Rpa Solution Design Document Template
Rpa Solution Design Document Template
Rpa Solution Design Document Template
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
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.
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.
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
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:
Notifications come with a default, but sites need to review these defaults to decide if
that is what they want to use.
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).
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.
Refer to the section “Team List Management Menu” below for more information
(under Patient Context Configuration).
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.
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
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
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.
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
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
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.
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.
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
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
---------------------------------------------------------------
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.
All viewing of demo patients only may be set for the following:
-- Setting Allow viewing of demo patients only for Division: DEMO HOSPITAL –
Limit to demo patients only?: ??
--------- Setting Patient detail report for Division: DEMO HOSPITAL ---------
Value: ?
Value: ??
Value:
This parameter controls whether a patient must have an assigned health record
number to be selectable within the EHR.
----- 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.
This recalls the last patient selected when a user logs on.
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.
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.
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).
Allow user to create new visits. may be set for the following:
------ Setting Allow user to create new visits. for Class: PROVIDER -------
Value: ???
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.
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:
-- 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.
General location for outside encounters. may be set for the following:
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.
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.
-------- Setting Visit Search Stop Date for Division: DEMO HOSPITAL --------
Visit Search Stop Date:
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.
-------- 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.
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:
The Sequence specifies the visit types selectable from the encounter context dialog.
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
KEY: ORES
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.
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.
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
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.
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
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.
At the main RPMS main menu, select Menu Management | KEYS | Allocation of
Security Keys:
Select Menu Management Option: key Key Management
The following table provides information about the various BGOZ keys and what
users need them:
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.
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.
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
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.)
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.
You can add, edit, or remove user classes on assigning User Classes.
If the user has the Provider key, you will not have to assign the BGOZ keys.
Generally, the CAC does not use this menu in the basic setup for the EHR.
The CAC uses the TIU Maintenance Menu (TMM) in the basic setup.
This section addresses only the Document Definitions (Managers) DDM option. This
option lets you manage document definitions, user classes, business rules and system
parameters.
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.
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
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.
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
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
Pharmacy Notes Nursing Notes PC Notes Crisis Notes Discharge Summaries Document Classes
Nurs Triage Note Nurs Admit Note Nurs Imm Note Discharge Summary Titles
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.
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
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.
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:
Change, delete, or rename Note Titles that do not add any significant or useful
information; for example, DICTATED XXX.
There are some Note Titles that are unique for different reasons. Examples:
PROCEDURE TRANSFER
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
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:
Because screen view space has some limitations, below are some examples of note
titles, in alphabetic order:
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.)
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.
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.
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//
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).
You must logout of the EHR and re-enter for your object to show up.
DESCRIPTION
Includes the list of active and pending meds and supplies all in one list
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.
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.
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.
This option allows you to define and modify parameters for the batch upload of
documents into RPMS.
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.
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.
Now enter the USER CLASSES for which cosignature will be required:
Select USERS REQUIRING COSIGNATURE: STUDENT//
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.
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.
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.
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.
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.
CHART COPY PRINTER: Select the printer for chart copies of routine documents.
STAT COPY PRINTER: Select the chart copy printer for STAT documents.
This is the hospital location to which the parameters apply. You can enter new
parameters.
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.
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.
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
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.
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.
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.
This option allows the CAC or other manager to remove all non-shared TIU
templates for all users who have been terminated.
(DEMO HOSPITAL)
You use this menu of options to manage User Class Definitions and Membership as
well as manage business rules.
You will use this option to view user classes and their hierarchy. Also, you will
create, edit, or remove user classes from this option.
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.
DOCTOR,DEMO
You will use this option to view, add, edit, or remove user classes for a specified user.
-------------------------------------------------------------------
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
This option allows you to add, edit, or delete business rules for a specified document
definition, as appropriate.
Enter selection:
This parameter determines how many seconds should elapse between each auto-save
of a note that is being editing in the EHR.
Y/N auto cleanup upon termination may be set for the following:
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’.
The parameter determines which user class can make personal templates.
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.
Template Field Editor User Classes may be set for the following:
-- 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.
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.
-------- Setting Personal Template Access for Division: DEMO HOSPITAL --------
PERSONAL TEMPLATE ACCESS: ?
READ ONLY allows use, but not creation of, personal templates.
0 FULL ACCESS
1 READ ONLY
2 NO 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
This parameter determines which Reminder Dialogs can be used as templates. Refer
to the Reminders Guide.
------- Setting Verify Note Title for Division: DEMO HOSPITAL -------
Verify Default Title:
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.
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.
Create New Templates: This selection is for users with access to personal templates.
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.
Template Type: The drop-down list determines the type of template being created.
There are four template choices available:
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.
Preview/Print Template: The selection lets you preview and print the template you are
creating.
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.
Edit Template Fields: Use this selection to edit the existing template fields.
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.
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.
The following table describes what each selection on the drop-down list for the Type
field:
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.
If you select 1, this will purge all existing alerts/notifications for a recipient/user.
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.
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):
------- 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’.
Select the Send Flagged Orders Bulletin (BUL) option on the Notification Parameters
menu to display the following:
Send Flagged Orders Bulletin
-- Setting Send Flagged Orders Bulletin for Division: DEMO INDIAN HOSPITAL --
Value: ??
Value:
Value:
Use this option to set parameters that determine deletion conditions for a notification.
------- 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.
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.
Priority threshold for Popup Alert may be set for the following:
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:
0 None
1 High
2 Medium
3 Low
Priority:
The providers, physicians and teams must be set up properly and accurately
for the correct individuals to receive the notification.
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:
Enter 'yes' if this person or team should always receive the notification.
Value:
---- Setting Notification Sort Method for Division: DEMO INDIAN HOSPITAL ----
Value: ?
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.
-------- 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
Value:
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!
Value: Disable//
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.
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.
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.
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.
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.
KEY: ORES
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.
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.
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.
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.
This option allows you to create or change actions that can be placed on the Add
Orders menu.
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.
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.
Type of Orderable:
This option lets you create or change the things that are orderable items via generic
text orders at your site.
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.
Enter selection:
This selects the new default consult dialog for the specified selection.
Enter selection:
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
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.
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.
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.
Menu for Write Orders List may be set for the following:
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.
0 Mnemonics Included
1 No Mnemonics
2 Reserved1
3 Reserved2
Menu Style:
The “style” determines whether the EHR order menus include mnemonics.
Select PROMPT:
This option lets you create or change prompts for generic orders.
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.
------------------------------------------------------------------------
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>
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
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.
------------------------------------------------------------------------
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
** You are NOW in the ORDERABLE ITEM matching for the dispense drug. **
Matching OUTSIDE RX 11
to
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:
No existing text
Edit? NO//
----------------------------------------------------------------------------
Dosage: 200mg
Route: ORAL
Schedule: Q8H
Priority: ROUTINE
------------------------------------------------------------------------
Category: <Enter>
Is this patient scheduled for pre-op? NO// <Enter>
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
--------------------------------------------------------------------------
------------------------------------------------------------------------
Consult to Service/Specialty: CARDIOLOGY
Reason for Request: r/o MI and arrythmia
Category: OUTPATIENT
Urgency: STAT
Place of Consultation: Emergency Room
------------------------------------------------------------------------
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.
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.
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
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].
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.
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.
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.
Enable or disable order checking system. may be set for the following:
E Enable
D Disable
Value: Enable//
Creatinine Results for Contrast Media may be set for the following:
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.
Value:
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.
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.
Order Check Clinical Danger Level may be set for the following:
Enter the code indicating the clinical danger level of the order check.
1 High
2 Moderate
3 Low
Value:
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:
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:
Duplicate lab orders date range may be set for the following:
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 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.
Orderable item duplicate date range may be set for the following:
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.
Duplicate radiology order date range may be set for the following:
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.
Order Check On/Off Editable by User may be set for the following:
Editable by User?:
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.
---- 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
Code indicating the processing flag for the entity and order check.
Value:
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).
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.
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.
------ Setting MRI SCANNER HEIGHT LIMIT for System: DEMO.MEDSPHERE.COM ------
Value: ?
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.
------ Setting MRI SCANNER WEIGHT LIMIT for System: DEMO.MEDSPHERE.COM ------
Value: ?
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.
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.
Would you like help understanding the list of order checks? No// (No)
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.
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.
Disable Hold:
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.
--- Setting Active Orders Context Hours for System: DEMO.OKLAHOMA.IHS.GOV ---
ACTIVE ORDERS CONTEXT HOURS:
You should setup miscellaneous OE/RR parameters before users actively start using
the application.
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)
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.
Nothing is needed here. This is a hold over from the old roll-and-scroll version
of order entry.
Restrict Requestor
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
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.
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.
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
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.
Enter the unsigned orders view to present ORES key holders on exit.
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.
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.
All copies printed from the EHR are not considered official copies. Chart copies can
be automatically printed on the ward.
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.
A All orders
P Pharmacy orders only
I Inpatient
O Outpatient
B Both
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.
1 Nature of order
2 Order Status
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.
1 Nature of order
2 Order Status
1 Detailed format
2 Columnar format
1 Nature of order
2 Order Status
1 Detailed format
2 Columnar format
1 Released/Unsigned
2 Unsigned
3 Unsigned/Unreleased
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.
1 Released/Unsigned
2 Unsigned
3 Unsigned/Unreleased
1 Service/Section
2 Provider
3 Patient
4 Location
5 Entered By
6 Division
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:
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
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.
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.
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.
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.
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.
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.
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:
The application asks users who can complete a consult to enter a progress note.
This limits the medication display on the Medications window to only those
medications that were active within the last number of days specified.
The entered value controls the upper limit for days supply of a dispensed medication.
The range is 90-365 days.
Controls the default collation order for the medication list. May be one or more
of the following:
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.
Default Print for Med Print Action may be set for the following:
Setting Default Printer for Med Print Action for System: DEMO.CIAINFORMATICS.COM
0 Brief
1 Detailed
2 Prescription
3 Sample Label
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.
Controls the availability of the Print Sample Label feature within EHR.
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.
Value: 5//
This parameter controls the maximum number of prescriptions that can be printed on
a single page.
--- Setting Enable Print Script Feature for System: DEMO.OKLAHOMA.IHS.GOV ---
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.
Renewal Limit (Days) for Expired Meds may be set for the following:
This is the maximum number of days following the expiration of a prescription that it
may still can be renewed.
The macro is launched from the Pharmacy Ed button that should appear in the
Patient-Visit Toolbar.
When the pharmacist clicks this button, The Medication Counseling dialog (a form)
appears where medication counseling information is entered.
The following sections described the various parts of the form that the CAC can
setup.
The default comprehension can be blank or it can set as Good, Fail, Poor.
The RPMS provides a list of valid POVs. At the “Default POV code” prompt, you
can enter the ICD diagnosis code number or description.
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).
This option allows you to specify a hospital location for visit creation. The hospital
locations must have a Pharmacy Stop Code associated with it.
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.
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.
Duration for Lab Order Display may be set for the following:
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.
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.
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.
Vital signs list for cover sheet may be set for the following:
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:
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.
-------- Setting Default units for measurement for User: DEMO,DOCTOR --------
Select Measurement Type: temperature
Are you adding TEMPERATURE as a new Measurement Type? Yes// YES
0 US
1 METRIC
Default Units:
You use this option to set the default units for a specified measurement type.
--------- Setting Can enter vital measurements? for User: USER,DEMO ----------
Can enter vital measurements?: ?
This establishes those users and classes who are allowed to enter vital signs.
----- 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.
This option allows the user to define formats for printing labels and requisitions.
List All Health Summary Types may be set for the following:
----- 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.
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.
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.
Select EHR SETUP MENU Option: VAHS Health Summary Overall 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
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.
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
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:
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.
14.3.1 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:
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.
Default time/occ for all reports may be set for the following:
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.
This decides the order of the reports for the system on the Reports window.
This decides the order of the reports for the user on the Reports window.
-------- Setting Disable Problem List Editing for User: DEMO,DOCTOR --------
Value: ???
Value:
--------- Setting Problem List Default Filter for User: DEMO,DOCTOR ---------
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.
Include Personal Hist Problem w/Active may be set for the following:
--- Setting Include Personal Hist Problem w/Active for User: DEMO,DOCTOR ---
Value: ???
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.
If you enter NO, the user /class will not be able to enter or edit POV information.
Maximum Entries Shown in POV History may be set for the following:
Setting Maximum Entries Shown in POV History for Division: DEMO HOSPITAL
Maximum Entries:
---- Setting Disable Reproductive History Editing for User: DEMO,DOCTOR ----
Value: ???
Value:
When the Value is YES, the selected user (or class) cannot enter or document
reproductive history information.
---- 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).
Disable Evaluation & Management Editing may be set for the following
At Value, enter Y so that the selected user/class cannot edit the E&M information.
Suppress Emergency Room E&M Codes may be set for the following:
At Value, enter Y so that the Emergency option will not be on the Type of Service
listing for E&M in the EHR.
At Value, enter Y so that the Hospital option will not be on the Type of Service
listing for E&M in the EHR.
Enable Support for ICD Procedure Entry may be set for the following:
Setting Enable Support for ICD Procedure Entry for Division: DEMO HOSPITAL
Value:
Yes means the entity can code for ICD procedures (used for hospitals).
7. On the Patient Education panel on the Wellness window, click the Add button
and then enable the Pick List radio button.
8. Click the Pick Lists button to display Manage Education Quick Picks dialog.
9. Click the Edit PickLists button on the Manage Education Quick Picks dialog to
display the Manage Categories dialog.
10. Click Add on the Manage Categories dialog to display the 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.
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
Setting Value to YES prohibits the specified user/class from editing exams.
Value set to Y will prevent the user/class from editing health factors.
Stop Immunizations from Adding CPT Codes may be set for following:
Enter Y at Value to stop the automatic adding of CPT codes when an immunization is
documented on super-bills.
Stop Immunizations from Adding ICD Codes may be set for following:
Enter Y at Value to stop the automatic adding of ICD codes when an immunization is
documented on POVs.
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.
Force automatic signature of ADR entries may be set for the following:
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.
Allow Entry of adverse reaction data may be set for the following:
---- 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.
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).
Select the Site Parameter Edit on the VueCentric Framework Configuration option to
display the following:
Site Parameter Edit
--- Setting Default object source path for System: DEMO.OKLAHOMA.IHS.GOV ---
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.
Host polling interval: This is the number of seconds (1-60) between polls.
Primary inactivity timeout: This is the number of seconds (30+) of inactivity before
locking the application.
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.
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.
Choose from:
BEHSPELLCHECK.SPELLCHECK
This option allows you to specify the spellchecking plugin this is VUECENTRIC
OBJECT REGISTRY PROGID, or NAME.
27.0Design Mode
The Site Manager/CAC uses Design Mode to add the following to change the GUI
template of the EHR.
Right-click on the top bar and select Design Mode from the menu.
After you select Design Mode, the Design menu becomes available.
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.
FONT: Sets the default font for the application. Click the button to display the
Font dialog.
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.
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.
Copy: use this button to copy the selected object to be pasted to another section.
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.
Select the Properties option on the menu to display the Properties of Tree View
dialog.
LEFT: Location of the left side of the object relative to its parent.
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.
LEFT: Location of the left side of the object relative to its parent.
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.
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
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.
27.6.1.1 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:
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.
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:
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"
19. Save the template and exit design mode. The end result is shown in the following
figure:
ALIGN: Alignment of the object relative to its parent. Choices are All, Bottom,
Center, Left, None, Right, Top.
27.7.1 Notifications
LEGEND: Location can set to left or right OR can be hidden.
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.
27.7.4 POV
This is the Visit Diagnosis component.
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.
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.
28.0IHS Setup
The IHS Setup involves making super-bills and pick-lists.
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.
Click the Add button on the Manage Categories dialog to add a new super-bill
category. The application displays the 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).
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.
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.
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.
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.
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.
When you click Save (and the Education Topic is checked, the Add Patient Education
Event dialog displays).
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).
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.
The list in the ICD Pick-Lists panel shows the pick list from which you
choose.
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.
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
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.
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.
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.
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.
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.
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.
First, using your Web browser, go to the search engine you want to use. In this
example, Yahoo was chosen.
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.
SEARCH URL: type (or paste) the search address; replace the search term with
[SEARCH TEXT] (in this example replace “diabetes” with [SEARCH TEXT])
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.
Select the Manage Pick Lists option from the right-click menu above the Chief
Complaint field.
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.
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).
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).
Click Yes to delete the selected pick list item. (Otherwise, click No.)
You access this configuration by selecting EHR | CCX to display the following:
Chief Complaint Configuration
After you enter PFX as the Chief Complaint Configuration Option, you get the
following:
Whatever you enter at the “Prefix text” prompt will be the text that appears when you
select a Chief Complain pick list item.
1. Create the menu option “POC - POC Results Entry…” in RPMS using the Edit
Options menu key in RPMS.
Select IHS Menu Management Option:
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
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//
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
6. Add all POC tests under the new ‘Point of Care’ menu.
Select VA FileMan Option: ENTer or Edit File Entries
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
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
Below is how the POC lab results would look in the EHR:
30.0Reminders
Reminders setup is complex process. Refer to the Reminders manual for more
information.
31.0Coding Tools
Your CAC can place a hyperlink in EHR to any Web resource. Below are some
examples.
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 ...
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.
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:
NONE
End of Report.
Press Return to continue:
IMPORTANT!! After editing the Drug Text Name OR Text, review the drugs and
orderable items linked to this entry for accuracy.
<=======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:
This option enables you to edit Orderable Item names, Formulary status,
drug text, Inactive Dates, and Synonyms.
Dispense Drugs:
---------------
DANDOCILLIN-XR AUG 06, 2004
DANDOCILLIN (A) JUN 14, 2004
Are you sure you want to edit this Orderable Item? NO// YES
-------------------------------------------------------------------------------
Name: SMITH,JOHN PHY: WELBY, MARCUS
DOB: 04 JUN 1972 ORD: 02 MAR 1998
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:
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
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
34.0Glossary
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.
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.
35.0Contact Information
If you have any questions or comments regarding this distribution, please contact the
OIT User Support (IHS).
Web: http://www.ihs.gov/GeneralWeb/HelpCenter/Helpdesk/index.cfm
Email: support@ihs.gov