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Medical College of Ohio
Pathways Care Manager
Physicians Access
Users Guide
Department of Clinical Informatics
Rm 6175
Julie Christy-Givin, Director
Churton Budd, Systems Analyst
Kathleen Barber, Systems Analyst
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INDEX
INDEX ...................................................................................................................................................................2
INTRODUCTION .......................................................................................................................................................3
SYSTEM OVERVIEW ...............................................................................................................................................3
TRAINING OVERVIEW: ..........................................................................................................................................3
SIGNING ON TO PCM: .............................................................................................................................................4
PC-VIEW MAIN MENU: ...........................................................................................................................................5
EXITING PCM: ..........................................................................................................................................................6
PATIENT SELECT: ..................................................................................................................................................7
PATIENT SELECT – SEARCH VIEW: ...................................................................................................................8
PATIENT NUMBERS: ...............................................................................................................................................8
ASSIGN RELATIONSHIP TO YOUR SELF: .........................................................................................................8
PHYSICIAN CENSUS AND PHYSICIAN ROUNDING REPORTS ....................................................................9
RE-ASSIGNING YOUR PATIENTS & ASSIGNMENTS TO ANOTHER PHYSICIAN ................................. 10
ENDING A PROVIDER RELATIONSHIP ............................................................................................................ 11
PATIENT RESULTS ................................................................................................................................................ 11
LAB / RADIOLOGY RESULTS .............................................................................................................................. 11
PHYSICIAN REPORTS ........................................................................................................................................... 12
CHANGE YOUR PASSWORD ............................................................................................................................... 12
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Introduction
This document will help to familiarize you with Pathways Care Manager (PCM). PCM is
a product of McKennison/HBOC and part of a suite of modules that make up the Pathways
2000™ family of products. Pathways Care Manager is a patient-centered, client-defined clinical
information system that offers a fast, accurate method for data input and retrieval at the point-of-
care and improves productivity and the quality of patient care.
This is a very exciting time for MCO as we have taken a major step forward to establish
ourselves on the cutting edge of health information technology and are making the commitment
to implement many new applications in the clinical setting. In addition to PCM, other
applications are being installed to replace or enhance patient management and health
information data. The STAR 2000 application will be used for patient registration,
admission/discharge/transfer functions, financial applications such as charging and billing and
other census and patient processing management, storage and reporting. The pathology
department will be installing Pathways LAB, HEMOCUE and TAMTRON which will handle all
functions of laboratory specimen processing, blood bank and surgical pathology. The Peri-
operative Services are presently using ORBIT which manages OR room scheduling and
inventory. Food and Nutrition Services will be installing C-Bord which will automate many
patient dietary functions.
System Overview
Pathways Care Manager is a Client/Server application that runs under the Unix
operating system and is resident on two Hewlett Packard 9000 mainframe computers located in
the computer room in Dowling Hall. The HP9000’s are connected to the MCO Network thus
enabling access from the MCO Local Area Network (LAN). STAR 2000 also runs on an
HP9000 and is located next to the PCM system.
Training Overview:
This training module will focus on the Results Reporting and Physician census modules
of PCM. PCM has many other modules which we will address in additional training documents
focused to various other MCO staff groups. These include Assessment and documentation,
Meds and IV’s, Clinical Query and Guidelines and Outcomes.
Pathways Care Manager is a highly configurable and sophisticated system. Its flexibility
will allow the Clinical Informatics Department to customize it to the way we practice clinically at
MCO and thus make the system more robust and user friendly and ultimately assist us in
providing quality clinical care. In addition, because of the extensive clinical data that the
software collects and maintains in its databases and it’s sophisticated retrieval tools, we will be
able to provide many new reports and extract data to help with clinical decision making and
quality improvement.
If you find room for improvement of the application or you feel that the software can be
enhanced to improve your clinical practice, please contact the Department of Clinical
Informatics to discuss your issues. We are very eager to assist the clinician in all aspects if
Information Technologies and integration of Information management applications in the clinical
setting with the ultimate goal of improving patient care.
An application enhancement suggestion form has been included in the appendix of this
manual. Please feel free to copy it, fill it out and mail it via campus mail to:
Clinical Informatics, Rn 6175 Hosp.
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Signing on to PCM:
To connect to PCM, you will be utilizing the Client application called PC-View. PC-View
exists on your Windows95/98 PC in the Novell Delivered Applications menu. As the application
relies on some sort of connection to the MCO network, you will first have to be signed on to
Novell or dialed into the MCONet via remote access.
Look for the Care Manager icon on your desktop. It is the triangle shaped icon that looks like
this:
When you double click on this icon, PC-View will execute and you will be presented with a login
screen.
Enter your USER ID and press
enter, type your BARCODE
(password) and press ENTER
again. For security, “*”s will
show when you type.
There are two things that must be entered here. The first is your USER ID. This is
unique for every individual accessing the system. It identifies you to the system so that the
system can deliver the correct menu’s and functions based on your security level. The second
line is asking for your BARCODE. Ultimately, the barcode would be scanned using a barcode
scanner similar to the checkout at the grocery store. This barcode is like the one on the back of
your ID. MCO is not utilizing this level of security yet, so the barcode is simply a password
typed from the PC keyboard.
Your USER ID and BARCODE (password) combination is your electronic signature on
the system. Every move you make while in the application is logged to a file for trouble shooting
and in order to maintain a permanent record of system activity. Knowledge of this fact should
not intimidate you, nor is it meant to. This kind of system monitoring is typical of Health
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Information Management systems and is a requirement of JCAHO in order to help protect the
confidentiality of patient information. Because of this fact, it is very important that you do not
disclose your password or allow others to access the system with your account. It is equally
important that you sign off the application when you are done with your session to prevent
others from accessing the system under your name. Treat your User ID and barcode with the
same respect as you would your bank machine card and pin number.
If you make a mistake when signing onto PCM. You will receive a message from PCM
stating “STAFF MEMBER NOT IN SYSTEM”. Simply retry your user ID and barcode
combination again. VERY IMPORTANT !!! Pathways Care Manager has been configured
so that your USER ID is in ALL CAPITALS. You can however change your
barcode/password. If you have done this and set your password to be lower case, this
may present problems while trying to sign on. PCM recognizes and differentiates upper
and lower case letters. It is best to maintain your password as upper case and make
sure you put the CAPS LOCK on when you are changing your password.
Patient
User ID Demographics
currently
PC-View Main Menu:
Signed
Box
on If you have successfully signed on to Pathways Care Manager, you will see the PC-View
Main Screen that is titled “HealthView”. Healthview is the launch pad that will deliver you to all
the other applications within PCM. Whenever you finish an application you will return to
Healthview. The components of Healthview’s screen are listed below.
Menu Bar Tool Bar
Logon Date / Time
MENU BAR: These are drop down menus. If you locate your mouse cursor on one of them
and click your left mouse button, the menu choices will appear in a drop down box. Move your
mouse cursor over the menu choice you wish to execute and click your left mouse button again.
If you decide to cancel your choosing a dropdown menu item, simply click outside of the
dropdown box or press the ESC key.
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TOOL BAR: These buttons are quick access buttons that do the same thing as some of the
menu bar dropdown choices. These are the most frequently used functions and the button is
provided as a time saving method of choosing that item. Simply click on the button to execute
the function.
PATIENT DEMOGRAPHICS BOX: If no patient has been selected, this information within this
box will be blank. If you choose a patient, the patient’s demographic information will be visible
as a reference within this box. Note: Many of the functions of the menu choices and buttons
require you to first select a patient as they act on the patient selected.
USER SIGNED ON: This box will list the current user ID who is signed on. If you are working
on the system and have correctly signed on, it should show your system name. If it does not,
then perhaps the user shown here forgot to sign off when they were done with their session.
You should sign them off with the EXIT button (or FILE and EXIT form the menu’s) and sign
back on using your correct USER ID and BARCODE.
CURRENT DATE/TIME: This is the date and time that any actions that you take on the system
will be recorded as. You can change this time but you can only change it backward to
document something that occurred in the past. You cannot future chart anything.
Exiting PCM:
You can exit PCM a number of ways.
1. You can double click on the PCM icon in the top left corner of your screen. This is right
above the FILE menu choice.
2. You can choose the FILE Menu choice and then choose the dropdown EXIT
3. You can click on the EXIT TOOL Button
4. You could click on the “X” in the top right corner of the HEALTHVIEW window. But it is not the best method
of closing HealthView and we ask that users refrain from executing it. Although this is Windows95/98’s
normal quick end task function and will immediately close the HealthView
window. This may in some cases cause system errors to develop. Please only
use methods 1 through 3 above.
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Patient Select:
To access the Patient Select function, choose the PATIENT Tool
Button or choose the PATIENT drop down menu choice, then
PATIENT SELECTION.
You will then receive a new window as shown below.
VIEW:
How to
view the
patient list DEPT: What
STATUS:Which department
patient types to (unit) to show
show
VIEW: Defines how to view patients. You can view patients by CENSUS, which shows patients
in order by department, room and bed. You can view patients by relationship if you have any
patients that have been assigned to you by yourself or others with the PROVIDER
ASSIGNEMENT function. The relationship view will probably be the most important view for the
physician as it shows only those patients you have established a relationship with (explained
later in this document) and ignores all other patients in the hospital. You can also view patients
by a SEARCH. The search will be explained a little more in detail in the next pages.
STATUS: Defines the status of patients that are displayed. By setting this, you can select
which patient types are viewed (ADMITTED, PRE-ADMITTED, DISCHARGED, etc. ).
DEPT: Defines which departments or nursing stations your view will display. If your security
allows you to view multiple departments or nursing stations, setting the department box to “ALL
AUTH” will allow you to view all patients in all departments you are authorized to view. The
department type of CC_OUTPT will set the view for all patients that are not in a bed (i.e. Out
Patients).
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Patient Select – Search View:
The Search view for patient select is a very powerful function that allows you to find a patient
that is presently being treated or was treated in the past 30 days. It searches records that are
stored in Care Manager. You still have the opportunity to set the STATUS and DEPT to further
refine your search.
You can begin your search by typing part or
the whole of a first or last name (you don’t
need to worry about capitalization, case is
ignored by the search). You can also begin
your search by entering a medical record #,
an account #, a Social Security # or a date of
birth. When you have entered your search
criteria, left click on FIND at the bottom of the
box. If you have multiple patients, you can
highlight one of them by clicking once on that
line and then click on DETAIL to get more
information on that particular patient. If you
need to start your search over, click on
CLEAR and re-enter your search criteria.
Patient Numbers:
UNIT # / MR #: This number is equivalent to a
Medical Record number. It is a 8 digit number
that is unique to the patient. This was referred to in the past at MCO as the patients “SIX-DIGIT
NUMBER”. PCM and the other HBOC products require an 8 digit number be used. Most
numbers will thus have two leading 0’s and then the six digits that we are familiar with. You
should get in the habit of calling this number the MEDICAL RECORD number and keep in mind
that it will be going to EIGHT, not 6 digits.
ACCOUNT #: This number is generated each time a patient is registered or admitted. Account
numbers are 10 digits. The format consists of “julian date – incremental number”. The julian
date is the year + 3 digits that indicated the sequential day of the year, 1 is Jan 1st, 365 would
be Dec 31st. The incremental number is incremented by the system automatically each time a
patient is registered. The first patient registered on January 1st, 1999 would have an account
number of 99001-00001.
Assign Relationship to your self:
If you are a Physician, Resident or Medical Student or other care provider that may need to
keep track of multiple patients that are assigned to you on multiple units, the ASSIGN
RELATIONSHIP function will be very helpful to
you. With this function, you can tell PCM which
patients you have been assigned to or are
responsible for. When you are in the
PATIENT SELECT screen, highlight the patient
you want to establish a relationship for by
clicking once on the line they appear on. This
highlights the line black. Next go to the drop
down menu choice titled RELATIONSHIP and
choose ASSIGN SELF. Choose the provider
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type you are assigning yourself as (i.e. CONSULTING PHYSICIAN, REFERRING PHYSICIAN,
RESIDENT, Etc.) Once you have assigned patients to yourself, you can
find them more quickly by choosing “By RELATIONSHIP” in the VIEW
option of PATIENT SELECT. This will speed your ability to find patients
when you want to review results or check on orders. Your view will now be
limited to only those you have a relationship with. In the census and
search view all the other patients in the lists may distract you and make it
difficult to focus in on only those patients you are responsible for.
Physician Census and Physician Rounding Reports
When we utilize the PROVIDER ASSIGNMENT function of PCM there are specialized reports
available that will print a summary of lab results and orders on patients you have a relationship
with. The reports titled “PHYSICIAN ROUNDING REPORT” and “PHYSICIAN CENSUS” can
be found in the REPORTS drop down menu or as a button on the TOOL BAR. Examples of
these reports can be found in the appendix of this document. The Care Manager report format is
customizable and specialized reports can be created by the systems development staff of the
Clinical Informatics Department. Please use the Enhancement Request form in the appendix of
this document to submit requests for specialized reports.
If you are no longer responsible for the patient, or want to remove them from your relationship
list, simply highlight them while viewing your relationship list and go to the drop down menu
choice titled RELATIONSHIP and choose UNASSIGN SELF to remove them from your list.
They will no longer show on your patient VIEW as relationship and they will no longer print when
you print your patient census and your physician rounding report.
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Re-assigning your patients & assignments to another
physician
Another function is available that lets you assign another clinician a relationship with a patient.
This might be useful to a department secretary or a clinical nurse specialist who, when a consult
is received in the department might assign a relationship to the attending who is rotating that
month. A physician might want to use this function at the end of a
month’s rotation to transfer the relationships they have to another
physician (i.e.: when a resident is done with a rotation and wants to re-
assign all of their patients to the oncoming resident). The Physician
can access the provider assignment function from the UTILITIES drop
down menu. When you choose the Care Provider Assignment you will see a new screen pop
up which looks a little busy. This screen is easier to follow when you remember that the right
side of the screen is for picking the provider and the left side is for picking the patient. The first
steps involve choosing a provider. You will need to pick the Provider Type (which in most cases
will be MD, RES, MDS), and the Care Relationship (which will be Consulting or Referring
Physician, Medical
Student, Resident or
Physician). You will then
need to choose a staff
member from the STAFF
box. The first time you go
into the screen, you may
see that all of the fields are
blank. When you have
filled them in a few times
and are comfortable with
the defaults, you can save
them by choosing the FILE
menu and SAVE
CONFIGURATION. The
next time you return to the
provider assignment
screen, the STAFF side of
the screen will fill in with
what you have just saved
as the default.
The next step involves
choosing a patient. To choose a patient, pick the census you want to review in the PATIENT
DEPT box. If you want to show only those patients who are not assigned to anyone other than
the attending and admitting MD check the unassigned only box. This will show only those
patients who have no consulting or referring MD in the patient department chosen. The patients
in the list who are highlighted blue are the ones who are already assigned to the provider listed
in the STAFF box with the relationship listed in the CARE RELATION box. To pick a patient,
click on the patient name and that patient will be highlighted. You can choose multiple patients
at a time by holding the CRTL key down when you click with your left mouse button. When you
have chosen your patients, click on the ASSIGN to assign these patients to the person
highlighted in the STAFF box. Choose REASSIGN to move all these patients to another staff
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member (i.e. when you are at the end of your rotation on a service and want to re-assign the
patients to the oncoming physician). Choose COVERED BY to set a date and time that another
provider is going to cover your selected patients for you. This puts those patients on that
provider’s list for the dates defined. You will get a pop-up box that allows you to set the covered
by dates. NOTE: You must change the START and END TIME to reflect the correct times.
If you don’t, the patient will not be assigned to anyone as the START and END time equal
each other when the box pops up.
Ending a provider relationship
In addition to the UNASSIGN SELF function, you can end a provider relationship for yourself or
others from the STAFF DETAIL or PAT. DETAIL screen. Choose the patient
you wish to end the relationship with and then click on the END box.
Another dialog box will pop up and ask you for the
date and time you wish to end the relationship and if
you wish to give a reason why the relationship was
ended. (Note the end date and time defaults to the
present date and time so the relationship is ended
immediately).
Patient Results
PCM will allow you to review the patients Laboratory and Radiology
results online. This function is executed by choosing the REVIEW drop
down menu and choosing the results you whish to view or by choosing
the buttons on the Tool Bar for LAB and
RAD results. You will first need to
choose a patient with the PATIENT
SELECT function. If you have not, when
you choose any of the results view
options, the application will force you to the patient select screen first.
Lab / Radiology Results
When you choose the LAB or RAD results function, you will
be taken to a flow sheet that will display the results for the
patient you have chosen with Patient Select. On the display
you will see the test displayed in dark blue to the left of the
results screen. As the actual test name may not be fully
readable, you can click your left mouse button while pointing
to this area to pop up a display of the complete test name.
The component values of the test will be displayed in
sequence vertically in a column that corresponds to the
collection time of the specimen. In the example to the right,
the Electrolyte Panel was drawn at 15:15 on 03/02/99. The
order status message in the first row lists the result as a final
result. The ampersand symbol “&” in the result column
indicates that there is more detail to the result. Some results
are only viewed in this way, such as Radiology results.
Radiology results are textual in nature and so all you will see is
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an “&” symbol in that result column. This can be TRENDS OFF TRENDS ON
viewed by clicking with the right mouse button while
pointing your mouse cursor at the value
you wish to review. The screen that pops
up is shown on the left. There may be
multiple columns in a display. Each
column will correspond to the date and
time of a new specimen. While in the flow
sheet view, you are able to make a few
adjustments to the way your display looks.
You can choose the time frame of what
will show by choosing the CONFIGURE
tool bar button or by choosing the CONFIGURE
option under the REPORT menu. From this menu you can choose options to set the time span
of what shows, the interval of the column display and the sequence of the occurrences. Under
the VIEW menu option, you can choose whether to TREND tests or not. If you set the trend
option to on, the result will force a display of the test values in the same row. This makes it
easier to look across the row to see a trend in the values. This is a very useful function to help
you view results and compare previous with later values that may not show up in the exact
same column. Experiment with these functions and you will quickly find out how you can
customize the PCM application to your own unique style and preference.
Physician Reports
Pathways Care Manager offers some excellent report capability. On May 1st we will have two
reports built and ready for use. The first report is the PATIENT ROUNDING REPORT. This
report will display patient data by patient. The patients demographic information including unit
and room number, diagnosis and attending physician. It will also display the allergies and height
and weight information. In this report, the LAB results will display the basic information for the
results (i.e. what is shown on the flowsheet) but will not print the detailed information (i.e. what
you see when you right click on a result in the flowsheet). RAD results will display the test
ordered and the status, but will not display the detail (i.e. the full dictation).
The other report that will be useful for you is the PHYSICIAN CENSUS report. This report lists
the same information as in the patient rounding report for all of the patients that the physician
has any relationship with. The first page of the report is an index page that lists the patients
unit, room number, bed, patient name and diagnosis. Keep in mind that the information that is
printed in this report is dependent on the time frame you request. Examples of both of these
reports are in the last few pages of this manual.
Change your Password
You can change your password by executing
the password change function from the
utilities menu. When you do this, you will
see the password change display. When
you enter your current password, you will be
prompted for a new password. You will be
again prompted for the same password. If
you make a typing error for either entry of
your new password, the application will not
change your password and make you start
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over again. This is to assure you don’t set a password that contains a typo. When you succeed
in changing your password, the next time you log on, you will need to enter your new password.
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Example Reports
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