272H – Unleash the Power of Reminder Dialogs Anne Rega, Hines Chief Information Office Field Office Eghosa Guobadia, CAC Philadelphia VAMC Joseph (Gus) O’Neil, VISN 1 Clinical Reminders Manager Learning Objectives • Definition of Reminder Dialog templates • Creation of Health Factors to record patient care events. • Building the Reminder Dialog components • Use of Element and Group dialogs to automate CPRS order entry • Using Branching Logic in reminder dialogs • Use of the ‘FORM LETTERS’ TIU document class. Introduction • What are Reminder Dialogs? One of the documentation interfaces available in CPRS. Can also be utilized as Note templates, without specific association to a Clinical Reminder. Introduction cont. • Advantages of Reminder Dialogs over regular TIU note templates – Enable recording of patient health events with Health Factors. Decision-support to CPRS users Introduction cont. • Design of a Reminder Dialog template is based on the blueprint • Collaboration – between Providers and CACs, is required to produce this blueprint Introduction cont. • For this class, we are going to demonstrate reminder dialog creation by creating the ## RAD MAM NOTE reminder dialog (where ## is your student number). Introduction cont. • Derived from the RADIOLOGY MAMMOGRAPHY NOTE reminder dialog, currently in use at Philadelphia VAMC • Used by Radiologists to document BIRADS category scores for mammography screen studies, using Health Factors. • This class is in no way intended to promote the use of the RADIOLOGY MAMMOGRAPHY NOTE. Introduction cont. • The CPRS note title for this reminder dialog was created in the ‘FORM LETTERS’ TIU document class • To permit printing of the progress note from CPRS as a Notification Letter to the patient, without sensitive, patient- identifying information appearing on the printout from CPRS. Introduction cont. • No Third-party software. • A sample blueprint for this dialog will be included with the class documentation on the VeHU website. • Screen prints of parts of the finished ## RAD MAM NOTE reminder dialog follow - Fig.1 - ## RAD MAM NOTE Fig. 2 - expansion of the BIRADS Category 0 Group dialog Fig.3 - display of the Patient Notification option element dialogs. Fig.4 – Note produced before signature (or before ‘Saving without Signature’) Fig.5 – Note displayed in CPRS, showing the ‘FORM LETTERS’ note title formatting Fig.6 - display of the Patient Notification prompts, for ‘OTHER’ type of decision. Clicking on the ‘Finish’ button will present a plaintext field Fig.7 – Plaintext field that pops-up after ‘Finish’ button clicked. Fig.8 – Note displayed in CPRS, after use of the plaintext field Using your Vista Account Make sure you keep CAPS LOCK on throughout this hands-on session When creating entries in ANY VISTA File, you should ALWAYS use UPPER CASE. Double click on the ‘Reflection’ icon on your desktops • Access Code is: ##VEHU • Verify Code is: VEHU## • Elec Sig Code is: VEHU## • Where ## is the student number listed at the workstation where you are sitting Generating Patient Lists • With the recording of medical events (in this case BIRADS scores) with Health Factors, Patient Lists can be generated based on such Health Factors • Rule Sets are used to generate such patient lists, in the Reminder Patient List Manager Menu. • The creation of Rule Sets involves - (1)mapping Health Factors to Reminder Terms (2)mapping Reminder Terms to Finding Rules (3)mapping Finding Rules to Rule Sets, and the Rule Sets specify the logic that determines the cohort of patients included in the Patient List. Generating Patient Lists (cont.) • Once Rule Sets have been set-up, the Patient Lists can be produced by non-IT Department users Such users will require – - Vista Access - PXRM EXTRACT PATIENT LIST secondary menu. • The following slides show use of a Rule Set, called ‘ZZ (RS) MAMMO BIRADS CATEGORY 0’ to detect patients with ‘BIRADS Category 0’ health factor recorded in their charts, from July 2007 to December 2007. Enter at the prompt: ^PATIENT LIST MANAGEMENT Generating Patient Lists (cont.) • Patient List reports are usually completed in minutes, except if the cohort is very large (All patients DUE for Flu Vaccine, for instance) • The following slides show completed Patient Lists and how they can be utilized Sample of report captured from SmarTerm session in (Notepad) text file Related Sessions • Patient List creation and support are discussed in another VeHU 2008 session, the 318H – Clinical Reminders Extracts session.