272H Unleash the Power of Reminder Dialogs

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272H Unleash the Power of Reminder Dialogs

• Anne Rega, Hines Chief Information Office Field
  Office
• Eghosa Guobadia, CAC Philadelphia VAMC
• Joseph (Gus) ONeil, VISN 1 Clinical Reminders
  Manager

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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.

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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.

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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

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Introduction cont.

• Design of a Reminder Dialog template is based on
  the blueprint
• Collaboration between Providers and CACs, is
  required to produce this blueprint

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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).

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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.

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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.

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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 -

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Fig.1 - RAD MAM NOTE
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Fig. 2 - expansion of the BIRADS Category 0 Group
dialog
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Fig.3 - display of the Patient Notification
option element dialogs.
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Fig.4 Note produced before signature (or
before Saving without Signature)
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Fig.5 Note displayed in CPRS, showing the FORM
LETTERS note title formatting
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Fig.6 - display of the Patient Notification
prompts, for OTHER type of decision. Clicking
on the Finish button will present a plaintext
field
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Fig.7 Plaintext field that pops-up after
Finish button clicked.
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Fig.8 Note displayed in CPRS, after use of the
plaintext field
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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

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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 -
• mapping Health Factors to Reminder Terms
• 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.

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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

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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

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Sample of report captured from SmarTerm session
in (Notepad) text file
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Related Sessions

• Patient List creation and support are discussed
  in another VeHU 2008 session, the 318H Clinical
  Reminders Extracts session.