spellchecking Service Plugin (PLG)........................................................177
26.0 REMINDER CONFIGURATION (REM)..............................................................179
27.0 DESIGN MODE..................................................................................................180
27.1 Accessing Design Mode..........................................................................180
27.2 Desktop Properties...................................................................................180
27.3 Layout Manager.......................................................................................183
27.4 Importing GUI Templates.........................................................................184
27.5 Communications Tab...............................................................................184
27.6 Patient Chart Tab.....................................................................................186
27.6.1 Setting the Patient Detail View................................................188
27.6.1.1 How to Setup the Patient Detail to Display on the Face
Sheet..................................................................................188

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27.6.1.2 How to Setup the Patient Detail to Display on the Health


Summary............................................................................188
27.6.1.3 How to get the DFN Number of the Health Summary........189
27.6.2 Adding IHS Patient Chart (Behavioral Health System) to the
EHR.........................................................................................190
27.7 Patient Chart Component........................................................................193
27.7.1 Notifications.............................................................................193
27.7.2 Problem List Window...............................................................193
27.7.3 ICD Pick List............................................................................194
27.7.4 POV.........................................................................................194
27.7.5 Super Bills................................................................................194
27.7.6 Suicide Form............................................................................194
27.8 Clear Patient Context Setup....................................................................195
28.0 IHS SETUP.........................................................................................................197
28.1 Making a Super-Bill..................................................................................197
28.1.1 Managing a New Super-Bill.....................................................198
28.1.1.1 Adding a New Super-Bill Category....................................198
28.1.1.2 Querying Super-Bills..........................................................200
28.1.1.3 Editing Super-Bill Items......................................................201
28.2 Making a Pick-List....................................................................................204
28.2.1 Managing Categories..............................................................205
28.2.2 Querying Quick Picks..............................................................207
28.3 Info Button Configuration.........................................................................208
28.3.1 Viewing Web Reference Sites Currently Available.................208
28.3.2 Adding Web Reference Sites..................................................209
28.4 Chief Complaint Pick List Configuration..................................................210
28.4.1 Add Pick List Item....................................................................210
28.4.2 Delete Pick List Item................................................................211
28.5 Chief Complaint Pretext Configuration....................................................211
29.0 POINT OF CARE LAB.......................................................................................213
30.0 REMINDERS.......................................................................................................218
31.0 CODING TOOLS................................................................................................219
32.0 DRUG TEXT ORDERS.......................................................................................221
33.0 CREATING PRINT FORMATS FOR CII PRESCRIPTIONS.............................226
34.0 GLOSSARY........................................................................................................229
35.0 Contact Information.............................................................................................231

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RPMS Electronic Health Record (EHR) v1.1 Patch 3

1.0 Introduction
The purpose of this manual is to provide technical information about the CACs set-up
guide. The set-up guide is designed to help clinical coordinators to run the Electronic
Health Record (EHR) application.

This setup will explain options that are part of the Veteran’s Administration CPRS,
TIU, and consult packages and how they differ from the EHR, as well as those items
that are unique to the EHR.

This document is divided into the following sections: Basic EHR Setup, Patient
Context Configuration, Encounter Context, Setting Up a New User, TIU
Configuration, Notification Configuration, Order Entry Configuration, Consult
Tracking Configuration, Medication Management Configuration, Lab Configuration,
Vital Measurement Configuration, Report Configuration, Problem List Configuration,
POV Configuration, Personal Health Hx Configuration, Procedure Configuration,
Patient Education Configuration, Exam Configuration, Health Factor Configuration,
Immunization Configuration, VueCnetric Framework Configuration, Spellchecking
Configuration, Reminder Configuration, Design Mode, IHS Setup, Point of Care Lab,
Reminders, Coding Tools, Drug Text Orders, and Print Formats for CII Prescriptions.

For further information on any topic, see the following manuals:

 CPRS GUI “Getting Started”


(http://www.va.gov/vdl/VistA_Lib/Clinical/Comp_Patient_Recrd_Sys_(CPRS
)/cprsguium.doc)
 CPRS Clinical Reminders (Clinicians)
(http://www.va.gov/vdl/VistA_Lib/Clinical/CPRS-Clinical_Reminders/pxrm-
um.doc)
 CPRS Set-up Guide
(http://www.va.gov/vdl/VistA_Lib/Clinical/Comp_Patient_Recrd_Sys_(CPRS
)/cprssetup.doc)
 IHS Health Summary (IHS)
(http://www.ihs.gov/Cio/RPMS/PackageDocs/apch/apch020u.pdf)
 CPRS Users Guide (VA)
(http://www.va.gov/vdl/VistA_Lib/Clinical/Comp_Patient_Recrd_Sys_(CPRS
)/cprsguium.doc)
 CPRS Consultations (VA) (http://www.va.gov/vdl/VistA_Lib/Clinical/CPRS-
Consult_Request_Tracking/CONSUM.doc)
 IHS Women’s Health Version 2.0 (IHS)
http://www.ihs.gov/Cio/RPMS/PackageDocs/bw/bw_020u.pdf
 IHS Immunization Tracking
http://www.ihs.gov/Cio/RPMS/PackageDocs/bi/bi__080u.pdf
 IHS Allergy Tracking (Refer to PSO Manual
http://www.ihs.gov/Cio/RPMS/PackageDocs/pso/OtherPSODocs.asp

CAC Setup Guide 1 Introduction


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

 IHS Laboratory Version 5.2


http://www.ihs.gov/Cio/RPMS/PackageDocs/lr/lr_052u.pdf
 IHS Outpatient Pharmacy Version 7.0 and Inpatient Pharmacy Version 5.0
 IHS Radiology Version 5.0
 IHS Dietary
 PIMS
 Lexicon
 Code-Set Versioning
 VistA Imaging Version 3.0 (not yet available)

CAC Manual 2 Introduction


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

2.0 Basic EHR Setup


The setup of the EHR involves the setup of several different packages. The setup is
generally done using RPMS options available to Clinical Coordinators. The setup is
also a continuing process. This section contains the various setups that need to be
done. The majority of the setup can be done through the RPMS-EHR Configuration
Master Menu. The CAC needs access to the BEHO menu and have the
BEHOZMENU key/ to access this master menu.
RPMS-EHR Configuration Master Menu

ART Adverse Reaction Tracking Configuration ...


CCX Chief Complaint Configuration ...
CON Consult Tracking Configuration ...
EDU Patient Education Configuration ...
ENC Encounter Context Configuration ...
EXM Exam Configuration ...
FRM VueCentric Framework Configuration ...
HFA Health Factor Configuration ...
IMM Immunization Configuration ...
LAB Lab Configuration ...
MED Medication Management Configuration ...
NOT Notification Configuration ...
ORD Order Entry Configuration ...
PAT Patient Context Configuration ...
PHX Personal Health Hx Configuration ...
PLS Problem List Configuration ...
POV POV Configuration ...
PRC Procedure Configuration ...
REM Reminder Configuration ...
RPT Report Configuration ...
SPL Spellchecking Configuration ...
TIU TIU Configuration ...
VIT Vital Measurement Configuration ...

Select RPMS-EHR Configuration Master Menu Option:

2.1 TIU Setup


Because TIU will be installed before the EHR software, some of the setup can be
started early. The TIU Maintenance Menu is where these options are found (EHR |
TIU Configuration | TIU Medical Records | TIU Maintenance Menu). Use the options
in bold.
DDM Document Definitions (Managers) ...
TAT TIU Alert Tools
TPM TIU Parameters Menu ...
TTM TIU Template Mgmt Functions ...
UCM User Class Management ...

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2.1.1 Document Definitions (Managers)


Select Document Definition (Manager) (DDM) option on the TIU Maintenance Menu
to display the following:
DDM1 Edit Document Definitions
DDM2 Sort Document Definitions
DDM3 Create Document Definitions
DDM4 Create Objects
DDM5 List Object Descriptions
DDM6 Create TIU/Health Summary Objects

You use these options to create and maintain note titles and objects. The only basic
one needed is the Create Document Definitions, because a site needs to make its
progress note titles before users can write progress notes.

2.1.2 User Class Management


Select TIU Management Menu Option | UCM (User Class Management.).

Start assigning users to the proper user class and review the business rules, using the
options in bold.
UCM1 User Class Definition
UCM2 List Membership by User
UCM3 List Membership by Class
UCM4 Manage Business Rules

2.1.2.1 List Membership by User (UCM2)


Use this function to assign user classes to users.
Select User Class Management Option: UCM2 List Membership by User
Select USER: HAGER, MARY
Current User Classes Jun 10, 2004 14:29:29 Page 1 of 1
HAGER, MARY G 4 Classes
User Class Title Effective Expires
----------------------------------------------------------------
1 Chief, MIS 02/09/04
2 Clinical Coordinator NO 01/07/04
3 Physician 05/02/04
4 Provider 02/01/04

-------+ Next Screen - Prev Screen ?? More Actions ------------


Add Remove Quit
Edit Change View
Select Action: Quit //

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2.1.2.2 Manage Business Rules (UCM4)


Print and review the business rules for Progress Notes, Discharge Summaries, and all
documents.

Figure 2-1: Sample Business Rules for Progress Notes

2.2 CPRS Setup


Once the EHR is loaded, several CPRS options for setup are available.

2.2.1 Allocate OE/RR Security Keys


You assign OE/RR security keys to those users going live. A user needs one and only
one of three keys to release orders:

 ORES – clinician key


 ORELSE – nurse key
 OREMAS – clerk key
Refer to the section “Allocate OE/RR Security Keys (ALL)” below for more
information (under the Order Entry Configuration section).

2.2.2 Miscellaneous Parameters


These miscellaneous parameters need to be set immediately after loading.
Miscellaneous OE/RR Definition for System: TCDEMO.NAV.IHS.GOV
--------------------------------------------------------------------
Active Orders Context Hours 24

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Allow Clerks to act on Med Orders NO


Auto Unflag YES
Confirm Provider YES (Exclude ORES)
Default Provider
Error Days
Grace Days before Purge
New Orders Default Sign & Release
Restrict Requestor YES (ORELSE & OREMAS)
Review on Patient Movement
Show Lab #
Show Status Description
Signature Default Action Release w/o Signature
Signed on Chart Default NO
--------------------------------------------------------------------

See the section “Miscellaneous Parameters (MSC)” below for more information
(under Order Entry Configuration | Order Parameters).

2.2.3 Notifications
Notifications must be reviewed and decisions made regarding:

 Which notifications will be Mandatory, Enabled, or Disabled


 What is the priority of the notification
 Who will receive the notification
 What makes the notification go away

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Notifications come with a default, but sites need to review these defaults to decide if
that is what they want to use.

Refer to the section “Notification Configuration” below for more information.

2.2.4 Order Checks


Order checks also must be reviewed and changes can be made from the default
settings.

Also, some local variables need to be setup for the order checks to work correctly.

A site needs to determine when an order check will be applicable. For example, when
is a lab order a duplicate lab? The entire order checking menu should be reviewed
before going live.

Refer to the section “Order Checking” below for more information (under Order
Entry Configuration).

2.2.5 Quick Orders


Each site will need to make the quick orders for the service that is going live.

Quick orders are a continuing need as different services start using the EHR.

Quick orders for pharmacy, lab, radiology, and consults can be created using the
Quick order Wizard component in the EHR application. Or, they are created using the
Order Menu Management menu in RPMS.

Either way, the orders must be placed on menus. See the section “Create/Modify
Quick Orders (QOC)” below for more information (under Order Entry
Configuration).

2.2.6 Teams
Teams are not needed to start the EHR unless you are going to make consults.
Consults should always be sent to a team of providers, not just one person.

Teams are lists of patients, providers, or both.

Refer to the section “Team List Management Menu” below for more information
(under Patient Context Configuration).

2.2.7 Print/Report Parameters


If you want to print copies of the orders as chart copies, work copies, or service
copies, or if you want to print lab requirements and labels, you need to choose print
formats and assign them to printers in the locations where the EHR will be running.

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 Walk around and make sure there are printers near where they should be
printing and that they are in secure locations for patient confidentiality.
 Get a listing of the printer names (RPMS names, not network names). They
must be setup in the device file.
 Review the print formats to see if they are acceptable. You can create your
own print format if you want.
 Setup the formats.
 Ensure that the printers are connected to the network.
See the section “Report Configuration” below for more information.

2.3 IHS Setup


The IHS Setup consists of assigning keys, creating pick-lists and super-bills, as well
as setting up consult services.

2.3.1 Assign Keys


To assign the BGOZ keys in RPMS, go to Menu Management | Key Managers |
Allocation of Security Keys.

There are four keys that allow users to enter or edit V-file data. Give these to users as
necessary.
Allocate key: BGOZ
1 BGOZ ASTHMA EDIT
2 BGOZ CAC
3 BGOZ ELDER CARE EDIT
4 BGOZ ER EDIT
5 BGOZ PEDIATRIC EDIT
6 BGOZ PROBLEM LIST
7 BGOZ REP HIST EDIT
8 BGOZ TX CONTRACT EDIT
9 BGOZ VCPT EDIT
10 BGOZ VIEW ONLY
11 BGOZ VPOV EDIT

Notes about the keys:

Option Action
1 for users who deal with asthma patients
2 for users who can add POV (ICD codes for visits)
3 for users who deal with elder care
4 for users who deal with ER patients
5 for users who deal with pediatric patients
6 for users who can add or edit the problem list
7 for users who can edit women’s health
8 for users who deal have TX Contracts
9 for users who can add or edit CPT codes for visits
10 for general users
11 for users who can add or edit the POV

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2.3.2 Pick-Lists and Super-Bills


Before providers can choose ICD9 codes and CPT codes to complete the visit, the
sites will probably want to create some pick-lists and super-bills that the providers
can use to make these selections.

Start with the clinic that is going live first. A pick-list and/or super-bill can be created
automatically by the Query method and using the codes already used by this clinic, or
they can be created by entering the codes already being used on a PCC+ form.

Figure 2-2: Manage Super-Bills Dialog

2.3.3 Consults
Consults do not need to be in place on the go-live date and will be an on-going setup
as more and more services become consulting services. The consults setup in the
EHR configuration guide will help you setup consults. The consults setup menu is
Consult Tracking Configuration option on the RPMS-EHR Configuration Master
Menu.
RPMS-EHR Configuration Master Menu

ART Adverse Reaction Tracking Configuration ...


CCX Chief Complaint Configuration ...
CON Consult Tracking Configuration ...
EDU Patient Education Configuration ...
ENC Encounter Context Configuration ...
EXM Exam Configuration ...
FRM VueCentric Framework Configuration ...
HFA Health Factor Configuration ...

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IMM Immunization Configuration ...


LAB Lab Configuration ...
MED Medication Management Configuration ...
NOT Notification Configuration ...
ORD Order Entry Configuration ...
PAT Patient Context Configuration ...
PHX Personal Health Hx Configuration ...
PLS Problem List Configuration ...
POV POV Configuration ...
PRC Procedure Configuration ...
REM Reminder Configuration ...
RPT Report Configuration ...
SPL Spellchecking Configuration ...
TIU TIU Configuration ...
VIT Vital Measurement Configuration ...

Select RPMS-EHR Configuration Master Menu Option:

The basic steps of a consults are:

1. Meet with the service to determine who will receive the consult and who will
answer the consult as well as who will get notifications and the printer where the
request will print.
2. Create the team of users who will receive the consult.
3. Setup the service with the names for the following:
 Who will process the consult (providers)
 Who can update the consult (clerical staff)
 Printer to print the consult for
 Default reason for request or pre-requisites to the request
4. Create the progress note title name.
5. Make the templates for the following:
 Reason for request
 Note to complete the consult

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6. Create a quick order for ordering the consult.

2.4 Parameters
The EHR make extensive use of parameters. This allows sites to control the
configuration of many of the items it uses. Parameter settings can be completed at
many different levels. Some parameters allow settings to be made at all levels while
other are more restrictive.

As an example, the health summaries available on the Reports window allow for one
or two settings.

Allowable Health Summary Types can be set for the following:


2 User USR [choose from NEW PERSON]
4 System SYS [TCDEMO.NAV.IHS.GOV]

Other parameters have a more extensive list of possible settings.

PXRM CPRS LOOKUP CATEGORIES can be set for the following:


1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
3 Service SRV [choose from SERVICE/SECTION]
4 Division DIV [TUBA CITY HO]
5 System SYS [TCDEMO.NAV.IHS.GOV]
6 Package PKG [ORDER ENTRY/RESULTS REPORTING]

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The package setting is what comes when the EHR is loaded. Package settings should
NEVER be altered.

Package settings are the highest level. In most but not all cases, parameters are
evaluated from lowest to highest setting. So if a person has no setting at the user
level, the application will check for a setting at the next highest level. It will stop
when it finds a setting and those values will take effect.

In some cases, such as the new reminders parameters, the effect is cumulative starting
at the highest level and working down. In those cases, if it finds items at a lower
setting, it adds them to the items already there from a higher setting.

2.4.1 Setting Parameters


Setting Parameters can be done using the RPMS-EHR Configuration Master Menu.

Some parameter editing is done in the standard CPRS configuration (Clin


Coordinator) menu when the setup is performed. Users can edit some parameters
when they setup their user preferences.

All parameters can be edited from the CPRS Configuration (IRM) menu. This menu
is defined as an IRM menu because parameters are used by many other packages
besides the EHR, and this menu should be given out with caution. Most sites do allow
their CACs to have access to these options.
OC Order Check Expert System Main Menu ...
TI ORMTIME Main Menu ...
UT CPRS Clean-up Utilities ...
XX General Parameter Tools

The option “XX General Parameter Tools” is the menu to use; it is part of the Kernel
set.
LV List Values for a Selected Parameter
LE List Values for a Selected Entity
LP List Values for a Selected Package
LT List Values for a Selected Template
EP Edit Parameter Values
ET Edit Parameter Values with Template
EK Edit Parameter Definition Keyword

2.4.1.1 List Value for a Selected Parameter (LV)


Use LV to show all the values out there. This can get quite long for parameters where
users can set their own values.
Values for CIAVCXEN PROVIDER

Parameter Instance Value


-----------------------------------------------------------------
USR: MARTIN, DOUG 1 YES
USR: HAGER, MARY G 1 NO
CLS: PROVIDERS 1 YES

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CLS: USER 1 YES

2.4.1.2 List values for a Selected Entity (LE)


This option prompts for the entry of an entity (Location, user, etc.) and lists all values
for that entity.
10 User USR [choose from NEW PERSON]
20 Team TEA [choose from TEAM]
30 Class CLS [choose from USR CLASS]
40 Location LOC [choose from HOSPITAL LOCATION]
50 Service SRV [choose from SERVICE/SECTION]
60 Division DIV [TUBA CITY HO]
70 System SYS [TCDEMO.NAV.IHS.GOV]
You can review all the setup for a person or the system. Below is the parameters for a
specified user class:
Enter Selection: 30 Class USR CLASS
Select USR CLASS: provider
Values for CLS: PROVIDER

Parameter Instance Value


-------------------------------------------------------------------
CIAVM DEFAULT TEMPLATE 1 %DEMO_TEMPLATE
BEHOENCX CREATE VISIT 1 YES
BEHOENCX PROVIDER 1 YES
CIAOXQPC REQUIRES E&M CODE 1 YES
BEHOVM DATA ENTRY 1 YES

2.4.1.3 List Value for a Selected Package (LP)


This option prompts for a package and lists all parameter values for the selected
package.

Below are the parameters for lab service:


Parameter Instance Value
-----------------------------------------------------------
LR IGNORE HOLIDAYS 1 YES
LR COLLECT FRIDAY 1 YES
LR COLLECT THURSDAY 1 YES
LR COLLECT WEDNESDAY 1 YES
LR COLLECT TUESDAY 1 YES
LR COLLECT MONDAY 1 YES
LR COLLECT SUNDAY 1 YES
LR COLLECT SATURDAY 1 YES
LR LAB COLLECT FUTURE 1 7

2.4.1.4 List Value for a Selected Template (LT)


This option prompts for a parameter template. Depending on the definition of the
template, the RPMS can prompt for additional information and then display the
parameter values defined by the template.
---------------------------------------------------------------
Default object source path\\ 161.223.37.201\vuecentric\EH

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RC\LIB\
Default installation path C:\Program Files\VueCentric\TC
EHRC\
Default login template %PROVIDER
Host polling interval
Maximum number of resource devices
Number of resource slots to allocate
Primary inactivity timeout 3000
Secondary inactivity timeout 3000
Interval to display countdown timer 20
Disable CCOW support YES
Recall last selected patient YES
---------------------------------------------------------------

2.4.1.5 Edit Parameter Values (EP)


This option calls the low level parameter editor that allows you to edit the values for
every parameter.

(1) Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST


Write Orders (Inpatient). (2) Select the level you want to edit:
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write Orders
(Inpatient)
ORWOR WRITE ORDERS LIST may be set for the following:
et
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [TUBA CITY HO]
3 System SYS [TCDEMO.NAV.IHS.GOV]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter the value. Because each parameter has different values, you can use the ?
notation to find possible choices.

2.4.1.6 Edit Parameter Value for a Template (ET)


Use ET to edit parameter values for a Template. Enter one of the templates and the
application will ask for results for each item in the template.

2.4.1.7 Edit Parameter Definition Keyword (EK)


Use EK to edit parameter definition keyword. Because parameter names are hard to
remember, you can give them keywords that are used in searches. You can also use a
keyword to group several parameters together.

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3.0 Patient Context Configuration (PAT)


Select the Patient Context Configuration (PAT) option on the RPMS-EHR
Configuration Master Menu to display the following:
Patient Context Configuration

ALS Ignore Aliases in Patient Lookup


DMO Allow Viewing of Demo Patients Only
DTL Set Logic for Patient Detail View
HRN Patient Selection Requires HRN
LST Recall Last Selected Patient
RNG Default Date Ranges for Patient Selection Dialog
TEA Team List Management Menu

Select Patient Context Configuration:

3.1.1 Ignore Aliases in Patient Lookup (ALS)


Select the Ignore Aliases in Patient Lookup (ALS) option on the Patient Context
Configuration to display the following:
Ignore Aliases in Patient Lookup

Ignore aliases in patient lookup may be set for the following:

200 Division DIV [DEMO INDIAN HOSPITAL]


300 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 200 Division DEMO INDIAN HOSPITAL

Setting Ignore aliases in patient lookup for Division: DEMO INDIAN HOSPITAL
Ignore aliases in patient lookup: ??

If set to YES, any aliases encountered in the primary index of the patient file
are ignored.

Ignore aliases in patient lookup:

This is referring to “Other Names” in the Patient Registration package. When a


patient’s name is changed (married, divorced, etc.) the package stores the name it was
changed from under “Other names” section. If sites don’t want the “Other names” to
show up in the EHR, they would set this parameter to YES.

3.1.2 Allow Viewing of Demo Patients Only (DMO)


Select the Allowing Viewing of Demo Patients Only (DMO) option on the Patient
Context Configuration to display the following:
Allow Viewing of Demo Patients Only

All viewing of demo patients only may be set for the following:

100 User USR (choose from NEW PERSON)


200 Division DIV (DEMO HOSPITAL)

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300 System SYS (DEMO.MEDSPHERE.COM)

Enter selection: 200 Division DEMO HOSPITAL

-- Setting Allow viewing of demo patients only for Division: DEMO HOSPITAL –
Limit to demo patients only?: ??

If yes, the only demo patients may be selected.

Limit to demo patients only?:

3.1.3 Set Logic for Patient Detail View (DTL)


Select the Set Logic for Patient Detail View (DTL) option on the Patient Context
Configuration to display the following:
Set Logic for Patient Detail View

Patient detail report may be set for the following:

100 User USR (choose from NEW PERSON)


300 Service SRV (choose from SERVICE/SECTION)
500 Division DIV (DEMO HOSPITAL)
900 System SYS (DEMO.MEDSPHERE.COM)

Enter selection: 500 Division DEMO HOSPITAL

--------- Setting Patient detail report for Division: DEMO HOSPITAL ---------
Value: ?

This response can be free text.

Value: ??

M code to generate a patient detail report.

Value:

This determine which routine of patient information is displayed.

3.1.4 Patient Selection Requires HRN (HRN)


Select the Patient Selection Requires HRN (HRN) option on the Patient Context
Configuration to display the following:
Patient Selection Requires HRN

- Setting Patient selection requires HRN for System: DEMO.OKLAHOMA.IHS.GOV -


Patient selection requires HRN: YES// ??

This parameter controls whether a patient must have an assigned health record
number to be selectable within the EHR.

Patient selection requires HRN: YES//

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3.1.5 Recall Last Selected Patient (LST)


Select the Recall Last Selected Patient (LST) option on the Patient Context
Configuration to display the following:
Recall Last Selected Patient

Recall last selected patient may be set for the following:

100 User USR (choose from NEW PERSON)


200 Division DIV (DEMO HOSPITAL)
300 System SYS (DEMO.MEDSPHERE.COM)

Enter selection: 200 Division DEMO HOSPITAL

----- Setting Recall last selected patient for Division: DEMO HOSPITAL -----
Recall last selected patient?: ??

If yes, the patient context is set to the last patient selected upon startup.

Recall last selected patient?:

This recalls the last patient selected when a user logs on.

3.1.6 Default Date Ranges for Patient Selection Dialog (RNG)


Select the Default Date Ranges for Patient Selection Dialog (RNG) option on the
Patient Context Configuration to display the following:
Default Date Ranges for Patient Selection Dialog

------- Setting Default Date Ranges for System: DMO.OKLAHOMA.IHS.GOV --------

Edit Value?: 20// ??


Enter Y to edit, @ to delete

Edit Value?: 20//

If you enter Y, you go to a text editor where you can edit the default date range. This
allows a user to change the default date range choices when choosing a patient.

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3.1.7 Team List Management Menu (TEA)


Select the Team List Management Menu (TEA) option on the Patient Context
Configuration to display the following:

Figure 3- : Team List Management Menu

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3.1.7.1 Overview of the Options


The options on the Team List Management Menu allows you to create team patient
lists. You can create or add autolinks to a team list, view existing lists, remove
patients or users from team list, delete autolinks from existing tem list or delete an
entire team list.

A team list is a list containing patients related to several providers. These providers
are the list’s users.

You can now create a new team list or add autolinks, user, and/or patients to an
existing team list.

Autolinks automatically add or remove patients with ADT movements.

Users on the list can receive notifications regarding patients on the same list.

Please prefix your list name with ‘TEAM; or ‘SERVICE’ (e.g., TEAM7B,
SERVICECARDIOLOGY).

3.1.7.2 Options Usage


Option Name Usage
Create/All to Team List (CRE) This option allows team list creation or the addition
of autolinks, providers, and/or patients to existing
lists.
Delete Existing List(s) (DEL) This option is used when you no longer need a
team list that you built. After you enter the team list
to delete, there is no confirmation.
Display Patients Linked to a User via Teams (DPT) This option is used to list the patients linked to a
user via teams from the OE/RR LIST file. You are
asked to the the user’s name.
Display User’s Teams (DUS) This option lists the teams from the OE/RR LIST
file. You are first asked for the user’s name.
Examine/Print Existing List(s) (EXA) This option allows you to examine or print an
existing patient list.
Remove Autolinks (RAL) This option is used to remove Autolinks from a
team list and the patients associated with the
removed Autolinks. You can select one of the lists
and remove one or more autolinks. Removal of
autolinks will stop the automatic addition or deletion
of patients with ADT movements associated with
the deleted autolink.
Patients that were placed on the list using the
deleted autolink will be removed from the list if they
were not placed on the list by another Autolink.
Rename Existing List(s) (REN) This option is used to rename an existing team list.
Remove Patients from a List (RPA) This option is used to remove patients from a team
list.
Remove Providers from a List (RPR) This option is used to remove users/providers from
a team list.

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4.0 Encounter Context (ENC)


Select the Encounter Context Configuration (ENC) option on the RPMS-EHR
Configuration Master Menu to display the following:
Encounter Context Configuration

CRT Allow User to Create New Visits


LCK Days After Which Visit is Locked
OTH General Location for Outside Encounters
OVR Temporarily Override Visit Lock for User
PRV Allow a User to be a Visit Provider
STP Visit Search Stop Date
STR Visit Search Start Date
TYP Selectable Visit Types

Select Encounter Context Configuration Option:

4.1.1 Allow User to Create New Visits (CRT)


Select the Allow User to Create New Visits (CRT) option on the Encounter Context
Configuration menu to display the following:
Allow User to Create New Visits

Allow user to create new visits. may be set for the following:

100 User USR [choose from NEW PERSON]


200 Class CLS [choose from USR CLASS]
300 Service SRV [choose from SERVICE/SECTION]
400 Location LOC [choose from HOSPITAL LOCATION]
500 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 200 Class USR CLASS


Select USR CLASS NAME: provider

------ Setting Allow user to create new visits. for Class: PROVIDER -------
Value: ???

Enter either 'Y' or 'N'.

Value:

You use this option to allow any entity to setup new visits in the EHR for the facility.
Usually you set CLASS for provider (the default) and for medical records (HIM)
technicians.

4.1.2 Days After Which Visit is Locked (LCK)

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Select the Days After Which Visit is Locked (LCK) option on the Encounter Context
Configuration menu to display the following:
Days After Which Visit is Locked

Number days visit can be modified. may be set for the following:

800 Division DIV (DEMO HOSPITAL)


900 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 800 Division DEMO HOSPITAL

-- Setting Number days visit can be modified. for Division: DEMO HOSPITAL --

Value:

This parameter determines the number of days (1-180) after creating a visit that the
visit cannot be modified. Once this period has passed, no additional PCC data can be
attached to a visit.

4.1.3 General Location for Outside Encounter (OTH)


Select the General Location for Outside Encounter (OTH) on the Encounter Context
Configuration menu to display the following:
General Location for Outside Encounters

General location for outside encounters. may be set for the following:

500 Division DIV [DEMO INDIAN HOSPITAL]


900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 900 System DEMO.OKLAHOMA.IHS.GOV

Setting General location for outside encounters. for System: DEMO.OKLAHOMA.IHS.GOV


Location:

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You use this option to select a location for your outside encounters. You can display a
list by entering “??” at the “Location” prompt.

When you enter a location for System, this has two implications in the EHR: (1) you
would enter OTHER for the Location field using the Facility radio button (like for
historical events), and (2) when you view Visit File information for the visit, the
LOC. OF ENCOUNTER will show the general location that you selected for the
System level for the General Location for Outside Encounters option.

4.1.4 Temporarily Override Visit Lock for User (OVR)


This option is only used by the HIM department.

4.1.5 Allow a User to be a Visit Provider (PRV)


Select the Allow a User to be a Visit Provider (PRV) option on the Encounter Context
Configuration menu to display the following:
Allow a User to be a Visit Provider

Can be a visit provider? may be set for the following:

10 User USR (choose from NEW PERSON)


100 Class CLS (choose from USR CLASS)

Enter selection: 100 Class USR CLASS


Select USR CLASS NAME: PROVIDER

------Setting Can be a visit provider? for Class: PROVIDER ------------


Can be a visit provider?: YES//

If YES, the user/class can be a provider associated with a visit. This controls which
users appear in the Provider list of the Encounter Settings for Current Activities
dialog.

4.1.6 Visit Search Stop Date (STP)


Select the Visit Search Stop Date (STP) option on the Encounter Context
Configuration menu to display the following:
Visit Search Stop Date

Visit Search Stop Date may be set for the following:

1 User USR (choose from NEW PERSON)


2 Service CLS (choose from SERVICE/SECTION)
3 Division DIV (DEMO HOSPITAL)
5 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 3 Division DEMO HOSPITAL

-------- Setting Visit Search Stop Date for Division: DEMO HOSPITAL --------
Visit Search Stop Date:

CAC Manual 22 Encounter Context


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

Enter the relative date to end the listing of visits for a patient. For example, ‘T’ will
not list visits later than today. ‘T+30’ will not list visits after 30 days from now.

4.1.7 Visit Search Start Date (STR)


Select the Visit Search Start Date (STR) option on the Encounter Context
Configuration menu to display the following:
Visit Search Start Date

Visit Search Start Date may be set for the following:

1 User USR (choose from NEW PERSON)


2 Service CLS (choose from SERVICE/SECTION)
3 Division DIV (DEMO HOSPITAL)
5 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 3 Division DEMO HOSPITAL

-------- Setting Visit Search Start Date for Division: DEMO HOSPITAL --------
Visit Search Start Date:

Enter the relative date to start the listing of visits for a patient. For example, ‘T-90’
will list visits beginning 90 days from now.

4.1.8 Selectable Visit Types (TYP)


Select the Selectable Visit Types (TYP) option on the Encounter Context
Configuration menu to display the following:
Selectable Visit Types

Selectable visit types may be set for the following:

5 Division DIV [DEMO INDIAN HOSPITAL]


10 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 10 System DEMO.OKLAHOMA.IHS.GOV

----- Setting Selectable visit types for System: DEMO.OKLAHOMA.IHS.GOV -----


Select Sequence: ?

Sequence Value
-------- -----
1 A~Ambulatory~Used for workload.
2 E~Historical~Used to document past events. Not used for workload.
3 T~Telephonic~Used to document informal patient encounters such as tel
4 C~Chart Review~Used to document chart reviews. Not used for workload
5 I~In-Hospital~Used to document ambulatory visits on hospitalized pati
6 S~Day Surgery~Used to document Day Surgery visits.
7 O~Observation~Observation
8 R~Nursing Home~Used to document nursing home visits.
9 N~Not Found~Used for service categories not otherwise specified.

Select Sequence:

CAC Manual 23 Encounter Context


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The Sequence specifies the visit types selectable from the encounter context dialog.

CAC Manual 24 Encounter Context


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

5.0 Setting Up a New User


The setup of a new user is essentially the same for all providers and can vary quite a
bit for other users. Below is a sample provider setup and then one for other users.

5.1 Provider Setup


The provider setup consists of assigning keys, user class, parameters, and electronic
signature.

5.1.1 CPRS Keys


All providers need to be given the PROVIDER key. In most cases, this will occur as
part of the usual provider setup in the system.

In order to sign orders, a user needs the ORES key. Do NOT give that type of user
any of the other CPRS keys because the keys are mutually exclusive.

You assign the ORES key using the Order Configuration option on the RPSM-EHR
Configuration Master Menu | ORD (Order Entry Configuration) | Key.
Key Management

ALL Allocate OE/RR Security Keys


CHK Check for Multiple Keys

Select Key Management Option:

Select ALL to display the Allocate OE/RR Security Keys window.


Allocate OE/RR Security Keys

KEY: ORES

This key is given to users that are authorized to write orders in


the chart. Users with this key can verify with their electronic
signature patient orders.

This key is typically given to licensed Physicians.

Orders entered by users with this key can be released to the ancillary
service for immediate action.

DO NOT give users both the ORES key and the ORELSE key.

Edit Holders? Yes//

CAC Setup Guide 25 Setting Up a New User


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

This key is given to those who are authorized to write orders in the patient chart
(typically given to licensed physicians). Users with this key can verify their orders
with their electronic signature.

Orders entered by users with this key can be released to the ancillary service for
immediate action.

DO NOT give users both the ORES key and the ORELSE key.
Edit Holders? Yes//
Select HOLDER

As you enter a user’s name, that person will automatically be given the key if the user
doesn’t have it. If the user already holds the key, the system will ask if you want to
delete it.

5.1.2 User Class


You setup the user class in the TIU Maintenance Menu (EHR | TIU Configuration |
TIU Medical Records | TIU Maintenance Menu).
TIU Maintenance Menu

(DEMO INDIAN HOSPITAL)

DDM Document Definitions (Manager) ...


TAT TIU Alert Tools
TPM TIU Parameters Menu ...
TTM TIU Template Mgmt Functions ...
UCM User Class Management Menu ...

Select TIU Maintenance Menu Option:

Use the UCM (User Class Management Menu) option to display the following:
UCM1 User Class Definition
UCM2 List Membership by User
UCM3 List Membership by Class
UCM5 Manage Business Rules

Select User Class Management Menu Option:

Select User Class Management Option: UCM2 List Membership by User


Select USER: HAGER, MARY
Current User Classes Jun 10, 2004 14:29:29 Page 1 of 1
HAGER, MARY G 4 Classes
User Class Title Effective Expires
----------------------------------------------------------------
1 Chief, MIS 02/09/04
2 Clinical Coordinator NO 01/07/04
3 Physician 05/02/04
4 Provider 02/01/04

CAC Manual 26 Setting Up a New User


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-------+ Next Screen - Prev Screen ?? More Actions ------------


Add Remove Quit
Edit Change View
Select Action: Quit //

You can add, edit, or remove user classes.

5.1.3 Parameters
You should not have to edit any parameters for a provider. The EHR uses the
provider class above to allow providers to be chosen for visits and to determine which
EHR template they use.

5.1.4 Pharmacy Setup


All new providers have to be setup in pharmacy. Pharmacy has an option to add a
provider that gives that person the ability to write medication orders and controlled
substances. If a provider gets a message the provider cannot do either of these tasks,
that means that person has not been correctly entered into pharmacy. A user’s DEA#
is required for controlled substances.

Providers should have their own DEA numbers; however, in some cases, providers
may not be using the facility’s DEA number to write for controlled substances.
Because each provider must have a unique number in the RPMS new person file, the
facility DEA number cannot be repeated. In this case, the Clinical Applications
Coordinator can enter a VA number by accessing the new person file in Fileman in
the RPMS.
VA FileMan Version 22.0

Enter or Edit File Entries


Print File Entries
Search File Entries
Modify File Attributes
Inquire to File Entries
Utility Functions ...
Data Dictionary Utilities ...
Transfer Entries
Other Options ...

Select VA FileMan Option: Enter or Edit File Entries

INPUT TO WHAT FILE: NEW PERSON//


EDIT WHICH FIELD: ALL// VA#
THEN EDIT FIELD:

Select NEW PERSON NAME: BARSTAD,DANIELLE NOEL N DNB DENTIST


VA#: B3079

CAC Manual 27 Setting Up a New User


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For the VA# prompt: Enter the name of the provider that you want to give a “DEA”
number to up above after the new person prompt, (technically it is a VA number not
DEA number that you are giving). Make sure to use first character of the last name
and last four of the social security number.

5.1.5 BGOZ Keys


There are several keys that can be assigned to various users.

At the main RPMS main menu, select Menu Management | KEYS | Allocation of
Security Keys:
Select Menu Management Option: key Key Management

Allocation of Security Keys


De-allocation of Security Keys
Enter/Edit of Security Keys
All the Keys a User Needs
Allocate/De-Allocate Exclusive Key(s)
Change user's allocated keys to delegated keys
Delegate keys
Keys For a Given Menu Tree
List users holding a certain key
Remove delegated keys
Show the keys of a particular user

Select Key Management Option:

The following table provides information about the various BGOZ keys and what
users need them:

Key Name Users


BGOZ ASHTHMA EDIT Users who deal with asthma patients
BGOZ CAC Users who can add/edit POV/CPT pick lists and Chief
Complaint pick list
BGOZ ELDER CARE EDIT Users who deal with elder care
BGOZ ER EDIT Users who deal with ER patients
BGOZ PEDIATRIC EDIT Users who deal with pediatric patients
BGOZ PROBLEM LIST EDIT Users who can add or edit the problem list
BGOZ REP HIST EDIT Users who can edit women’s health
BGOZ TX CONTRACT EDIT Users who deal with TX Contracts
BGOZ VCPT EDIT Users who can add or edit CPT codes for visits
BGOZ VIEW ONLY General Users
BGOZ VPOV EDIT Users who can add or edit POV codes

Those users who have the PROVIDER key assigned to them can perform all of the
BGOZ key functions (except BGOZ CAC). This means that it is not necessary to
individually assign the keys to providers.

CAC Manual 28 Setting Up a New User


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

Other keys might be necessary, such as the BIZ and GMRA keys, to allow access to
other packages.

Those who need access to the RPMS-EHR Configuration Master Menu need the
BEHOZMENU key.

5.1.6 Electronic Signature


Every provider needs to use the User’s Toolbox option in RPMS to setup the
provider’s own electronic signature. Use the option in bold:
Select TIU Maintenance Menu Option: TBOX User’s Toolbox

Change my Division
Display User Characteristics
Edit User Characteristics
Electronic Signature code Edit
Menu Templates . . .
Spooler Menu . . .
Switch UCI
Taskman User
User Help

Prompts will appear for the electronic signature on notes and orders. Users should not
enter their initials (such as MD) under both their block name and title or it will appear
twice. Make sure your signature block printed name contains your name and
credential.
INITIAL: MGH//
SIGNATURE BLOCK PRINTED NAME: MARY HAGER//MARY HAGER, RN
SIGNATURE BLOCK TITLE
OFFICE PHONE:
VOICE PAGER
DIGITIAL PAGER

When the following prompt appears in RPMS:


Enter your Current Signature Code:

CAC Manual 29 Setting Up a New User


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

This means the person already has an electronic signature code. Otherwise, the person
will be asked to enter a new code. If the user forgets the code, it must be cleared out
by IRM or the CAC; then the user must create a new one. The personal signature
code must be entered by the user (and no one else).

Enter a new code (between 6 and 20 characters) with Cap Lock ON. However, when
you enter the electronic signature (on an order for example), it can be in lower case.
(No special characters are allowed.)

5.2 Other Users


The other users setup consists of assigning CPRS keys, user class, parameters,
electronic signature, and BGOZ keys.

5.2.1 CPRS Keys


The other two CPRS keys are ORELSE and OREMAS.

The ORELSE key is given those who are credentialed to release telephone and verbal
orders. Generally, this is RNs and pharmacists.

Clerks who do transcription of orders get the OREMAS key. For those who enter
orders with this key, they must have a written, signed order in front of them. If you do
not plan on your clerks doing transcription, especially in an outpatient setting, do not
give them this key.

See the above instructions on assigning CPRS keys. Say “NO” to editing the ORES
key holders and go onto the ORELSE key. Enter the person’s name. If that person
doesn’t have the key, it will be given immediately. If that person does have it, you’ll
be asked to delete it.

5.2.2 User Classes


All users need a user class. There are several user classes available and sites can add
their own if needed. See the above instructions

You can add, edit, or remove user classes on assigning User Classes.

5.2.3 Electronic Signature


Any user who can write a progress note will need an electronic signature. See the
setup above for creating the electronic signature.

5.2.4 BGOZ Keys


Depending upon the user, that person also needs the BGOZ keys to edit the problem
list, POVs, and CPT codes. Assign them accordingly. The BGOZ keys are as follows:

CAC Manual 30 Setting Up a New User


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

BGOZ EDIT DIAGNOSIS


BGOZ EDIT PROBLEM LIST
BGOZ VCPT EDIT
BGOZUSER
Other keys might be necessary, such as the BIZ and GMRA keys, to allow access to
other packages.

If the user has the Provider key, you will not have to assign the BGOZ keys.

CAC Manual 31 Setting Up a New User


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

6.0 TIU Configuration (TIU)


Select the TIU Configuration (TIU) option on the RPMS-EHR Configuration Master
Menu to display the following:
TIU Configuration

CLN TIU Menu for Clinicians ...


HIS TIU for Medical Records ...
PAR TIU Parameters ...

Select TIU Configuration Option

6.1 TIU Menu for Clinicians (CLN)


Select the TIU Menu for Clinicians (CLN) option on the TIU Configuration Menu to
display the following:
*****************************************
* INDIAN HEALTH SERVICE *
* TIU CLINICIAN'S MENU *
* VERSION 1.0, NOV 10,2004 *
*****************************************

DEMO INDIAN HOSPITAL


EED Enter/edit Document
EUV Edit/Update Visit
HLP TIU Help for Clinicians ...
IPD Individual Patient’s Documents
MPD Multiple Patient Documents
MYU All MY UNSIGNED Documents
SPT Search by Patient AND Title
TRD Transcribe Document
TRM TIU Reports Menu ...

Select TIU Menu for Clinicians Option:

Generally, the CAC does not use this menu in the basic setup for the EHR.

6.2 TIU Menu for Medical Records (HIS)


Select the TIU Menu for Medical Records (HIS) option on the TIU Configuration
Menu to display the following:
*****************************************
* INDIAN HEALTH SERVICE *
* TIU MEDICAL RECORDS MENU *
* VERSION 1.0, NOV 10,2004 *
*****************************************

DEMO INDIAN HOSPITAL


IPD Individual Patient Document
LAD List of Active Document Titles
MPD Multiple Patient Documents
PDM Print Documents Menu ...

CAC Setup Guide 32 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

SIG Awaiting Signature Listing


SSD Search for Selected Documents
STR Statistical Reports ...
TMM TIU Maintenance Menu ...
UPL TIU Upload Menu ...
VUA View a User’s Alerts

Select ITU Menu for Medical Records Option:

The CAC uses the TIU Maintenance Menu (TMM) in the basic setup.

6.2.1 TIU Maintenance Menu (TMM)


Select the TIU Maintenance Menu (TMM) option on the TIU Medical Records Menu
to display the following:
TIU Maintenance Menu

(DEMO INDIAN HOSPITAL)

DDM Document Definitions (Manager) ...


TAT TIU Alert Tools
TPM TIU Parameters Menu ...
TTM TIU Template Mgmt Functions ...
UCM User Class Management Menu ...

Select TIU Maintenance Menu Option:

This section addresses only the Document Definitions (Managers) DDM option. This
option lets you manage document definitions, user classes, business rules and system
parameters.

6.2.1.1 Document Definition (Manager)


Select Document Definition (Manager) (DDM) option on the TIU Maintenance Menu
to display the following:
Document Definitions (Manager)

(DEMO INDIAN HOSPITAL)

DDM1 Edit Document Definitions


DDM2 Sort Document Definitions
DDM3 Create Document Definitions
DDM4 Create Objects
DDM5 List Object Descriptions
DDM6 Create TIU/Health Summary Objects

CAC Manual 33 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

This option offers a variety of ways to manage the Document Definition Hierarch.

TIU uses a document storage database called the Document Definition hierarchy.
This hierarchy provides the building blocks for Text Integration Utilities (TIU). It
allows documents (Titles) to inherit characteristics of the higher levels, Class and
Document Class, such as signature requirements and print characteristics. This
structure, while complex to set up, creates the capability for better integration, shared
use of boilerplate text, components, and objects, and a more manageable organization
of documents. End users (clinical, administrative, and MIS staff) need not be aware of
the hierarchy. They work at the Title level with the actual documents.

6.2.1.1.1 Edit Document Definitions (DDM1)


Select the DDM1 option on the Document Definition (Manager) menu to display the
following:
Edit Document Definitions Nov 26, 2007 09:26:09 Page: 1 of 1
BASICS

Name Type
1 CLINICAL DOCUMENTS CL
2 +PROGRESS NOTES CL
3 +ADDENDUM DC
4 +DISCHARGE SUMMARY CL
5 CLINICAL PROCEDURES CL
6 +LR LABORATORY REPORTS CL

?Help >ScrollRight PS/PL PrintScrn/List +/- >>>


Expand/Collapse Detailed Display/Edit Items: Seq Mnem MenuTxt
Jump to Document Def Status... Delete
Boilerplate Text Name/Owner/PrintName... Copy/Move
Select Action: Quit//

This option lets you view and edit note titles. Entries are presented in hierarchy order.
ITEMS of an entry are in Sequence order, or if they have no Sequence, in alphabetic
order by Menu Text, and are indented below the entry. Because Objects do not belong
to the hierarchy, they cannot be viewed/edited using the Edit option.

Example of expand an entry: Enter E for expand, then enter 2 for progress notes. You
can combine these requests into E=2.

6.2.1.1.2 Sort Document Definitions (DDM2)


Select the DDM2 option on the Document Definition (Manager) menu to sort the
document definitions list according to the following attributes: type, owner, status, in
use, parentage, or all document definitions.

6.2.1.1.3 Create Document Definitions (DDM3)


Select the DDM3 option on the Document Definition (Manager) menu to create new
note titles. The following displays:
Create Document Definitions Nov 26, 2007 09:27:36 Page: 1 of 1
BASICS

CAC Manual 34 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Name Type
1 CLINICAL DOCUMENTS CL
2 PROGRESS NOTES CL
3 ADDENDUM DC
4 DISCHARGE SUMMARY CL
5 CLINICAL PROCEDURES CL
6 LR LABORATORY REPORTS CL

New Users, Please Enter '?NEW' for Help >>>


Class/DocumentClass Next Level Detailed Display/Edit
(Title) Restart Status...
(Component) Boilerplate Text Delete
Select Action: Next Level//

You use this option to create progress note titles; titles are needed before users can
write progress notes.

This option lets you create new entries (Classes, Document Classes, Titles) of any
type except Object, placing them where they belong in the hierarchy. This option
presents entries in hierarchy order, showing ONE line of descent, starting with
Clinical Documents at the top.

The Create Document Definitions option lets you view, edit, or create entries, but
only in the current line of descent. This option does not let you copy an entry.

Remember, status must be active before anyone can use the note but status must be
inactive before you can edit or change the note.

TIU note titles are hierarchical with CLINICAL DOCUMENTS being the parent
class of all documents.

Clinical Documents

Progress Notes Discharge Summaries Classes

Pharmacy Notes Nursing Notes PC Notes Crisis Notes Discharge Summaries Document Classes

Nurs Triage Note Nurs Admit Note Nurs Imm Note Discharge Summary Titles

Figure 6-3: Overview of Hierarchy of Notes

CAC Manual 35 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Business rules as well as basic and technical fields for progress notes follow this
relationship. If a title does not have a field defined, the program will search for the
document class. If the document class has nothing defined, it will search for the class.

So, you can overwrite any field at a lower level. Otherwise that field has inherited
values.

As an example, bring up the technical fields for progress notes.


Technical Fields Note: Values preceded by * have been inherited
Commit Action:
Release Action:
Verification Action:
Delete Action:
Package Reassignment
Action:
Entry Action:
Exit Action:
Post-signature Code:
Edit Template: [TIU ENTER/EDIT PROGRESS NOTE]
Print Method: D ENTRY^TIUPRPN
Print Form Header: Progress Notes
Print Form Number: Vice SF 509
Print Group: 2
Visit Linkage Method: D ENPN^TIUVSIT(.TIU,.DFN,1)
Validation Method: S TIUASK=$$CHEKPN^TIULD(.TIU,.TIUBY)
+
Allow Custom
Form Headers: NO

Upload
Upload Target File: TIU DOCUMENT
Laygo Allowed: YES
Target Text Field: REPORT TEXT
Upload Look-up Method: D LOOKUP^TIUPUTPN
Upload Post-filing Code: D FOLLOWUP^TIUPUTPN(TIUREC("#"))
Upload Filing Error Code: D PNFIX^TIUPNFIX

CAC Manual 36 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

You would change anything only if you wanted to change any of these fields for a
particular document or title. Otherwise, each progress note will follow the rules for
the entire class.

Considerations for Naming Notes

For IHS EHR sites, there needs to be a systematic document naming nomenclature for
naming notes. Local sites will customize and add note titles that improve patient care.

We recommend that you start the note title with a specialty, then add CONSULT, for
example. If CONSULT were used first, the list could become quite long and the
search would be time consuming.

Because all are NOTES, it is not necessary to add “NOTE” to the end of each title;
for example, PHARM REFILL rather than PHARM REFILL NOTE.

Use note titles defined by role/event/location rather than by disease state. DM might
be the exception due to its prevalence and importance in IHS. Examples:

DM EDU DM QUARTERLY DM ANNUAL

DM NUT DM PROGRAM DM CASE MGMT

Change, delete, or rename Note Titles that do not add any significant or useful
information; for example, DICTATED XXX.

Unique Note Titles

There are some Note Titles that are unique for different reasons. Examples:

ADDENDUM ADVANCE DIRECTIVES

ADVERSE REACTION ALLERGY

BLOOD TRANSFUSION CHART REVIEW

CONSCIOUS SEDATION CONSENT

DELIVERY DISCHARGE SUMMARY

HISTORY & PHYSICAL PREOP PE

PROCEDURE TRANSFER

Codes to Combine Role, Event, Service, Location

CAC Manual 37 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

A combination of two and three linked “names” from the categories of ROLE,
EVENT, SERVICE, and LOCATION might satisfy the basic naming conventions for
both Outpatient and Inpatient notes to help quickly identify the information that the
note contains.

ROLE + EVENT

PHARM REFILL for Pharmacy Medication Refill


NURS PICC LINE for Nurse PICC line placement
NRS INTAKE for Nurse admission intake assessment
SERVICE + EVENT

CARDS CONSULT for Cardiology Consult


PULM F/U for Pulmonary follow up
PT PFT for Physical Therapy pulmonary function test
LOCATION + ROLE

INPT DOC for Doctor Inpatient daily progress note


INPT NURS for Inpatient Nurse note
EVENT (could stand alone without additional specifications)

COLPO for colposcopy


EGD for esophogogastricduodenoscopy
ETT for exercise tolerance test/treadmill

CAC Manual 38 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Sample Titles for Each Provider

Every provider needs at least one Note Title at a minimum. Additional Note Titles are
added when it will enhance initial patient care or contains significantly different
information and will enhance the retrieval of this information at future visits. Below
are some examples:

Discipline Sample Note Title


Social Service SS DV INTAKE
SS SUICIDE
SS FAMILY MEETING
Cardiologist CARDIO CONSULT
CARDIO F/U
Pharmacist PHARM REFILL
PHARM CONSULT
PHARM ANTICOAG
PHARM ASTHMA
Clinical Nurse NURS CLINIC
Inpatient Nurse INPT NURS INTAKE
INPT NURS DAILY
Primary Care Clinic Provider GEN MED
WELL BABY
PRENATAL FIRST
PRENATAL F/U
DM QUARTERLY
CONSCIOUS SEDATION
Doctor with expanded duties H&P
DISCHARGE SUMMARY
TRANSFER
PROCEDURE
CONSENT
CONSCIOUS SEDATION
BLOOD TRANSFUSION
DELIVERY
DEATH SUMMARY
Surgeon SURG CONSULT
SURG F/U
SURG PROCEDURE
PREOP PE

Codes for Various Hospital Areas

CAC Manual 39 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Because screen view space has some limitations, below are some examples of note
titles, in alphabetic order:

Code Meaning for


CARDIO Cardiology
CHR Community Health Representative
COLPO Colposcopy
DDS Dental
DM Diabetes Mellitus
ENDO Endocrinology
ER Emergency Room
EYE Optometry or Ophthalmology
INPT Inpatient
MCH Maternal Child Health
MH Mental Health (Psychologist)
NEURO Neurology
NURS Nursing
NUT Nutrition
ORTHO Orthopedics
PHARM Pharmacy
PHN Public Health Nursing
POD Podiatry
PSYCH Psychiatrist
PT Physical Therapy
RAD (or XRAY) Radiology/Radiologist
SURG Surgery
SS Social Service

Codes for General Medicine or Primary Care

General Medicine and Primary Care are acceptable alternative for a simple Note Title
to share between most primary care providers. However, it seems that the local EHR
team is in the best position to determine where the similarities and differences are
across their primary care providers (Internal Medicine, Family Practice, etc.)

National Note Titles

The national Note Titles were part of the original setup of the software within the VA.
Some are still valuable to the VA while others are no longer used but must be
included for the package to run properly. Even though we do not want to use some of
the national titles, we did not want to delete them. Instead, we simply made them
inactive, so they are not used inadvertently or clutter our options.

Here is the recommended inactive list:

ASI-ADDITION SEVERITY INDEX


CLINICAL WARNING, CRISIS NOTE
LR AUTOPSY REPORT
LR CYTOPATHOLOGY REPORT
LR ELECTRON MICROSCOPE REPORT
LR SURGICAL PATHOLOGY REPORT

CAC Manual 40 TIU Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

NOTE WITH BOILERPLATE


NOTE WITH COMPONENTS
RISK OF CJD
SAMPLE DICTATED NOTE
SAMPLE EVENT NOTE
TRANSITIONAL PHARMACY BENEFIT NOTE.
Clinical Warning Note Title

Notes created with a clinical warning note titles will appear on the Overview page in
the clinical warning window. The note title and date will appear in the window. If you
click on the window, the entire note associated with this note title and date displays.
To create a clinical warning note title, go to the TIU menu and create a new document
title under the clinical warning document class.

When providers choose this note title, their note links with a clinical warning and will
appear in the Crisis Alerts window.

6.2.1.1.4 Create Objects (DDM4)


Select the DDM4 option on the Document Definition (Manager) menu to display the
following:
Objects Nov 26, 2007 09:30:29 Page: 1 of 14
Objects

Status
1 ACTIVE MEDICATIONS A
2 ACTIVE MEDS COMBINED A
3 ACTIVE MEDS ONE LIST A
4 ACTIVE PROBLEMS A
5 ACTIVE PROBLEMS W/O DATES A
6 ADDRESS-ONE LINE A
7 ADMITTING DX A
8 ADMITTING PROVIDER A
9 ALLERGIES/ADR A
10 BEHDICTATE HEADER A
11 BEHDICTATE NOTE IEN A
12 BMI A
13 BMI WITH CAPTION A
14 BPXRM ALCOHOL SCREEN A
+ ?Help >ScrollRight PS/PL PrintScrn/List +/- >>>
Find Detailed Display/Edit Copy/Move
Change View Try Quit
Create Owner
Select Action: Next Screen//

CAC Manual 41 TIU Configuration


October 2008
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You use this option to create objects; objects can then be placed into templates.

This option lets you select Start With and Go to values. It then displays Objects
within these values in alphabetic order by name. The user can create new objects or
edit existing objects.

Example: Creating a Lab Result Object (you must have programmer access to do the
following):

Find the object Last Lab Test (Sample) and note its number.

Select Action | Copy/Move. Enter the number of the last test. Select the entry to copy
(Last Lab Test).

Replace: Lab Test Sample with HGB (this must match your test name in Lab file 60).

The object will be copied into the file and assigned an entry number. The object will
now display in the Objects list, with a status of Inactive.

Select Detailed Display/Edit and select the entry number of the new object.

Select Technical Fields and under Object Method replace Lab Test Name with HGB
(actual lab test name).

Select Basics and change the status to Active.

You must logout of the EHR and re-enter for your object to show up.

6.2.1.1.5 List Object Descriptions (DDM5)


Select the DDM5 option on the Document Definition (Manager) menu to display the
following:
Object Descriptions Nov 26, 2007 09:32:12 Page: 1 of 81

Object Name Status Owner


1 ACTIVE MEDICATIONS ACTIVE CLINICAL COORDINATOR
Method: S X=$$LIST^TIULMED(DFN,"^TMP(""TIUMED"",$J)",1)

Returns list of patient's active medications, sorted alphabetically.

2 ACTIVE MEDS COMBINED ACTIVE CLINICAL COORDINATOR


Method: S X=$$LIST^TIULMED(DFN,"^TMP(""TIUMED"",$J)",1,0,0,1)

Returns list of active medications for a patient, sorted alphabetically,


one line per medication.

3 ACTIVE MEDS ONE LIST ACTIVE CLINICAL COORDINATOR


Method: S X=$$LIST^TIULMED(DFN,"^TMP(""TIUMED"",$J)",1,0,0,1,0,1)

DESCRIPTION
Includes the list of active and pending meds and supplies all in one list

+ Enter ?? for more actions

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Select Action: Next Screen//

This option lists a description of each patient/visit object so TIU Application


Coordinators can decide which objects to use in templates and boilerplates. The CAC
can see what national objects are supposed to do. Descriptions are always written for
national objects.

6.2.1.1.6 Create TIU/Health Summary Objects (DDM6)


Select the DDM6 option on the Document Definition (Manager) menu to display the
following:
TIU Health Summary Object Nov 26, 2007 09:33:36 Page: 1 of 1

TIU Object Name Health Summary Type


1 HS MEDS-CHRONIC No Health Summary Type Found
2 PERSONAL HISTORY No Health Summary Type Found
3 TIU TPBN FUTURE APPTS TIU TPBN FUTURE APPTS

Enter ?? for more actions


Create New TIU Object Find
Detailed Display/Edit TIU Object Detailed Display/Edit HS Object
Quit
Select Action: Quit//
This allows you to create a TIU object from a health summary.

6.2.2 TIU Alert Tools (TAT)


The TIU Alert Tools (TAT) option on the TIU Maintenance Menu allows you to
search for documents using a variety of search criteria.

6.2.3 TIU Parameters Menu (TPM)


Select the TIU Parameters (TPM) option on the TIU Maintenance Menu to display
the TIU Parameters Menu. This menu shows those things to do or review before the
EHR is installed.
TIU Parameters Menu

TPM1 Basic TIU Parameters


TPM2 Modify Upload Parameters
TPM3 Document Parameter Edit
TPM4 Progress Notes Batch Print Locations
TPM5 Division – Progress Notes Print Params

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6.2.3.1 Basic TIU Parameters (TPM1)


Select the TPM1 option on the TIU Parameters Menu to display the following: (you
need to do all of these)
First edit Division-wide parameters

Select INSTITUTION: TUBA CITY HO


ENABLE ELECTRONIC SIGNATURE: YES//
ENABLE NOTIFICATIONS DATE: DEC 1, 2003//
GRACE PERIOD FOR SIGNATURE: 4//
FUTURE APPOINTMENT RANGE: 1//
CHARACTERS PER LINE: 80//
OPTIMIZE LIST BUILDING FOR: security//
SUPPRESS REVIEW NOTES PROMPT: NO//
DEFAULT PRIMARY PROVIDER:
BLANK CHARACTER STRING: @@@//

This option allows the user to enter the basic (or general parameters) that govern the
behavior of the Text Integration Utilities for a selected institution.

INSTITUTION: This is the institution name.

ENABLE ELECTRONIC SIGNATURE: Using YES will activate the electronic


signature component of TIU for the designated institution.

ENABLE NOTIFICATIONS DATE: This date indicates when the system will begin
sending signature notifications.

GRACE PERIOD FOR SIGNATURE: This indicates the number of days (1 to 10)
following transcription or hand entry before an author or expected cosigner is notified
of a deficiency. If no grace period is entered, clinicians are not notified of overdue
signatures.

FUTURE APPOINTMENT RANGE: This is the number of days that determine how
far in advance a future appointment can be selected when entering a document for
outpatient care. Allowable values range from 1 to 180 days, defaulting to 1 day.

CHARACTERS PER LINE: This is the number (10 to 80) you want to use as a
divisor in determining line counts of transcribed documents.

OPTIMIZE LIST BUILDING FOR: This indicates whether you want to optimize the
list for either performance or security. The following table describes the differences
between these options.

Item Description
Performance When a performance-optimized system creates a list, the system
bypasses business rules so even notes the user cannot view are
listed.
Security When a security-optimized system creates a list, the system
excludes any documents you are not authorized to view.

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SUPPRESS REVIEW NOTES PROMPT: Use YES to suppress the prompt that asks
if you want to see available Progress Notes before entering a new note. Use NO if
you want the system to display this prompt. If you answer NO here, each user can
override it under Personal Preferences.

DEFAULT PRIMARY PROVIDER: This indicates how the system should prompt
for provider information. The following table details the differences among the
options.

Item Description
0 The system does not prompt you to enter a primary provider for a standalone
encounter.
1 The system prompts you to enter the default provider for the given location
associated with a standalone encounter.
2 The system prompts you to enter the default author, if the author is a provider.
If the author is not a provider, the prompt has no default.

BLANK CHARACTER STRING: This indicates the string of characters used by


Transcriptionists to represent a blank when a word or phrase in the dictation cannot
understood for inclusion in the transcription. Example: @@@

6.2.3.2 Modify Upload Parameters (only for dictation sites)


Select the TPM2 option on the TIU Parameters Menu to display the following:
Select INSTITUTION: TUBA CITY HO
ASCII UPLOAD SOURCE:
UPLOAD HEADER FORMAT:
RECORD HEADER SIGNAL:
BEGIN REPORT TEXT SIGNAL:
RUN UPLOAD FILER IN FOREGROUND: NO//

Now Select upload error alert recipients:

Select ALERT RECIPIENT:

IHS UPLOAD PARAMETERS

UPLOAD FILE DIRECTORY:


ARCHIVE FILE DIRECTORY:
UPLOAD FILE NAME:

Now edit the DOCUMENT DEFINITION file:


DOCUMENT DEFINITION:

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This option allows you to define and modify parameters for the batch upload of
documents into RPMS.

INSTITUTION: This is the institution name.

ASCII UPLOAD SOURCE: This indicates the source from which you will upload
documents. The following table details the different source options.

Note: This only applies when the ASCII upload protocol is used.

Item Description
Host Indicates to the upload processor that the source of the data is an
ASCII host file.
Remote Indicates to the upload processor that the data is an ASCII stream
coming from a terminal emulator on a remote computer.

UPLOAD HEADER FORMAT: This indicates whether you will be uploading


captioned or delimited string formats for the header of each document.

RECORD HEADER SIGNAL: This indicates the text tag you will use to signal to the
upload process that it has encountered a new document record header. This can be as
simple as a three-letter acronym.

BEGIN REPORT TEXT SIGNAL: This indicates the text tag you will use to signal to
the upload processor that it has fully read the fixed-field header for a given report
record, and that the body of the narrative report follows.

RUN UPLOAD FILER IN FOREGROUND: This indicates whether or not to run the
process in the foreground.

ALERT RECIPIENT: This is the name of the person you want to receive upload error
notifications. This individual will receive notifications when a document cannot be
filed or located, or has missing fields.

ARCHIVE FILE DIRECTORY: This is the path and file name of the file that the
upload process should look for.

UPLOAD FILE NAME: This is the file name for the upload.

DOCUMENT DEFINITION: This is the name of the appropriate document.

6.2.3.3 Document Parameter Edit (TPM3)


Select the TPM3 option on the TIU Parameters Menu to display the following:
Select DOCUMENT DEFINITION: PROGRESS NOTES

DOCUMENT DEFINITION: PROGRESS NOTES//


REQUIRE RELEASE: NO//
REQUIRE MAS VERIFICATION: UPLOAD ONLY//
REQUIRE AUTHOR TO SIGN: YES//

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ROUTINE PRINT EVENT(S):


STAT PRINT EVENT(S):
MANUAL PRINT AFTER ENTRY: YES//
ALLOW CHART PRINT OUTSIDE MAS: YES//
ALLOW >1 RECORDS PER VISIT: YES//
ENABLE IRT INTERFACE:
SUPPRESS DX/CPT ON ENTRY:
FORCE RESPONSE TO EXPOSURES:
ASK DX/CPT ON ALL OPT VISITS:
SEND ALERTS ON ADDENDA: YES//
ORDER ID ENTRIES BY TITLE: NO//
SEND ALERTS ON NEW ID ENTRY: NO//
SEND COSIGNATURE ALERT:

If document is to be uploaded, specify Filing Alert Recipients:

Select FILING ERROR ALERT RECIPIENTS:

Now enter the USER CLASSES for which cosignature will be required:
Select USERS REQUIRING COSIGNATURE: STUDENT//

Now enter the DIVISIONAL parameters:


Select DIVISION:
CHART COPY PRINTER:
STAT COPY PRINTER:

This option allows the user to enter the parameters that apply to specific documents
(e.g., Titles), or groups of documents (e.g., Classes or Document Classes).

DOCUMENT DEFINITION: This is the name of the Class, Document Class or Title,
such as Crisis Note or Discharge Summary.

REQUIRE RELEASE: This indicates whether or not to require the individual


entering a document to release the document from a draft state upon exit from the
entry and editing processes.

REQUIRE MAS VERIFICATION: indicate when verification by Medical Records


staff is required. The following table details the available options.

Item Description
0 No verification required.
1 Always require verification.
2 Require verification for uploads only.
3 Require verification for direct entries only.

REQUIRE AUTHOR TO SIGN: This field indicates whether or not the author should
sign the document before the expected cosigner If YES, this indicates the author is
alerted for signature, and if the expected cosigner should attempt to sign the
document first, he is informed that the author has not yet signed. If NO, this indicates
only the expected cosigner is alerted for signature. Although the unsigned document
appears in the author’s unsigned list, and the author is ALLOWED to sign it, the
author’s signature is not REQUIRED.

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ROUTINE PRINT EVENT: This indicates at what stage (before signature) you want
the document to print, if any: upon release, upon verification, or both.

MANUAL PRINT AFTER ENTRY: This indicates whether or not to have user
prompted to print a copy on exit from that person’s preferred editor.

ALLOW CHART PRINT OUTSIDE MAS: Use YES to allow non-Medical Records
staff you to print either work or chart copies. Use NO to limit chart copies to Medical
Records only.

ALLOW >1 RECORDS PER VISIT: Use YES to allow users to create a given
document more than once per visit, such as multiple Progress Notes for a single
Hospitalization. Use NO to limit you to creating only one document to only once per
visit, such as a Discharge Summary.

ENABLE IRT INTERFACE: leave blank. This parameter is not used by IHS.
Interface with IHS Incomplete Chart module is automatic, if the appropriate chart
deficiencies are linked to TIU titles.

SUPPRESS DX/CPT ON ENTRY: Use YES to suppress system prompts for


diagnosis and procedure information after signing or editing an outpatient document.
Use NO to receive these prompts. The answer to this question does not affect how
TIU in List Manager runs in IHS, because we are linked to PCC and not the VA PCE
coding.

SEND ALERTS ON ADDENDA: leave blank because IHS does not use this field.

ORDER ID ENTRIES BY TITLE: leave blank because IHS uses PCC to code visits
and not. This prompt applies only to notes with interdisciplinary entries under them

SEND ALERTS ON NEW ID ENTRY: Use YES to have authors and cosigners of a
document receive an informational alert when other persons add addenda. Use NO to
suppress alerts. This parameter applies only to interdisciplinary parent notes.

SEND COSIGNATURE ALERT: This parameter controls the sequence in which


alerts are sent to the expected cosigner of a document. Use 0 to enable the system to
alert the cosigner only after the author has signed a document. Use 1 to enable the
system to alert the cosigner immediately.

FILING ERROR ALERT RECIPIENTS: This indicates the individuals who will
receive alerts from the upload filer process when a document of the given type cannot
be filed or located, or has a missing field. These are Medical Records staff members
who process and verify uploaded documents.

Select USERS REQUIRING COSIGNATURE: You may enter a new USERS


REQUIRING COSIGNATURE, if you wish. Specify which user class(es) require
cosignature.

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Select DIVISION: You may enter a new DIVISION, if you wish.

CHART COPY PRINTER: Select the printer for chart copies of routine documents.

STAT COPY PRINTER: Select the chart copy printer for STAT documents.

The “Select DIVISION” prompt displays (again).

6.2.3.4 Progress Notes Batch Print Location (TPM4)


Select the TPM4 option on the TIU Parameters Menu to display the following:
Select Clinic or Ward: ACU
OK? Yes// (Yes)

PROGRESS NOTES DEFAULT PRINTER: ACU PRINTER//


EXCLUDE FROM PN BATCH PRINT:

This is the hospital location to which the parameters apply. You can enter new
parameters.

Select Clinic or Ward: enter a location.

PROGRESS NOTES DEFAULT PRINTER: enter the printer name. You can
override this default at the time a job is printed.

EXCLUDE FROM PN BATCH PRINT: Use YES to have progress notes for this
location will not be included in the progress outpatient batch print job [TIU PRINT
PN BATCH]. Do this if you want to print the CHART copies of the notes for this
location in the clinic and not in the file room.

6.2.3.5 Division – Progress Notes Print Params (TPM5)


Select the TPM5 option on the TIU Parameters Menu to display the following:
Select Division for PNs Outpatient Batch Print: tuba CITY HO IHS 3987
OK? Yes// Yes

LOCATION TO PRINT ON FOOTER: Tuba City HO IHS//


PROGRESS NOTES BATCH PRINTER: acu PRINTER ACU IP PRINTER 161.223.42.97
|PRN|\\NAVTCB\ACUPRINTER

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Select Division for PNs: enter the appropriate division name.

LOCATION TO PRINT ON FOOTER: type the number of the division, using 3 to 26


characters, as it should display on the footer of Progress Notes; however, you can
override this default at the time a job is printed.

PRN: one print for all outpatient notes.

Footer is the bottom part of the note that remains the same on each page of the note.

These parameters are used by the [TIU PRINT PN BATCH INTERACTIVE] and
[TIU PRINT PN BATCH SCHEDULED] options. If the site wants a header other
than what is returned by $$SITE^VASITE, the .02 field of the 1st entry of this file
will be used. For example, Waco-Temple-Martin can have the institution of their
progress note as ‘CENTRAL TEXAS HCF.’

If you want to print the outpatient notes as a batch program, someone in IRM needs to
setup the TIU PRINT PN BATCH SCHEDULED option to run every day. The
location chosen will need plenty of paper, and this should probably be scheduled for a
time when someone will be around to watch the printer.

EHR Printing Option

Because there is no good batch print option for both inpatient and outpatient notes,
another routine has been created that allows for batch printing. An option will need to
be created to run BATCH^DIAVIHHS(FLAG) where the flag can be set for printing:

Everything

All notes

Signed progress notes

Orders

PCC data

This job will need to be scheduled to run everyday in Taskman. The output is printed
to the default host file server directory.

Please note that progress notes, orders, and other information can be printed manually
from the EHR.

6.2.4 TIU Template Mgmt Functions (TTM)


Select the TIU Template Mgmt Functions (TTM) option on the TIU Maintenance
Menu to display the following:
1 Delete TIU template for selected user

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2 Edit auto template cleanup parameters


3 Delete template for ALL terminated users

Select TIU Template Mgmt Functions Option:

6.2.4.1 Delete TIU template for selected user


Select the “Delete TIU template for selected user” option on the TIU Template Mgmt
Functions menu to display the following:
Enter/select user for whom templates will be deleted: DEMO,DOCTOR
Delete all non-shared templates for user USER,CLEAR (Y/N)? NO//

Choose YES to delete all non-shared templates for the specified user. This option
accepts user input for an individual from the NEW PERSON file, then deletes non-
shared TIU templates for that user. The application prompts for confirmation of the
deletion.

6.2.4.2 Edit auto template cleanup parameters


Select the “Edit auto template cleanup parameters” option on the TIU Template
Mgmt Functions menu to display the following:
Y/N auto cleanup upon termination may be set for the following:

1 Division DIV (DEMO HOSPITAL)


2 System SYS (DEMO.CIAINFORMATICS.COM)

Enter Selection:

You use this option to automatically delete non-shared TIU templates for a user upon
termination (or skip any such automatic action). Enter Y or N, where Y turns on auto-
template cleanup.

6.2.4.3 Delete templates for ALL terminated users


Select the “Delete templates for ALL terminated users” option on the TIU Template
Mgmt Functions menu to display the following:
Delete all non-shared templates for all terminated users (Y/N)? NO//

This option allows the CAC or other manager to remove all non-shared TIU
templates for all users who have been terminated.

6.2.5 User Class Management Menu (UCM)


Select the User Class Management Menu (UCM) option on the TIU Maintenance
Menu to display the following:
User Class Management Menu

(DEMO HOSPITAL)

UCM1 User Class Definition

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UCM2 List Membership by User


UCM3 List Membership by Class
UCM4 Manage Business Rules

Select User Class Management Menu Option:

You use this menu of options to manage User Class Definitions and Membership as
well as manage business rules.

6.2.5.1 User Class Definition (UCM1)


Select the User Class Definition (UCM1) option on the User Class Management
Menu and the application asks you to select user class status (Active, Inactive, All),
Start with class, and Go to class. Then it displays the following:
User Classes Nov 26, 2007 09:37:25 Page: 1 of 8
ACTIVE USER CLASSES 117 Classes
Class Name Abbrev
1 Allergist ALLRG Active
2 Allergy & Immunology ADR Active
3 Anesthesiologist ANES Active
4 Associate Chief Of Staff ACOS Active
5 Attending Physician ATT Active
6 Audiologist AUD Active
7 Cardiologist CARD Active
8 Chaplain CHAP Active
9 Chief Resident CR Active
10 Chief, MIS CMIS Active
11 Chief, Medical Service CMED Active
12 Chief, Psychiatry Service CPSYCH Active
13 Chief, Surgical Service CSURG Active
14 Clinical Clerk CLCLRK Active
15 Clinical Coordinator CLPAC Active
+ + Next Screen - Prev Screen ?? More Actions
Find Expand/Collapse Class Change View
Create a Class List Members Quit
Edit User Class
Select Action: Next Screen//

You will use this option to view user classes and their hierarchy. Also, you will
create, edit, or remove user classes from this option.

Provider User Class

All users need a user class. The user class is set in the TIU menus. There is an
automatic option that allows a site to populate all holders of the PROVIDER key into
the Provider user class, but this has not been enacted because of the time needed to
clean up this list at many sites. So individuals will have to be added as they start using
the EHR.

6.2.5.2 List Membership by User (UCM2)


Select the List Membership by User (UCM2) option on the User Class Management
Menu and the application asks you to select a user. Then it displays the following:
Current User Classes Mar 27, 2006 16:18:32 Page 1 of 1

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DOCTOR,DEMO

User Class Title Effective Expires


1 Physician 01/02/00
2 Provider 01/02/00

+ Next Screen - Prev Screen ?? More Actions


Add Remove Quit
Edit Change View
Select Action: Quit//

You will use this option to view, add, edit, or remove user classes for a specified user.

6.2.5.3 List Membership by Class (UCM3)


Select the List Membership by Class (UCM3) option on the User Class Management
Menu and the application asks you to select a class. Then it displays the following:
User Class Members Nov 26, 2007 09:39:02 Page: 1 of 2
PROVIDERs 24 Members
Member Effective Expires
1 BAROFF,SCOT A 07/26/04
2 BARRETT,KARI E 07/26/04
3 BISHOP,BRADLEY M 07/26/04
4 BROWN,GERALD R 07/26/04
5 BRUNING,BJ 08/28/06
6 CHEATHAM,IVANNE L 07/26/04
7 COOKSON,DEBORAH M 07/26/04
8 COX,PATRICK
9 DEMO,DOCTOR (?SBPN) 11/09/07
10 GUZIC,CARLA D 07/26/04
11 HOGAN,SHERA M 07/26/04
12 INGRAM,DENA G 07/26/04
13 JONES,KERRI A 07/26/04
14 KLEPACKI,STEPHANIE 09/16/07
15 MCLEMORE,MISTY B 07/26/04
+ (?SBPN) missing SIGNATURE BLOCK PRINTED NAME >>>
Add Remove Change View
Edit Schedule Changes Quit
Select Action: Next Screen//

You use this option to view members of a specified class.

6.2.5.4 Manage Business Rules (UCM4)


Select the Manage Business Rules (UCM4) option on the User Class Management
Menu to display the following:
Select User Class Management Option: ucm4 Manage Business Rules
Select SEARCH CATEGORY: DOCUMENT DEFINITION//
Select DOCUMENT DEFINITION: PROGRESS NOTES
ASU Rule Browser Jun 10, 2004 14:30:39 Page 1 of 2
----------------------------------------------------------------------------
List Business Rules by DOCUMENT DEFINITION 24 Rules
for CLASS PROGRESS NOTES

-------------------------------------------------------------------
1 A COMPLETED (CLASS) PROGRESS NOTE may be VIEWED by a USER
2 An UNSIGNED (CLASS) PROGRESS NOTE may be EDITED by a STUDENT who is also
an AUTHOR/DICTATOR

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3 An UNSIGNED (CLASS) PROGRESS NOTE may BE DELETED by an AUTHOR/DICTATOR


4 An UNSIGNED (CLASS) PROGRESS NOTE may BE VIEWED by an AUTHOR/DICTATOR
5 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE VIEWED by an AUTHOR/DICTATOR
6 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE VIEWED by an EXPECTED COSIGNER
7 An UNSIGNED (CLASS) PROGRESS NOTE may BE PRINTED by an AUTHOR/DICTATOR
8 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE PRINTED by an AUTHOR/DICTATOR
9 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE EDITED by an EXPECTED COSIGNER
10 An UNSIGNED (CLASS) PROGRESS NOTE may BE EDITED by an AUTHOR/DICTATOR
11 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE PRINTED by an EXPECTED
COSIGNER
12 An UNSIGNED (CLASS) PROGRESS NOTE may BE SIGNED by an AUTHOR/DICTATOR
13 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE COSIGNED by an EXPECTED
COSIGNER

+-------------+ Next Screen - Prev Screen ?? More Actions ---------------


Find Edit Rule Change View
Add Rule Delete Rule Quit
Select Action: Next Screen//

This option allows you to add, edit, or delete business rules for a specified document
definition, as appropriate.

6.3 TIU Parameters (PAR)


Select the TIU Parameters (PAR) option on the TIU Configuration Menu to display
the following:
TIU Parameters

AUT Note Autosave Interval


CLN Auto Cleanup Upon User Termination
CLS Personal Template Access by User Class
DEF Default Template for Document Type
FLD Template Field Editor User Classes
OBJ Allowed Personal Template Objects
PER Personal Template Access
REM Reminder Dialogs Allowed as Templates
VER Verify Note Title

Select TIU Parameters Option:

6.3.1 Note Autosave Interval (AUT)


Select the Note Autosave Interval (AUT) option on the TIU Parameters menu to
display the following:
Note Autosave Interval

Interval for Autosave of Notes may be set for the following:

1 User USR (choose from NEW PERSON


5 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection:

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This parameter determines how many seconds should elapse between each auto-save
of a note that is being editing in the EHR.

6.3.2 Auto Cleanup Upon User Termination (CLN)


Select the Auto Cleanup Upon User Termination (CLN) option on the TIU
Parameters menu to display the following:
Auto Cleanup Upon User Termination

Y/N auto cleanup upon termination may be set for the following:

1 Division DIV (DEMO HOSPITAL)


2 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection:

If the parameter is set to ‘Y’ then whenever a user is terminated, that person’s non-
shared TIU templates will be deleted. The default setting is ‘N’.

6.3.3 Personal Template Access by User Class (CLS)


Select the Personal Template Access by User Class (CLS) option on the TIU
Parameters menu to display the following:
Personal Template Access by User Class

Setting Personal Template Access by User Class for System: DEMO.CIAINFORMATICS.COM


Select User Class:

The parameter determines which user class can make personal templates.

6.3.4 Default Template for Document Type (DEF)


Select the Default Template for Document Type (DEF) option on the TIU Parameters
menu to display the following:
Default Template for Document Type

Select NEW PERSON NAME: ZIPPER,KIMERLY KZ CLINICAL COORDINATOR

- Setting Default Template Notes/Consults/DC Summ for User: ZIPPER,KIMERLY


DEFAULT TEMPLATES:

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The entry here marks the specified template as the user’s default template. This
means that when the user goes to the template and right-clicks, the user can use the
option “go to default template” to use the (specified) default template; this way the
user doesn’t have to search through the folders for that favorite template.

6.3.5 Template Field Editor User Classes (FLD)


Select the Template Field Editor User Classes (FLD) option on the TIU Parameters
menu to display the following:
Template Field Editor User Classes

Template Field Editor User Classes may be set for the following:

1 User USR [choose from NEW PERSON


2 Service SRV [choose from SERVICE/SECTION]
4 Division DIV [DEMO HOSPITAL]
5 System SYS [DEMO.CIAINFORMATICS.COM]

Enter selection: 4 Division DIV [DEMO HOSPITAL]

-- Setting Template Field Editor User Classes for Division: DEMO HOSPITAL --
Select Sequence Number:

This parameter contains a list of ASU user classes whose members are allowed to edit
template fields.

6.3.6 Allowed Personal Template Objects (OBJ)


Select the Allowed Personal Template Objects (OBJ) option on the TIU Parameters
menu to display the following:
Allowed Personal Template Objects

Allowed Personal Template Objects may be set for the following:

1 User USR [choose from NEW PERSON


2 Service SRV [choose from SERVICE/SECTION]
4 Division DIV [DEMO HOSPITAL]
5 System SYS [DEMO.CIAINFORMATICS.COM]

Enter selection: 4 Division DIV [DEMO HOSPITAL]

-- Setting Allowed Personal Template Objects for Division: DEMO HOSPITAL --


Select Sequence Number:

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This allows you to choose a TIU object as a personal template. These are the TIU
Objects that are allowed in the Insert Patient Data Object dialog of the Template
Editor, when adding objects to a personal template. This parameter is cumulative at
all levels. If no objects are entered in this parameter, all objects will be allowed.

6.3.7 Personal Template Access (PER)


Select the Personal Template Access (PER) option on the TIU Parameters menu to
display the following:
Personal Template Access

Personal Template Access may be set for the following:

1 User USR [choose from NEW PERSON


2 Location LOC [choose from HOSPITAL LOCATION]
3 Service SRV [choose from SERVICE/SECTION]
4 Division DIV [DEMO HOSPITAL]
5 System SYS [DEMO.CIAINFORMATICS.COM]

Enter selection: 4 Division DIV [DEMO HOSPITAL]

-------- Setting Personal Template Access for Division: DEMO HOSPITAL --------
PERSONAL TEMPLATE ACCESS: ?

READ ONLY allows use, but not creation of, personal templates.

Select one of the following:

0 FULL ACCESS
1 READ ONLY
2 NO ACCESS

PERSONAL TEMPLATE ACCESS:

You use this parameter to specify access to personal templates. A setting of READ
ONLY allows the use of personal templates, but does not allow the creation of new
personal templates. To restrict template use by USER CLASS, use the TIU
TEMPLATE ACCESS BY CLASS parameter. These two parameters work together,
in the following precedence order:
Precedence Parameter
---------- ----------------------------
USER TIU PERSONAL TEMPLATE ACCESS
USER CLASS TIU TEMPLATE ACCESS BY CLASS
LOCATION TIU PERSONAL TEMPLATE ACCESS
SERVICE TIU PERSONAL TEMPLATE ACCESS
DIVISION TIU PERSONAL TEMPLATE ACCESS
SYSTEM TIU PERSONAL TEMPLATE ACCESS

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6.3.8 Reminder Dialogs Allowed as Templates (REM)


Select the Reminder Dialogs Allowed as Templates (REM) option on the TIU
Parameters menu to display the following:
Reminder Dialogs Allowed as Templates

Reminder Dialogs Allowed as Templates may be set for the following:

1 User USR [choose from NEW PERSON


3 Service SRV [choose from SERVICE/SECTION]
4 Division DIV [DEMO HOSPITAL]
5 System SYS [DEMO.CIAINFORMATICS.COM]

Enter selection: 4 Division DIV [DEMO HOSPITAL]

-- Setting Reminder Dialogs Allowed as Templates for Division: DEMO HOSPITAL --


Select Sequence Number:

This parameter determines which Reminder Dialogs can be used as templates. Refer
to the Reminders Guide.

6.3.9 Verify Note Title (VER)


Select the Verify Note Title (VER) options on the TIU Parameters menu to display
the following:
Verify Note Title

Verify Note Title may be set for the following:

1 User USR (choose from NEW PERSON)


7 Division DIV (DEMO HOSPITAL)
8 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 7 Division DEMO HOSPITAL

------- Setting Verify Note Title for Division: DEMO HOSPITAL -------
Verify Default Title:

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You use this parameter to verify if you want to use the default note title.

If this parameter is set to YES, the window that allows the user to change a note title
will appear whenever the user starts to enter a new note, even if the user has a default
title.

If this parameter is set to NO and the user has a default title, that title will be
automatically loaded when a new note is entered.

6.4 Create Templates


Template boilerplates are standardized pieces of text and patient information.
Boilerplates are not notes. Providers can select from different boilerplate templates to
place repetitive text and information from the patient’s medical record into the current
note in an effort to speed up and enhance the note writing process.

Boilerplate templates contain text, patient data objects, and patient template objects.

 Text – words
 Patient data objects – elements from the patients medical record
 Patient template objects – choices that can be used during the note writing
process (check boxes, combo boxes, buttons)
Template creation will be on-going. However, each site needs to have templates made
for the services that will go LIVE with the EHR. Templates can be imported from
other sites or made by the CAC together with the provider.

6.5 Template Options


Below shows the Options drop-down menu of the Notes window. This is where
templates are created.

Figure 6-4: Options Menu on Notes Tab

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Create New Templates: This selection is for users with access to personal templates.

Edit/Create Shared Templates: These selections are for CACs.

Edit Template Fields: This selection is for users setup in the TIU FIELD EDITOR
CLASS. Edit templates enables the clinician or template designer to edit the template
fields.

6.5.1 Template Editor

Figure 6-5: Template Editor Dialog

Shared Templates: This panel shows a list of shared templates.

New Template: This button creates a new template.

Name: This field contains the name of the new template.

Template Type: The drop-down list determines the type of template being created.
There are four template choices available:

1. Dialogs – dialogs are components of the boilerplate that enable standardized


text and objects. They also enable the addition of other templates that can be
selected and added to the template boilerplate.

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2. Folder - a folder holds templates in one place as a means for organization.


Folders are not a part of the boilerplate because they do not contain text or
objects.
3. Template – a template is a one-page document that can contain standardized
text and object. Templates can be a boilerplate by themselves or part of a
boilerplate.
4. Group Template - Group Templates contain text and TIU objects and can also
contain other templates. If you place a group template in a document, all text
and objects in the group template and all the templates it contains (unless they
are excluded from the group template) will be placed in the document. You
can also expand the view of the group template and place the individual
templates it contains in a document one at a time.

6.5.2 Template Creation


When you click the New Template button on the Template Editor screen, the
application displays the Template Editor dialog.

Figure 6-6: Edit Menu on Template Editor Dialog

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The Edit menu provides several functions for creating a template.

Cut, Copy, Paste: The selections allows you to cut, copy, or paste data from other
areas of the EHR or from Word documents.

Insert Patient Data: The selection inserts any object previously created. An object is
data to be inserted into a note that is retrieved from the RPMS file.

Insert Template Field: The selection inserts a template field.

Preview/Print Template: The selection lets you preview and print the template you are
creating.

6.5.3 Template Finishing

Figure 6-7: Information in Template Boilerplate Panel

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Template Boilerplate panel: Objects are surrounded by straight brackets (such as |


ALLERGIES| in the above screen). Template fields are surrounded by curly brackets
(such as {FLD:583 DERM ANESTH2} in the above screen).

Personal Template Properties panel: Use the selections to make the template look
better visually.

Apply: Click this button before you leave the Template Editor dialog. If you do not,
your changes will NOT be saved. You should use this button more often if you have
spent a great deal of time creating the template (avoids losing all that hard work!).

When you have finished the template, you can check it for errors by selecting Edit |
Check for Errors.

6.5.4 Template Importing


You use the Tools menu on the Template Editor to import templates.

Figure 6-8: Tools Menu on Template Editor Dialog

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Edit Template Fields: Use this selection to edit the existing template fields.

Import/Export Templates: Use these selections to import or export templates. A site


can receive and send templates to other sites. The import selection expects the
template to be loaded from a file on the PC.

6.5.5 Template Fields

Figure 6-9: Template Field Editor Dialog

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New: Use this button to create a new field.

Template Fields: This list shows the existing fields. Template fields are pre-defined
fields that you use to make documentation easier and faster. They can be drop-down
menus, buttons, radio buttons, or fill-in-the blank fields.

Type field: The drop-down list shows the different types of template fields.

Items: This is where you can enter the items for the specified Type. For example, for
check boxes, you would enter the text for each check box on one line. If you need to
lengthen the Items field, you expand the EHR window (like drag the left border of the
window to the right) to length the field.

Miscellaneous panel: The selections define the options for the field. If you check the
Required check box, this will force the person using the template dialog to document
something in this field. If the Required check box is not checked, the person has the
option to use it or not use it.

Apply: Click this button when you are finished.

Each type of template has other options for defining it:

 For combo boxes, radio buttons, buttons, and check boxes, enter the choices to
be presented to the user, one on each line.
 There are several choices that you can make for date fields.
 You can enter the low and high with increments for number fields. However,
you cannot use decimals.
 You can list the length of the box for text boxes and word processing fields.

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The following table describes what each selection on the drop-down list for the Type
field:

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Field Type What It Does


Edit Box Allows the person using the template dialog to enter text (for short responses).
The Field Length is the size of the Edit Box in the dialog (up to 70 characters).
The Text Length is how much text can be typed into the field (up to 240
characters).
Default is the optional edit box default text (up to Field Length characters).

Combo Box Allows the person using the template dialog to select one item from a drop-down
list.
Field Length is the size of the Combo Box in the dialog (up to 70 characters).
Text Length (if not zero) allows other text, not in the pre-defined items, to be typed
into the combo box (up to 240 characters).
Button Allows the person using the template dialog to select one item by cycling through
each item as the button is clicked.
If the Default is blank, the button will initially appear without any text.
Button size reflects the longest text item.

Check Box Allows the person using the template dialog to select as many items as needed.
The Default item will initially be checked (if any).
If multiple items are checked, the text will be separated by commas.

Radio Button Allows the person using the template dialog to select only one item from a list (one
radio button for each item).
The Default item can be initially be selected.
If there is no default item, then there will be no initial default.

Date Default will evaluate to the current date/time. You must enter the year first,
followed by the month. There are six types of date fields:
Date
Date & Time and Date & Required Time
Combo Style
Combo Year Only
Combo Year & Month:
Number This type of field allows numeric values between a specified range. It always has a
default value. The Minimum and Maximum value can range from -9999 to +9999.
The Button Increment values can be as high as 999.
Word Processing This type of field allows an unlimited amount of text to be entered (scroll bars will
appear if needed). Field Length and Number of Lines indicate how wide and high
the field will appear in the dialog.
Hyperlink This type of field is text-only fields that allows linking to Web pages. In addition, it
does not allow you to specify text. It cannot be marked as Required. However, it
can be marked as Exclude From Note – dialog instructional text. This type of field
is useful in boilerplate Titles and Reasons for Request. Hyperlink text is either the
Default (if specified) or the actual URL address. Address specifies the URL link.

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Field Type What It Does


Text These types of fields provide a mechanism for embedding predefined (not
editable) text into the dialog. Predefined Text is entered in the Items property of
the field. They do not allow the person using the template dialog to specify text.
They cannot be marked as Required. However, they can be marked as Exclude
From Note – dialog instructional text. These types of fields are useful in boilerplate
Titles and Reasons for Request.

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7.0 Notification Configuration (NOT)


Select the Notification Configuration (NOT) option on the RPMS-EHR Configuration
Master Menu to display the following:
Notification Configuration

DET Determine Recipients


DIS Display Notifications a User Can Receive
ERA Erase Notifications
FLG Flag Orderable Items to Send Notifications
FWD Forward Notifications ...
PAR Notification Parameters ...
PRC Enable/Disable Notifications
REC Display Patient Alerts and Alert Recipients
SYS Enable/Disable Notification System
UNV Set Delays for Unverified Orders ...
URG Set Urgency for Notifications

Select Notification Configuration Option:

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7.1 Determine Recipients (DET)


Select the Determine Recipients (DET) option on the Notification Configuration
menu to display a debugging tool that creates a simulated notification recipient list,
without sending the alert. The application prompts you for information about
recipients, patient, and notification, with the option to enter an order number and/or a
recipient. Output can be directed to a device. This option is intended to serve as a tool
to help determine if and why a user did or did not receive a particular notification.

NOTE: If team lists, patient-provider relationships (e.g., Attending


and Primary), and/or parameter values have changed between the
moment when the original notification was triggered and when this
option is triggered, the outcome of the recipient list might be
different.

7.2 Display Notifications a User Can Receive (DIS)


Select the Display Notifications a User Can Receive (DIS) option on the Notification
Configuration menu to show a debugging tool that produces a list of all OE/RR alerts
for a specified patient for the specified date range. You can also get a detailed listing
on specific alerts attached to the patient record. The detailed report shows each
recipient and gives dates and times of key actions concerning the alert (such as first
displayed, processed, deleted, etc.) As the system processes each notification, it
determines if and why the user will receive the notification.

7.3 Erase Notifications (ERA)


Select the Erase Notifications (ERA) option on the Notification Configuration menu
to display the following:
Erase Notifications

1. Erase all notifications for a User


2. Erase all notifications for a Patient
3. Erase all instances of a notification (regardless of Patient or User)
4. Erase specific notifications for a User
5. Edit Erase All Notifications parameter for a User

Select Erase option:

If you select 1, this will purge all existing alerts/notifications for a recipient/user.

7.4 Flag Orderable items to Send Notifications (FLG)


Select the Flag Orderable items to Send Notifications (FLG) option on the
Notification Configuration menu to display the following:
Flag ORDERABLE ITEMS to send Notifications

1. Flag INPATIENT orders/results/expiring orders.

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2. Flag OUTPATIENT orders/results/expiring orders.


3. Flag Lab tests for Threshold Exceeded alerts.

Select “1” to flag INPT orders/results.

Select “2” to flag OUTPT orders/results.

Select “3” to set Lab Thresholds.

7.5 Forward Notifications (FWD)


Select the Forward Notifications (FWD) option on the Notification Configuration
menu to display the following:
Forward Notifications

BCK Forward Unprocessed Notification to Backup


SUP Forward Unprocessed Notification to Supervisor
SUR Forward Unprocessed Notification to Surrogates

Select Forward Notifications Option:

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This option lets you set the number of days to hold a notification before forwarding it
to the recipient’s supervisor, surrogate, or a backup reviewer. The maximum is 30
days.

For example, if a notification has a value of 14 for this option, it will be forwarded to
the supervisor of each recipient who hasn’t processed the notification after 14 days.
The Kernel Alert Utility determines the recipients who have not processed the
notification and who their supervisors are. Kernel identifies the supervisor as the
service chief of the user’s service. The notification will not be forwarded to
supervisors of recipients who have processed the alert within 14 days.

If not indicated or zero, the notification will not be forwarded. Forwarding of


unprocessed alerts is triggered by the option XQALERT DELETE OLD. This
Kernel option should be run periodically. In addition to forwarding alerts, it cleans up
old alerts greater than 14 days old.

The Alert Management Tool option is used to setup the Backup Reviewer,
Supervisor, and Surrogate relationships. Below is where you perform is action (you
might have contact your Site Manager to get access to this):

Figure 7-10: Alert Management Options

7.6 Notification Parameters (PAR)


Select the Notification Parameters (PAR) option on the Notification Configuration
menu to display the following:
Notification Parameters

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ALL Set Show All Notifications


BUL Send Flagged Orders Bulletin
DEL Set Deletion Parameters
EMC Providers that Require an E&M Code
PRG Set Purging Interval
PRI Priority Threshold for Popup Alerts
PRV Set Provider Recipients
RCD Set Default Recipient Devices
RCP Set Default Recipients
SRT Notification Sort Column

Select Notification Parameters Option:

7.6.1 Set Show All Notifications (ALL)


Select the Set Show All Notifications (ALL) option on the Notification Parameters
menu to display the following:
Set Show All Notifications

Show All Notifications may be set for the following:

10 User USR (choose from NEW PERSON)


90 Division DIV (DEMO HOSPITAL)
100 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 90 Division DEMO HOSPITAL

------- Setting Show All Notifications for Division: DEMO HOSPITAL --------
Value:

If set to YES, the default setting for displaying notifications in the EHR is ‘all
patients’. If set to NO, the default setting is ‘selected patients only’.

7.6.2 Send Flagged Orders Bulletin (BUL)


Do not use this option unless your site actively uses RPMS Mailman.

Select the Send Flagged Orders Bulletin (BUL) option on the Notification Parameters
menu to display the following:
Send Flagged Orders Bulletin

Send Flagged Orders Bulletin may be set for the following:

1 User USR [choose from NEW PERSON]


2 Service SRV [choose from SERVICE/SECTION]
3 Division DIV [DEMO INDIAN HOSPITAL]
4 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 3 Division DEMO INDIAN HOSPITAL

-- Setting Send Flagged Orders Bulletin for Division: DEMO INDIAN HOSPITAL --
Value: ??

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'Yes' indicates a MailMan bulletin will be sent to the order's Current


Provider (usually the Ordering Provider) when the order is flagged for
clarification. This parameter has no effect on the Flagged Orders
notification which is also triggered when an order is flagged for
clarification.

Value:

7.6.3 Set Deletion Parameters (DEL)


Select the Set Deletion Parameters (DEL) option on the Notification Parameters menu
to display the following:
Set Deletion Parameters

Delete Mechanism may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

-------- Setting Delete Mechanism for System: DEMO.OKLAHOMA.IHS.GOV --------


Select Notification: NEW SERVICE CONSULT/REQUEST
Are you adding NEW SERVICE CONSULT/REQUEST as a new Notification? Yes// YES

Notification: NEW SERVICE CONSULT/REQUEST// NEW SERVICE CONSULT/REQUEST NEW


SERVICE CONSULT/REQUEST
Value: ??

Set of codes used to determine how a notification will be deleted at a


site. Codes include: I (Individual Recipient): delete the notification
for an individual recipient when a) that individual completes the
follow-up action on notifications with associated follow-up action, b)
that individual reviews notifications without follow-up actions. A (All
Recipients): delete the notification for all recipients when a) any
recipient completes the follow-up action on notifications with follow-up
actions, b) any recipient reviews notifications without follow-up
actions.

Value:

Use this option to set parameters that determine deletion conditions for a notification.

7.6.4 Providers that Require an E&M Code (EMC)


Select the Providers that Require an E&M Code (EMC) option on the Notification
Parameters menu to display the following:
Providers that Require an E&M Code

Provider requires E&M code may be set for the following:

10 User USR (choose from NEW PERSON)


50 Class CLS (choose from USR CLASS)

Enter selection: 10 User NEW PERSON


Select NEW PERSON NAME: ZIPPER,KIMBERLY KZ CLINICAL COORDINATOR

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------- Setting Provider requires E&M code? for User: ZIPPER,KIMBERLY -------
Value??

Indicates whether or not a primary provider requires an E&M code for billing
purposes.

Value:

This creates a notification in the Notifications window when a visit WITH A NOTE
is completed and no E&M code is documented.

7.6.5 Set Purging Interval (PRG)


Select the Set Purging Interval (PRG) option on the Notification Parameters menu to
display the following:
Set Purging Interval

Grace Period Before Deletion may be set for the following:

1 Division DIV (DEMO HOSPITAL)


2 System SYS (DEMO.CIAINFORMATICS.COM)
3 Package PKG (ORDER ENTRY/RESULTS REPORTING)

Enter selection: 2 System DEMO.CIAINFORMATICS.COM

- Setting Grace Period Before Deletion for System: DEMO.CIAINFORMATICS.COM –


Select Notification:

You can select a notification from a list, if necessary. Then you can enter the number
of days to archive the specified notification. The default is 30 days. You enter a
maximum of 100,000 days (about 200 years). This value is passed to the Kernel Alert
Utility where the actual archiving and deletion of alerts/notifications occurs.

7.6.6 Priority Threshold for Popup Alerts (PRI)


Select the Priority Threshold for Popup Alerts (PRI) option on the Notification
Parameters menu to display the following:
Priority Threshold for Popup Alerts

Priority threshold for Popup Alert may be set for the following:

10 User USR [choose from NEW PERSON]


90 Division DIV [DEMO INDIAN HOSPITAL]
100 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 90 Division DEMO INDIAN HOSPITAL

Setting Priority threshold for Popup Alert for Division: DEMO INDIAN HOSPITAL
Priority: ??

This is the alert priority threshold at or above which a popup alert will be
displayed when an alert of that or greater priority is received. Possible
values are:

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0 None
1 High
2 Medium
3 Low

Priority:

7.6.7 Set Provider Recipients (PRV)


Select the Set Provider Recipients (PRV) option on the Notification Parameters menu
to display the following:
Set Provider Recipients

Provider Recipients may be set for the following:

1 Division DIV (DEMO HOSPITAL)


2 System SYS (DEMO.CIAINFORMATICS.COM)
3 Package PKG (ORDER ENTRY/RESULTS REPORTING)

Enter selection: 2 System DEMO.CIAINFORMATICS.COM

------ Setting Provider Recipients for System: DEMO.CIAINFORMATICS.COM -----


Select Notification: critical lab results (aCTION)
Are you adding CRITICAL LAB RESULTS (ACTION) as new notification? Yes// YES
CRITICAL LAB RESULTS (ACTION)// CRITICAL LAB RESULTS (ACTION)
CRITICAL LAB RESULTS (ACTION)
Value:??

Set of codes indicating default provider recipients of a notification by


their title or relationship to the patient. Notifications can be set up
with any or all of the following codes:

P (Primary Provider): deliver notification to the patient's Primary


Provider.
A (Attending Physician): deliver notification to the patient's Attending
Physician.
T (Patient Care Team): deliver notification to the patient's primary
care Team.
O (Ordering Provider): deliver notification to the provider
who placed the order which trigger the notification.
M (PCMM Team): deliver notification to users/providers linked to the
patient via PCMM Team Position assignments.
E (Entering User): deliver notification to the user/provider who entered
the order's most recent activity.
R (PCMM Primary Care Practitioner): deliver notification to the
patient's PCMM Primary Care Practitioner.
S (PCMM Associate Provider): deliver notification to the patient's PCMM
Associate Provider.
D (IHS Primary Care Provider): deliver notification to the patient's
Primary Care Provider.
I (IHS Primary Team): deliver notification to the patient's Primary
Team.
G (IHS Designated Providers): deliver notification to all of the patient's
Designated Providers.

The providers, physicians and teams must be set up properly and accurately
for the correct individuals to receive the notification.

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Value:

This option lets you set any one or combination of a set of codes indicating default
(provider) recipients of a notification by their title or relationship to the patient.
Notifications can be set up with any or all of the following codes:

 P (Primary Provider): deliver notification to the patient’s Primary Provider.


 A (Attending Physician): deliver notification to the patient’s Attending
Physician.
 T (Patient Care Team): deliver notification to the patient’s Primary Care
Team.
 O (Ordering Provider): deliver notification to the provider who placed the
order that triggered the notification.
 M (PCMM Team): deliver notification to users/providers linked to the patient
via PCMM Team Position assignments. NOT USED IN THE EHR
 E (Entering User): deliver notification to the user/provider that entered the
order's most recent activity.
 R (PCMM Primary Care Practitioner): deliver notification to the patient’s
PCMM Primary Care Practitioner. NOT USED IN THE EHR
 S (PCMM Associate Provider): deliver notification to the patient’s PCMM
Associate Provider. NOT USED IN THE EHR
 D (IHS Primary Care Provider: deliver notification to the patient’s Primary
Team
 I (Patient Care Team): deliver notification to the patient’s primary care
Team.
 G (IHS Designated Providers): deliver notification to the patient’s
Designated Providers.
The providers, physicians, and teams must be set up properly and accurately for the
correct individuals to receive the notification.

7.6.8 Set Default Recipient Devices (RCD)


Select the Set Default Recipient Devices (RCD) option on the Notification
Parameters menu to display the following:
Set Default Recipient Devices

Notification Regular Recipient Devices may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

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Setting Notification Regular Recipient Devices for System: DEMO.OKLAHOMA.IHS.G


OV
Select Notification: NEW SERVICE CONSULT/REQUEST
Are you adding NEW SERVICE CONSULT/REQUEST as a new Notification? Yes// YES

Notification: NEW SERVICE CONSULT/REQUEST// NEW SERVICE CONSULT/REQUEST NEW


SERVICE CONSULT/REQUEST
Value: ?
Answer with DEVICE NAME, or LOCAL SYNONYM, or $I, or VOLUME SET(CPU), or
SIGN-ON/SYSTEM DEVICE, or FORM CURRENTLY MOUNTED
Do you want the entire DEVICE List?

7.6.9 Set Default Recipients (RCP)


Select the Set Default Recipients (RCP) option on the Notification Parameters menu
to display the following:
Set Default Recipients

Notification Regular Recipients may be set for the following:

1 User USR [choose from NEW PERSON]


2 Team (OE/RR) OTL [choose from OE/RR LIST]

Enter selection: 1 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

------- Setting Notification Regular Recipients for User: DEMO,DOCTOR -------


Select Notification: NEW SERVICE CONSULT/REQUEST
Are you adding NEW SERVICE CONSULT/REQUEST as a new Notification? Yes// YES

Notification: NEW SERVICE CONSULT/REQUEST// NEW SERVICE CONSULT/REQUEST NEW


SERVICE CONSULT/REQUEST
Value: ?

Enter 'yes' if this person or team should always receive the notification.

Value:

7.6.10 Notification Sort Column (SRT)


Select the Notification Sort Column (SRT) option on the Notification Parameters
menu to display the following:
Notification Sort Column

Notification Sort Method may be set for the following:

100 User USR [choose from NEW PERSON]


200 Division DIV [DEMO INDIAN HOSPITAL]
400 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 200 Division DEMO INDIAN HOSPITAL

---- Setting Notification Sort Method for Division: DEMO INDIAN HOSPITAL ----
Value: ?

Sort method for notification display as P:Patient, T:Type, U:Urgency.

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Select one of the following:

P Patient
T Type
U Urgency

Value:

The Value determines the sorting method when notifications are displayed. Methods
include: by Patient, by Type (notification name), and by Urgency. Within these sort
methods, notifications are presented inverse chronological order.

7.7 Enable/Disable Notifications (PRC)


Select the Enable/Disable Notifications (PRC) option on the Notification
Configuration menu to display the following:
Enable/Disable Notifications

Processing Flag may be set for the following:

1 User USR [choose from NEW PERSON]


2 Team (OE/RR) OTL [choose from OE/RR LIST]
3 Service SRV [choose from SERVICE/SECTION]
4 Location LOC [choose from HOSPITAL LOCATION]
5 Division DIV [DEMO INDIAN HOSPITAL]
6 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 5 Division DEMO INDIAN HOSPITAL

-------- Setting Processing Flag for Division: DEMO INDIAN HOSPITAL --------
Select Notification: LAB TESTS ??
Select Notification: LAB RESULTS
Are you adding LAB RESULTS as a new Notification? Yes// YES

Notification: LAB RESULTS// LAB RESULTS LAB RESULTS


Value: ??

Flag used to determine if a notification should be delivered to a user/


recipient. Valid values include Mandatory, Enabled or Disabled.

Value:

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The Clinical Coordinator uses this option to turn specific notifications on or off. It is
important to consider what notifications are turned on to prevent overwhelming the
user. For example, certain lab orders could potentially result in five notifications for
one lab result!

Note: If a CAC or IT person has answered “Yes” in the option Set


Default Recipients for Notification, indicating that the user should
always receive the notification, that Team or User will always
receive the notification, regardless of the Enabled/Disabled
settings.

7.8 Display Patient Alerts and Alert Recipients (REC)


Select the Display Patient Alerts and Alert Recipients (REC) option on the
Notification Configuration menu to display a debugging tool. This option prompts for
a patient and then displays all Kernal Alerts for that person. You are then prompted to
select one or more alerts. Recipients of those alerts are displayed and printed along
with relevant data regarding how they processed the alert. If an alert has an associated
order number, it is displayed in brackets.

7.9 Enable/Disable Notification System (SYS)


Select the Enable/Disable Notification System (SYS) option on the Notification
Configuration menu to display the following:
Enable/Disable Notification System

Enable or disable notifications. may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

Setting Enable or disable notifications. for System: DEMO.OKLAHOMA.IHS.GOV


Value: Disable// ??

Parameter determines if any notification processing will occur. 'E' or


'Enable' indicates the notifications system is enabled and running. 'D'
or 'Disabled' indicates the notifications system is disabled and not
running. Can be set at the Institution, System or Package level.

Value: Disable//

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This turns on or off the entire Notification system for the healthcare facility (don’t
turn this on until you go live). For multi-division sites, only turn on for the division
that is using notifications.

7.10 Set Delay for Unverified Orders (UNV)


Select the Set Delay for Unverified Orders (UNV) option on the Notification
Configuration menu to display the following:
Set Delays for Unverified Orders

MED Set Delay for Unverified Medication Orders


ORD Set Delay for Unverified Orders

Select Set Delays for Unverified Orders:

This is used mainly for inpatient.

7.10.1 Set Delay for Unverified Medication Orders (MED)


Select the Set Delay for Unverified Medication Orders (MED) option on the Set
Delays for Unverified Orders menu to display the following:
Set Delay for Unverified Medication Orders

Unverified Medication Orders may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

-- Setting Unverified Medication Orders for System: DEMO.OKLAHOMA.IHS.GOV --


Hours: ??

The number of hours to delay triggering an unverified medication order


notification/alert. The maximum number of hours is 10,000.

Hours:

Enter the number of hours delay to wait after a medication order is placed before
triggering an Unverified Medication Order notification. The maximum number of
hours is 10,000.

7.10.2 Set Delay for Unverified Orders (ORD)


Select the Set Delay for Unverified Orders (ORD) option on the Set Delays for
Unverified Orders menu to display the following:
Set Delay for Unverified Orders

Unverified Orders may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]

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2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

-------- Setting Unverified Orders for System: DEMO.OKLAHOMA.IHS.GOV --------


Hours: ??

The number of hours to delay triggering an unverified order


notification/alert. This parameter is used for all types of orders
(including medication.) The maximum number of hours is 10,000.

Hours:

Enter the number of hours delay to wait after an order is placed before triggering an
Unverified Order notification. The maximum number of hours is 10,000.

7.11 Set Urgency for Notifications (URG)


Select the Set Urgency for Notifications (URG) option on the Notification
Configuration menu to display the following:
Set Urgency for Notifications

Notification Urgency may be set for the following:

1 User USR [choose from NEW PERSON]


2 Service SRV [choose from SERVICE/SECTION]
3 Division DIV [DEMO INDIAN HOSPITAL]
4 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 4 System DEMO.OKLAHOMA.IHS.GOV

------ Setting Notification Urgency for System: DEMO.OKLAHOMA.IHS.GOV ------


Select Notification: CRITICAL LAB RESULT
Are you adding CRITICAL LAB RESULTS (ACTION) as a new Notification? Yes// YES

Notification: CRITICAL LAB RESULTS (ACTION)// CRITICAL LAB RESULTS (ACTION)


CRITICAL LAB RESULTS (ACTION)
Value: ??

Set of codes indicating the urgency for a notification for a site. The
urgency is mainly used for sorting in displays. The codes include: 1
(High): notification is Highly urgent. 2 (Moderate): notification is
Moderately urgent. 3 (Low): notification is of Low urgency.

Value:

Use this option to set the Urgency for a notification for a site. You mainly use the
urgency for sorting in GUI displays.

CAC Manual 82 Notification Configuration


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8.0 Order Entry Configuration (ORD)


Select the Order Entry Configuration (ORD) option on the RPMS-EHR Master
Configuration Menu to display the following:
Order Entry Configuration

DOC Delayed Orders Configuration ...


KEY Key Management ...
MNU Order Menu Management ...
OCX Order Check Configuration ...
PAR Order Parameters ...
PRN Print/Report Parameters ...
RPT Order Reports ...

Select Order Entry Configuration Option:

8.1 Delayed Orders Configuration (DOC)


Select the Delayed Order Configuration (DOC) option on the Order Entry
Configuration menu to display the following:
Delayed Orders/Auto-DC Setup

DOE Delayed Orders/Auto-DC Setup


EDO Enable Event-Delayed Orders
INQ Inspect the OE/RR Patient Event File
PAR Event-Delayed Order Parameters
REL Release/Cancel Delayed Orders

Select Delayed Orders Configuration Option:

This setup is done for Inpatients. See the EHR Inpatient manual for more information.

When the Enable Event-Delayed Orders is enabled, then Write Delayed Orders will
be placed in the Write Orders panel in the Order window.

8.2 Key Management (KEY)


Select the Key Management (KEY) option on the Order Entry Configuration menu to
display the following:
Key Management

ALL Allocated OE/RR Security Keys


CHK Check for Multiple Keys

Select Key Management Option:

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October 2008
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8.2.1 Allocate OE/RR Security Keys (ALL)


Select the Allocate OE/RR Security Keys (ALL) option on the Key Management
menu to display the following:
Allocate OE/RR Security Keys

KEY: ORES

This key is given to users that are authorized to write orders in


the chart. Users with this key can verify with their electronic
signature patient orders.

This key is typically given to licensed Physicians.

Orders entered by users with this key can be released to the ancillary
service for immediate action.

DO NOT give users both the ORES key and the ORELSE key.

Edit Holders? Yes// (Yes)

Select HOLDER: demo DEMO,DOCTOR


Delete key? Yes//

Keys must be setup before anyone can write any order using the EHR.

There are three keys used by EHR for use in ordering. These keys are mutually
exclusive. If a user has more than one key, the system will respond is some very odd
ways.

The clinical coordinator has the ability to assign these keys using the option above. If
a user does not have the key, it is automatically added when the CAC enters the
user’s name. If the user has the key, the key will be removed when the CAC enters
the user’s name.

The keys and their usage are as follows:

 ORES: This is the clinician key. It should be given to anyone who can write
orders under that person’s own authority.
 ORELSE: This is the nurse key. It should go to anyone who is credentialed to take
verbal and telephone orders (such as, RNs and pharmacists). The order will be
released to the service, and the ordering clinician will get an alert to sign the
order.
 OREMAS: This is the clerk key. It should go to anyone who is transcribing
written orders. The “real” order must exist with a signature in paper format. The
person must only be transcribing.
 No keys: This key is for those who can still enter orders. These orders will not be
released and will be held until the clinician signs the orders after getting an alert
that they are there. Many sites will assign no keys to medical students.

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8.2.2 Check for Multiple Keys (CHK)


Select the Check for Multiple Keys (CHK) option on the Key Management menu to
display the following:
Check for Multiple Keys

This utility identified users that have more than one OR key assigned. Users
with more than one key can encounter problems when adding order. Any users
listed will need to their keys edited and correctly assigned.

Ok to continue? Yes//

If the application exhibits unexplained behavior or the person can’t sign orders (but
could before), that person might have been given more than one key. Use this option
to get a list of anyone with more than one key. Then determine which key is correct
and update that person to the correct key.

8.3 Order Menu Management (MNU)


Select the Order Menu Management (MNU) option on the Order Entry Configuration
menu to display the following:
Order Menu Management

ACT Create/Modify Actions


DIS Enable/Disable Order Dialogs
GEN Create/Modify Generic Orders
LST List Primary Order Menus
MNU Create/Modify Order Menus
OIC Create/Modify Orderable Items
PAR Menu Parameters ...
PMT Create/Modify Prompts
PRI Assign Primary Order Menu
PRT Convert Protocols
QOC Create/Modify Quick Orders
QOR Create/Modify QO Restrictions
SET Create/Modify Order Sets
SRC Search/Replace Components
SRO Search/Replace Orderables

Select Order Menu Management Option:

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8.3.1 Create/Modify Actions (ACT)


Select the Create/Modify Actions (ACT) option on the Order Menu Management
Menu to display the following:

Figure 8-11: Create/Modify Actions Information

This option allows you to create or change actions that can be placed on the Add
Orders menu.

8.3.2 Enable/Disable Order Dialogs (DIS)


Select the Enable/Disable Order Dialogs (DIS) option on the Order Menu
Management menu to display the following:
Enable/Disable Order Dialogs

Select ORDER DIALOG: ORZM MAIN MENU


ANOTHER ONE:

Enter a message to disable the dialog(s), or @ to enable again.


MESSAGE:

Use this option to disable order dialogs that are no longer in use. However, only use it
after the search option has found that it is not on any active menus. Dialogs can also
be re-enabled with this option.

8.3.3 Create/Modify Generic Orders (GEN)


Select the Create/Modify Generic Orders (GEN) option on the Order Menu
Management menu to display the following:
Create/Modify Generic Orders

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Select ORDER DIALOG NAME:

A generic order was the only way to make nursing orders in the past. Now most
nursing orders are done through quick orders. However, generic orders can still be
useful when you want template field in the order or need to do rather complex orders
with many steps.

This option allows you to create or change generic text orders that can be placed on
the Add Orders menu; limited access to some clinical service order dialogs is also
available through this option.

8.3.4 List Primary Order Menus (LST)


IHS does not use this option.

8.3.5 Create/Modify Order Menus (MNU)


Select the Create/Modify Order Menus (MNU) option on the Order Menu
Management menu to create or edit order menus. Establish a facility-wide policy on
naming the menus so that someone can always find the order menus.

If you enter an existing order menu, you could get:

Figure 8-12: Example of Modify Order Menus

CAC Manual 87 Order Entry Configuration


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8.3.6 Create/Modify Orderable Items (OIC)


Select the Create/Modify Orderable Items (OIC) option on the Order Menu
Management menu to display the following:
Create/Modify Orderable Items

Type of Orderable:

This option lets you create or change the things that are orderable items via generic
text orders at your site.

Quick orders all need to be attached to an orderable item.

For most services, such as lab and pharmacy, these orderable items are created when
the application is installed. However, any orders that don’t get sent to a service, such
as nursing or clerk orders, need to have orderable items created before they can be
used as quick orders.
After you enter the type of orderable, you will be asked to select the orderable items.

8.3.7 Menu Parameters (PAR)


Select the Menu Parameters (PAR) option on the Order Menu Management menu to
display the following:
Menu Parameters

CON New Consult Dialog Default


INP Write Orders List (Inpatient)
MED New Med Dialog Default
OUT Write Orders List (Outpatient)
PRO New Procedure Dialog Default
STY Order Menu Style

Select Menu Parameters Option:

8.3.7.1 New Consult Dialog Default (CON)


Select the New Consult Dialog Default (CON) option on the Menu Parameters menu
to display the following:
New Consult Dialog Default

New consult dialog default may be set for the following:

1 User USR (choose from NEW PERSON)


2 Location LOC (choose from HOSPITAL LOCATION)
3 System SYS (DEMO.MEDSPHERE.COM)

Enter selection:

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This selects the new default consult dialog for the specified selection.

8.3.7.2 Write Orders List (Inpatient) (INP)


Select the Write Orders List (Inpatient) (INP) option on the Menu Parameters menu
to display the following:
Write Orders List (Inpatient)

Write Orders (Inpatient) may be set for the following:

1 User USR (choose from NEW PERSON)


2 Location LOC (choose from HOSPITAL LOCATION)
2.3 Service SRV (choose from SERVICE/SECTION)
2.7 Division DIV (DEMO HOSPTIAL)
3 System SYS (DEMO.MEDSPHERE.COM)

Enter selection:

This has nothing to do with inpatient (it’s just the name).

Quickorders must be added through parameters and menus to the EHR in order for
users to access them. The primary menu is a parameter called ORWOR and is like the
roots of a tree. Various menus including laboratory (LR), outpatient pharmacy
(PSOZ), and others are added and create the trunk of the tree. From these primary
menus, additional menus will branch off; for example, you can have an outpatient
medication menu that is used by one clinic, while another menu is used in the
emergency room. These menus can continue to branch out. An example of quickorder
menus is shown below:
Tree Roots = ORWOR write orders

Tree trunk Branches Tree Leaves

LR (lab) Main lab menu Hematology


Chemistry
Urine
Microbiology
PSOZ (Outpt Pharmacy Outpat med menu Cardiovascular
Diabetes
Neurologic
Outpt meds given in clinc Immunizations
Antibiotics
Pain Meds

Once a new order menu has been created, you can place it on another order menu that
is already being used in the EHR, or you can add it to the list. The list that appears in
the EHR is setup by the parameter called ORWOR WRITE ORDERS LIST.

ORWOR WRITE ORDERS LIST can be set for the following:


1 User USR [choose from NEW PERSON]
2 location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [TUBA CITY HO]

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3 System SYS [TCDEMO.NAV.IHS.GOV]


4 Package PKG [ORDER ENTRY/RESULTS REPORTING]

This list can be set at many different levels so that users can have different order lists.
Below is an example of a system setup of the orders list:

The user sets up the order of the items as well as what items appear.
Sequence Value
-------- -----
1 GMRAOR ALLERGY ENTER/EDIT
5 FHWI
10 PSJ OR PAT OE
15 PSO OERR
20 PSJI OR PAT FLUID OE
25 LR OTHER LAB TESTS
30 RA OERR EXAM
35 GMRCOR CONSULT
38 GMRCOR REQUEST
40 GMRVOR
45 OR GXTEXT WORK PROCESSING ORDER
50 ORZ ADMISSION ORDER MENU
55 ORZ QUICK ORDER SAMPLE

This parameter is used to list the order dialog names that appear in the Write Orders
panel of the Orders window.

Figure 8-13: Orders Window in EHR

CAC Manual 90 Order Entry Configuration


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

8.3.7.3 New Med Dialog Default (MED)


Select the New Med Dialog Default (MED) option on the Menu Parameters menu to
display the following:
New Med Dialog Default

New Med Dialog may be set for the following:

1 User USR (choose from NEW PERSON)


3 System SYS (DEMO.MEDSHERE.COM)

Enter selection:

This parameter is used to present the order dialog for New Medication on the
Medications window. A separate order dialog can be used to inpatients and
outpatients.

8.3.7.4 Write Orders List (Outpatient) (OUT)


Select the Write Orders List (Outpatient) (OUT) option on the Menu Parameters
menu to display the following:
Write Orders List (Outpatient)

Menu for Write Orders List may be set for the following:

2 User USR (choose from NEW PERSON)


4 Location LOC (choose from HOSPITAL LOCATION)
5 Service SRV (choose from SERVICE/SECTION)
7 Division DIV (DEMO HOSPITAL)
8 System SYS (DEMO.MEDSHERE.COM)

Enter selection:

This is an alternative way to set up the Write Orders list; this will overwrite the
ORWOR WRITE ORDERS list. In this method, you create one menu and you attach
all of your items to this one menu.

8.3.7.5 New Procedure Dialog Default (PRO)


IHS does not use this option.

8.3.7.6 Order Menu Style (STY)


Select the Order Menu Style (STY) option on the Menu Parameters menu to display
the following:
Order Menu Style

-------- Setting Order Menu Style for System: DEMO.OKLAHOMA.IHS.GOV --------


Menu Style: ?

Select the style of ordering menu to be used with the GUI.

Select one of the following:

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0 Mnemonics Included
1 No Mnemonics
2 Reserved1
3 Reserved2

Menu Style:

The “style” determines whether the EHR order menus include mnemonics.

8.3.8 Create/Modify Prompts (PMT)


Select the Create/Modify Prompts (PMT) option on the Order Menu Management
Menu to display the following:
Create/Modify Prompts
Select PROMPT: OR GTX
1 OR GTX ADDITIVE
2 OR GTX ADMIN SCHEDULE
3 OR GTX ALLERGY TYPE
4 OR GTX AND/THEN
5 OR GTX CALLHO
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 1 OR GTX ADDITIVE
NAME: OR GTX ADDITIVE DISPLAY TEXT: Additive:
TYPE: prompt PACKAGE: ORDER ENTRY/RESULTS REPORTING
DATA TYPE: pointer DOMAIN: 101.43:EQS
ID: ORDERABLE TIMESTAMP: 59741,31497

This prompt is not editable!

Select PROMPT:

This option lets you create or change prompts for generic orders.

8.3.9 Assign Primary Order Menu (PRI)


IHS does not use this option.

8.3.10 Convert Protocols (PRT)


This feature is not used at this time.

8.3.11 Create/Modify Quick Orders (QOC)


Select the Create/Modify Quick Order (QOC) option on the Order Menu
Management Menu to display the following:
Create/Modify Quick Orders

Select QUICK ORDER NAME:

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You can select from a list of quick orders. After selecting a quick order name, the
system displays several parts of the quick order that you can edit.

8.3.11.1 Namespaces for Quick Orders


Namespace Department
RA Radiology
LR Lab
PSO Outpatient meds
PSJ Inpatient (Unit dose) meds
PSIV IV meds
GMRC Consults
OR CPRS
FH Dietary

8.3.11.2 Laboratory Test Quick Order


The laboratory quick order uses LR as the namespace and Z means local. Below is an
example of the lab quick order for Creatinine.
Select QUICK ORDER NAME: LRZ CREATININE OUTPT
NAME: LRZ CREATININE OUTPT// <Enter>
DISPLAY TEXT: Creatinine Today// <Enter>
VERIFY ORDER: YES// <Enter>
DESCRIPTION:
Blood creatinine level ordered for today
Edit? NO//
1><Enter>
ENTRY ACTION: <Enter>

Lab Test: CREATININE


1 CREATININE
2 CREATININE CLEARANCE (SO)
3 CREATININE URINE URINE CREATININE
CHOOSE 1-3: 1 <Enter>
SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood on the
ward. This method is limited to laboratory defined collection times.

SP Send patient to lab


WC Ward collect & deliver
LC Lab blood team
Collected By: SP Send patient to lab
Collected Sample: BLOOD//
Collection Date/Time: N (JUN 18, 1997@14:11)
How often: ONCE <Enter>

------------------------------------------------------------------------
Lab Test: CREATININE
Collected By: Send patient to lab
Collection Sample: BLOOD
Specimen: BLOOD
Collection Date/Time: TODAY
How often: ONCE
------------------------------------------------------------------------
(P)lace, (E)dit, or (C)ancel this quick order? PLACE//<Enter>

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Auto-accept this order? NO <Enter>


Comments about the above order sample:

Field Comment
NAME This is the official name
DISPLAY TEXT This is the name the user sees
VERIFY ORDER? This controls whether the clinician is asked to edit the order
Collection Date/Time Do not enter a date here for this type of test

8.3.11.3 All Other Labs Quickorder


This feature enables users to order labs that are not available as quickorders; the CAC
can incorporate the quickorder LR OTHER LAB TESTS as a link to all other
medications.

Figure 8-14: Sample Outpatient Meds

8.3.11.4 Outpatient Pharmacy Quick Order


A site will probably want to either have someone from pharmacy create the quick
orders for medications or at least have a pharmacist review them before users can
access them. PS is the namespace for pharmacy.
Select Order Menu Management Option: Enter/edit quick orders

Select QUICK ORDER NAME: PSIVZ AMINOPH 1GM


Are you adding 'PSJZ AMINOPH 1GM' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: IV MEDICATIONS
NAME: PSJZ AMINOPH 1GM// <Enter>
DISPLAY TEXT: Aminophylline drip
VERIFY ORDER: NO// Y (Yes)
DESCRIPTION:
No existing text
Edit? NO// <Enter>

Solution: D5W INJ,SOLN IV


Additive: AMINOPHYLLINE INJ,SOLN IV AMINOPHYLLINE INJ,SOLN IV
AMINOPHYLLINE

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INJ,SOLN IV
(Units for this additive are MG)
Strength: 1000
Another Additive: <Enter>
Infusion Rate: 10
Priority: ROUTINE// <Enter>Provider Comments:
1> Titrate to effect.
2> <Enter>
Edit OPTION: <Enter>

------------------------------------------------------------------------
Solutions: D5W INJ,SOLN IV 1000 ml
Additives: AMINOPHYLLINE INJ,SOLN IV 1000 MG
Infusion Rate: 10 ml/hr
Priority: ROUTINE
Provider Comments: Titrate to effect.
------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE//<Enter>

8.3.11.5 All Other Meds Pharmacy Quickorder


When you click the All Other Meds quickorder, the following Medication Order
dialog displays.

Figure 8-15: Sample Medication Order Dialog

8.3.11.6 Outside Rx
To set up Outside Prescription (medications not dispensed from your site)
quickorders follow the instructions below. Much of this must be done by the
Pharmacist, using the Pharmacy package.
Select Pharmacy Data Management Option: DRUG
1 Drug Enter/Edit
2 Drug Interaction Management
3 Drug Text Enter/Edit
4 Drug Text File Report

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CHOOSE 1-4: 1 Drug Enter/Edit

Select DRUG GENERIC NAME: OUTSIDE RX 11


Are you adding 'OUTSIDE RX 11' as a new DRUG (the 2924TH)? No// Y (Yes)
DRUG NUMBER: 85889//
DRUG VA CLASSIFICATION:
DRUG FSN:
DRUG CURRENT INVENTORY:
DRUG LOCAL NON-FORMULARY:
DRUG INACTIVE DATE:
DRUG MESSAGE:
DRUG RESTRICTION:
GENERIC NAME: OUTSIDE RX 11//
VA CLASSIFICATION:
DEA, SPECIAL HDLG: 9

NATIONAL FORMULARY INDICATOR: Not Matched To NDF


LOCAL NON-FORMULARY:
VISN NON-FORMULARY:
Select DRUG TEXT ENTRY:
Select FORMULARY ALTERNATIVE:
Select SYNONYM:
MESSAGE:
RESTRICTION:
FSN:
INACTIVE DATE:
WARNING LABEL:
ORDER UNIT:
DISPENSE UNIT:
DISPENSE UNITS PER ORDER UNIT:
NDC:
PRICE PER ORDER UNIT:
AWP PER ORDER UNIT:
AWP PER DISP UNIT is
SOURCE OF SUPPLY:
DISPENSING LOCATION:
STORAGE LOCATION:
PRICE PER DISPENSE UNIT:

Do you wish to match/rematch to NATIONAL DRUG file? Yes// N (No)


Just a reminder...you are editing OUTSIDE RX 11.

LOCAL POSSIBLE DOSAGES:

Do you want to edit Local Possible Dosages? N// O

MARK THIS DRUG AND EDIT IT FOR:


O - Outpatient
U - Unit Dose
I - IV
W - Ward Stock
D - Drug Accountability
C - Controlled Substances
X - Non-VA Med
A - ALL

Enter your choice(s) separated by commas : O,X


O - Outpatient
X - Non-VA Med
** You are NOW editing OUTPATIENT fields. **

AN Outpatient Pharmacy ITEM? No// Y (Yes)


CORRESPONDING INPATIENT DRUG:

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MAXIMUM DOSE PER DAY:


LOCAL NON-FORMULARY:
NORMAL AMOUNT TO ORDER:
SOURCE OF SUPPLY:
CURRENT INVENTORY:
ACTION PROFILE MESSAGE (OP):
MESSAGE:
QUANTITY DISPENSE MESSAGE:

Do you wish to mark/unmark as a LAB MONITOR or CLOZAPINE DRUG?


Enter Yes or No: NO
** You are NOW Marking/Unmarking for NON-VA MEDS. **

A Non-VA Med ITEM? No// Y (Yes)

** You are NOW in the ORDERABLE ITEM matching for the dispense drug. **

Choose Dosage Form: PILL

Dose Form -> PILL

Match to another Orderable Item with same Dosage Form? NO// NO

Dosage Form -> PILL


Dispense Drug -> OUTSIDE RX 11

Orderable Item Name: OUTSIDE RX 11

Matching OUTSIDE RX 11
to
OUTSIDE RX 11 PILL

Is this OK? YES//


Match Complete!

Now editing Orderable Item:


OUTSIDE RX 11 PILL

FORMULARY STATUS:
Select OI-DRUG TEXT ENTRY:
INACTIVE DATE:
DAY (nD) or DOSE (nL) LIMIT:
MED ROUTE:
SCHEDULE TYPE:
SCHEDULE:
PATIENT INSTRUCTIONS:

Select SYNONYM:

------
TO MAKE THE QUICKORDER:

Select QUICK ORDER NAME: PSOZ OUTSIDE RX 11


Are you adding 'PSOZ OUTSIDE RX 11' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: OUTPATIENT MEDICATIONS
NAME: PSOZ OUTSIDE RX 11//
DISPLAY TEXT: Outside Rx 11
VERIFY ORDER: y YES
DESCRIPTION:

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No existing text
Edit? NO//

Medication: OUTSIDE RX 11 PILL


Complex dose? NO//
Dose:
Days Supply:
Quantity:
Refills (0-11):
Pick Up: C ADMINISTERED IN CLINIC
Priority: ROUTINE//
Comments:
No existing text
dit? No// (No)

----------------------------------------------------------------------------

Medication: OUTSIDE RX 11 PILL


Pick Up: ADMINISTERED IN CLINIC
Priority: ROUTINE
----------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE//


Auto-accept this order? NO//

Select QUICK ORDER NAME:

8.3.11.7 Inpatient Pharmacy Quick Order


Below is an example of an inpatient pharmacy order.
Select Order Menu Management Option: Enter/edit quick orders

Select QUICK ORDER NAME: PSJZ CIMETIDINE


Are you adding 'PSJZ CIMETIDINE ' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: UNIT DOSE MEDICATIONS
NAME: PSJZ CIMETIDINE // <Enter>
DISPLAY TEXT: Tagamet q8h
VERIFY ORDER: Y (Yes)
DESCRIPTION:
1> <cr>
Edit OPTION: <Enter>

Medication: CIMETIDINE TAB

Choose from: Selection of a dispensed


drug is not required, but
1 CIMETIDINE 200MG TAB UD PK $0.018 order checking will not
2 CIMETIDINE 300MG TAB UD PK $0.107 occur unless one is
3 CIMETIDINE 400MG TAB UD TAB $0.251 defined.
Dispense Drug: CIMETIDINE 200MG TAB UD PK $0.018 U.D.
Dosage: 200mg
Route: ORAL// <Enter>
Schedule: Q8H
First Dose Now?:
Priority: ROUTINE// <Enter>
Provider Comments:
No existing text Edit? No// <Enter> (No)
------------------------------------------------------------------------
Medication: CIMETIDINE TAB
Dispense Drug: CIMETIDINE 200MG TAB UD

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Dosage: 200mg
Route: ORAL
Schedule: Q8H
Priority: ROUTINE
------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE// <Enter>

8.3.11.8 Radiology Quick Order


You might leave many of the prompts on the Radiology quick orders blank so that
users can fill them in. This is especially true for “reason for exam” although you can
use a reason with a template field of possible choices.
Select QUICK ORDER NAME: RAZ CHEST 2 VIEWS STAT TODAY
Are you adding 'RAZ CHEST 2 VIEWS STAT TODAY' as a new ORDER DIALOG? No// Y
(Yes)
TYPE OF QUICK ORDER: IMAGING
NAME: RAZ CHEST 2 VIEWS STAT TODAY Replace
DISPLAY TEXT: Stat Chest 2 views
VERIFY ORDER: Y (Yes)
DESCRIPTION:
1> <Enter>
Edit OPTION: <Enter>
Select one of the following imaging types:
NUCLEAR MEDICINE The application displays a
GENERAL RADIOLOGY list for the selected
Imaging Types
Select IMAGING TYPE: GENERAL RADIOLOGY

Common General Radiology Procedures:


1 ABDOMEN 1 VIEW 21 FOOT 3 OR MORE VIEWS
2 ABDOMEN 2 VIEWS 22 FOREARM 2 VIEWS
3 ANKLE 3 OR MORE VIEWS 23 HAND 3 OR MORE VIEWS
4 CALCANEOUS 2 VIEWS 24 HIP 1 VIEW
5 CHEST 2 VIEWS PA&LAT 25 HUMERUS 2 OR MORE VIEWS
6 CHEST SINGLE VIEW 26 KNEE 3 VIEWS
7 CHOLECYSTOGRAM ORAL CONT 27 NASAL BONES MIN 3 VIEWS
8 COLON AIR CONTRAST 28 NON-INVAS.,DUPLEX SCAN OF CRAN
9 COLON BARIUM ENEMA 29 PELVIS 1 VIEW
10 CT ABDOMEN W/O CONT 30 RIBS UNILAT 2 VIEWS
11 CT CERVICAL SPINE W/O CONT 31 SHOULDER 2 OR MORE VIEWS
12 CT HEAD W/O CONT 32 SINUSES 3 OR MORE VIEWS
13 CT LUMBAR SPINE W/O CONT 33 SKULL 4 OR MORE VIEWS
14 CT MAXILLOFACIAL W/O CONT 34 SPINE CERVICAL MIN 4 VIEWS
15 CT NECK SOFT TISSUE W/O CONT 35 SPINE LUMBOSACRAL MIN 2 VIEWS
16 CT THORAX W/O CONT 36 SPINE THORACIC 2 VIEWS
17 ELBOW 3 OR MORE VIEWS 37 TIBIA & FIBULA 2 VIEWS
18 ESOPHAGUS 38 UPPER GI AIR CONT W/O KUB
19 ESOPHAGUS RAPID SEQUENCE FILMS 39 UROGRAM IV W NEPHROTOMOGRAMS
20 FEMUR 2 VIEWS 40 WRIST 3 OR MORE VIEWS
Radiology Procedure: 5 CHEST 2 VIEWS PA&LAT
Modifier:
History and Reason for Exam:
1> R/O pneumonia or mass If Category is left blank,
2> <Enter> the current patient status
Edit OPTION: <Enter> will be assumed

Category: <Enter>
Is this patient scheduled for pre-op? NO// <Enter>

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Date Desired: TODAY// T (AUG 30, 1997) You can leave this blank
Mode of Transport: P PORTABLE to allow the user to direct
Is patient on isolation procedures? <Enter> the request to the correct
Urgency: ROUTINE// STAT imaging location
Submit request to: TUSCALOOSA VAMC
--------------------------------------------------------------------------
Radiology Procedure: CHEST 2 VIEWS PA&LAT
History and Reason for Exam: R/O pneumonia or mass.
Date Desired: NOW
Mode of Transport: PORTABLE
Urgency: STAT
Submit request to: TUSCALOOSA VAMC
--------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE// <Enter>


Auto-accept: NO <Enter>

8.3.11.9 Consults Quick Order


Below is a sample Consults quick order.
Select QUICK ORDER NAME: GMRCZ EKG STAT ER
Are you adding 'GMRCZ EKG STAT ER' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: CONSULTS
NAME: GMRCZ EKG STAT ER// <Enter>
DISPLAY TEXT: Stat EKG
VERIFY ORDER: <Enter>
DESCRIPTION:
1> <Enter>
ENTRY ACTION: <Enter>

Consult to Service/Specialty: CARDIOLOGY


1 CARDIOLOGY
2 CARDIOLOGY CLINIC
CHOOSE 1-2: 1 CARDIOLOGY
Reason for Request:
1>r/o MI and arrythmia
2>
EDIT Option: <Enter>
Category: OUTPATIENT
Urgency: STAT
Place of Consultation: EMERGENCY ROOM
Attention: <Enter>
Provisional Diagnosis: <Enter>

------------------------------------------------------------------------
Consult to Service/Specialty: CARDIOLOGY
Reason for Request: r/o MI and arrythmia
Category: OUTPATIENT
Urgency: STAT
Place of Consultation: Emergency Room
------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE// <Enter>


No changes are saved
until you select PLACE

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8.3.11.10 Nursing Quick Order


Below is an example of a Nursing quick order.
Select Order Menu Management Option: Enter/edit quick orders

Select QUICK ORDER NAME: NURSING


NAME: ORZ FOLEY CATHETER// <Enter>
DISPLAY TEXT: Foley Catheter to Drainage
VERIFY ORDER: <Enter>
DESCRIPTION:
No existing text
Edit NO//
ENTER ACTION:
Patient Care: FOLEY CATHETER
Instruction: Empty drainage bag q shift
Start Date/Time: NOW//
Stop Date/Time: t+7
Medication: CIMETIDINE TAB
------------------------------------------------------------------------
Patient Care: FOLEY CATHETER
Instructions: Empty drainage bag q shift
Start Date/Time: NOW
Stop Date/Time: 7 DAYS FROM TODAY
------------------------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE// <Enter>

8.3.12 Create/Modify QO Restrictions (QOR)


Select the Create/Modify QO Restriction (QOR) option on the Order Menu
Management Menu to display the following:
Create/Modify QO Restrictions

Select an ORDERABLE ITEM (meds or labs only): ACETAMINOPHEN TAB ACETAMINOPHEN


TAB

Select the type of usage for which you wish to restrict ordering this item.
Usage: ??

Select the type of usage for which you wish to restrict ordering this item.
Choose from:
OUTPATIENT MEDICATIONS
PHARMACY
SUPPLIER/DEVICES
UNIT DOSE MEDICATIONS
Usage:

This allows ordering only as a quick order. The item does not appear in the “Other”
ordering dialogs.

8.3.13 Create/Modify Order Sets (SET)


Select the Create/Modify Order Sets (SET) option on the Order Menu Management
Menu to display the following:
Create/Modify Order Sets

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Select ORDER SET NAME:

An order set is when you put several quick orders together. The application guides
you through each item in the set. You can cancel out of an order set or can cancel a
specific order; the general idea is that the user is expected to order each item in the
set.

Example of Order Set:


Select ORDER SET NAME: LRZ DIABETIC TESTS ORDER SET
NAME: LRZ DIABETIC TESTS ORDER SET//<Enter>
DISPLAY TEXT: Diabetic Yearly tests
DESCRIPTION:
No existing text
EDIT? No//
ENTER ACTION:
EXIT ACTION:
ORDER SET COMPONENTS
1 LRZ HGBAIC OUTPT
2 LRZ LIPID PANEL
3 LRZ TSH OUTPT
Select COMPONENT SEQUENCE#:

Notes about example:

Field Description
NAME This is the official name
DISPLAY TEXT This is the name the user sees
DESCRIPTION This explains what the order set is for

8.3.14 Search/Replace Components (SRC)


Select the Search/Replace Components (SRC) option on the Order Menu
Management Menu to display the following:
Search/Replace Components

Search for: LRZ CALCIUM OUTPT

Ancestor of LRZ CALCIUM OUTPT


Name Type
------------------------------------------------------------------------------
1 LRZM LAB ORDERS menu
------------------------------------------------------------------------------
Replace LRZ CALCIUM OUTPT with:

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This option lets you search for specific components on menus and replace or delete
one or more instances of these components.

Enter the name of the component you want to replace this one with or enter @ to
remove this component. To quit without changing anything, press [Enter].

8.3.15 Search/Replace Orderables (SRO)


Select the Search/Replace Orderables (SRO) option on the Order Menu Management
Menu to display the following:
Search/Replace Orderables

Search for: SUSP

Quick Orders and Dialogs containing acetaminophen elixir SUSP


-------------------------------------------------------------------------------
1 PSOZ INBUPROFEN 100 MG/5ML SUST
-------------------------------------------------------------------------------
Replace with:

This option lets you search for specific orderable items saved as responses within
quick orders; a new orderable item can be selected to automatically replace it, as well.

8.4 Order Check Configuration (OCX)


Select the Order Check Configuration (OCX) option on the Order Entry
Configuration menu to display the following:
Order Check Configuration

ACT Activate/Inactivate Rules


COM Compile Rules
ENA Enable/Disable Order Checking System
INQ Expert System Inquiry
PAR Order Check Parameters ...
Select Order Check Configuration Option:

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Order Checking is based on a system of rules that review orders to see if they meet
defined criteria. If they do not meet the criteria, an electronic message is sent to the
ordering provider before the order is completed (such as duplicate order, drug-lab
interaction, etc.). The provider can then choose to cancel the order or override the
order check and place the order.

The Order Checking system lets users determine when order checks and notifications
are sent. To accomplish this, EHR includes several prepackaged order checks as well
as three menus for setting Order Checking parameters such as enabling and disabling
specific order checks. Order Checks can also be configured to be mandatory by the
CAC or the IT Department. If this feature is enabled, individual order checks cannot
be edited by the end users. Non-mandatory order checks can be enabled or disabled
by selecting Tools | Options.

Order checks exported with EHR


ALLERGY-CONTRAST MEDIA INTERACTION
ALLERGY-DRUG INTERACTION
AMINOGLYCOSIDE ORDERED
BIOCHEM ABNORMALITY FOR CONTRAST MEDIA
CLOZAPINE APPROPRIATENESS
CT & MRI PHYSICAL LIMITATIONS
DRUG-DRUG INTERACTION
DUPLICATE DRUG CLASS ORDER
DUPLICATE DRUG ORDER
DUPLICATE ORDER
ESTIMATED CREATININE CLEARANCE
GLUCOPHAGE-CONTRAST MEDIA
LAB ORDER FREQ RESTRICTIONS
MISSING LAB TESTS FOR ANGIOGRAM PROCEDURE
ORDER CHECKING NOT AVAILABLE
RECENT BARIUM STUDY
RECENT ORAL CHOLECYSTOGRAM
RENAL FUNCTIONS OVER AGE 65

NOTE: All of these order checks are exported in the disabled state
at the system level. Sites can then turn them on for individuals or
teams, as determined by the site. Clinical Application
Coordinators, individuals, or services can also disable individual
order checks, if they so choose.

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8.4.1 Activate/Inactivate Rules (ACT)


Should not be here

8.4.2 Compile Rules (COM)


Should not be here

8.4.3 Enable/Disable Order Checking System (ENA)


Select the Activate/Inactivate Rules (ACT) option on the Order Check Configuration
Menu to display the following:
Enable/Disable Order Checking System

Enable or disable order checking system. may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

Setting Enable or disable order checking system. for System: DEMO.OKLAHOMA.IHS


.GOV
Value: Enable// ?

Enter 'Enable/E' for order checking, 'Disable/D' to stop order checking.

Select one of the following:

E Enable
D Disable

Value: Enable//

Use this option to enable or disable the Order Checking System.

8.4.4 Expert System Inquiry (INQ)


Should not be here

8.4.5 Order Check Parameters (PAR)


Select the Order Check Parameters (PAR) option on the Order Check Configuration
Menu to display the following:
Order Check Parameters

CON Creatinine Date Range for Contrast Media Orders


CTH CT Scanner Height Limit
CTW CT Scanner Weight Limit
DAN Set Clinical Danger Level
DBG Enable/Disable Debug Message Logging
DPL Lab Duplicate Order Range
DPO Orderable Item Duplicate Order Range

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DPR Radiology Duplicate Order Range


EDT Mark Order Checks Editable by User
ENA Enable/Disable an Order Check
GLU Creatinine Date Range for Glucophage-Lab Results
LCL Edit Local Terms
MRH MRI Scanner Height Limit
MRW MRI Scanner Weight Limit
PLY Number of Medications for Polypharmacy
USR Order Checks a User Can Receive

Select Order Check Parameters Option:

8.4.5.1 Creatinine Date Range for Contrast Media Orders (CON)


Select the Creatinine Date Range for Contrast Media Orders (CON) on the Order
Check Parameters menu to display the following:
Creatinine Date Range for Contrast Media Orders

Creatinine Results for Contrast Media may be set for the following:

1 Location LOC (choose from HOSPITAL LOCATION)


2 Division DIV (DEMO HOSPITAL)
3 System SYS (DEMO.MEDSHERE.COM)

Enter selection:

This order check searches to see when the last creatinine was done for patients when
a radiology exam is ordered with contrast media. The package value is 30 days. This
value is used in the Biochem Abnormality for Contract Media Order check.

8.4.5.2 CT Scanner Height Limit (CTH)


Select the CT Scanner Height Limit (CTH) on the Order Check Parameters menu to
display the following:
CT Scanner Height Limit

CT SCANNER HEIGHT LIMIT may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

----- Setting CT SCANNER HEIGHT LIMIT for System: DEMO.OKLAHOMA.IHS.GOV -----


Value: ??

This parameter is used by order checking to determine if


a patient is too tall to be examined by the CAT scanner.

Value:

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This can be ignored if the site does not have a CT scanner. The height needs to be in
whole inches and is the maximum height of the patient.

8.4.5.3 CT Scanner Weight Limit (CTW)


Select the CT Scanner Weight Limit (CTW) on the Order Check Parameters menu to
display the following:
CT Scanner Weight Limit

CT SCANNER WEIGHT LIMIT may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

----- Setting CT SCANNER WEIGHT LIMIT for System: DEMO.OKLAHOMA.IHS.GOV -----


Value: ??

This parameter is used by order checking to determine if a patient weighs too


much to be safely examined by the CAT Scanner.

Value:

This can be ignored if the site does not have a CT scanner. The weight needs to be in
whole pounds and is the maximum weight of the patient.

8.4.5.4 Set Clinical Danger Level (DAN)


Select the Set Clinical Danger Level (DAN) on the Order Check Parameters menu to
display the following:
Set Clinical Danger Level

Order Check Clinical Danger Level may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

Setting Order Check Clinical Danger Level for System: DEMO.OKLAHOMA.IHS.GOV


Select Order Check: no allergy ASSESSMENT
Are you adding NO ALLERGY ASSESSMENT as a new Order Check? Yes// YES

Order Check: NO ALLERGY ASSESSMENT// NO ALLERGY ASSESSMENT NO ALLERGY ASSESS


MENT
Value: ?

Enter the code indicating the clinical danger level of the order check.

Select one of the following:

1 High
2 Moderate
3 Low

Value:

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Order checks come with a pre-set danger level for Parameter ORK CLINICAL
DANGER LEVEL and Entity ORDER ENTRY/RESUTLS REPORTING, as given in
the following table:

Order Check Value


ALLERGY-CONTRAST MEDIA INTERAC High
ALLERGY-DRUG INTERACTION High
AMINOGLYCOSIDE ORDERED High
BIOCHEM ABNORMALITY FOR CONTRA High
CLOZAPINE APPROPRIATENESS High
CRITICAL DRUG INTERACTION High
CT & MRI PHYSICAL LIMITATIONS High
DISPENSE DRUG NOT SELECTED High
DUPLICATE DRUG CLASS ORDER High
DUPLICATE DRUG ORDER High
DUPLICATE ORDER Moderate
ERROR MESSAGE Low
ESTIMATED CREATININE CLEARANCE Moderate
GLUCOPHAGE-CONTRAST MEDIA High
LAB ORDER FREQ RESTRICTIONS Moderate
MISSING LAB TESTS FOR ANGIOGRA High
ORDER CHECKING NOT AVAILABLE Low
POLYPHARMCY Moderate
RECENT BARIUM STUDY High
RECENT ORAL CHOLECYSTOGRAM High
RENAL FUNCTIONS OVER AGE 65 Moderate
SIGNIFICANT DRUG INTERACTION Moderate
These danger levels are based on rules supplied by a panel of physicians.

NOTE: High danger level order checks require entry of a reason if


they are overridden. Moderate and low order checks can be
overridden without entry of a reason.

8.4.5.5 Enable/Disable Debug Message Logging (DBG)


Select the Enable/Disable Debug Message Logging (DBG) on the Order Check
Parameters menu to display the following:
Enable/Disable Debug Message Logging

Enable or disable debug log. may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

-- Setting Enable or disable debug log. for System: DEMO.OKLAHOMA.IHS.GOV --


Value: ??

Parameter determines if order checking will log debug messages into


^XTMP("ORKLOG". 'Enabled' indicates logging will occur. 'Disabled' will
prevent logging of messages and delete log file (^XTMP("ORKLOG")).

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The data for zero node entries is the information passed to order checking
from OE/RR. The zero node is in the format:
^XTMP("ORKLOG",<order check date/time>,<pt id>,<orderable item>,<dlog mode>,
<user id>,0)=
<orderable item>|<filler>|<natl id^natl text^natl sys^local id^local text^
local sys>|<order effective date/time>|<order number>|<filler data>

The data for non-zero node entries is the information passed from order
checking back to OE/RR. It is the order check messages plus other info to
enhance OE/RR processing. It is in the format:
^XTMP("ORKLOG",<order check date/time>,<pt id>,<orderable item>,<dlog mode>,
<user id>,<non-zero>)=
<order number>^<order check id - 864.5 ien>^<clin danger level>^<message>

Value:

8.4.5.6 Lab Duplicate Order Range (DPL)


Select the Lab Duplicate Order Range (DPL) on the Order Check Parameters menu to
display the following:
Lab Duplicate Order Range

Duplicate lab orders date range may be set for the following:

1 Location LOC [choose from HOSPITAL LOCATION]


2 Service SRV [choose from SERVICE/SECTION]
3 Division DIV [DEMO INDIAN HOSPITAL]
4 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 4 System DEMO.OKLAHOMA.IHS.GOV

- Setting Duplicate lab orders date range for System: DEMO.OKLAHOMA.IHS.GOV -


Value: ?

Enter the number of hours back in time you wish to check for duplicate
orders.

Value:

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Use this option to set the number of hours backwards in time to look for duplicate lab
orders. For example, a value of “24” indicates a lab procedure intended to be
collected within 24 hours of the collection of the same lab procedure will trigger an
order check indicating duplicate lab order. The range can be set up differently for
various locations. For example, a lab could be a duplicate in outpatient areas if
ordered within 30 days, but a lab in ICU would not be a duplicate if ordered in 24
hours.

The package default is 48 hours and covers all labs except those specifically
mentioned in the orderable item duplicate range.

8.4.5.7 Orderable Item Duplicate Order Range (DPO)


Select the Orderable Item Duplicate Order Range (DPO) on the Order Check
Parameters menu to display the following:
Orderable Item Duplicate Order Range

Orderable item duplicate date range may be set for the following:

1 Location LOC (choose from HOSPITAL LOCATION)


2 Service SRV (choose from SERVICE/SECTION)
3 Division DIV (DEMO HOSPITAL)
4 System SYS (DEMO.MEDSHERE.COM)

Enter selection: 4 System DEMO.MEDSHERE.COM

Setting Orderable item duplicate date range for System: DEMO.MEDSHERE.COM


Select Orderable Item:

Use this option to set the number of hours backwards in time to look for duplicate
orders related to specific orderable items. The duplicate order range for lab and
radiology procedures in general is set by the Lab Duplicate Order Range and
Radiology Duplicate Order Range options.

This is for SPECIFIC orderable items (not all text orders), and it takes precedence
over the lab and radiology duplicates. So, you could set the duplicate radiology order
to 48 hours but come into this option and set the duplicate chest x-ray order to 8
hours.

8.4.5.8 Radiology Duplicate Order Range (DPR)


Select the Radiology Duplicate Order Range (DPR) on the Order Check Parameters
menu to display the following:
Radiology Duplicate Order Range

Duplicate radiology order date range may be set for the following:

1 Location LOC [choose from HOSPITAL LOCATION]


2 Service SRV [choose from SERVICE/SECTION]
3 Division DIV [DEMO INDIAN HOSPITAL]
4 System SYS [DEMO.OKLAHOMA.IHS.GOV]

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Enter selection: 4 System DEMO.OKLAHOMA.IHS.GOV

Setting Duplicate radiology order date range for System: DEMO.OKLAHOMA.IHS.GOV

Value: ?

Enter the number of hours back in time you wish to check for duplicate
orders.

Value:

Use this option to set the number of hours backwards in time to look for duplicate
radiology orders. For example, a value of “48” indicates a radiology procedure
intended to be performed within 48 hours of the completion of the same radiology
procedure will trigger an order check indicating duplicate radiology order. This range
can be setup differently for various locations.

The package default is 48 hours and includes all items except those covered in the
orderable item duplicate range.

8.4.5.9 Mark Order Checks Editable by User (EDT)


Select the Mark Order Checks Editable by User (EDT) on the Order Check
Parameters menu to display the following:
Mark Order Checks Editable by User

Order Check On/Off Editable by User may be set for the following:

1 Division DIV [DEMO INDIAN HOSPITAL]


2 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 2 System DEMO.OKLAHOMA.IHS.GOV

Setting Order Check On/Off Editable by User for System: DEMO.OKLAHOMA.IHS.GOV


Select Order Check: NO ALLERGY ASSESSMENT
Are you adding NO ALLERGY ASSESSMENT as a new Order Check? Yes// YES

Order Check: NO ALLERGY ASSESSMENT// NO ALLERGY ASSESSMENT NO ALLERGY ASSESS


MENT
Editable by User?: ?

Enter 'yes' if the order check can be "Enabled" or "Disabled" by users.

Editable by User?:

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For System and Division, indicate if the order check can be edited by a user. Valid
values include YES and NO.

If the value is YES, the order check can be “Enabled” or “Disabled” by a user. Users
do have access to change the order check's ORK PROCESSING FLAG parameter
value.

If the value is NO, the order check CANNOT be “Enabled” or “Disabled” by a user.
Users do NOT have access to change the order check's ORK PROCESSING FLAG
parameter value. An order check with a NO value does not prevent CACs from
setting or changing the order check’s enabled/disabled values.

8.4.5.10 Enable/Disable an Order Check (ENA)


Select the Enable/Disable an Order Check (ENA) on the Order Check Parameters
menu to display the following:
Enable/Disable an Order Check

Order Check Processing Flag may be set for the following

1 User USR (choose from NEW PERSON


2 Location LOC (choose from HOSPITAL LOCATION)
3 Service SRV (choose from SERVICE/SECTION)
4 Division DIV (DEMO HOSPITAL)
5 System SYS (DEMO.MEDSHERE.COM)

Enter selection: 5 System DEMO.MEDSHERE.COM

---- Setting Order Check Processing Flag for System: DEMO.MEDSHERE.COM ----
Select Order Check: NO ALLERGY ASSESSMENT
Are you adding NO ALLERGY ASSESSMENT as a new Order Check? YES// YES

Order Check: NO ALLERGY ASSESSMENT// NO ALLERGY ASSESSMENT NO ALLERGY


ASSESSMENT
Value: ?

Code indicating the processing flag for the entity and order check.

Select one of the following:


E Enable
D Disable

Value:

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Use this option to turn specific order checks on or off for a user or for a location. This
option works by entering a processing flag for an entity and order check. The entity
can be a user, location, service, division, system, or package.

Processing flags

E (Enabled): Order check is enabled for the entity unless an entity of higher
precedence has order check disabled (e.g., if Enabled at System level and Disabled at
User level, order check is not processed).

D (Disabled): Order check is disabled for the entity unless an entity of higher
precedence has the order check Enabled (e.g., if Disabled at System level and
Enabled at User level, order check is processed).

8.4.5.11 Creatinine Date Range for Glucophage-Lab Results (GLU)


Select the Creatinine Order Range for Glucophage Lab Results (GLU) on the Order
Check Parameters menu to display the following:

Figure 8- : Creatinine Date Range for Glucophage Lab Results

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This parameter sets how far back to look for a creatinine result for a patient taking
glucophage. The package value is 60 days. This value is used in the Glucophage -
Lab Results order check.

8.4.5.12 Edit Local Terms (LCL)


Select the Edit Local Terms (LCL) on the Order Check Parameters menu to display
the following:

Figure 8- : Edit Local Terms

There is a set of national terms that are used by Order Checking. In order for them to
work properly, a site’s local terms must be mapped to the national terms (you can
map more than one of your local terms to one national term).

The CAC picks the national term and matches it to the local term. Often the names
are identical.

8.4.5.13 MRI Scanner Height Limit (MRH)


Select the MRI Scanner Height Limit (MRH) on the Order Check Parameters menu to
display the following:
MRI Scanner Height Limit

MRI SCANNER HEIGHT LIMIT may be set for the following:

1 Division DIV (DEMO.HOSPITAL)


2 System SYS (DEMO.MEDSPHERE.COM]

Enter selection: 2 System DEMO.MEDSPHERE.COM

------ Setting MRI SCANNER HEIGHT LIMIT for System: DEMO.MEDSPHERE.COM ------
Value: ?

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Enter the maximum height (in inches) of a patient.

Value:

Can be ignored if the site does not have a CT scanner. This order check should also
be disabled at the system level. The height needs to be in whole inches. This
parameter determines if the patient is too tall to be safely examined by the MRI
scanner.

8.4.5.14 MRI Scanner Weight Limit (MRW)


Select the MRI Scanner Weight Limit (MRW) on the Order Check Parameters menu
to display the following:
MRI Scanner Weight Limit

MRI SCANNER WEIGHT LIMIT may be set for the following:

1 Division DIV (DEMO.HOSPITAL)


2 System SYS (DEMO.MEDSPHERE.COM]

Enter selection: 2 System DEMO.MEDSPHERE.COM

------ Setting MRI SCANNER WEIGHT LIMIT for System: DEMO.MEDSPHERE.COM ------
Value: ?

Enter the maximum weight (in inches) of a patient.

Value:

Can be ignored if the site does not have a CT scanner. This order check should also
be disabled at the system level. The weight needs to be in whole pounds. This
parameter determines if the patient is too heavy to be safely examined by the MRI
scanner.

8.4.5.15 Number of Medications for Polypharmacy (PLY)


Select the Number of Medications for Polypharmacy (PLY) on the Order Check
Parameters menu to display the following:
Number of Medications for Polypharmacy

Number of Polypharmacy Medications may be set for the following:

1 Location LOC [choose from HOSPITAL LOCATION]


2 Division DIV [DEMO INDIAN HOSPITAL]
3 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 3 System DEMO.OKLAHOMA.IHS.GOV

Setting Number of Polypharmacy Medications for System:


DEMO.OKLAHOMA.IHS.GOV
Number of meds more than: ?

Enter the number of medications for polypharmacy.

Number of meds more than:

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Enter the number of meds that will trigger this check if it has been enabled. The
package number is 7.

This parameter accepts values from 0 to 100. It is used by the Polypharmacy order
check.

8.4.5.16 Order Checks a User Can Receive (USR)


Select the Order Checks a User Can Receive (USR) on the Order Check Parameters
menu to display the following:
Order Checks a User Can Receive

Enter user’s name: USER,DEMO// DU

Would you like help understanding the list of order checks? No// (No)

This will take a moment or two, please stand by ....................


DEVICE: HOME// CONSOLE

The delivery of order checks is determined from values set for Users, Inpatient
Locations, Service/Sections, Hospital Divisions, Computer System, and OERR.
Possible values include ‘Enabled’ and ‘Disabled’. These values indicate a User’s,
Location’s, Service/Section’s, Division’s, System’s and OERR’s desire for the order
check to be ‘Enabled’ (displayed under most circumstances) or ‘Disabled’ (normally
not displayed.)

All values, except the OERR (Order Entry) value, can be set by the CAC. Individual
users can set their ‘Enabled/Disabled’ values for each specific order check via the
‘Enable/Disable My Order Checks’ option under the Personal Preferences and Order
Check Management for Users.

The value ON indicates the user will receive the order check under normal conditions.

The value OFF indicates the user normally will not receive the order check.

Order check recipient determination can also be influenced by patient location


(inpatients only.) This list does not consider patient location when calculating the
ON/OFF value for an order check because a patient is not known when the option is
selected.
Order Check List for DEMO,USER Page: 1

Order Check ON/OFF For This User and Why


-------------------------------- ---------------------------------------------
ALLERGY-CONTRAST MEDIA INTERAC ON OERR value is Enabled
ALLERGY-DRUG INTERACTION ON OERR value is Enabled
AMINOGLYCOSIDE ORDERED ON OERR value is Enabled
BIOCHEM ABNORMALITY FOR CONTRA ON OERR value is Enabled
CLOZAPINE APPROPRIATENESS ON OERR value is Enabled
CRITICAL DRUG INTERACTION ON OERR value is Enabled

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CT & MRI PHYSICAL LIMITATIONS ON OERR value is Enabled


DANGEROUS MEDS FOR PT > 64 ON No value found
DISPENSE DRUG NOT SELECTED ON OERR value is Enabled
DUPLICATE DRUG CLASS ORDER ON OERR value is Enabled
DUPLICATE DRUG ORDER ON OERR value is Enabled
DUPLICATE OPIOID MEDICATIONS OFF OERR value is Disabled
DUPLICATE ORDER ON OERR value is Enabled
ERROR MESSAGE ON OERR value is Enabled
ESTIMATED CREATININE CLEARANCE ON OERR value is Enabled
GENERIC RESULTS ON No value found
Press RETURN to continue or '^' to exit:

This option displays a list of all Order Checks annotated with the status of each
processing flag. The right-hand column has an explanation for the processing flag
status.

8.5 Order Parameters (PAR)


Select the Order Parameters (PAR) option on the Order Entry Configuration menu to
display the following:
Order Parameters

HLD Disable Hold/Unhold Actions in EHR


IND Enable Clinical Indicator Prompt
MSC Miscellaneous Parameters
ORD Disable Ordering in EHR
RSN Edit DC Reasons
UOV Set Unsigned Orders View on Exit
VER Enable/Disable Order Verify Actions

Select Order Parameters Option:

8.5.1 Disable Hold/Unhold Actions in EHR (HLD)


Select the Disable Hold/Unhold Actions in the EHR (HLD) option on the Order
Parameters menu to display the following:
Disable Hold/Unhold Actions in EHR

Setting Disable Hold/Unhold Actions in GUI for System: DEMO.OKLAHOMA.IHS.GOV


Disable Hold: ?

Enter yes if using the Hold/Unhold actions should be disallowed in GUI.

Disable Hold:

This parameter will prevent orders from being placed on hold.

8.5.2 Enable Clinical Indicator Prompt (IND)


Select the Enable Clinical Indicator Prompt (IND) on the Order Parameters menu to
display the following:
Enable Clinical Indicator Prompt

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Enable Clinical Indicator Prompt may be set for the following:

800 Division DIV [DEMO INDIAN HOSPITAL]


900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 900 System DEMO.OKLAHOMA.IHS.GOV

Setting Enable Clinical Indicator Prompt for System: DEMO.OKLAHOMA.IHS.GOV


Select Package: ??

Choose from:
LAB SERVICE LR
OUTPATIENT PHARMACY PSO

Select Package:

When this prompt is Enabled, then the person entering the order is not allowed to
Accept the order until a diagnosis is entered in the Clinical Indication field (in the
EHR).

IHS has started requiring this for Labs because the Insurance companies want this
information.

This feature can also appear in outpatient medication orders.

8.5.3 Miscellaneous Parameters (MSC)


Select the Miscellaneous Parameters (MSC) option on the Order Parameters menu to
display the following:
Miscellaneous Parameters

Miscellaneous OE/RR Definition for System: DEMO.OKLAHOMA.IHS.GOV


------------------------------------------------------------------------------
Active Orders Context Hours
Allow Clerks to act on Med Orders NO
Allow Clerks to act on Outside Med Orders
Auto Unflag
Confirm Provider
Default Provider
Error Days 3
New Orders Default
Restrict Requestor YES (ORELSE & OREMAS)
Review on Patient Movement
Show Lab #
Show Status Description
Signature Default Action
Signed on Chart Default
------------------------------------------------------------------------------

--- Setting Active Orders Context Hours for System: DEMO.OKLAHOMA.IHS.GOV ---
ACTIVE ORDERS CONTEXT HOURS:

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You should setup miscellaneous OE/RR parameters before users actively start using
the application.

Active Orders Context Hours 24

This parameter determines the number of hours that orders remain in the
Active/Current Orders context after they have been completed. Most sites choose
either 24 or 72 hours depending of whether or not the order should remain active
over the span of a weekend.
Allow Clerks to act on Med Orders NO

If clinicians are to enter their own med orders (recommended), this should be set
to no. Set to yes ONLY if you want to have clerks (those holding the OREMAS
key) are allowed to act on medication orders. Enter YES 117
to permit clerks to enter a new or DC medication order and release it to
Pharmacy as ‘Signed on Chart’, or UNRELEASED ONLY to restrict clerks to
only entering unreleased orders.
Allow Clerks to act on Outside Med Orders

This parameter determines if clerks (i.e., users holding the OREMAS key) are
allowed to act on outside med orders. Enter YES to permit a clerk to enter new
or DC outside med orders and send them to Pharmacy for reports and order
checks. Enter UNRELEASED ONLY to restrict clerks to only entering
unreleased orders. To prohibit clerks from handling outside med orders entirely,
select NO.
Auto Unflag YES

Enter YES to automatically cancel the Flag Orders Notification and unflag all
orders for the patient when a user processes a Flagged Order Notification.
Confirm Provider YES (Exclude ORES)

This is for the VA; therefore, use the default.


Default Provider

Enter YES to allow the attending physician to be prompted (as a default) when
adding orders.
This can save time if a site has no residents or interns but changing the clinician
for cross-coverage on weekends will need to be taught. Once a requesting
clinician is chosen, you cannot change it.
Error Days

Enter the number of days to keep the OE/RR Error file current. The default is
three days.

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New Orders Default

Nothing is needed here. This is a hold over from the old roll-and-scroll version
of order entry.
Restrict Requestor

This does not work!


Review on Patient Movement

This no longer works. It is a hold over from the old version of order entry.
Show Lab #

Enter YES to have the lab order number displayed to physicians on Release.
Show Status Description

Enter YES to have the lab status displayed to physicians on Release. Probably
not needed.
Signature Default Action Release w/o Signature

This parameter is for nurses. When they sign off orders, “what is the default?”
should be answered here. Because most nurse orders should be telephone or
verbal, RS is the logical choice.
Select one of the following:
OC Signed on Chart
RS Release w/o Signature

Signed on Chart Default NO

This defines the default value to be presented when the user gets the prompt to
mark orders as Signed on Chart; if no value is entered, then NO is used as the
default.

8.5.4 Disable Ordering in EHR (ORD)


Select the Disable Ordering in EHR (ORD) option on the Order Parameters menu to
display the following:
Disable Ordering in EHR

Disable Ordering in GUI may be set for the following

2 User USR (choose from NEW PERSON


5 System SYS (DEMO.MEDSHERE.COM)
10 Package PKG (ORDER ENTRY/RESULTS REPORTING)

Enter selection: 5 System DEMO.MEDSHERE.COM

---- Setting Disable Ordering in GUI for System: DEMO.MEDSHERE.COM ----


Disable Ordering: ??

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This parameter disables writing orders and taking actions on orders in the GUI.

Disable Ordering:

This parameter will prevent the System or a User from entering or doing anything to
an existing order other than looking at it.

The person(s) affected should still be able to log onto EHR and do anything else, just
not enter new orders (of any kind, including meds) nor change any existing order.

8.5.5 Edit DC Reasons (RSN)


Select the Edit DC Reasons (RSN) option on the Order Parameters menu to display
the following:
Edit DC Reasons

Select DC REASON: ??

Choose from:
7 Duplicate Order
8 Discharge
9 Transfer
10 Treating Specialty Change
11 Admit
14 Requesting Physician Cancelled
15 Obsolete Order
16 Entered in error
17 Death
20 Surgery
21 Pass
22 ASIH

You may enter a new ORDER REASON, if you wish


This is the name of the DC Reason.

Select DC REASON:

If an order is discontinued, the application asks to enter a reason that will appear on
the order details. Some of the reasons will appear automatically such as those when a
patient is discharged. Sites can make local reasons to augment the national list.

8.5.6 Set Unsigned Orders View on Exit (UOV)


Select the Set Unsigned Orders View on Exit (UOV) option on the Order Parameters
menu to display the following:
Set Unsigned Orders View on Exit

Unsigned Orders View on Exit may be set for the following:

1 User USR [choose from NEW PERSON]


3 Service SRV [choose from SERVICE/SECTION]
5 Division DIV [DEMO INDIAN HOSPITAL]
7 System SYS [DEMO.OKLAHOMA.IHS.GOV]

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Enter selection: 7 System DEMO.OKLAHOMA.IHS.GOV

-- Setting Unsigned Orders View on Exit for System: DEMO.OKLAHOMA.IHS.GOV --


UNSIGNED ORDERS VIEW ON EXIT: ?

Enter the unsigned orders view to present ORES key holders on exit.

Select one of the following:

0 NEW ORDERS ONLY


1 MY UNSIGNED ORDERS
2 ALL UNSIGNED ORDERS

UNSIGNED ORDERS VIEW ON EXIT:

8.5.7 Enable/Disable Order Verify Actions (VER)


Select the Enable/Disable Order Verify Actions (VER) option on the Order
Parameters menu to display the following:
Enable/Disable Order Verify Actions

Enable/Disable Order Verify Actions may be set for the following:

1 User USR [choose from NEW PERSON]


5 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 5 System DEMO.OKLAHOMA.IHS.GOV

Setting Enable/Disable Order Verify Actions for System: DEMO.OKLAHOMA.IHS.GOV


Verify Action Status: ??

This parameter controls whether nurses are allowed to verify orders in the
GUI. The default value is 0, which allows nurses to verify orders only
when ordering is enabled. To allow nurses to verify orders when ordering
is disabled, set the value to 1. To never allow the verify actions, set
the value to 2.

This parameter applies to the "Verify" and "Chart Review" on the Actions
menu on the Order tab.

Verify Action Status:

8.6 Print/Report Parameters (PRN)


Select the Print/Report Parameters (PRN) option on the Order Entry Configuration
menu to display the following:
Print/Report Parameters

CHT Chart Copy Parameters


HOS Print Parameters for Hospital
LOC Print Parameters for Wards/Clinics
REQ Requisition/Label Parameters
SUM Summary Report Parameters
SVC Service Copy Parameters
WRX Work Copy Parameters

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Select Print/Report Parameters Option:

The Print/Report Parameters menu contains options for editing the parameters of
various types of reports printed at healthcare facilities. It should be available to the
CAC and the IRM Staff.

Menu Text Description


Chart Copy Parameters Use this option to edit hospital-wide Chart Copy
parameters.
Print Parameters for Hospital Use this option to edit hospital wide print parameters for
OE/RR.
Print Parameters for Wards/Clinics Use this option to edit print parameters for each
ward/clinic location.
Requisition/Label Parameters Use this option to edit requisition and label site
parameters.
Summary Report Parameters Use this option to edit Summary Report site parameters.
Service Copy Parameters Use this option to edit Service Copy site parameters.
Work Copy Parameters Use this option to edit Work Copy site parameters.

8.6.1 Chart Copy Parameters (CHT)


Select the Chart Copy Parameters (CHT) option on the Print/Report Parameters menu
to display the following:
Chart Copy Parameters

Chart Copy Definition for System: DEMO.MEDSPHERE.COM


----------------------------------------------------------------------------
Chart Copy Format
Chart Copy Header
Chart Copy Footer
Expand Continuous Orders
Print Chart Copy When
Prompt for Chart Copy
----------------------------------------------------------------------------
CHART COPY FORMAT:

Use this option to edit hospital-wide Chart Copy parameters.

All copies printed from the EHR are not considered official copies. Chart copies can
be automatically printed on the ward.

8.6.2 Print Parameters for Hospital (HOS)


Select the Print Parameters for Hospital (HOS) option on the Print/Report Parameters
menu to display the following:
Print Parameters for Hospital

Miscellaneous Hospital Prints for System: DEMO.MEDSPHERE.COM


----------------------------------------------------------------------------
Initials on Summary YES
Requisition Sort Field
Label Sort Field

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Order Summary Sort Forward YES


Prompt for Chart Copy DON’T PROMPT
Prompt for Work Copy PROMPT AND ASK DEVICE
Prompt for Requisitions DON’T PROMPT
Prompt for Labels DON’T PROMPT
----------------------------------------------------------------------------
PRINT INITIALS ON SUMMARY REPORT: YES//

Use this option to edit hospital-wide print parameters for OE/RR.

8.6.3 Print Parameters for Wards/Clinics (LOC)


Select the Print Parameters for Wards/Clinics (LOC) option on the Print/Report
Parameters menu to display the following:
Print Parameters for Wards/Clinics

Select HOSPITAL LOCATION NAME: GENERAL

Print Definition (Loc) for Location: GENERAL


----------------------------------------------------------------------------
Chart Copy Print Device S-132
Prompt for Chart Copy DON’T PROMPT
Work Copy Print Device S-132
Prompt for Work Copy PROMPT AND ASK DEVICE
Requisition Print Device S-132
Prompt for Requisitions DON’T PROMPT
Label Print Device S-132
Prompt for Labels DON’T PROMPT
Daily Order Summary Device S-132
Service Copy Default Device RADIOLOGY/NUCLEAR MEDICATIN S-132
Print Chart Copy Summary
Print Daily Order Summary
----------------------------------------------------------------------------
CHART COPY PRINT DEVICE: S-132//

Use this option to edit print parameters for each ward.

8.6.4 Requisition/Label Parameters (REQ)


Select the Requisition/Label Parameters (REQ) option on the Print/Report Parameters
menu to display the following:
Requisition/Label Parameters

Requisition/Label Definition for System: DEMO MEDSPHERE.COM


----------------------------------------------------------------------------
Ward Requisition Format LAB SERVICE LAB REQUISITION
Ward Requisition Header
Ward Requisition Footer
Ward label Format
Prompt for Requisitions DON’T PROMPT
Prompt for Labels DON’T PROMPT
----------------------------------------------------------------------------

For Ward Requisition Format -


Select Package:

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Use this option to edit print parameters for requisitions or labels. A Requisition is a
working copy of order(s) that will be sent with the order to the service. It doesn’t
contain a header or footer.

8.6.5 Summary Report Parameters (SUM)


Select the Summary Report Parameters (SUM) option on the Print/Report Parameters
menu to display the following:
Summary Report Parameters

Summary Report Definition for System: DEMO MEDSPHERE.COM


----------------------------------------------------------------------------
Chart Copy Summary Sort Forward
Work Copy Summary Sort Forward
Print ‘NO ORDERS’ on summary
Condensed Order Summary
Print All orders on Chart Summary
----------------------------------------------------------------------------
CHART SUMMARY ORDER:

Use this option to edit Summary Report site parameters.

8.6.6 Service Copy Parameters (SVC)


Select the Service Copy Parameters (SVC) option on the Print/Report Parameters
menu to display the following:
Service Copy Parameters

Select PACKAGE: LAB SERVICE LR

Service Copy Definition for System: DEMO MEDSPHERE.COM, LAB SERVICE


----------------------------------------------------------------------------
Service Copy Format LAB SERVICE DOCTOR’S ORDERS
Service Copy Header LAB SERVICE LAB SERVICE COPY HEADER
Service Copy Footer LAB SERVICE CHART COPY FOOTER
Service Copy Default Device LAB SERVICE LASER
----------------------------------------------------------------------------

SERVICE COPY FORMAT: DOCTOR’S ORDERS//

Use this option to edit Service Copy parameters.

8.6.7 Work Copy Parameters (WRK)


Select the Work Copy Parameters (WRK) option on the Print/Report Parameters
menu to display the following:
Work Copy Parameters

Work Copy Definition for System: DEMO.MEDSPHERE.COM


----------------------------------------------------------------------------
Work Copy Format WORK COPY FORMAT
Work Copy Header WORK COPY FORMAT
Work Copy Footer WORK COPY FORMAT

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Prompt for Work Copy PROMPT AND ASK DEVICE


----------------------------------------------------------------------------
WORK COPY FORMAT: WORK COPY FORMAT//

Use this option to edit Work Copy parameters.

8.7 Order Reports (RPT)


Select the Order Reports (RPT) option on the Order Entry Configuration menu to
display the following:
Order Reports

MON Performance Monitor Report


NAT Search orders by Nature or Status
UNS Unsigned orders search

Select Order Reports Option:

8.7.1 Performance Monitor Report (MON)


Select the Performance Monitor Report (MON) option on the Order Reports menu to
display the following:
Performance Monitor Report

Enter starting date: T-365 (FEB 14, 2005)


Enter ending date: T (FEB 14, 2006)
Do you want ALL providers to appear on this report? Y// YES

Select one of the following:

A All orders
P Pharmacy orders only

Select order category: P// All orders

Select one of the following:

I Inpatient
O Outpatient
B Both

Select patient status: B// Both

Select one of the following:

S Summary (includes provider details)


D Detail (includes order details)
B Both (Summary & Detail)
T Summary Report Totals Only (no provider details)

Select report: S//

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This report will allow a site to track the percent of orders entered electronically.

This report shows the number of orders entered by the provider. It includes a detailed
listing as well as a summary. The detail listing includes pertinent information about
each order associated with the listed provider. The summary report shows the number
of orders entered for a provider, the number of orders entered by an ORES key
holder, the percentage of orders entered by an ORES key holder for the given
provider and a break down of the orders by nature of order for those that were entered
by a non-ORES key holder.

8.7.2 Search orders by Nature or Status (NAT)


Select the Search orders by Nature or Status (NAT) option on the Order Reports
menu to display the following:
Nature of Order or Order Status Search.
This report is formatted for 132 column output.

Select one of the following:

1 Nature of order
2 Order Status

Enter the search criteria:

This option will allow the user to search orders for a specific NATURE OF ORDER
or order STATUS. There are two formats available: (1) a detailed display that is
printed in real time as the order number that meets the search criteria is encountered;
there is a further sort capability for this format and (2) is the columnar format that
will allow the sort by ENTERING person or by SERVICE/SECTION; this format
works best if sending the output to a 132 column compressed printer or to the
BROWSER device.

8.7.2.1 Nature of order


Select the Nature of order option on the Search orders by Nature or Status menu to
display the following:
Nature of Order or Order Status Search.
This report is formatted for 132 column output.

Select one of the following:

1 Nature of order
2 Order Status

Enter the search criteria: 1 Nature of order


Select Nature of order: verbal V
Enter a starting date: t-365 (NOV 26, 2006)
Enter a ending date: t (NOV 26, 2007)

Select one of the following:

1 Detailed format

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2 Columnar format

Select output format:

8.7.2.2 Order Status


Select the Order Status option on the Search orders by Nature or Status menu to
display the following:
Nature of Order or Order Status Search.
This report is formatted for 132 column output.

Select one of the following:

1 Nature of order
2 Order Status

Enter the search criteria: 2 Order Status


Select Order Status: pending p
Enter a starting date: t-365 (NOV 26, 2006)
Enter a ending date: t (NOV 26, 2007)

Select one of the following:

1 Detailed format
2 Columnar format

Select output format: 1 Detailed format


DEVICE: HOME//

8.7.3 Unsigned Orders Search (UNS)


Select the Unsigned Orders Search (UNS) option on the Order Reports menu to
display the following:
Unsigned Orders Search
This report is formatted for a 132 column output.

Select one of the following:

1 Released/Unsigned
2 Unsigned
3 Unsigned/Unreleased

Enter the type of orders to search:

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Medical Records (HIM Department) should run this report at least once a week.

This option will allow the user to search for either RELEASED by UNSIGNED
orders or just UNSIGNED orders and sort them by Service/section, Provider, Patient,
or Location.

The Start Date entry allows the site to ignore unsigned orders that fall within their
allowed grace period. For example: the site allows the clinician 48 hours to sign
unsigned orders, you would enter T-2 for a start date.

The Stop Date allows the site to ignore orders older than the date entered.

All three options ask for the same information as shown below:
Unsigned Orders Search
This report is formatted for a 132 column output.

Select one of the following:

1 Released/Unsigned
2 Unsigned
3 Unsigned/Unreleased

Enter the type of orders to search: 1 Released/Unsigned

Select one of the following:

1 Service/Section
2 Provider
3 Patient
4 Location
5 Entered By
6 Division

Enter the sort criteria: 2 Provider


Would you like a specific Provider? NO//
Enter a starting date: t-365 (NOV 26, 2006)
Enter an ending date: t (NOV 26, 2007)
Print summary only ? NO// yes YES
DEVICE: HOME//

8.8 Automatically Print Orders to a Service Printer


This process is on the CPRS Clinical Coordinators menu (and NOT on the Order
Entry Configuration option of the RPMS-EHR Configuration Menu).
Select CPRS Configuration (Clin Coord) Option: pr  Print/Report Parameters

CC Chart Copy Parameters


WC Work Copy Parameters
SC Service Copy Parameters
RE Requisition/Label Parameters
UM Summary Report Parameters
HO Print Parameters for Hospital
LO Print Parameters for Wards/Clinics

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Select Print/Report Parameters Option: lo Print Parameters for Wards/Clinics


Select HOSPITAL LOCATION NAME: ACUTE ORTHO FU WYLIE,ROBERT J

Print Definition (Loc) for Location: ACUTE ORTHO FU


------------------------------------------------------------------------------
Chart Copy Print Device PRT-82
Prompt for Chart Copy DON'T PRINT
Work Copy Print Device
Prompt for Work Copy
Requisition Print Device
Prompt for Requisitions
Label Print Device PRT-78
Prompt for Labels DON'T PRINT
Daily Order Summary Device
Service Copy Default Device OUTPATIENT PHARMACY PRT-90
Print Chart Copy Summary
Print Daily Order Summary
------------------------------------------------------------------------------
CHART COPY PRINT DEVICE: PRT-82// PRT-82    CLINIC C |PRN|\\PHXWR-CH2\HP41
00CLINICC TRNG
PROMPT FOR CHART COPY: DON'T PRINT//
WORK COPY PRINT DEVICE:
PROMPT FOR WORK COPY:
REQUISITION PRINT DEVICE:
PROMPT FOR REQUISITIONS:
LABEL PRINT DEVICE: PRT-78// PRT-78     OPD CLINIC C     |PRN|\\PHXWR-CH2\OPDC
_LABLABEL TRNG
PROMPT FOR LABELS: DON'T PRINT//
DAILY ORDER SUMMARY DEVICE:
 6887626
For Service Copy Default Device -
Select PACKAGE: OUT
1 OUTPATIENT PATCH (PSO*6*1) PSOK
2 OUTPATIENT PHARMACY PSO
CHOOSE 1-2: 2  OUTPATIENT PHARMACY     PSO

PACKAGE: OUTPATIENT PHARMACY// OUTPATIENT PHARMACY  PSO OUTPATIENT PHARMACY


SERVICE COPY DEVICE: PRT-90// PRT-90   PHARMACY PCC+ |PRN|\\PHXWR-CH2\HP4
100PHARM TRNG

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9.0 Consult Tracking Configuration (CON)


Select the Consult Tracking Configuration (CON) option on the RPMS-EHR
Configuration Master Menu to display the following:
Consult Tracking Configuration

CP Copy Prosthetics Services


CS Consult Service Tracking
DS Duplicate Sub-Service
GU Group Update of Consult/Procedure Requests
IFC IFC Management Menu ...
LH List Consult Service Hierarchy
NR Determine Notification Recipients for a Service
PR Setup Procedures
RPT Consult Tracking Reports ...
RX Pharmacy TPN Consults
SS Setup Consult Services
SU Service User Management
TD Test Default Reason for Request
TP Print Test Page
UA Determine User's Update Authority
UN Determine If User Is a Notification Recipient

Select Consult Tracking Configuration Option:

NOTE: This is VERY IMPORTANT: All consults MUST be


attached to the ALL SERVICES consult or they will not appear in
the selection list. Once a consult is setup, be sure to add it to the
ALL SERVICES SUB-SERVICE/SPECIALTY field.

Below is a sample setup with the needed fields highlighted.


SERVICE NAME: DIABETES EDUCATION//
ABBREVIATED PRINT NAME (Optional):
Select SYNONYM:
SERVICE USAGE:
SERVICE PRINTER:
NOTIFY SERVICE ON DC:
REPRINT 513 ON DC:
PREREQUISITE:
No existing text
Edit? NO//
PROVISIONAL DX PROMPT:
PROVISIONAL DX INPUT:
DEFAULT REASON FOR REQUEST:
Topics to cover: {FLD:DIABETES EDUCATION}

Edit? NO//
RESTRICT DEFAULT REASON EDIT:
SERVICE INDIVIDUAL TO NOTIFY:
Select SERVICE TEAM TO NOTIFY: TEAM D//
Select NOTIFICATION BY PT LOCATION:
PROCESS PARENTS FOR NOTIFS:
Select UPDATE USERS W/O NOTIFICATIONS:
Select UPDATE TEAMS W/O NOTIFICATIONS:
Select UPDATE USER CLASS W/O NOTIFS:

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Select ADMINISTRATIVE UPDATE USER: SALMON,PHILLIP


//
ADMINISTRATIVE UPDATE USER: SALMON,PHILLIP//
NOTIFICATION RECIPIENT: Y YES
Select ADMINISTRATIVE UPDATE USER:
Select ADMINISTRATIVE UPDATE TEAM:
PROCESS PARENTS FOR UPDATES:

SPECIAL UPDATES INDIVIDUAL:


RESULT MGMT USER CLASS:
UNRESTRICTED ACCESS:
Select SUB-SERVICE/SPECIALTY:
Comments about the example:

Prompt Comment
SERVICE PRINTER This would be good to identify (but not
required).
Use either SERVICE INDIVIDUAL TO NOTIFY These are the people who will resolve the
or Select SERVICE TEAM TO NOTIFY consult with a note. This might be clerks.
Use either ADMINISTRATIVE UPDATE USER This is who will receive the consult.
or ADMINISTRATIVE UPDATE TEAM

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9.1 Overview of the Options


The following table provides information about the various options on the Consult
Tracking Configuration menu.

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Option Meaning
Copy Prosthetics Services (CP) IHS does not use this option.
Consult Service Tracking (CS) This option provides actions that a service can use
to track consults and requests.
Duplicate Sub-Service (DS) This option checks to see if any Consult/Request
Tracing REQUEST SERVICE are Sub-Services of
more than one Service.
Group Update of Consult/Procedure Requests This option allows a search of the REQUEST
(GU) /CONSULTATION file for request to a particular
service within a date range. The status of the
entries meeting the selected criteria can be
updated to COMPLETE or DISCONTINUED. A
comment of up to 256 characters can be entered
once and attached to each of the entries.
A report of those records to be updated can be
printed without performing the status updates. This
option also allows printing of the records along with
the status updates.
IFC Management Menu (IFC) IHS does not use this option.
List Consult Service Hierarchy (LH) This option allows the Consult Service hierarchy to
be printed. The listing will include all disabled and
tracking only services. Any services in the
REQUEST SERVICES file that are not part of the
hierarchy will be listed last.
Determine Notification Recipients for a Service This option determines the notification recipients for
(NR) a specified service.
Setup Procedures (PR) IHS does not use this option.
Consult Tracking Report (RPT) Refer to the Consult Manage for more information
about these options.
Pharmacy TPN Consults (RX) This option is used by the Pharmacy Service
Consult (mainly inpatient).
Setup Consult Services (SS) This option is used to set up the hierarchy of
(see the table below for the meaning of the fields services and specialties.
associated with this option) Each service/specialty defined in this file can be
setup to have a consult print at its own service
printer when the consult is entered and signed
using the “Add order” menus in OE/RR.
Teams of clinicians can also be associated with
each Service/Specialty. The team members will be
notified when a new consult is ordered from their
service/specialty.
Service User Management (SU) This option is used to identify individuals or teams
that should be notified when a Consult/Request is
being sent out to their receiving service.
It also identifies individuals who will not be notified
when consults are being sent to the service, but DO
have update/tracking capabilities for the service.
Individuals or teams can also be notified of a new
consult based on the Patient’s Location. When a
Consult/Request is sent to a service, the Patient
Location will be checked. If the receiving service
has broken down its notice notifications by Hospital
location, the notification will be sent to the individual
and/or team defined in this option.

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Option Meaning
Test Default Reason for Request (TD) This option shows the default reason for request for
a specified service and patient.
Print Test Page (TP) This option allows a user to select a printer for
reviewing print parameters. A report is generated
that includes the current device print parameters
and a ruler to verify the length of the current print
page. A description of how to use the ruler is
included in the report.
Determine User’s Update Authority (UA) This option determines a selected user’s update
authority for a selected service.
Determine if User is a Notification Recipient (UN) This option determines if a user would be a
notification recipient for a selected service.

The Setup Consult Services can be any of the following fields:

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Field Meaning
SERVICE NAME The Name of a service or specialty that might receive
consult/requests. This can also be a name which represents
a group of services or specialties.
ABBREVIATED PRINT NAME The commonly known Abbreviation for this Service /
Specialty. The application uses this name to build Consult
Notifications; the name must be seven characters or less in
length.
INTERNAL NAME The alternate name for the service. This name does not
appear on printouts or displays, but can be used to access
the service through the Setup Services (SS) option or with
FileMan.
SYNONYM This identifies the commonly known names and
abbreviations for the Service named in the .01 Name field.
Synonyms identified here are used in the look-up of services
at “Select Service/Specialty:” prompts as well as during
ordering in CPRS.
SERVICE USAGE Whenever a value is defined in the SERVICE USAGE: field,
the Service entry will NOT be selectable to send consults
“TO” in the OE/RR ordering process. Service Usages cause
functioning as follows:
GROUPER ONLY This allows a service to be used for grouping other services
together for review purposes; it aids in defining the service
hierarchy (e.g., ALL SERVICES, INPATIENT SERVICES,
OUTSIDE SERVICES). During the order process, selecting
a GROUPER ONLY service shows the service hierarchy
under that service grouper. A GROUPER ONLY service
should never be a "TO" Service on a consult.
TRACKING ONLY This allows a service to be defined in a hierarchy, but will not
allow users ordering consults in OE/RR to be able to see or
select a service marked for TRACKING ONLY. (For
example, Psychology might be defined with its Service
Usage blank, and its Sub-specialty multiple defined with
services of which some or all might be “TRACKING ONLY”
services. This hierarchy facilitates the situation when a
service, such as Psychology, prefers a common location for
all related consults to be sent to. A Tracking user at the
common location then “Forwards” the request to one of the
sub-service TRACKING ONLY services for completion.)
Update users for the service can see and order directly to a
tracking service.
DISABLED This represents Disable services. You cannot select
disabled services for ordering or tracking. Existing requests
for a disabled service can still be processed to completion.
SERVICE PRINTER This allows the service/specialty to identify a device to be
used for printing Consult Forms (SF 513) ‘automatically’ at
the service when the consult/request order is released by
CPRS. If the device is not defined, the Consult Form will not
print unless a default service copy device is defined for the
Consults package for the ordering location. The default
service copy device parameter can be found by using the
Print Parameters for Wards/Clinics [OR PARAM PRINTS
(LOC)] option.

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Field Meaning
NOTIFY SERVICE ON DC This controls when members configured to receive
notifications for this service in the Consult hierarchy will be
alerted to a consult being discontinued. This field can be set
to ALWAYS, NEVER, or REQUESTOR ACTION.
REQUESTOR ACTION stipulates notification only if the
person discontinuing the consult is not an update user for
the consulting service.
REPRINT 513 ON DC The field will determine if the SF 513 should reprint to the
consulting service when a consult is discontinued. Again the
three choices are ALWAYS, NEVER, or REQUESTOR
ACTION. The REQUESTOR ACTION choice stipulates
reprinting only if the person discontinuing the consult is not
an update user for the consulting service.
PROVISIONAL DX PROMPT This determines how to prompt for the provisional diagnosis
when ordering consults for this service. If this field is set to
OPTIONAL, the application prompts for the provisional
diagnosis; the user can bypass answering the prompt. If the
field is set to SUPPRESS, there is no provisional diagnosis
prompt. If set to REQUIRED, the user must answer the
prompt to continue placing the order.
PROVISIONAL DX INPUT This determines the method to prompt for input of the
provisional diagnosis when ordering a consult. If set to
FREE TEXT, one can type any text from 2 to 80 characters
in length. If set to LEXICON, one is required to select a
coded diagnosis from the Clinical Lexicon.
PREREQUISITE This is a word-processing field to communicate pre-requisite
information to the ordering person prior to ordering a consult
to this service. This field is presented to the ordering person
upon selecting a Consult service and allows one to abort the
ordering at that time if needed. TIU objects can be
embedded within this field that are resolved for the current
patient during ordering. Any TIU objects must be contained
within vertical bars (e.g., |BLOOD PRESSURE| ).
DEFAULT REASON FOR REQUEST This is default text used as the reason for the request when
ordering a consult for this service. This field allows a
boilerplate of text to be imported into the reason for request
when placing consult orders for this service. If the user
places an order using a quick order having boilerplate text,
that text supersedes any default text stored in this field. This
field can contain any text including TIU objects. TIU Objects
must be enclosed in vertical bars (e.g., |PATIENT NAME| ).
RESTRICT DEFAULT REASON EDIT This field (if it exists for this service) affects the ordering
person’s ability to edit the default reason while placing an
order if a DEFAULT REASON FOR REQUEST exists for
this service. This field can be set to UNRESTRICTED, NO
EDITING, or ASK ON EDIT ONLY. The third value, ASK ON
EDIT ONLY, allows the ordering person to edit the default
reason if the order is edited before releasing it to the service.
Fields for Inter-Facility Consult All Inter-Facility consult fields are not used in the EHR.

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Field Meaning
SERVICE INDIVIDUAL TO NOTIFY This field allows a person who is identified in this field as
having primary responsibility for receiving consults and
tracking that person through to completion or
discontinuance. This individual will receive a “NEW
SERVICE CONSULT” notification type when a new order is
released to the service through CPRS. That person must
have the “NEW SERVICE CONSULT/REQUEST”
notification type enabled.
SERVICE TEAM TO NOTIFY This is the name of the Service Team that is to receive
notifications of any actions taken on a consult. A team of
users can be identified (from the OE/RR LIST file #100.21)
who will receive a “NEW SERVICE CONSULT” notification
when a new order is released to the service through OE/RR.
The individuals on the teams must have the “NEW
SERVICE CONSULT/REQUEST” notification type turned
ON. Team members will be able to perform update tracking
capabilities.
NOTIFICATION BY PT LOCATION This is a ward/clinic location or hospital location to which the
service wants to assign a service individual or team. When a
consult or request is ordered, notifications to the receiving
service checks to see if the patient’s location is defined here.
If defined, notifications are sent to an individual and/or
members of a team specifically associated with this location.
PROCESS PARENTS FOR NOTIFS When this field is set to YES, this will cause the parent
service of this service to be processed when determining
notification recipients. The check is carried up the chain until
ALL SERVICES is reached or until a service is marked NO.
UPDATE USERS W/O NOTIFICATIONS This is a list of individuals who can do update tracking, but
who will not get a notification.
UPDATE TEAMS W/O NOTIFICATIONS This is a list of teams to be assigned update authority for this
service. All clinicians in the teams have update authority no
matter what patients are in the teams.
UPDATE USER CLASS W/O NOTIFS This is a list of user classes to be assigned update authority
for this service. All persons assigned to the user classes
included have update authority with the current service.
ADMINISTRATIVE UPDATE USER This is a list of the users for a service who can perform
Administrative Completes (Completes without a note
attached). Optionally, this individual can be set as a
notification recipient. In addition, this person can forward a
consult.
ADMINISTRATIVE UPDATE TEAM This contains the names of team lists from the OE/RR LIST
(#100.21) file. All provider/users of the teams will have
administrative update authority for requests directed to this
service, and the teams can optionally be designated as
notification recipients.
PROCESS PARENTS FOR UPDATES When this field is set to YES, this will cause the parent
services of this service to be screened to determine update
authority for a given user. Hence, if an individual is set as an
update user in a grouper service, this individual will have
privileges for all sub-services that have this field set to YES.

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Field Meaning
SPECIAL UPDATES INDIVIDUAL This is someone with privileges to perform group status
updates for this service or any of the entries in the SUB-
SERVICE/ SPECIALTY field. It is recommended that this
individual be a responsible service update user or a Clinical
Application Coordinator. If given the option Group update of
consult/procedure requests [GMRCSTSU], that person can
choose all requests within a date range that are pending,
active, or both and can update the request to discontinued
or complete. This will also update the related order in CPRS
to the same status.
RESULT MGMT USER CLASS This field is not used by the EHR because it requires the
medicine package. This field defines the Authorization /
Subscription User Class that is permitted to disassociate a
Medicine result from a Consult request. It is recommended
that this function be restricted to a very select group of
individuals. It should be left blank.
UNRESTRICTED ACCESS When this field is set to yes, this will allow all users to
perform the full range of update activities on consult or
procedure requests directed to this service. If this field is set
to yes, all other fields related to assignment of update users
are ignored. The SERVICE INDIVIDUAL TO NOTIFY and
the SERVICE TEAM(S) TO NOTIFY fields are still used to
determine notification recipients for each individual service.
SUB-SERVICE/SPECIALTY This is the list of sub-service/specialties that are grouped
under this Service. The sub-service / specialty entries must
each be defined as entries in this file. There is no limit on
how deep the hierarchy of services can be defined. The only
requirement is that the “ALL SERVICES” entry be at the top
of the hierarchy. It is also highly recommended that a
service be defined as the sub-service of only one entry in
the hierarchy.

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9.2 Tracking a Consult


If someone has been chosen as a service individual to notify an update user or an
administrative user, that person will be able to track the consult using the EHR. If that
person has update status for a cardiology consult, that person will not be able to track
ENT consults. The option to update the consult will only appear for those consults
that the service individual has privileges for.

Figure 9-16: Action Menu on the Consults Window

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Comments about Consults window:

The selections on the Action menu are the choices for those who can take action on a
consult.

The list from Consult Tracking… are the choices an update User can make.

Click the Receive selection and the application displays the Receive Consult dialog:

Figure 9-17: Receive Consult Dialog

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Comments about the Receive Consult dialog:

You can add comments as the consult is received or scheduled.

9.3 Finishing a Consult

Figure 9-18: Options on the Consult Results Selection

The application asks users who can complete a consult to enter a progress note.

Note titles must be from the CONSULT document class.

Figure 9-19: Consult Note Properties Dialog

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10.0Medication Management Configuration (MED)


Select the Medication Management Configuration (MED) option on the RPMS-EHR
Configuration Master Menu to display the following:
Medication Management Configuration

ACT Days of Medication Activity


MAX Maximum Allowable Days Supply
MEC Medication Counseling Configuration ...
PRT Medication Report Configure ...
ORD Default Collation Order
REN Renewal Limit of Expired Meds

Select Medication Management Configuration Option:

These options establish a standard view for medications on the Medication


Management window.

10.1 Days of Medication Activity (ACT)


Select the Days of Medication Activity (ACT) option on the Medication Management
Configuration menu to display:
Days of Medication Activity

Days of Medication Activity may be set for the following:

100 USR (choose from NEW PERSON)


800 DIV (DEMO HOSPITAL)
900 SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 900 System CIAINFORMATICS.COM

-- Setting Days of Medication Activity for System: DEMO.CIAINFORMATICS.COM –-


Days Active: 180//

This limits the medication display on the Medications window to only those
medications that were active within the last number of days specified.

10.2 Maximum Allowable Days Supply (MAX)


Select the Maximum Allowable Days Supply (MAX) on the Medication Management
Configuration menu to display:
Maximum Allowable Days Supply

Maximum Allowable Days Supply may be set for the following:

800 DIV (DEMO HOSPITAL)


900 SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 800 System DEMO HOSPITAL

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-- Setting Maximum Allowable Days Supply for System: DEMO HOSPITAL –-


Maximum Allowable Days Supply:

The entered value controls the upper limit for days supply of a dispensed medication.
The range is 90-365 days.

10.3 Medication Counseling Configuration (MEC)


This option is discussed in Section 11, Medication Counseling.

10.4 Default Collation Order (ORD)


Select the Default Collation Order (ORD) option on the Medication Management
Configuration menu to display:
Default Collation Order

Medication List Collation Order may be set for the following:

100 User USR (choose from NEW PERSON)


800 Division DIV (DEMO HOSPITAL)
900 System SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 800 Division DEMO HOSPITAL

Setting Medication List Collation Order for Division: DEMO HOSPITAL


Collation Order: ??

Controls the default collation order for the medication list. May be one or more
of the following:

C = Chronic med status


E = Expiration date
F = Last fill date
I = Issue date
M = Medication name
N = Rx #
P = Provider
R = Refills remaining
S = Status

To reverse the collation order, use the lowercase equivalent.

Collation Order: CSIMP//

These option applies to the Medications window.

10.5 Medication Report Configuration (PRT)


Select this menu option to configure manual prescription printing.
Medication Report Configuration

DEF Set Default Printers for Medication Reports


LBL Enable Printing of Sample Labels
MAX Maximum # of Scripts per Page

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SCR Enable Printing of Prescriptions

Select Medication Report Configuration Option:

Note that Maximum # of Script per Page option only affects output for the MULTIPAGE
prescription format (see below) and is ignored for SINGLE PAGE format.

10.5.1 Set Default Printers for Medication Reports (DEF)


Select the “Set Default Printers for Medication Reports” option on the Medication
Report Configuration menu to display:
Set Default Printers for Medication Reports

Default Print for Med Print Action may be set for the following:

700 Location LOC [choose from HOSPITAL LOCATION]


800 Division DIV [DEMO HOSPITAL]
900 System SYS [DEMO.CIAINFORMATICS.COM]

Enter selection: 900 System DEMO.CIAINFORMATICS.COM

Setting Default Printer for Med Print Action for System: DEMO.CIAINFORMATICS.COM

Select Report Type: ?

Select one of the following:

0 Brief
1 Detailed
2 Prescription
3 Sample Label

Select Report Type:

To set the default printer for prescriptions, choose option 2 and enter the name of the
printer exactly as it appears in the printer list on the printer selection dialog. If no
default is set, the default printer for the workstation will be assumed.

10.5.2 Enable Printing of Sample Labels (LBL)


Select the “Enable Printing of Sample Labels” option on the Medication Report
Configuration menu to display:
Enable Printing of Sample Labels

Enter Print Script Feature may be set for the following:

800 Division DIV [DEMO HOSPITAL]


900 System SYS [DEMO.CIAINFORMATICS.COM]

-- Setting Enable Printing Sample Labels for System: DEMO.CIAINFORMATICS.COM --


Enable Printing Sample Labels: ?

Controls the availability of the Print Sample Label feature within EHR.

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This is referring to using the Print button on the Medication Management window in
the EHR and selecting the Label radio button on the Print Medications dialog.

Figure 10-20: Label Radio Button on Print Medications Dialog

10.5.3 Maximum # of Scripts per Page (MAX)


Select the Maximum # of Scripts per Page (MAX) option on the Medication Report
Configuration menu to display the following:
Maximum # of Scripts per Page

Maximum # of scripts per page may be set for the following:

100 User USR [choose from NEW PERSON]


500 Class CLS [choose from USR CLASS]
800 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 900 System DEMO.OKLAHOMA.IHS.GOV

-- Setting Maximum # of scripts per page for System: DEMO.OKLAHOMA.IHS.GOV --


Value: 5// ??

Controls the maximum number of prescriptions that may be printed on a


single page.

Value: 5//

This parameter controls the maximum number of prescriptions that can be printed on
a single page.

10.5.4 Enable Printing of Prescriptions (SCR)


Select the Enable Printing of Prescriptions (SCR) option on the Medication Report
Configuration menu to display the following:
Enable Printing of Prescriptions

Enable Print Script Feature may be set for the following:

800 Division DIV [DEMO INDIAN HOSPITAL]


900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 900 System DEMO.OKLAHOMA.IHS.GOV

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--- Setting Enable Print Script Feature for System: DEMO.OKLAHOMA.IHS.GOV ---
Enable Print Script Feature: SINGLE PAGE// ??

Controls the availability of the Print Rx print feature within EHR.

Possible values are:

DISABLED = Feature is not available within the GUI.


MULTIPAGE = Use multi-page prescription format.
SINGLE PAGE = Use single page prescription format.

Enable Print Script Feature: SINGLE PAGE//

This parameter takes one of three possible values. Select SINGLE PAGE to use the
same prescription format as the background fax feature.

Once the prescription printing has been properly configured, a new report format will
appear on the Print Medications dialog (after you click the Print button on the
Medications window). The dialog with have the following Report Formats available:
Brief, Detailed, and Prescription.

10.6 Renewal Limit for Expired Meds (REN)


Select the Renewal Limit for Expired Meds (REN) option on the Medication
Management Configuration menu to display:
Renewal Limit for Expired Meds

Renewal Limit (Days) for Expired Meds may be set for the following:

800 DIV (DEMO HOSPITAL)


900 SYS (DEMO.CIAINFORMATICS.COM)

Enter selection: 900 System DEMO.CIAINFORMATICS.COM

Setting Renewal Limit (Days) of Expired Meds for System: DEMO.CIAINFORMATICS.COM

Renewal Limit (Days)for Expired Meds:

This is the maximum number of days following the expiration of a prescription that it
may still can be renewed.

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11.0 Medication Counseling


The RPMS-EHR application contains the Pharmacy Refill Counseling macro that is
available to be placed on the pharmacist’s VueCentric template. The macro enables
rapid visit creation and documentation of Purpose of Visit and Patient Education for
high volume workflow situations, such as dispensing medication refills.

The macro is launched from the Pharmacy Ed button that should appear in the
Patient-Visit Toolbar.

Figure 11- : Pharmacy Ed Button

11.1 Pharm Ed Button


The CAC needs to insert the Pharm Ed button on the toolbar, using the Medication
Counseling component.

Please note the following about the Pharmacy Ed button:

If no patient has been selected, the button will not be selectable.


If the macro has not been run on that patient on that day, the button is selectable
and launches the macro.
If the macro has been run on that patient on that day, the button will not be
selectable.

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When the pharmacist clicks this button, The Medication Counseling dialog (a form)
appears where medication counseling information is entered.

Figure 11- : Sample Medication Counseling Dialog

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The following sections described the various parts of the form that the CAC can
setup.

11.2 Medication Counseling Configuration


Go to the RPMS database and select EHR | MED | MEC to display the Medication
Counseling Configuration options.

Figure 11- : Medication Counseling Configuration Options

11.2.1 Default Comprehension Value (DCMP)


The Default Comprehension Value controls what options appear in the drop-down list
for Comprehension.

Figure 11- : Example of Comprehension on Form

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The default comprehension can be blank or it can set as Good, Fail, Poor.

Figure 11- : Sample Default Comprehension Value

11.2.2 Default Counsel Time (DCTM)


The Default Counsel Time allows the default duration for medication counseling to
determined.

Figure 11- : Example of Time on Form

Time can be set to any number between 1 and 999 minutes

Figure 11- : Sample Setting Counseling Time Default

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11.2.3 Default POV (DPOV)


The Default POV allows a site to set the Purpose of Visit code radio button to be pre-
selected when the macro is launched.

Figure 11- : Sample Pre-Selected POV on Form

The RPMS provides a list of valid POVs. At the “Default POV code” prompt, you
can enter the ICD diagnosis code number or description.

Figure 11- : Sample List of Valid POVs

11.2.4 Edit Disclaimer Text (EDTX)


The Edit Disclaimer Text option allows you to edit the bolded disclaimer text.

Figure 11- : Sample Disclaimer Text

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At the “Edit Value” prompt, enter Y and you go to word processing field where you
type the text of the disclaimer (there is no limit on the number of characters).

Figure 11- : Sample Edit Disclaimer Text

11.2.5 Education Topics (ELST)


The Education Topics option allows a site to modify the list of available education
topics that are listed under the Counseling List label on the Medication Counseling
dialog. The default education topics displayed in the component are the Medication
education topics in the standard IHS patient education table.

Figure 11- : Sample Education Topics

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11.2.6 Hospital Location for Visit (HL)


The Hospital Location for Visit option allows you to change the default Hospital
Location. The default Hospital Location for the component is Pharmacy.
DEMO INDIAN HOSPITAL RPMS-EHR Management Version 1.2

Hospital Location for Visit

PharmED hospital location may be set for the following:

80 Division DIV [DEMO INDIAN HOSPITAL]


90 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection:: 80 Division DEMO INDIAN HOSPITAL

-- Setting PharmED hospital location for Division: DEMO INDIAN HOSPITAL --


Hospital Location for Visit: GENEAL PHARMACY//

This option allows you to specify a hospital location for visit creation. The hospital
locations must have a Pharmacy Stop Code associated with it.

11.2.7 POV List (PLST)


The POV List option allows a site to select different ICD-9 codes that they want to
use instead of the default POVs that display on the Medication Counseling dialog.
The POV List is a list of pointed to values.

Figure 11- : Sample POV List

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11.2.8 POV Narrative Text (PNL)


The POV Narrative Text allows you to define the Provider Narrative once the set of
POVs that will be used in the component are selected. This narrative will be stored
along with the ICD-9 codes. If no Provider Narrative is defined, the standard ICD-9
code language will be used. The POV Narrative Text is a list of external name
synchronized with the POV List.

Figure 11- : Sample POV Panel

In the above screen capture, “Medication Counseling” is the narrative text for V65.49
and “Medication Counseling By Proxy” is the narrative text for V65.19.

You enter the text at the “Narrative Text” prompt.

Figure 11- : Sample POV Narrative Text

Note: The two parameters, POV List and POV Narrative Text are
required to hold information about the pointed to value and the list
of external names. These two parameters are pre-populated and
require little adjustment. Using the “List Value for a Selected
Parameter?” option, you can output the values for each parameter
to ensure that the mappings are correct.

CAC Manual 155 Medication Counseling


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12.0Lab Configuration (LAB)


Select the Lab Configuration (LAB) option on the RPMS-EHR Configuration Master
Menu to display the following:
Lab Configuration

CVR Days of Lab Results to Retrieve (Cover Sheet)

Select Lab Configuration Option:

12.1 Days of Lab Results to Retrieve (Cover Sheet) (CVR)


Select the CVR option on the Lab Configuration menu to display the following:
Days of Lab Results to Retrieve (Cover Sheet)

Duration for Lab Order Display may be set for the following:

100 User USR [choose from NEW PERSON]


200 Location LOC [choose from HOSPITAL LOCATION]
300 Service SRV [choose from SERVICE/SECTION]
400 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 900 System DEMO.OKLAHOMA.IHS.GOV

- Setting Duration for Lab Order Display for System: DEMO.OKLAHOMA.IHS.GOV -


Select Inpatient/Outpatient: ??

The number of days back in time to search for lab orders/results. If not
indicated, the default period of 2 days will be used. The maximum number of
days is 100,000 or about 220 years.

Select Inpatient/Outpatient: outpatient Outpatient

Inpatient/Outpatient: Outpatient// Outpatient


Number of Days to Display: 30//
Select Inpatient/Outpatient: Inpatient

Inpatient/Outpatient: Inpatient// Inpatient


Number of Days to Display: 2//

This sets the number of days back in time to display lab orders/results on the Cover
Sheet. It can be set for inpatient as well as for outpatient.

CAC Setup Guide 156 Lab Configuration


October 2008
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13.0Vital Measurement Configuration (VIT)


Select the Vital Measurement Configuration (VIT) option on the RPMS-EHR
Configuration Master Menu to display the following:
Vital Measurement Configuration

CVR Measurement Listed on Cover Sheet


OVR Override Default Units
PER Data Entry Permissions
TPL Data Entry Templates

Select Vital Measurement Configuration Option:

The vital signs that appear on the cover sheet and the vital signs that can be entered
into the EHR are established on this option.

13.1 Measurement Listed on Cover Sheet (CVR)


Select the Measurement Listed on Cover Sheet (CVR) option on the Vital
Measurement Configuration menu to display the following:
Measurements Listed on Cover Sheet

Vital signs list for cover sheet may be set for the following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS
300 Service SRV (choose from SERVICE/SECTION
400 Location LOC (choose from HOSPTIAL LOCATION)
500 Division DIV (DEMO HOSPITAL)

Enter selection: 500 Division (DEMO HOSPITAL)

Setting vital signs for cover sheet for Division: DEMO HOSPITAL
30
Sequence 30// 30
Are you adding 30 as a new Sequence? Yes// YES

Vital:

CAC Setup Guide 157 Vital Measurement Configuration


October 2008
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The Sequence determines the vital signs that appear on the Cover Sheet and in what
order. At the Vital prompt, answer with a BEH MEASUREMENT CONTROL
NAME for the sequence.

13.2 Override Default Units (OVR)


Select the Override Default Units (OVR) option on the Vital Measurement
Configuration menu to display the following:
Override Default Units

Default units for measurement may be set for the following:

100 User USR [choose from NEW PERSON]


200 Class CLS [choose from USR CLASS]
300 Service SRV [choose from SERVICE/SECTION]
400 Location LOC [choose from HOSPITAL LOCATION]
500 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

-------- Setting Default units for measurement for User: DEMO,DOCTOR --------
Select Measurement Type: temperature
Are you adding TEMPERATURE as a new Measurement Type? Yes// YES

Measurement Type: TEMPERATURE// TEMPERATURE TEMPERATURE


Default Units: ???

Enter a code from the list.

Select one of the following:

0 US
1 METRIC

Default Units:

You use this option to set the default units for a specified measurement type.

13.3 Data Entry Permissions (PER)


Select the Data Entry Permissions (PER) option on the Vital Measurement
Configuration menu to display the following:
Data Entry Permissions

Can enter vital measurements? may be set for the following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)
300 Service SRV (choose from SERVICE/SECTION)
400 Location LOC (choose from HOSPITAL LOCATION)
500 Division DIV (DEMO HOSPITAL)

Enter selection: 100 User NEW PERSON

CAC Manual 158 Vital Measurement Configuration


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Select NEW PERSON NAME: USER,DEMO DU

--------- Setting Can enter vital measurements? for User: USER,DEMO ----------
Can enter vital measurements?: ?

Enter either ‘Y’ or ‘N’.

Can enter vital measurements?: y

This establishes those users and classes who are allowed to enter vital signs.

13.4 Data Entry Templates (TPL)


Select the Data Entry Templates (TPL) option on the Vital Measurement
Configuration menu to display the following:
Data Entry Templates

Vital Measurement Input Template may be set for the following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)
300 Service SRV (choose from SERVICE/SECTION)
400 Location LOC (choose from HOSPITAL LOCATION)
500 Division DIV (DEMO HOSPITAL)
900 System SYS (DEMO.MEDSPHERE.COM

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: ZIPPER,KIMBERLY KZ CLINICAL COORDINATOR

----- Setting Vital Measurement Input Template for User: ZIPPER,KIMBERLY -----
Select Sequence: 1//
Measurement:

The Sequence controls the formatting of the vital measurement data entry dialog. At
the Measurement prompt, answer with a BEH MEASUREMENT CONTROL NAME
for the sequence.

CAC Manual 159 Vital Measurement Configuration


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14.0Report Configuration (RPT)


Select the Report Configuration (RPT) option on the RPMS-EHR Configuration
Master Menu to display the following:
Report Configuration

FMT Print Formats


HSM Health Summary Configuration ...
PAR Report Parameters ...
SYS System Display Parameters
USR User Display Parameters
Select Report Configuration Option:

14.1 Print Formats (FMT)


Select the Print Formats (FMT) option on the Report Configuration menu to display
the following:
Print Formats
Select OE/RR PRINT FORMATS NAME: lab order label
1 LAB ORDER LABEL
2 LAB ORDER LABEL New & reprint,WC,SP
3 LAB ORDER LABEL-WC New Orders & Reprint
CHOOSE 1-3: 1 LAB ORDER LABEL
NAME: LAB ORDER LABEL//
Select FIELDS: FREE TEXT//
FIELDS: FREE TEXT//
ROW: 7//
COLUMN: 39//
LITERAL TEXT: Specimen Label: //
Select FIELDS:
ROWS: 12//
ORDER TEXT LENGTH:
SINGLE: YES//

OK to compile print format? Yes//

This option allows the user to define formats for printing labels and requisitions.

14.2 Health Summary Configuration (HSM)


Select the Health Summary Configuration (HSM) option on the Report Configuration
menu to display the following:
Health Summary Configuration

ALL List All Health Summaries


IHS IHS Health Summary Configuration ...
VHA VHA Health Summary Configuration ...

Select Health Summary Configuration Option:

CAC Setup Guide 160 Report Configuration


October 2008
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14.2.1 List All Health Summaries (ALL)


Select the List All Health Summaries (ALL) option on the Health Configuration
menu to display the following:
List All Health Summaries

List All Health Summary Types may be set for the following:

2 User USR [choose from NEW PERSON]


5 Division DIV [DEMO HOSPITAL]
6 System SYS [DEMO.MEDSPHERE.COM]

Enter selection: 5 Division DEMO HOSPITAL

----- Setting List All Health Summary Types for Division: DEMO HOSPITAL -----
LIST ALL: ??

This parameter overrides the ORWRP HEALTH SUMMARY TYPE LIST by making all
health summary types available, in alphabetic order.

LIST ALL:

At the LIST ALL prompt, enter YES to have all Health Summary Types listed. If you
enter NO, you can specify the IHS health summaries to appear on the Reports
window using the IHS Health Summary Configuration option.

14.2.2 IHS Health Summary Configuration (IHS)


Select the IHS Health Summary Configuration (IHS) option on the Health
Configuration menu to display the following:
IHS Health Summary Configuration

DF Delete Health Summary Flowsheet


DI Delete Health Summary Flowsheet Item
DM Delete Measurement Panel Definition
DS Delete Health Summary Type
FMMT Create/Modify Health Summary Type using Fileman
HM Health Maintenance Reminders ...
HS Generate Health Summary
HSSP Update Health Summary Site Parameters
IS Inquire About a Health Summary Type
LC List Health Summary Components
LF List Health Summary Flowsheets
LI List Health Summary Flowsheet Items
LM List Measurement Panel Types
LS List Health Summary Types
MF Create/Modify Flowsheet
MI Create/Modify Flowsheet Item
MM Create/Modify Measurement Panel
MS Create/Modify Health Summary Type
PP Print Health Maintenance Item Protocols
TYP IHS Health Summary Types

Select IHS Health Summary Configuration Option:

CAC Manual 161 Report Configuration


October 2008
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The following table provides an overview of the options. Most likely you will only
use the IHS Health Summary Types (TYP) option, shown in bold in the table.

CAC Manual 162 Report Configuration


October 2008
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Option Name Usage


Delete Health Summary Flowsheet (DF) This option allows you to delete a specified health
summary flowsheet. It uses the APCH DELETE
HLTH SUM FLOWSHEET to delete an entry in the
HEALTH SUMMARY FLOWSHEET file.
Delete Health Summary Flowsheet Item (DI) This option uses the APCH DELETE HLTH SUM
FLOWSHEET ITEM template to delete an entry in
the HEALTH SUMMARY FLOWSHEET ITEM file.
Delete Measurement Panel Definition (DM) This option invokes the APCH DEL HLTH SUM
MEAS PANEL template to delete health summary
measurement panel definitions (HEALTH
SUMMARY MEASUREMENT PANELS file).
Delete Health Summary Type (DS) This option allows you to delete a specified health
summary type. It invokes the APCH DELETE
SUMMARY TYPE template to delete a health
summary type. A separate option (APCHSTED) is
available to edit summary types.
Create/Modify Health Summary Type using This option invokes the APCH EDIT HEALTH
Fileman (FMMT) SUMMARY TYPE template to create/edit a health
summary type.
Health Maintenance Reminders (HM) Refer to the Reminder manuals for further
information about this menu.
Generate Health Summary (HS) This option invokes the APCHS to generate health
summary, either printed or CRT display version.
This option requires the presence of the following
dictionaries: (1) HEALTH SUMMARY TYPE, (2)
HEALTH SUMMARY COMPONENT, (3) HEALTH
SUMMARY MEASUREMENT PANELS (if
measurement panels are used).
Update Health Summary Site Parameters (HSSP) This option allows you to update a specified health
summary type, where you select the site and the
parameter.
Inquire About a Health Summary Type (IS) This option allows you to view the structure of a
summary type (an “inquire” option against the
HEALTH SUMMARY TYPE dictionary).
List Health Summary Components (LC) From the “B” index on HEALTH SUMMARY
COMPONENT, this option displays available
components from which a summary can be built.
List Health Summary Flowsheets (LF) From the “B” index on HEALTH SUMMARY
FLOWSHEET, this option displays available
components from which a flowsheet can be built.
List Health Summary Flowsheet Items (LI) From the “B” index on HEALTH SUMMARY
FLOWSHEET ITEMS, this option displays available
components from which a flowsheet can be built.
List Measurement Panel Types (LM) This option displays measurement panel types from
“B” index on the HEALTH SUMMARY MEAS
PANEL file.
List Health Summary Types (LS) This option displays the health summary types from
“B” index on the HEALTH SUMMARY TYPE file.
Create/Modify Flowsheet (MF) This option uses the APCH EDIT HLTH SUM
FLOWSHEET ITEM template to create or modify a
flowsheet definition in the FLOW SHEET
DEFINITION file.

CAC Manual 163 Report Configuration


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Option Name Usage


Create/Modify Flowsheet Item (MI) This option uses the APCH EDIT HLTH SUM
FLOWSHEET ITEM template to create or modify a
flowsheet definition in the FLOW SHEET ITEMS
file.
Create/Modify Measurement Panel (MM) This option invokes the APCH EDIT HLTH SUM
MEAS PANEL template to allow creating or editing
the measurement panels (prototype definition which
controls the content and ordering of a panel of
measurement).
Create/Modify Health Summary (MS) This option invokes the APCH EDIT HEALTH
SUMMARY TYPE template to create/edit a health
summary type
Print Health Maintenance Item Protocols (PP) This option prints all items with their associated
descriptions in the health maintenance item file.
IHS Health Summary Types (TYP) This option specifies the IHS health summaries that
are to appear on the Reports window (if you say
NO to all summaries)

14.2.3 VHA Health Summary Configuration (VHA)


Select the VHA Health Summary Configuration (VHA) option on the Health
Configuration menu to display the following:
VHA Health Summary Configuration

BAT List Batch Health Summary Locations


BLD Build Health Summary Type Menu ...
DEF Display/Edit Health Summary Site Defaults ...
LOC Setup Batch Print Locations
MNT Health Summary Maintenance Menu ...
PRN Print Health Summary Menu ...
TYP VHA Health Summary Types Menu ...

You have PENDING ALERTS


Enter "VA to jump to VIEW ALERTS option

Select VHA Health Summary Configuration Option:

CAC Manual 164 Report Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

The following table provides an overview of the options. Most likely you will only
use the VHA Health Summary Types (TYP) option, shown in bold in the table.

Option Name Usage


List Batch Summary Locations (BAT) This option displays a list of all locations that will be
checked to see if the health summaries should be
printed in the nightly run of GMTS TASK START
UP.
Build Health Summary Type Menu (BLD) This menu contains options to create or delete
Health Summary Types, along with options that
help in this process.
Display/Edit Health Summary Site Defaults (DEF) This option allows you to display the site defaults,
to select the Health Summary Types to list on the
Reports window, to edit the method of building the
list or re-sequence the allowable entities in the
order that they will appear on the list.
Setup Batch Print Locations (LOC) This option allows the user to setup Health
Summary Types to be batch printed nightly for all
patients at a specified location.
Location can be a ward or a clinic. If location is
clinic, the user is asked to specify ‘Print Days
Ahead.’ Health Summaries will then be printed for
all patients with appointments that many days in the
future.
To generate summaries, this option requires that
option GMTS TASK STARTUP be queued to run
nightly. Summaries should then be printed during
the night and ready for distribution by early
morning. Thus, 0 Print Days Ahead means
summaries should be ready by early morning of
day of clinic appointments.
For ease in separating printouts queued to the
same device, a location banner appears in front of
each location’s health summary.
Health Summary Maintenance Menu (MNT) This option provides the IT staff with a set of tools
for Health Summary implementation and
maintenance.
Print Health Summary Menu (PRN) This menu includes all of the various print options
available for Health Summaries, allowing the user
to generate Health Summary by Patient, by Patient
and date range, by patient and an outpatient visit or
an admission, by Location, for patients at all clinics,
and on an Ad Hoc basis.
VHA Health Summary Types Menu (TYP) This option allows you to select the Health
Summaries to list on the Reports window, to
arrange the order of these Health Summaries on
the list, and to view the user’s preferences.
You will use the VHA Health Summary Types
(TYP) option to determine which VHA Health
Summaries that will appear on the Reports window
(if you say NO to all summaries).

CAC Manual 165 Report Configuration


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

14.2.4 Adding the Patient Wellness Handout


Below are the directions on how to make the Wellness Handout a HS in EHR:
Select IHS Core Option: EHR SETUP MENU
Select IHS Core Option: EHR  EHR SETUP MENU
TIU TIU Menu for Medical Records
BEHO IHS-EDHT Configuration Master Menu
TIU TIU Menu for Medical Records ...
BEHO IHS-EHR Configuration Master Menu ...
CON Consult Management ...
CPRS CPRS Manager Menu ...
HS Health Summary Maintenance ...
REM Reminder Managers Menu ...
TIU1 TIU Menu for Clinicians ...
VAHS Health Summary Overall Menu ...
XX General Parameter Tools ...

Select EHR SETUP MENU Option: VAHS Health Summary Overall Menu

1 Health Summary Coordinator's Menu ...


2 Health Summary Enhanced Menu ...
3 Health Summary Menu ...
4 Health Summary Maintenance Menu ...

Select Health Summary Overall Menu Option: 4 Health Summary Maintenance Menu
1 Disable/Enable Health Summary Component
2 Create/Modify Health Summary Components
3 Edit Ad Hoc Health Summary Type
4 Rebuild Ad Hoc Health Summary Type
5 Resequence a Health Summary Type
6 Create/Modify Health Summary Type
7 Edit Health Summary Site Parameters
8 Health Summary Objects Menu ...
9 CPRS Reports Tab 'Health Summary Types List' Menu ...
10 CPRS Health Summary Display/Edit Site Defaults ...

Select Health Summary Maintenance Menu Option: 6 Create/Modify Health Summary Type

Select Health Summary Type: PATIENT WELLNESS HANDOUT

Are you adding 'PATIENT WELLNESS HANDOUT' as a new HEALTH SUMMARY TYPE (the 75th)?
No// YES

WARNING: You are about to edit a Health Summary Type that is being used by a Health
Summary Object. Changing the structure of this Health Summary Type will alter how the
Object will display.

Do want to continue? NO// YES
NAME: PATIENT WELLNESS HANDOUT Replace TITLE:
SUPPRESS PRINT OF COMPONENTS WITHOUT DATA:
LOCK:
OWNER: MOORE,LORI B PHARM//

Do you wish to copy COMPONENTS from an existing Health Summary Type? YES// NO
Select COMPONENT: WELLNESS HANDOUT������ WHO
SUMMARY ORDER: 5// 5
HEADER NAME: Wellness Handout//
Select COMPONENT:

Do you wish to review the Summary Type structure before continuing? NO//
Please hold on while I resequence the summary order.

CAC Manual 166 Report Configuration


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

1 Disable/Enable Health Summary Component


2 Create/Modify Health Summary Components
3 Edit Ad Hoc Health Summary Type
4 Rebuild Ad Hoc Health Summary Type
5 Resequence a Health Summary Type
6 Create/Modify Health Summary Type
7 Edit Health Summary Site Parameters
8 Health Summary Objects Menu ...
9 CPRS Reports Tab 'Health Summary Types List' Menu ...
10 CPRS Health Summary Display/Edit Site Defaults ...

Select Health Summary Maintenance Menu Option: 9 CPRS Reports Tab 'Health Summary
Types List' Menu
1 Display 'Health Summary Types List' Defaults
2 Precedence of 'Health Summary Types List'
3 Method of compiling 'Health Summary Types List'
4 Edit 'Health Summary Types List' Parameters

Select CPRS Reports Tab 'Health Summary Types List' Menu Option: 4 Edit 'Health
Summary Types List' Parameters

Allowable Health Summary Types may be set for the following:

2 User USR [choose from NEW PERSON]


4 System SYS [SFH.ALBUQUERQUE.IHS.GOV]
Enter selection: 4 System SFH.ALBUQUERQUE.IHS.GOV

Setting Allowable Health Summary Types for System: SFH.ALBUQUERQUE.IHS.GOV


Select Sequence: ?

Sequence Value
-------- -----
5 GMTS HS ADHOC OPTION
10 MOST RECENT LABS
15 OUTPT ENCOUNTERS
20 WOMEN'S HEALTH SUMMARY

Select Sequence: 25
Are you adding 25 as a new Sequence? Yes// YES
Sequence: 25// 25
Health Summary: PATIENT WELLNESS HANDOUT�
Select Sequence:

CAC Manual 167 Report Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Figure 14-21: Position where New HS for user to click and print

If you are logged into EHR you will need to log off and back in to see the new HS.

14.3 Report Parameters (PAR)


Select the Report Parameters (PAR) option on the Report Configuration menu to
display the following:
Report Parameters

ALL Default Time and Occurrence Limits for All Reports


RPT Default Time and Occurrence Limits by Report

Select Report Parameters Option:

14.3.1 Default Time and Occurrence Limits for All Reports (ALL)
Select the Default Time and Occurrence Limits for All Reports (ALL) option on the
Report Parameters menu to display the following:
Default Time and Occurrence Limits for All Reports

Default time/occ for all reports may be set for the following:

1 User USR (choose from NEW PERSON)

CAC Manual 168 Report Configuration


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4 Division DIV (DEMO HOSPITAL)


6 System SYS (DEMO.CIAINFORMATICS.COM)
9 Package PKG (ORDER ENTRY/RESULTS REPORTING)

Enter selection: 6 System DEMO.CIAINFORMATICS.COM


Setting Default time/occ for all reports for System: DEMO.CIAINFORMATICS.COM
Time and Occurrence limits for all:

This parameter sets the default time and occurrence limits for all reports found on the
Reports window in the EHR. The format for the “Time and Occurrence limits for all”
prompt is: Start Date; End Date; Occurrence Limit. Example: T-100; T; 200.

14.3.2 Default Time and Occurrence Limits by Report (RPT)


Select the Default Time and Occurrence Limits by Report (RPT) option on the Report
Parameters menu to display the following:
Default Time and Occurrence Limits by Report

Default time/occ for all reports may be set for the following:

1 User USR (choose from NEW PERSON)


6 System SYS (DEMO.CIAINFORMATICS.COM)
9 Package PKG (ORDER ENTRY/RESULTS REPORTING)

Enter selection: 6 System DEMO.CIAINFORMATICS.COM


Setting Default time/occ for all reports for System: DEMO.CIAINFORMATICS.COM
Select Report: ORRP LAB STATUS Lab Status Lab Status
Are you adding ORRP LAB STATUS as a new Report? Yes// Yes

Time and Occurrence Limits:

CAC Manual 169 Report Configuration


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This parameter sets the default time and occurrence limits for a specified report found
on the Reports window in the EHR. The format for the “Time and Occurrence
Limits” prompt is: Start Date; End Date; Occurrence Limit. Example: T-100; T; 100.

14.4 System Display Parameters (SYS)


Select the System Display Parameters (SYS) option on the Report Configuration
menu to display the following:

Figure 14-22: System Display Parameters

This decides the order of the reports for the system on the Reports window.

14.5 User Display Parameters (USR)


Select the User Display Parameters (USR) option on the Report Configuration menu
to display the following:
User Display Parameters
Select NEW PERSON NAME: demo DEMO,DOCTOR

GUI Reports - User for User: DEMO,DOCTOR


------------------------------------------------------------------------------
List of reports
List of lab reports
------------------------------------------------------------------------------

--------------- Setting List of reports for User: DEMO,DOCTOR ---------------


Select Sequence:

This decides the order of the reports for the user on the Reports window.

CAC Manual 170 Report Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

15.0Problem List Configuration (PLS)


Select the Problem List Configuration (PLS) option on the RPMS-EHR Configuration
Master Menu to display the following:
Problem List Configuration

DPE Disable Problem List Editing


FLT Default Filter for Problem List
IPH Include Personal Hist Problem w/Active

Select Problem List Configuration Option:

15.1 Disable Problem List Editing (DPE)


Select the Disable Problem List Editing (DPE) option on the Problem List
Configuration to display the following:
Disable Problem List Editing

Disable Problem List Editing may be set for the following:

100 User USR [choose from NEW PERSON]


200 Class CLS [choose from USR CLASS]

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

-------- Setting Disable Problem List Editing for User: DEMO,DOCTOR --------
Value: ???

Enter either 'Y' or 'N'.

Value:

This disables editing of the Problem List by specified user/class.

15.2 Default Filter for Problem List


Select the Default Filter for Problem List (FLT) option on the Problem List
Configuration to display the following:
Default Filter for Problem List

Problem List Default Filter may be set for the following:

10 User USR [choose from NEW PERSON]


20 Class CLS [choose from USR CLASS]
30 Division DIV [DEMO INDIAN HOSPITAL]
90 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 10 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

--------- Setting Problem List Default Filter for User: DEMO,DOCTOR ---------

Setup Guide 171 Problem List Configuration


October 2008
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Default filter: ???

Select which filter should be the default.

Select one of the following:

0 ALL
1 ACTIVE
2 INACTIVE
3 PERSONAL HX
4 FAMILY HX

Default filter:

You use this option to select the default Problem List category for the Problem List
component.

15.3 Include Personal Hist Problem w/Active (IPH)


Select the Include Personal Hist Problem w/Active (IPH) option on the Problem List
Configuration to display the following:
Include Personal Hist Problem w/Active

Include Personal Hist Problem w/Active may be set for the following:

10 User USR [choose from NEW PERSON]


20 Class CLS [choose from USR CLASS]
30 Division DIV [DEMO INDIAN HOSPITAL]

Enter selection: 10 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

--- Setting Include Personal Hist Problem w/Active for User: DEMO,DOCTOR ---
Value: ???

Enter either 'Y' or 'N'.

Value:

When you add a problem, you can designate it as a family history or a personal
history (problem). This parameter adds the personal history items into the active
problem list. Otherwise, it only shows up if the user select All Problems or Personal
History.

The reason for this parameters is that information from the behavioral health GUI
stores problems in the personal health file and NOT as an active problem. So, for sites
using this GUI, the patient’s problems would not appear unless the site has this
parameter turned ON.

CAC Manual 172 Problem List Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

16.0POV Configuration (POV)


Select the POV Configuration (POV) option on the RPMS-EHR Configuration
Master Menu to display the following:
POV Configuration

DPE Disable POV Editing


MAX Maximum Entries Shown in POV History

Select POV Configuration Option:

16.1 Disable POV Editing (DPE)


Select the Disable POV Editing (DPE) option on the Problem List Configuration to
display the following:
Disable POV Editing

Disable POV Editing may be set for the following”

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100

If you enter NO, the user /class will not be able to enter or edit POV information.

16.2 Maximum Entries Shown in POV History (MAX)


Select the Maximum Entries Shown in POV History (MAX) option on the Problem
List Configuration to display the following:
Maximum Entries Shown in POV History

Maximum Entries Shown in POV History may be set for the following:

10 User USR [choose from NEW PERSON]


20 Class CLS [choose from USR CLASS]
30 Division DIV [DEMO HOSPITAL]
40 Package PKG [BGO COMPONENTS]

Enter selection: 30 Division DEMO HOSPITAL

Setting Maximum Entries Shown in POV History for Division: DEMO HOSPITAL

Maximum Entries:

The range you can enter is 25 to 250.

Setup Guide 173 POV Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

17.0Personal Health Hx Configuration (PHX)


Select the Personal Health Hx Configuration (PHX) option on the RPMS-EHR
Configuration Master menu to display the following:
Personal Health Hx Configuration

DRE Disable Reproductive History Editing

You have 23 PENDING ALERTS

Select Personal Health Hx Configuration Option:

17.1 Disable Reproduction History Editing (DRE)


Select the Disable Reproduction History Editing (DRE) option on the Personal Health
Hx Configuration to display the following:
Disable Reproductive History Editing

Disable Reproductive History Editing may be set for the following:

100 User USR [choose from NEW PERSON]


200 Class CLS [choose from USR CLASS]

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

---- Setting Disable Reproductive History Editing for User: DEMO,DOCTOR ----
Value: ???

Enter either 'Y' or 'N'.

Value:

When the Value is YES, the selected user (or class) cannot enter or document
reproductive history information.

Setup Guide 174 Personal Health Hx Configuration


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18.0Procedure Configuration (PRC)


Select the Procedure Configuration (PRC) option on the RPMS-EHR Configuration
Master Menu to display the following:
Procedure Configuration

CNF Suppress Confirmatory E&M Codes


CPT Disable CPT Code Editing
EAM Disable Evaluation & Management Editing
ERC Suppress Emergency Room E&M Codes
HOS Suppress Hospital E&M Codes
ICD Enable Support for ICD Procedure Entry

Select Procedure Configuration Option

18.1 Suppress Confirmatory E&M Codes (CNF)


Select the Suppress Confirmatory E&M Codes (CNF) option on the Procedure
Configuration to display the following:
Suppress Confirmatory E&M Codes

Suppress Confirmatory E&M Codes may be set for the following:

10 User USR (choose from NEW PERSON)


20 Class CLS (choose from USR CLASS)
80 Division DIV (DEMO HOSPITAL)
90 Package PKG (BGO COMPONENTS)

Enter selection: 80 Division DEMO HOSPITAL

---- Setting Suppress Confirmatory E&M Codes for Division: DEMO HOSPITAL

Value:

Make value = YES, if this is a hospital healthcare facility (confirmatory codes for
new and established patients).

18.2 Disable CPT Code Editing (CPT)


Select the Disable CPT Code Editing (CPT) option on the Procedure Configuration to
display the following:
Disable CPT Code Editing

Disable CPT Code Editing may be set for the following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100 User NEW PERSON

Setup Guide 175 Procedure Configuration


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Select NEW PERSON NAME: DEMO,DOCTOR


--------Setting Disable CPT Code Editing for User: DEMO,DOCTOR--------
Value:

At Value, enter Y so that the user/class cannot enter or edit super-bills.

18.3 Disable Evaluation & Management Editing (EAM)


Select the Disable Evaluation & Management Editing (EAM) option on the Procedure
Configuration to display the following:
Disable Evaluation & Management Editing

Disable Evaluation & Management Editing may be set for the following

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: DEMO,DOCTOR
-----Setting Disable Evaluation & Management Editing for User: DEMO,DOCTOR-----
Value:

At Value, enter Y so that the selected user/class cannot edit the E&M information.

18.4 Suppress Emergency from E&M Codes (ERC)


Select the Suppress Emergency from E&M Codes (ERC) option on the Procedure
Configuration to display the following:
Suppress Emergency Room E&M Codes

Suppress Emergency Room E&M Codes may be set for the following:

10 User USR (choose from NEW PERSON)


20 Class CLS (choose from USR CLASS)
80 Division DIV (DEMO HOSPITAL)
90 Package PKG (BGO COMPONENTS)

Enter selection: 80 Division DEMO HOSPITAL


--------Setting Suppress Emergency Room E&M Codes for Division--------
Value:

At Value, enter Y so that the Emergency option will not be on the Type of Service
listing for E&M in the EHR.

18.5 Suppress Hospital E&M Codes (HOS)


Select the Suppress Hospital E&M Codes (HOS) option on the Procedure
Configuration to display the following:
Suppress Hospital E&M Codes

Suppress Hospital E&M Codes may be set for the following

CAC Manual 176 Procedure Configuration


October 2008
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10 User USR (choose from NEW PERSON)


20 Class CLS (choose from USR CLASS)
80 Division DIV (DEMO HOSPITAL)
90 Package PDG (BGO COMPONENTS)

Enter selection: 80 Division DEMO HOSPITAL


------------Setting Hospital E&M Codes for Division-------------
Value:

At Value, enter Y so that the Hospital option will not be on the Type of Service
listing for E&M in the EHR.

18.6 Enable Support for ICD Procedure Entry (ICD)


Select Enable Support for ICD Procedure Entry (ICD) option on the Procedure
Configuration to display the following:
Enable Support for ICD Procedure Entry

Enable Support for ICD Procedure Entry may be set for the following:

80 Division DIV (DEMO HOSPITAL)


90 Package PKG (BGO COMPONENTS)

Enter selection: 80 Division DEMO HOSPITAL

Setting Enable Support for ICD Procedure Entry for Division: DEMO HOSPITAL
Value:

Yes means the entity can code for ICD procedures (used for hospitals).

CAC Manual 177 Procedure Configuration


October 2008
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19.0Patient Education Configuration (EDU)


Select the Patient Education Configuration (EDU) option on the RPMS-EHR
Configuration Master Menu to display the following:
Patient Education Configuration

DPE Disable Patient Education Editing

Select Patient Education Configuration Option:

19.1 Disable Patient Education Editing (DPE)


Select the Disable Patient Education Editing (DPE) option on the Patient Education
Configuration to display the following:
Disable Patient Education Editing

Disable Patient Education Editing may be set for the following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME:

Setup Guide 178 Patient Education Configuration


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19.2 Creating Patient Education Pick Lists


Creating Patient Education Pick List will allow the user to document multiple
education topics at one time from a single pick list.

Make sure a visit is selected. Follow these steps:

7. On the Patient Education panel on the Wellness window, click the Add button
and then enable the Pick List radio button.

Figure 19- : Sample Education Topic Selection Dialog

CAC Manual 179 Patient Education Configuration


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8. Click the Pick Lists button to display Manage Education Quick Picks dialog.

Figure 19- : Sample Manage Education Quick Picks Dialog

9. Click the Edit PickLists button on the Manage Education Quick Picks dialog to
display the Manage Categories dialog.

Figure 19- : Sample Manage Categories Dialog

CAC Manual 180 Patient Education Configuration


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10. Click Add on the Manage Categories dialog to display the Add Category dialog.

Figure 19- : Add Category Dialog

11. Enter the name in the Category Name field and click the OK button.
12. This creates to the Pick List and you go to the Manage Education Quick Picks
dialog. You need to add Education Topic Quick List Items by using the Add or
Query button on the dialog.

Figure 19- : Manage Education Quick Picks Dialog

CAC Manual 181 Patient Education Configuration


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13. After you leave the Manage Education Quick List dialog, the Pick List name will
be available on the Education Topic dialog.

Figure 19- : Education Topic Selection Dialog with New Pick List

CAC Manual 182 Patient Education Configuration


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20.0Exam Configuration (EXM)


Select the Exam Configuration (EXM) option on the RPMS-EHR Configuration
Master menu to display the following:
Exam Configuration

DEE Disable Exam Editing

Select Exam Configuration Option

20.1 Disable Exam Editing (DEE)


Select the Disable Exam Editing (DEE) option on the Exam Configuration to display
the following:
Disable Exam Editing

Disable Exam Editing may be set for following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100 User NEW PERSON

Select NEW PERSON NAME: DEMO,DOCTOR


------Setting Disable Exam Editing for User: DEMO,DOCTOR -----
Value:

Setting Value to YES prohibits the specified user/class from editing exams.

Setup Guide 183 Exam Configuration


October 2008
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21.0Health Factor Configuration (HFA)


Select the Health Factor Configuration (HFA) option on the RPMS-EHR
Configuration Master Menu to display the following:
Health Factor Configuration

DHE Disable Health Factor Editing

Select Health Factor Configuration Option:

21.1 Disable Health Factor Editing (DHE)


Select the Disable Health Factor Editing (DHE) option on the Patient Education
Configuration to display the following:
Disable Health Factor Editing

Disable Health Factor Editing may be set for following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100 User NEW PERSON

Select NEW PERSON NAME: DEMO,DOCTOR


------Setting Disable Health Factor Editing for User: DEMO,DOCTOR ------
Value:

Value set to Y will prevent the user/class from editing health factors.

Setup Guide 184 Health Factor Configuration


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22.0Immunization Configuration (IMM)


Select the Immunization Configuration (IMM) option on the RPMS-EHR
Configuration Master Menu to display the following:
Immunization Configuration

CPT Stop Immunizations from Adding CPT Codes


DIE Disable Immunization Editing
ICD Stop Immunizations from Adding ICD Codes

Select Immunization Configuration Option:

22.1 Stop Immunization from Adding CPT Codes (CPT)


Select the Stop Immunization from Adding CPT Codes (CPT) option on the
Immunization Configuration to display the following:
Stop Immunizations from Adding CPT Codes

Stop Immunizations from Adding CPT Codes may be set for following:

10 User USR (choose from NEW PERSON)


80 Division DIV (DEMO HOSPITAL)
90 Package PKG (BGO COMPONENTS)

Enter selection: 100 User NEW PERSON

Select NEW PERSON NAME: DEMO,DOCTOR


----Setting Stop Immunizations from Adding CPT Codes for User: DEMO,DOCTOR ----
Value:

Enter Y at Value to stop the automatic adding of CPT codes when an immunization is
documented on super-bills.

22.2 Disable Immunization Editing (DIE)


Select the Disable Immunization Editing (DIE) option on the Immunization
Configuration to display the following:
Disable Immunization Editing

Disable Immunization Editing may be set for the following:

100 User USR (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: DEMO,DCOTOR

--------Setting Disable Immunization Editing for User: DEMO,DOCTOR --------


Value:

Setup Guide 185 Immunization Configuration


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Enter Y at Value to disable the user/class from editing immunizations.

22.3 Stop Immunizations from Adding ICD Codes (ICD)


Select the Stop Immunizations from Adding ICD Codes (ICD) option on the
Immunization Configuration to display the following:
Stop Immunizations from Adding ICD Codes

Stop Immunizations from Adding ICD Codes may be set for following:

10 User USR (choose from NEW PERSON)


80 Division DIV (DEMO HOSPITAL)
90 Package PKG (BGO COMPONENTS)

Enter selection: 100 User NEW PERSON

Select NEW PERSON NAME: DEMO,DOCTOR


----Setting Stop Immunizations from Adding ICD Codes for User: DEMO,DOCTOR ----
Value:

Enter Y at Value to stop the automatic adding of ICD codes when an immunization is
documented on POVs.

CAC Manual 186 Immunization Configuration


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23.0ART Configuration
The ART configuration allows you to configure the Adverse Reactions panel to allow
data entries of adverse reactions. The options include enabling adverse reaction data
entry and verifying adverse reactions.

Select the ART Configuration (ART) option on the RPMS-EHR Configuration


Master menu to display the following:
Adverse Reaction Tracking Configuration

AUT Automatic Signature for Adverse Reaction Data


ENT Enable Adverse Reaction Data Entry
VER Allow Adverse Reaction Verification

Select Adverse Reaction Tracking Configuration Option:

23.1 Automatic Signature for Adverse Reaction Data (AUT)


Type AUT at the at the “Selection Adverse Reaction Tracking Configuration Option”
prompt to display the following:
Automatic Signature of Adverse Reaction Data

Force automatic signature of ADR entries may be set for the following:

100 User USR [choose from NEW PERSON]


200 Class CLS [choose from USR CLASS]
800 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 900 System DEMO.OKLAHOMA.IHS.GOV

Setting Force automatic signature of ADR entries for System: DEMO.OKLAHOMA.IHS


.GOV
Automatic signature of ADR entries?: NO//

Type Y or N at the Automatic signature of ADR entries prompt.

If yes, signature of any new or edited adverse reaction entries is forced upon context
change. If no, the user can opt to sign changes at a later time.

23.2 Enable Adverse Reaction Data Entry (ENT)


Type ENT at the “Selection Adverse Reaction Tracking Configuration Option”
prompt to display the following:
Enable Adverse Reaction Data Entry

Allow Entry of adverse reaction data may be set for the following:

100 User USE (choose from NEW PERSON)


200 Class CLS (choose from USR CLASS)

Setup Guide 187 ART Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

800 Division DIV (DEMO HOSPITAL)


900 System SYS (DEMO.OKLAHOME.IHS.GOV)

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

---- Setting Allow entry of adverse reaction data for User: DEMO,DOCTOR ----
Allow entry of adverse reaction data?:

Type Y at the “Allow entry of adverse reaction data?” prompt to have the right-click
menu to appear on the Adverse Reactions panel (otherwise, type N). The options
allow the entity to add or edit adverse reactions.

Figure 23-23: Right-Click Menu Options

23.3 Allow Adverse Reaction Verification (VER)


The VER option allows the specified user to verify adverse reaction records (when
applying the electronic signature).

Type VER at the “Selection Adverse Reaction Tracking Configuration Option”


prompt to display the following:
Allow Adverse Reaction Verification

GMRA-ALLERGY VERIFY Key Management

Select a user for key assignment: demo DEMO,DOCTOR

This user does not currently have the GMRA-ALLERGY VERIFY key.
Do you wish to assign this key to the selected user? N

Type Y at the “Do you wish to assign this key to the selected user?” prompt to have
the user to have verify privileges for the adverse reaction record (otherwise, type N).

CAC Manual 188 ART Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

24.0VueCentric Framework Configuration (FRM)


Select the VueCentric Framework Configuration (FRM) option on the RPMS-EHR
Configuration Master menu to display the following:
VueCentric Framework Configuration

1 Site Parameter Edit


2 Show Current VueCentric Users
3 Startup VueCentric Framework
4 Shutdown VueCentric Framework
5 Change Template Defaults

Select VueCentric Framework Configuration Option:

24.1 Site Parameter Edit


The CAC does not use this option (only for site managers).

Select the Site Parameter Edit on the VueCentric Framework Configuration option to
display the following:
Site Parameter Edit

VueCentric Site Parameters for System: DEMO.OKLAHOMA.IHS.GOV


------------------------------------------------------------------------------
Default object source path \\161.223.9.243\ehr\dev\lib\
Default login template %DEFAULT
Host polling interval 5
Maximum number of resource devices 5
Number of resource slots to allocate 5
Primary inactivity timeout 9999
Secondary inactivity timeout 9999
Interval to display countdown timer 20
Disable CCOW support YES
------------------------------------------------------------------------------

--- Setting Default object source path for System: DEMO.OKLAHOMA.IHS.GOV ---
Object Source Path: \\161.223.9.243\ehr\dev\lib\ Replace ???

Default path to the object repository.

Object Source Path: \\161.223.9.243\ehr\dev\lib\ Replace

Default object source path: This is the default path to the object repository.

Default login template: This is the default login template for the system.

Setup Guide 189 VueCentric Framework Configuration


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

Host polling interval: This is the number of seconds (1-60) between polls.

Maximum number of resource devices: This is the maximum number (1-20) if


resource devices that may be created.

Number of resource slots to allocate: This is maximum number of resource devices


for the system.

Primary inactivity timeout: This is the number of seconds (30+) of inactivity before
locking the application.

Secondary inactivity timeout: This is the number of seconds (30+) of inactivity


before initiating automatic logout.

Interval to display countdown timer: This is the number of seconds (5-999) to


display the countdown timer.

Disable CCOW support: If YES, this disables connection to a CCOW-complaint


context manager.

24.2 Show Current VueCentric Users


Select the Show Current VueCentric Users option on the VueCentric Framework
Configuration to show the active VueCentric users (like a report).

24.3 Startup VueCentric Framework


Select the Startup VueCentric Framework option on the VueCentric Framework
Configuration to abort shutdowns in progress and to allow logins.

24.4 Shutdown VueCentric Framework


Select the Shutdown VueCentric Framework option on the VueCentric Framework
Configuration to specify the number of seconds till shutdown (the minimum is 30).

24.5 Change Template Defaults


Select the Change Template Defaults option on the VueCentric Framework
Configuration to display the following:
Change Template Defaults

Default login template may be set for the following:

100 User USR [choose from NEW PERSON]


200 Class CLS [choose from USR CLASS]
300 Service SRV [choose from SERVICE/SECTION]
400 Location LOC [choose from HOSPITAL LOCATION]

CAC Manual 190 VueCentric Framework Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

500 Division DIV [DEMO INDIAN HOSPITAL]


900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 100 User NEW PERSON


Select NEW PERSON NAME: demo DEMO,DOCTOR

----------- Setting Default login template for User: DEMO,DOCTOR -----------


Default Template: ???

Choose from:
$6063
%CIH PROVIDER1
%CIH PROVIDER2
%DEFAULT
%EHR_PROVIDER
%EHR_QUICK ORDER WIZARD
%PCC OBJECTS BGO
%PROVIDER
%PROVIDER_
%PROVIDER_BJ
%PROVIDER_EHRV11
%PROVIDER_GHH3
%PROVIDER_IBH
%QUICK ORDER WIZARD

Default Template:

This allows you to select a default template for the specified entity; it requires a
VUECENTRIC TEMPLATE REGISTRY NAME. This is what the user sees after
logon to the EHR.

CAC Manual 191 VueCentric Framework Configuration


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25.0Spellchecking Configuration (SPL)


Select the Spellchecking Configuration (SPL) option on the RPMS-EHR
Configuration Master Menu to display the following:
Spellchecking Configuration

ENA Enable Spellchecking Service


PLG Spellchecking Service Plugin

Select Spellchecking Configuration Option:

25.1 Enable Spellchecking Service (ENA)


Select the Enable Spellchecking Service (ENA) option on the Spellchecking
Configuration menu to display the following:
Enable Spellchecking Service

Enable Spellchecker Service may be set for the following:

100 User USR [choose from NEW PERSON]


500 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 500 Division DEMO INDIAN HOSPITAL

-- Setting Enable Spellchecker Service for Division: DEMO INDIAN HOSPITAL --


Enable spellchecking service?: ?

Enter YES to enable the spellchecking service.

Enable spellchecking service?:

This option allows you to enable or disable the spellchecking service (in the EHR).
You would disable this if your site uses a spellchecking service plugin.

25.2 Spellchecking Service Plugin (PLG)


Select the Spellchecking Service Plugin (PLG) option on the Spellchecking
Configuration menu to display the following:
Spellchecking Service Plugin

Spellchecker Service Plugin may be set for the following:

100 User USR [choose from NEW PERSON]


500 Division DIV [DEMO INDIAN HOSPITAL]
900 System SYS [DEMO.OKLAHOMA.IHS.GOV]

Enter selection: 500 Division DEMO INDIAN HOSPITAL

-- Setting Spellchecker Service Plugin for Division: DEMO INDIAN HOSPITAL --


Spellchecker service plugin: ??

Setup Guide 192 Spellchecking Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Choose from:
BEHSPELLCHECK.SPELLCHECK

Spellchecker service plugin:

This option allows you to specify the spellchecking plugin this is VUECENTRIC
OBJECT REGISTRY PROGID, or NAME.

CAC Manual 193 Spellchecking Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

26.0Reminder Configuration (REM)


Select the Reminder Configuration (REM) option on the RPMS-EHR Configuration
Master Menu to display the following:

Figure 26-24: Options on the Reminder Configuration

Implementing Clinical Reminders at your site is an ongoing process. Clinical and


management groups need to evaluate the needs of your site. They should review and
prioritize the clinical guidelines that need to be implemented at your site. The clinical
reminders your site uses will probably change over time. For example, a new clinical
guideline might require one or more new clinical reminders. When a reminder
becomes outdated, it can be inactivated. Refer to the Reminders Guide for more
information.

Setup Guide 194 Reminder Configuration


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

27.0Design Mode
The Site Manager/CAC uses Design Mode to add the following to change the GUI
template of the EHR.

27.1 Accessing Design Mode


Make sure you are in the EHR application.

Right-click on the top bar and select Design Mode from the menu.

Figure 27-25: How to Access Design Mode

After you select Design Mode, the Design menu becomes available.

Figure 27-26: Design Menu Options

Setup Guide 195 Design Mode


October 2008
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27.2 Desktop Properties


Select the option “Desktop Properties” on the Design menu to display the Properties
for Desktop dialog.

Figure 27-27: Properties for Desktop Dialog

Setup Guide 196 Design Mode


October 2008
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You can change the setting on this dialog that affect the desktop properties. Place
your cursor in the field to change it. You can see your changes by clicking the Apply
button.

CAPTION: Determines what appears in the top bar of the window.

FONT: Sets the default font for the application. Click the button to display the
Font dialog.

Figure 27-28: Font Dialog

Setup Guide 197 Design Mode


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HEIGHT: Determines the height of the main window.

HELPFILE: Specifies the name of the help file for the Desktop Properties window.

ICON: Determines the index of the icon to use for the application title bar.

ICONS: Contains the icons for use by the application. Click the button to display
the Open dialog.

IMAGE: Sets the background image that appears when you login to the EHR. Click
the button to display the Open dialog.

INFOCOLOR: Sets the color of the balloon dialog. Click the drop-down list to select
another color.

POPUPCOLOR: Sets the color of the popup dialogs. Click the drop-down list to
select another color.

POPUPCOLOR2: Sets the gradient color of pop-up dialogs. Click the drop-down
list to select another color.

PROGRESSCOLOR: Sets the color of the progress bar. Click the drop-down list to
select another color.

STATUSCOLOR: Sets the color of the status bar. Click the drop-down list to select
another color.

WIDTH: Determines the width of the main window.

Customize Menus: manages the custom menu items. Click the Customize Menus
button and the right panel of the Properties for Desktop changes. You can add a new
menu by clicking the + button, for example.

Figure 27-29: Right Panel of Properties for Desktop Dialog

Setup Guide 198 Design Mode


October 2008
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27.3 Layout Manager


Select the Layout Manager option on the Design menu to do various editing from one
location.

Figure 27-30: Layout Manager Option

Cut: use this button to cut the selected object.

Copy: use this button to copy the selected object to be pasted to another section.

Add: use this button to add an object to a particular section.

Figure 27-31: Add an Object Window

Setup Guide 199 Design Mode


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Delete: use this button to delete a selected object.

Properties: use this button to view and edit he properties of a selected object.

About: use this button to view information about the selected object and the version
of the object.

27.4 Importing GUI Templates


GUI templates from other sites can be imported into the EHR using the VC Manager
application.

27.5 Communications Tab


When you click the Communications tab, right-click on the RPMS label in the left
panel to display a list of items on the communications tab.

Figure 27-32: Menu in Left Panel of Communications Tab

Setup Guide 200 Design Mode


October 2008
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Select the Properties option on the menu to display the Properties of Tree View
dialog.

Figure 27-33: Properties for Tree View

Setup Guide 201 Design Mode


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TOP: Location of top of the object relative to its parent.

LEFT: Location of the left side of the object relative to its parent.

HEIGHT: Height of the object.

WIDTH: Width of the object.

ALIGN: Alignment of the object relative to its parent. Choices are All, Bottom,
Center, Left, None, Right, Top.

ANCHORS: Position of the object relative to the selected sides of its parent.

BORDER: Appearance of the border surrounding the object. Choices are Flat,
Groove, Lowered, None, Popup, Raised, Up.

ICONS: Determines the file containing the icons for the tree view.

LARGEICONS: Determines the size of the icons. If true, large icons are displayed.
If false, small icons are displayed.

ORIENT: Determines the location of the panels. Choices are Right, Left.

Node Editor: Allows you to create, delete, or modify the nodes. Click this button to
have the right panel of the Properties for Tree View to change. Click the + sign to add
a new tab, for example. After you add a new tab, you can highlight the new tab, right-
click on it and select “Add Object” to add a selected object to the new tab.

Figure 27-34: Right Panel of Properties for Tree View Dialog

Setup Guide 202 Design Mode


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27.6 Patient Chart Tab


Go to the Patient Chart tab and right-click on any of the tabs at the bottom, select
“Properties” to display the Properties for Tabbed Notebook dialog.

Figure 27-35: Properties of Tabbed Notebook

Setup Guide 203 Design Mode


October 2008
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TOP: Location of top of the object relative to its parent.

LEFT: Location of the left side of the object relative to its parent.

HEIGHT: Height of the object.

WIDTH: Width of the object.

ALIGN: Alignment of the object relative to its parent. Choices are All, Bottom,
Center, Left, None, Right, Top.

ANCHORS: Position of the object relative to the selected sides of its parent.

FIXEDWIDTH: If false, the respective caption lengths determine the tab width.
Otherwise, all tabs are set to the same width.

MULTILINE: Affects how the tabs are displayed if there is insufficient room to
display them all. If true, tabs are wrapped onto multiple lines. Otherwise, a scroll bar
appears.

TABPOSITION: Changes the location of the tabs. Choices are Bottom, Left, Right,
Top.

TABSTYLE: Determines the cut of the tab. Choices are Cut Corner, Double Slant,
Round Corners, Single Slant. Below are illustrations of the types.

Cut Corner Single Slant Round Corners Double Slant

Tab Editor: Allows you to create, delete, or modify the tabs. Click this button and
the right side of the Properties for Tabbed Notebook changes.

Figure 27-36: Right Side of Properties for Tabbed Notebook for the Tab Editor

Setup Guide 204 Design Mode


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Use the up and down arrows to rearrange the tab order.

The + sign adds a tab and you can name it after adding it.

Go to the new tab, right-click on the body of the tab, and select “Add Object” to add
selected objects to the tab. If more than one object will go on the tab, you need to
insert a splitter pane and then add the objects to each pane of the splitter pane.

27.6.1 Setting the Patient Detail View

Figure 27-37: Patient/Visit Toolbar Showing the Magnifying Glass

27.6.1.1 How to Setup the Patient Detail to Display on the Face Sheet
You get to this by accessing the EHR option on the initial RPMS menu. Then select
PAT | then select DTL to display the following:

Figure 27-38: Set Logic for Patient Detail View Choices

Setup Guide 205 Design Mode


October 2008
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27.6.1.2 How to Setup the Patient Detail to Display on the Health Summary
If you do not know the DFN number of the Health Summary, go to the next section to
find out how to retrieve it.

Figure 27-39: Set Logic for Patient Detail View Information

27.6.1.3 How to get the DFN Number of the Health Summary


Enter or Edit File Entries
Print File Entries
Search File Entries
Modify File Attributes
Inquire to File Entries
Utility Functions ...
Data Dictionary Utilities ...
Transfer Entries
Other Options ...

Select VA FileMan Option: print File Entries

OUTPUT FROM WHAT FILE: HEALTH SUMMARY TYPE//


SORT BY: NAME// NUMBER
START WITH NUMBER: FIRST//
WITHIN NUMBER, SORT BY:
FIRST PRINT FIELD: NAME
THEN PRINT FIELD: NUMBER

SORT BY: NAME//


START WITH NAME: FIRST//
FIRST PRINT FIELD: NUMBER
THEN PRINT FIELD: NAME
THEN PRINT FIELD:
Heading (S/C): HEALTH SUMMARY TYPE LIST  Replace
DEVICE: Right Margin: 80//
HEALTH SUMMARY TYPE LIST JUL 25,2005  06:56    PAGE 1
NUMBER NAME
--------------------------------------------------------------------------------

Setup Guide 206 Design Mode


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18 ADULT REGULAR
73 ALLERGIES
91 AMBULANCE
28 APPT
XX Your own custom health summary

27.6.2 Adding IHS Patient Chart (Behavioral Health System) to the EHR
Follow these steps to add an IHS Patient Chart tab to the EHR:

14. Go into Design Mode.


Right-click on the top bar and select Design Mode from the menu.

Figure 27-40: Selecting Design Mode

15. Add another tab:


Right-click on an area to the right side of the tabs.

Figure 27-41: Menu When You Right-Click Next to Tabs

Select Properties|Tab Editor.


Select the + sign and add a tab. (Rename the tab and click OK.)

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Figure 27-42: Adding Another Tab

16. Right-click in the body of the tab that you just created and add an object called
PROGRAM LAUNCHER. A small box will appear. Double click on the small
box so that it expands into the whole tab.
17. Right-click in the body of the tab and go to properties.
Paste this into the EXENAME field (include the quotes): "C:\Program Files\IHS
Patient Chart Application\BPCPC.exe"
Paste this into the COMMAND LINE field: "C:\Program Files\IHS Patient Chart
Application"

Setup Guide 208 Design Mode


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18. Put the words CLICK HERE in the CAPTION field.

Figure 27-43: Property Additions

19. Save the template and exit design mode. The end result is shown in the following
figure:

Figure 27-44: End Result Showing New Tab

Setup Guide 209 Design Mode


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27.7 Patient Chart Component


Go to the Patient Chart tab and right-click on any component, select “Properties” to
display the Properties for [component name] dialog.

Figure 27-45: Sample Properties Dialog for Component

Setup Guide 210 Design Mode


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

TOP: Location of top of the object.

LEFT: Location of the left side of the object.

HEIGHT: Height of the object.

WIDTH: Width of the object.

ALIGN: Alignment of the object relative to its parent. Choices are All, Bottom,
Center, Left, None, Right, Top.

ANCHORS: Position of the object relative to the selected sides.

Below are special setting for various components.

27.7.1 Notifications
LEGEND: Location can set to left or right OR can be hidden.

27.7.2 Problem List Window


This applies to the Problem Management component.

HideButtons: If TRUE, the Add, Edit, and Delete keys will not show up on the
component. If FALSE (the False checkbox is not checked), they will show up. This
would be used on the template for the type of user who should not be editing the
Problem List.

UseLexicon: If TRUE, this means that the Lexicon radio button (search method) is
the default on the Diagnosis Lookup.

27.7.3 ICD Pick List


RequireCACKey: If True, only CACs can add/edit the pick list.

27.7.4 POV
This is the Visit Diagnosis component.

RequirePOVforChartReview: If TRUE, the component will generate a notification


to the user if the user is the primary provider on a Chart Review visit type and if the
user did not enter a POV. If FALSE, this notification will not be generated.

RequirePOVforTeleVisit: If TRUE, the component will generate a notification to


the user if the user is the primary provider on a Telephonic visit type and if the user
did not enter a POV. If FALSE, this notification will not be generated.

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HideButtons: If TRUE, the Add, Edit, and Delete keys will not show up on the
component. If FALSE, they will show up. This would be used on the template for the
type of user who should not be editing the Problem List. This would be used on the
template for the type of user who should not be editing the POV.

UseLexicon: If TRUE, this means that the Lexicon radio button (search method) is
the default on the Diagnosis Lookup.

27.7.5 Super Bills


RequireCACKey: If True, only CACs can add/edit the pick list.

27.7.6 Suicide Form


Patient Centric: If TRUE (checked), the form will display any (all) existing Suicide
Forms for the selected patient. If FALSE (not checked), the component will display
ALL suicide forms in the system for ANY patient, by selectable date range that
defaults to a year prior to the current date. This feature is for management-types to
see all suicide data. There isn’t any way to dump this data from the GUI, but there are
reports in AMH that can be used. This means if you want to use the non-patient-
centric option for the Suicide Form, you’d probably want to this on a different tab
(outside the Patient Chart) and only have it on manager (CD or BH director, for
example) templates.

27.8 Clear Patient Context Setup


You can set-up a function where the user can clear the patient context (meaning no
patient is selected) by clicking a (new) menu (or can be an option on the menu). You
complete this set-up in Design Mode in the EHR.

Follow these steps:

20. Go to Design Mode and select Design | Desktop Properties.


21. On the Properties for Desktop dialog, click the Customize Menus button to show
the Menu items.
22. Click the Plus Sign button to create a new menu. Name this new menu Clear.
You could make this function an option on an existing menu, say the File menu
or the Patient menu.

Setup Guide 212 Design Mode


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Figure 27-46: New Menu Named Clear

23. Select the Clear menu item. Click the Menu Action button ( ) to display the
edit action dialog for Clear.
24. In the text box below the “Edit action;” label, type the $(patient.clear) to define
the action for the Clear menu.

Figure 27-47: Sample Clear Dialog

Setup Guide 213 Design Mode


October 2008
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25. Click OK to dismiss the Clear Dialog.


26. Click OK to dismiss the Properties for Desktop dialog.
27. Get out of the Design Mode.
28. Click the Clear menu to see if it removes the patient context. This action
removes any information about the patient as well as the patient context.

Setup Guide 214 Design Mode


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28.0IHS Setup
The IHS Setup involves making super-bills and pick-lists.

28.1 Making a Super-Bill


Super-bills are lists of CPT codes for billing and for documenting services performed.
Each super-bill is attached to a visit. The EHR allows clinicians to enter the CPT
codes into PCC from the Services window. A selection of evaluation and
management codes as well as the historical codes for the chosen patient are already
available, but a list of codes from a particular clinic might be helpful in making a new
choice.

Figure 28-48: Services Window in EHR

Notes about the Services window:

 The Historical Services panel contains the historical codes in the Code
column.
 The list next to the Super-Bills button are the super-bill codes for the selected
super-bill.
 Use the Super-Bills button to show a new set of codes.
 The button allows you to do a Web search on a term.

Setup Guide 215 IHS Setup


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28.1.1 Managing a New Super-Bill


Click the Super-Bills button on the Services window. The application displays the
Manage Super-Bills dialog. You can manage only your super-bills.

Figure 28-49: Sample Manage Super-Bills Dialog

28.1.1.1 Adding a New Super-Bill Category


Click the Add/Edit Super-Bill button on the Manage Super-Bills dialog to add a new
super-bill category. The application displays the Manage Categories dialog.

Figure 28-50: Sample Manage Categories Dialog

Setup Guide 216 IHS Setup


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Click the Add button on the Manage Categories dialog to add a new super-bill
category. The application displays the Add Category dialog.

Figure 28-51: Add Category Dialog

Use the Add Category dialog to name the super-bill category and to associate it with a
clinic or a provider. The creator of a super-bill automatically becomes the manager of
the super-bill.

Click OK to save the new super-bill category. Otherwise, click Cancel to not save it.

You can go back and edit the super-bill categories (use the Edit button on the Manage
Category dialog) to add other people to be managers (use the Add and Delete buttons
on the Edit Category dialog).

Figure 28-52: Edit Category Dialog

Setup Guide 217 IHS Setup


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28.1.1.2 Querying Super-Bills


After saving the new super-bill category, go back to the Manage Super-Bills dialog
and click the Query button. The application displays the CPT Query dialog. This is
one of the ways to add items for your new super-bill category.

Figure 28-53: CPT Query Dialog to Query Super-Bills

Setup Guide 218 IHS Setup


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Click the Clinic button to pick your clinic. The application can search PCC, Third
Party Billing, and CHS for CPT codes. This process might take some time to run
depending on the size of the clinic chosen.

You must enter either a Clinic or a Provider.

When the query is finished, another super-bill will be available. The manager should
review this query and perhaps remove items that are not frequent or seem
inappropriate for the clinic chosen.

Figure 28-54: Manage Super-Bills Dialog after Query

Setup Guide 219 IHS Setup


October 2008
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Items with zero only frequency or those that seem inappropriate, such as a long
function test in an optometry super-bill, can be deleted before others see the super-bill
codes.

Others will see this super-bill whenever they specify a visit to the chosen clinic.
However, there is also a button on the tab that allows a person to see all the super-
bills and choose items from them.

28.1.1.3 Editing Super-Bill Items


Select a super-bill item. Then, click the Edit button. The Edit Pick-List dialog
displays.

Figure 28-55: Edit Pick-List Dialog

Setup Guide 220 IHS Setup


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

You can do two things on this dialog: (1) rename the super-bill item (in the List Item
Name field) and (2) change the associations (in the bottom panel).

When you rename the item, that changes the Narrative for the super-bill item.

You can add, edit, or delete associations for the super-bill item.

To add an association, click the Add button. The Add/Edit Pick List Association
dialog displays.

Figure 28-56: Add/Edit Pick List Association Dialog

Setup Guide 221 IHS Setup


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

You can choose an association from the Lookup Table list or you search for a CPT
(lower field).

The checkboxes at the bottom determine the additional requirements for the
association. Associations are used to link additional PCC documentation with a super-
bill item, such adding an education topic, a health factor, or an exam to the procedure.

When the Super-Bill item is listed in the Super-Bills panel, you click on its name and
Items to Save dialog displays.

Figure 28-57: Items to Save Dialog

When you click Save (and the Education Topic is checked, the Add Patient Education
Event dialog displays).

Figure 28-58: Add Patient Education Event Dialog

Setup Guide 222 IHS Setup


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

After you click Add, the topic is added to the Education panel on the Wellness
window (after you change patients or leave and re-enter the EHR).

Figure 28-59: Check Boxes for Associations

When the Super-Bill item associations have the following checked:

Auto Add: you do not have a choice; it automatically adds the selected association to
the Visit Services panel.

Default to Add: the association will be added to the Visit Services panel unless
deselected on the Items to Save dialog.

Prohibit Duplication: you cannot add the same data element (like CPT) twice.

28.2 Making a Pick-List


Pick lists are groupings of ICD9 codes that can be chosen for a particular clinic.

Figure 28-60: Prob/POV Window in EHR

Notes about the Prob/POV window:

 The list in the ICD Pick-Lists panel shows the pick list from which you
choose.

Setup Guide 223 IHS Setup


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 The ICD Pick Lists button allows the user to make a new pick list and to
manage existing pick lists.
Click the ICD Pick Lists button and the Manage ICD Pick Lists dialog displays.

Figure 28-61: Manage ICD Quick Picks Dialog

Comments about the Manage ICD Quick Picks dialog:

Button Action
Add Adds items to the already created list
Rename Renames the current quick-pick item
Delete Deletes items from the list
Copy Clones this list to another one and make changes
Query Executes a query on the files for more ICD codes
Zero Freq Causes the frequency for all ICDs to become zero
Import Imports an existing pick list
Export Exports the current pick list
Exit Leaves the dialog
Cancel Cancels a query process

Setup Guide 224 IHS Setup


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28.2.1 Managing Categories


Click the EditPick Lists button on the Manage ICD Quick Picks dialog to display the
Manage Categories dialog.

Figure 28-62: Manage Categories Dialog

Use the Manage Categories dialog to make changes to the pick list category you
already have or to add a new one.

Click the Add button on the Manage Categories dialog to display the Add Category
dialog.

Figure 28-63: Add Category Dialog to Add New Category

Comments about the Add Category dialog:

 Use the Category Name field to create your own category name.
 Use the Clinic and Provider fields to associate it with a clinic, a provider, or
both.
 The creator automatically becomes a manager but other people can be added.

Setup Guide 225 IHS Setup


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 Click OK when finished. The Manage ICD Quick Picks dialog displays.

Figure 28-64: Manage ICD Quick Picks after Adding New Category

The new pick list category is setup but there are no codes in it. You can either add
them one at time using Add or use the Query function to find the ones appropriate for
the clinic.

You could import a pick list and then all the elements to the new category.

28.2.2 Querying Quick Picks


Click the Query button on the Manage ICD Quick Picks dialog to display the
Database Query dialog.

Figure 28-65: Database Query Dialog to Query Quick Picks

Setup Guide 226 IHS Setup


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Enter the date range to search the database. The further back the longer the search.

Enter the clinic, provider, or both to search. Click OK and wait. This might take some
time.

Figure 28-66: Manage ICD Quick Picks After Query

When the query returns, you can sort by frequency and remove seldom used codes, or
delete invalid codes one at a time. Exit the Manage ICD Quick Picks dialog; now the
new pick list category will be able to be selected when using the Problem/POV tab.

28.3 Info Button Configuration


You can configure the Info Button in the RPMS. This configuration determines
the list of Web sites that are available on the drop-down list for the Reference Site
field.

Figure 28-67: Reference Site Field

28.3.1 Viewing Web Reference Sites Currently Available


You need to go to VA FileMan option in the RPMS.
VA FileMan Version 22.0

Setup Guide 227 IHS Setup


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Enter or Edit File Entries


Print File Entries
Search File Entries
Modify File Attributes
Inquire to File Entries
Utility Functions ...
Data Dictionary Utilities ...
Transfer Entries
Other Options ...

Select VA FileMan Option: inq Inquire to File Entries

OUTPUT FROM WHAT FILE:// BGO WEB REFERENCE SITES


Select BGO WEB REFERENCE SITES: ??

Choose from:
CDC
FamilyDoctor.org
Google
JAMA
Medline
UpToDate

The list following the “Choose from” wording is currently what is on the drop-down
list for the Reference Site field.

28.3.2 Adding Web Reference Sites


This process will add options to the drop-down list for the Reference Site field.

First, using your Web browser, go to the search engine you want to use. In this
example, Yahoo was chosen.

Type in a search term (example = diabetes)

In the address bar of your Web browser, the search address should be visible, such as:

http://search.yahoo.com/search?p=diabetes&fr=yfp-t-501&toggle=1&cop=mss&ei=UTF-8
Copy the Web address that appears in the address bar.

Go to VA Fileman in the RPMS.


Select VA FileMan Option: Enter or Edit File Entries

INPUT TO WHAT FILE:// BGO WEB REFERENCE SITES


EDIT WHICH FIELD: ALL// <Enter>

Select BGO WEB REFERENCE SITES: Yahoo


Are you adding ‘Yahoo’ as a new BGO WEB REFERENCE SITES (the 7TH)? No// Yes

SEARCH URL:  type (or paste) the search address; replace the search term with
[SEARCH TEXT] (in this example replace “diabetes” with [SEARCH TEXT])

SEQUENCE: <Type a Number between 1 and 99>


INACTIVE: <Enter>

Setup Guide 228 IHS Setup


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RPMS Electronic Health Record (EHR) v1.1 Patch 3

NOTE: the SEARCH URL would look like this:

http://search.yahoo.com/search?p=[SEARCHTEXT]&fr=yfp-t-
501&toggle=1&cop=mss&ei=UTF-8

Please note that the EHR has a 240 character limit on the length of a URL that can be
saved.

28.4 Chief Complaint Pick List Configuration


You must have the BGOZ CAC key to edit the pick list for the Chief Complaint
component.

Select the Manage Pick Lists option from the right-click menu above the Chief
Complaint field.

Figure 28-68: Chief Complaint Right-Click Menu

The Manage Chief Complaint Pick Lists dialog displays.

Figure 28-69: Add Chief Complaint Dialog

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This process lets you add/delete pick list items for symptoms, diagnosis, and patient
requests. You do not have to a visit selected to manage the pick lists.

28.4.1 Add Pick List Item


29. Select the radio button (Symptom, Diagnosis, or Patient Request).
30. Click Add to display the add dialog.
For Symptom, the Add Symptom dialog displays.
For Diagnosis, the Add Diagnosis dialog displays.
For Patient Request, the Add Request dialog displays.

Figure 28-70: Add Symptom Dialog

31. Type the name of the pick list item that you want to add (in the text box).
32. Click Add. (Otherwise, click Cancel.)
For Diagnosis or Patient Request, the item is added to the pick list.
For Symptoms, the Confirm location information dialog displays (this dialog
does not display for the other radio buttons).

Figure 28-71: Confirm Body Location Information Message

Click Yes. The entered pick list name will appear on pick list with an asterisk
following its specified name. (For example, Pain*.) This means that when the
user selects the chief complaint symptom with an asterisk, the Location group
box will be active where the user can select the location and the side (left, right,
both).
Click No, the pick list name will appear as its specified name (only).

Setup Guide 230 IHS Setup


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28.4.2 Delete Pick List Item


33. Select the radio button (Symptom, Diagnosis, or Patient Request.)
34. Highlight the pick list item you want to delete.
35. Click Delete to display the “Delete Entry?” information message.

Figure 28-72: Sample Delete Entry Information Message

Click Yes to delete the selected pick list item. (Otherwise, click No.)

28.5 Chief Complaint Pretext Configuration


You can configure the pretext for each chief complaint pick list item in the RPMS.
This means you can create a phrase to be the pretext for each type of chief complaint
pick list item. For example, you might want each Symptom to have the phrase
“Patient Complains of” before the selected symptom.

Figure 28-73: Example of Pretext

You access this configuration by selecting EHR | CCX to display the following:
Chief Complaint Configuration

PFX Prefix text for chief complaint pick list

Select Chief Complaint Configuration Option:

Setup Guide 231 IHS Setup


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After you enter PFX as the Chief Complaint Configuration Option, you get the
following:

Figure 28-74: Prefix Text for Chief Complaint Pick List

Whatever you enter at the “Prefix text” prompt will be the text that appears when you
select a Chief Complain pick list item.

Setup Guide 232 IHS Setup


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

29.0Point of Care Lab


The creation of a laboratory test using the “CH” subscript allows a site to add Point of
Care (POC) testing capabilities and to manually enter the results of all POC tests into
the RPMS system. The POC test is created using the Laboratory (LR) application and
all results will be entered via the “Fast/Bypass” option. Results will then be accessible
through the Electronic Health Record. Required personnel for this project are the
facility Site Manager and the Laboratory Package administrator. RPMS Fileman
access is also required.

Follow these steps to set up a laboratory POC testing menu in RPMS:

1. Create the menu option “POC - POC Results Entry…” in RPMS using the Edit
Options menu key in RPMS.
Select IHS Menu Management Option:

CORE IHS CORE . . .


MMM MailMan Master Menu . . .
PER Add/Edit New Persons
POC POC Results Entry . . .

2. Under the POC option, add the “LRFASTS” key to enable the Fast/Bypass option
for the entry of POC test.
Select Menu Management Option: EOP Edit options

Select OPTION to edit: AZU POCTESTMENU POC Results Entry


NAME: AZU POCTESTMENU//
MENU TEXT: POC Results Entry//
PACKAGE: LAB SERVICE// Namespace for the POC Results Entry option
OUT OF ORDER MESSAGE:
LOCK: AZUPOCTEST//
REVERSE/NEGATIVE LOCK:
DESCRIPTION:
This menu item is for Point of Care testing personnel and is to be used
for the entry of Point of Care test results.

Edit? NO//
TYPE: menu//
HEADER:
ENTRY ACTION:
EXIT ACTION:
Select ITEM: LRFASTS//
ITEM: LRFASTS// All LRFASTS as an item and give the option a synonym. In
SYNONYM: BY// this example, “BY” is the synonym.
DISPLAY ORDER:
Select ITEM:
CREATOR: SMILEY,CLARENCE//

3. The above steps result in the following menu choices in RPMS.


Select IHS Kernel Option: POC POC Results Entry
RPMS is not ready for the
BY Fast Bypass Data Entry/Verify entry of POC test results.

Select POC Results Entry Option: BY Fast Bypass Data Entry/Verify

Setup Guide 233 Point of Care Lab


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

4. Create the POC test in file 60 using the RPMS Fileman.


Select IHS Kernel Option: FM VA FileMan

VA FileMan Version 22.0

Enter or Edit File Entries


Print File Entries
Search File Entries
Modify File Attributes
Inquire to File Entries
Utility Functions ...
Data Dictionary Utilities ...
Transfer Entries
Other Options ...

Select VA FileMan Option: ENTer or Edit File Entries

Select LABORATORY TEST NAME: POC GLUCOSE


Are you adding 'POC GLUCOSE' as a new LABORATORY TEST (the 1068TH)? No// Y
(Yes)
LABORATORY TEST LABTEST IEN: 9999004//
LABORATORY TEST SUBSCRIPT: CH CHEM, HEM, TOX, SER, RIA, ETC.
LABORATORY TEST HIGHEST URGENCY ALLOWED: ROUTINE
LABORATORY TEST PRINT NAME: POC GLU Test created in Lab Package
LABORATORY TEST DATA NAME: 516003 POC GLUCOSE using the “CH” subscript

NOTE: The Site Manager or the Lab Package administrator might


have to create a new Lab Accession area called Point of Care. This
ensures that all POC tests are accounted for correctly. See example
below:

Select VA FileMan Option: ENTer or Edit File Entries

INPUT TO WHAT FILE: LABORATORY TEST// ACCESSSION (10 entries)

EDIT WHICH FIELD: ALL//

Select ACCESSION AREA: ?


Answer with ACCESSION AREA, or UID, or HOST UID
Choose from:
AUTOPSY
BLOOD BANK
CHEMISTRY
CYTOPATHOLOGY
ELECTRON MICROSCOPY
HEMATOLOGY
MICROBIOLOGY
SENDOUTS
SURGICAL PATHOLOGY
URINALYSIS
New ‘Point of Care’ lab
You may enter a new ACCESSION, if you wish accession area created to
ANSWER MUST BE 2-20 CHARACTERS IN LENGTH properly account for all POC
testing
Select ACCESSION AREA: POINT OF CARE
Are you adding 'POINT OF CARE' as a new ACCESSION (the 11TH)? No// Y
(Yes)

Setup Guide 234 Point of Care Lab


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

5. Create a ‘Point of Care’ menu option to display all POC tests that are created.
This will make it much easier for POC testing personnel to access all POC tests
quickly and efficiently.
Select VA FileMan Option: ENTer or Edit File Entries

INPUT TO WHAT FILE: LABORATORY TEST// ACCESSION TEST GROUP


(3 entries)
EDIT WHICH FIELD: ALL//
This creates a POC specific
menu option for POC testing
personnel
Select ACCESSION TEST GROUP: POINT OF CARE
Are you adding 'POINT OF CARE' as
a new ACCESSION TEST GROUP (the 4TH)? No// Y (Yes)

6. Add all POC tests under the new ‘Point of Care’ menu.
Select VA FileMan Option: ENTer or Edit File Entries

INPUT TO WHAT FILE: ACCESSION TEST GROUP//


EDIT WHICH FIELD: ALL//
Add the POC test under the
Select ACCESSION TEST GROUP: POINT OF CARE new menu
ACCESSION TEST GROUP: POINT OF CARE//
LAB SECTION: POINT OF CARE//
LAB ONLY:
LAB COLLECT ONLY:
DISPLAY ORDER:
Select TEST: POC GLUCOSE
Are you adding 'POC GLUCOSE' as a new TEST (the 1ST for this ACCESSION
TEST GROUP)? No// Y (Yes)
TEST NUMBER: 1//
TEST NAME: POC GLUCOSE//
COLLECTION SAMPLE: CAPILLARY BLOOD BLOOD CAPILLARY
SAMPLE NAME: BLOOD (CAPILLARY)//

7. Once the new Point of Care test is created in the lab package, order and result the
new item to ensure that all correct reference ranges and specimen collection are
displayed.
Select IHS Kernel Option: POC POC Results Entry

BY Fast Bypass Data Entry/Verify

Select POC Results Entry Option: BY Fast Bypass Data Entry/Verify

Do you want to review the data before and after you edit? YES//

WANT TO ENTER COLLECTION TIMES? Y// New ‘Point of Care’ option allows
Select ACCESSION TEST GROUP: POINT OF CARE for easier access for POC testing
personnel to access POC tests

Select Patient Name: 110567


DEMO, FEMALE F 11-07-1989 WE 110567

Select one of the following:

Setup Guide 235 Point of Care Lab


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

LC LAB COLLECT(INPATIENTS-MORN. DRAW)


SP SEND PATIENT
WC WARD/CLINIC COLLECT
New ‘Point of Care’ option allows
for easier access for POC testing
Specimen collected how ? : SP// SEND PATIENT personnel to access POC tests
PATIENT LOCATION: ICU
PROVIDER: SMILEY,CLARENCE
LAB Order number: 254
Choose one (or more, separated by commas) ('*' AFTER NUMBER TO CHANGE URGENCY)
1 POC GLUCOSE 2 POC KOH
TEST number(s): 1
Other tests? N//
You have just selected the following tests for DEMO, FEMALE 110567
entry no. Test Sample
1 POC GLUCOSE CAPILLARY BLOOD
All satisfactory? Yes// (Yes)
Actual order of POC Glucose test by
POC test personnel
LAB Order number: 254

Collection Date@Time: NOW// (FEB 11, 2005@01:56:02)


Print labels on: LABLABEL//
Do you wish to test the label printer: NO//

Enter Sign or Symptom for LAB Order number 254


(DO NOT USE 'RULE OUT', 'PROBABLE', 'QUESTIONABLE', etc.): SURGERY
Is this correct? YES//

ACCESSION: POC 0211 3 <0450420003>


POC GLUCOSE CAPILLARY BLOOD
DEMO, FEMALE 110567 LOC:ICU
Sample: BLOOD
Specimen: BLOOD POC Glucose test ordered by testing
personnel in the Laboratory Package.
1 POC GLUCOSE
Note accession number and
collection sample
DEMO, FEMALE HRCN: 110567 LOC: ICU
Practitioner: SMILEY, CLARENCE

ACCESSION: POC 0211 3


02/11 0156d
POC GLUCOSE //90
Select COMMENT: Result entered by POC test personnel

DEMO, FEMALE HRCN: 110567 LOC: ICU


Practitioner: SMILEY, CLARENCE

ACCESSION: POC 0211 3


02/11 0156d

POC GLUCOSE 90 MG/DL


SELECT ('E' to Edit, 'C' for Comments, 'W' Workload )
Approve for release by entering your initials: CS Result entered by test
personnel
Result approved by test
personnel

Setup Guide 236 Point of Care Lab


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Below is how the POC lab results would look in the EHR:

Figure 29-75: Sample of POC Lab Results in the EHR

Setup Guide 237 Point of Care Lab


October 2008
RPMS Electronic Health Record (EHR) v1.05

30.0Reminders
Reminders setup is complex process. Refer to the Reminders manual for more
information.

Setup Guide 238 Reminders


October 2008
RPMS Electronic Health Record (EHR) v1.05

31.0Coding Tools
Your CAC can place a hyperlink in EHR to any Web resource. Below are some
examples.

1. The E&M Code Calculator from the Portland VHA.

Figure 31-76: VA E&M Code Helper

Setup Guide 239 Coding Tools


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

2. Flash Code: http://66.17.18.109/flashcode/home.jsp (shown in the figure above.)


This tool will help the provider pick a code. The color codes are: red is billable,
green is non-billable; it prompts the user to click for another billable code.

Figure 31-77: Flash Code

3. Palm Pilot Resource: Statcoder (http://www.statcoder.com)

Setup Guide 240 Coding Tools


October 2008
RPMS Electronic Health Record (EHR) v1.05

32.0 Drug Text Orders

Figure 32- : Sample Medication Order with Restrictions

Click the “Display Restrictions/Guidelines” link to get the following:

Figure 32- : Sample Restrictions/Guidelines Information

Step 1 – Create Drug Text


Select Health Systems Option: ^PDM

Setup Guide 241 Drug Text Orders


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

1 Pharmacy Data Management [PSS MGR] (PDM)


2 Print Documents Menu [BTIU MENU PRINT DOCS] (PDM)

Type '^' to stop, or choose a number from 1 to 2 :1 PDM Pharmacy Data Management

Dosages ...
Drug Enter/Edit
Drug Interaction Management ...
Electrolyte File (IV)
Lookup into Dispense Drug File
Medication Instruction File Add/Edit
Medication Route File Enter/Edit
Orderable Item Management ...
Orderable Item Report
Formulary Information Report
Drug Text Enter/Edit
Drug Text File Report
Pharmacy System Parameters Edit
Standard Schedule Edit
Synonym Enter/Edit
Controlled Substances/PKI Reports ...

Select Pharmacy Data Management Option: DRUG


1 Drug Enter/Edit
2 Drug Interaction Management
3 Drug Text Enter/Edit
4 Drug Text File Report
CHOOSE 1-4: 3 Drug Text Enter/Edit
This option enables you to edit entries in the DRUG TEXT file.

Select DRUG TEXT NAME: DANDOCILLIN DOSING


Are you adding 'DANDOCILLIN DOSING' as a new DRUG TEXT (the 45TH)? No// Y
(Yes)

There may be entries in your DRUG file and PHARMACY ORDERABLE ITEM file linked
to this Drug Text Name. Editing information related to this Drug Text entry
will affect the display of information related to these.

Do you want to review the list of drugs and orderable items linked to this Drug
Text entry? ? YES//
You may queue the report to print, if you wish.

DEVICE: HOME// VT Right Margin: 80//

Drug Text Report for drug text : DANDOCILLIN DOSING

Date printed: NOV 4,2004 Page: 1


===============================================================

PLEASE NOTE: The National Formulary Restriction Text is the original text
exported with the DRUG TEXT file (#51.7) and automatically linked to the DRUG
file (#50) entries based on the VA product match. No ORDERABLE ITEM file
(#50.7) entries were automatically linked with DRUG TEXT file (#51.7).

DRUG TEXT NAME: DANDOCILLIN DOSING

DRUG TEXT:

DRUG file entries:


-----------------

Setup Guide 242 Drug Text Orders


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

NONE

ORDERABLE ITEM file entries:


---------------------------

Enter RETURN to continue or '^' to exit:

Drug Text Report for drug text : DANDOCILLIN DOSING

Date printed: NOV 4,2004 Page: 2


==============================================================
NONE
----------------------------------------------------------------------

End of Report.
Press Return to continue:

Do you want to edit the Drug Text Name? NO//

IMPORTANT!! After editing the Drug Text Name OR Text, review the drugs and
orderable items linked to this entry for accuracy.

Do you want to edit the text for this entry? YES//


TEXT:
No existing text
Edit? NO// YES

A text editor will open up

==[ WRAP ]==[ INSERT ]==========< TEXT >=========[ <PF1>H=Help ]====


AGE DANDOCILLIN DOSE
1-3 500MG
4-10 1000MG
>10 2000MG

<=======T=======T=======T=======T=======T=======T=======T======

Select SYNONYM: ??
You may enter a new SYNONYM, if you wish
This field will be used to allow quick lookup for the drug text defined.

Select SYNONYM:
INACTIVATION DATE:

Select DRUG TEXT NAME:

Step 2 – Link Drug Text to Drug


Select Pharmacy Data Management Option: DRUG
1 Drug Enter/Edit
2 Drug Interaction Management
3 Drug Text Enter/Edit
4 Drug Text File Report
CHOOSE 1-4: 1 Drug Enter/Edit

Select DRUG GENERIC NAME: DANDO


Lookup: GENERIC NAME
DANDOCILLIN-XR 06-14-04 55555-1234-99

Setup Guide 243 Drug Text Orders


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

...OK? Yes// (Yes)

GENERIC NAME: DANDOCILLIN-XR//


VA CLASSIFICATION:
DEA, SPECIAL HDLG: 5//

NATIONAL FORMULARY INDICATOR: Not Matched To NDF


LOCAL NON-FORMULARY:
VISN NON-FORMULARY:
Select DRUG TEXT ENTRY: DANDOCILLIN DOSING
Are you adding 'DANDOCILLIN DOSING' as
a new DRUG TEXT ENTRY (the 1ST for this DRUG)? No// Y (Yes)
Select DRUG TEXT ENTRY:
Select FORMULARY ALTERNATIVE:
Select SYNONYM: 055555123499//
SYNONYM: 055555123499//

Step 3 – Link Drug Text in orderable items dialog


Select Pharmacy Data Management Option: ORDERABLE
1 Orderable Item Management
2 Orderable Item Report
CHOOSE 1-2: 1 Orderable Item Management

Edit Orderable Items


Dispense Drug/Orderable Item Maintenance
Orderable Item/Dosages Report
Patient Instructions Report

Select Orderable Item Management Option: EDIT Orderable Items

This option enables you to edit Orderable Item names, Formulary status,
drug text, Inactive Dates, and Synonyms.

Select PHARMACY ORDERABLE ITEM NAME: DANDOCILLIN-XR DANDOCILLIN-XR TAB 08-06-


04

Orderable Item -> DANDOCILLIN-XR


Dosage Form -> TAB

List all Drugs/Additives/Solutions tied to this Orderable Item? YES//

Orderable Item -> DANDOCILLIN-XR


Dosage Form -> TAB

Dispense Drugs:
---------------
DANDOCILLIN-XR AUG 06, 2004
DANDOCILLIN (A) JUN 14, 2004

Are you sure you want to edit this Orderable Item? NO// YES

Now editing Orderable Item:


DANDOCILLIN-XR TAB
Orderable Item Name: DANDOCILLIN-XR//

This Orderable Item is Formulary.

Setup Guide 244 Drug Text Orders


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Select OI-DRUG TEXT ENTRY: DANDOCILLIN DOSING


Are you adding 'DANDOCILLIN DOSING' as
a new OI-DRUG TEXT ENTRY (the 1ST for this PHARMACY ORDERABLE ITEM)? No// Y

Setup Guide 245 Drug Text Orders


October 2008
RPMS Electronic Health Record (EHR) v1.05

33.0Creating Print Formats for CII Prescriptions


Federal law requires that the pharmacy have and maintain a signed copy of all CII
prescriptions for at least two years (might vary by state). For this reason, the
pharmacy still needs some type of a hand-signed prescription for all CII drugs.

Requirements for CII prescriptions are:

1. be dated as of, and signed on, the day issued


2. bear the full name and address of the patient
3. bear the drug name, strength, dosage form, and quantity prescribed
4. contain directions for the use
5. list the name address and DEA registration number of the practitioner
6. be signed by the practitioner in the same manner as a check or legal document
7. written in ink, indelible pencil, or by typewriter
To facilitate the prescribing of CII medications through the EHR, the provider will
order the medication. After the medication is ordered and signed, the provider must
select File | Print. When prompted, select the appropriate print format (Chart Copy)
and designate a printer. Before using this method, be sure that your Clinical
Applications Coordinator has developed the chart copy print format to facilitate this
process.

An example of this printout is shown below.


-------------------------------------------------------------------------------
    MEDICAL  RECORD        |            D O C T O R ' S    O R D E R  S
-------------------------------------------------------------------------------
NOTE:  Physician's signature must accompany each entry including standing  orders
Date and time for instituting and discontinuing the orders must be  recorded
-------------------------------------------------------------------------------
 DATE  & TIME |                  O  R D E R S                   |  SIGNATURES
-------------------------------------------------------------------------------

03/02/2005  10:00  MORPHINE TAB 15MG                        


                                     TAKE 1 TABLET BY MOUTH TWICE A  DAY
                  Quantity:  60                              ____________________

-------------------------------------------------------------------------------
Name:  SMITH,JOHN                        PHY:  WELBY, MARCUS
DOB: 04 JUN 1972                        ORD:  02 MAR 1998

CHEROKEE INDIAN HOSPITAL; HOSPITAL ROAD; CHEROKEE, NC  28719; PHONE 828.497.9163

Setup Guide 246 Print Formats for CII Prescriptions


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

The provider can sign the form and write down his DEA number (although all DEA
numbers are stored in the RPMS) and send the Controlled Substance prescription to
the pharmacy (or can have it print out in the pharmacy) where it can be filed and
stored.

To enable this functionality, you’ll need to reword your chart copy print formats and
adjust your chart copy parameters.

Set up the print parameters by creating a new parameter. The new parameter created
in this example is called “Chart Copy Footer1.”
Select Print/Report Parameters Option:

AL Allocate OE/RR Security  Keys...


FP Print Formats  ...
PM Performance Monitor  Report

Select CPRS Configuration (Clin Coord) Option: FP Print Formats

Select OE/RR PRINT FORMATS NAME: CHART COPY  FOOTER1  


NAME: CHART COPY FOOTER1//
Select FIELDS: HORIZONTAL  LINE//
FIELDS: HORIZONTAL LINE//
ROW: 1//  
 COLUMN: 1//
CAPTION (Optional):  
SUPPRESS CAPTION:
Select FIELDS:
ROWS: 5//
ORDER TEXT LENGTH: 132//
SINGLE: NO//

OK to compile print format? Yes// (Yes)

... 'CHART COPY FOOTER1' format has been compiled.

|||||------------------------     Column Numbers     ------------------------|||||


0---+----1----+----2----+----3----+----4----+----5----+----6----+----7----+----8
1 0 0 0 0 0 0 0 0
-------------------------------------------------------------------------------
Name: SMITH,JOHN                        PHY:  WELBY, MARCUS
DOB:                                    ORD:  02 MAR 1998

CHEROKEE INDIAN HOSPITAL; HOSPITAL ROAD; CHEROKEE, NC  28719; PHONE 828.497.9163

Select OE/RR PRINT FORMATS NAME:  

Finally, go back to your print/reports parameters and add in your new field(s)
Select Patient List Mgmt Menu Option:
AL Allocate OE/RR Security Keys
PR Print/Report Parameters ...
PM Performance Monitor Report

Select CPRS Configuration (Clin Coord) Option: PR Print/Report Parameters


CC Chart Copy Parameters
WC Work Copy Parameters
SC Service Copy Parameters
RE Requisition/Label Parameters

Setup Guide 247 Print Formats for CII Prescriptions


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

UM Summary Report Parameters


HO Print Parameters for Hospital
LO Print Parameters for Wards/Clinics

Select Print/Report Parameters Option: CC Chart Copy Parameters

Chart Copy Definition for System:  CHEROKEE-HO.NSH.IHS.GOV


----------------------------------------------------------------------------
Chart Copy Format CHART COPY BODY
Chart Copy Header CHART COPY HEADER
Chart Copy Footer CHART COPY FOOTER1
Expand Continuous Orders NO
Print  Chart Copy When signing orders
Prompt for Chart Copy PROMPT AND NOT ASK  DEVICE
----------------------------------------------------------------------------
CHART COPY FORMAT: CHART COPY BODY// CHART COPY BODY
CHART COPY HEADER: CHART COPY HEADER// CHART COPY HEADER
CHART COPY FOOTER: CHART COPY FOOTER1// CHART COPY  FOOTER1
EXPAND CONTINUOUS ORDERS: NO//
PRINT CHART COPY WHEN: signing orders//
PROMPT FOR CHART COPY: PROMPT AND NOT ASK DEVICE//

The following are the chart copy parameters we chose for printing out orders:
Select Patient List Mgmt Menu Option:
AL Allocate OE/RR Security Keys ...
PR Print/Report Parameters ...
PM Performance Monitor  Report

Select CPRS Configuration (Clin Coord) Option: PR   Print/Report Parameters


CC Chart Copy Parameters
WC Work Copy Parameters
SC Service Copy Parameters
RE Requisition/Label Parameters
UM Summary Report Parameters
HO Print Parameters for Hospital
LO Print Parameters for Wards/Clinics

Select  Print/Report Parameters Option: CC  Chart Copy  Parameters

Chart Copy Definition for System:  CHEROKEE-HO.NSH.IHS.GOV


------------------------------------------------------------------------------
Chart Copy Format CHART COPY BODY
Chart Copy Header CHART COPY HEADER
Chart Copy Footer CHART COPY FOOTER1
Expand Continuous Orders NO
Print  Chart Copy When signing orders
Prompt for Chart Copy PROMPT AND NOT ASK DEVICE
------------------------------------------------------------------------------
CHART  COPY FORMAT: CHART COPY BODY// CHART COPY BODY
CHART  COPY HEADER: CHART COPY HEADER// CHART COPY HEADER
CHART  COPY FOOTER: CHART COPY FOOTER1// CHART COPY  FOOTER1
EXPAND CONTINUOUS ORDERS: NO//
PRINT CHART COPY WHEN: signing orders//
PROMPT FOR CHART COPY: PROMPT AND NOT ASK DEVICE//

Setup Guide 248 Print Formats for CII Prescriptions


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

34.0Glossary

Setup Guide 249 Print Formats for CII Prescriptions


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Term Definition
Associations Some procedures found in the pick list may be linked to
associations. Associations enable the addition of one or
more data fields, which may include: additional CPT codes,
CPT code modifiers, patient education, exams, health
factors, ICD diagnosis, ICD procedure, immunization, skin
test, or transaction code.
Boilerplate Text A pre-defined Progress Notes or Discharge Summary
template containing standard text, with blanks to fill in for
specific data about a patient.
Business Rule Business rules control what actions can be taken on a
particular note.
CAC Clinical Application Coordinator.
Chart Copy Each hospital can only have one format for Chart Copies.
Chart copies can also be automatically printed on the ward.
Clinician A doctor or provider in a healthcare facility who is authorized
to provide patient care.
Consults Consults are referrals of patients by the physician to another
hospital service/specialty, to obtain a medical opinion based
on patient evaluation and completion of any procedures or
treatments the consulting specialist deems necessary to
render a medical opinion.
Cover Sheet A screen of the patient chart that displays an overview of the
patient’s record, with tabs at the bottom representing
components of a patient’s chart.
GUI Graphical User Interface. A type of display format the
enables users to choose commands, initiate programs, and
other options by selecting pictorial representations (icons)
via a mouse or a keyboard.
Health Summary A product that can be viewed through the application. It
includes snapshots of part of all of a patient’s tests and
results.
Icon A picture or symbol that graphically represents an object or
concept.
Imaging A component of the patient chart that includes Radiology, X-
rays, Nuclear Medicine, etc.
Modal A state or “mode” in which the user can only act or respond
to a single dialog or window. You must select a response
before you can exit or do anything else in the program.
Namespace A convention for naming package elements.
Notifications Alerts regarding specific patients that appear on the patient
chart.
Object Object is data to be inserted into a note that is retrieved from
the RPMS file.
Orderable Orderable items correspond to those services or products
that might be requested and provided by the patient care
services; they can be things such as a lab test, an imaging
procedure, or a medication.
OE/RR Order Entry/Result Reporting.
PCMM Patient Care Management Module.
Print Format: Service Copy Copies of orders and actions for a particular service that can
be printed upon request for the use of that service. The
service copy can also be set up for automatic printing at a
defined location. Contains header, body, and footer.

Setup Guide 250 Print Formats for CII Prescriptions


October 2008
RPMS Electronic Health Record (EHR) v1.1 Patch 3

Term Definition
Print Format: Chart Copy The official document that reflects the information in the
EHR. A copy of all current orders that appear on a patient’s
chart, using a pre-defined format. Each facility can only have
one format for Chart Copies. Chart copies can also be
automatically printed on the ward.
Print Format: Label A copy of the order that is printed on a label to be stuck on
the container of the order (e.g., lab sample).
Progress Notes Progress Notes are used by healthcare givers to enter and
sign online patient progress notes and are used by
transcriptionists to enter notes to be signed by caregivers at
a later date. Caregivers can review progress notes online or
print them in chart format for filing in a patient’s record.
SP513 The Consult form.
Team List A list containing patients related to several providers. These
providers are the list’s users.
TIU Text Integration Utility. This package consists of Progress
Notes, Discharge Summary, and a set of utilities for
managing clinical documents.

Setup Guide 251 Print Formats for CII Prescriptions


October 2008
RPMS Electronic Health Record (EHR) v1.05

35.0Contact Information
If you have any questions or comments regarding this distribution, please contact the
OIT User Support (IHS).

Phone: (505) 248-4371 (local) or (888) 830-7280 (toll free)

Fax: (505) 248-4363

Web: http://www.ihs.gov/GeneralWeb/HelpCenter/Helpdesk/index.cfm

Email: support@ihs.gov

Setup Guide 252 Contact Information


October 2008

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