Questions regarding CPRS note signing
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kdt...@gmail.com
Mar 6, 2009, 12:04:03 AM3/6/09
to Hardhats
With Rich Vertigan's and Sam Hiebel's help, I was able to expand the
functionality of CPRS in my office by setting up Consults for use when
ordering mammograms from CPRS. It spits out a paper that can be used
for a mammogram requisition. And then my nurse can track those orders
that have not come back and been finished out.
My nurse can create the order for the mammogram 'consult'. But she
can't sign the order. Thus, she won't be able to get the requisition
to print until I specifically go into CPRS and sign that order for
that patient.
Doe anyone know what rule is being applied to determine if she can
sign the order? She has a PROVIDER key. When I look at the RPC
calls, it seems to be using the key system rather than the UCM
business class logic.
Also, there is no alert sent to me that I have orders to sign. So she
would have to tell me the patient that I need to sign them for. That
seems like a situation where things could slip through the cracks. My
CPRS is 1.0.23.15. Is this different in newer CPRS's? Is this a
configuration issue? When she creates the mammogram consult order,
there is a way to choose a person to whom the order should be brought
to their attention. Perhaps if she selected me it would generate the
alert.
And lastly, is it possible to put an order for this mammogram consult
into the order list on the Order tab? That way it could be launched
from there, instead of the consults tab. It is a little awkward to
have to remember to switch to the orders tab to sign the order before
the requisition will print out.
Thanks all. I had a great time at the developer's conference.
Kevin
functionality of CPRS in my office by setting up Consults for use when
ordering mammograms from CPRS. It spits out a paper that can be used
for a mammogram requisition. And then my nurse can track those orders
that have not come back and been finished out.
My nurse can create the order for the mammogram 'consult'. But she
can't sign the order. Thus, she won't be able to get the requisition
to print until I specifically go into CPRS and sign that order for
that patient.
Doe anyone know what rule is being applied to determine if she can
sign the order? She has a PROVIDER key. When I look at the RPC
calls, it seems to be using the key system rather than the UCM
business class logic.
Also, there is no alert sent to me that I have orders to sign. So she
would have to tell me the patient that I need to sign them for. That
seems like a situation where things could slip through the cracks. My
CPRS is 1.0.23.15. Is this different in newer CPRS's? Is this a
configuration issue? When she creates the mammogram consult order,
there is a way to choose a person to whom the order should be brought
to their attention. Perhaps if she selected me it would generate the
alert.
And lastly, is it possible to put an order for this mammogram consult
into the order list on the Order tab? That way it could be launched
from there, instead of the consults tab. It is a little awkward to
have to remember to switch to the orders tab to sign the order before
the requisition will print out.
Thanks all. I had a great time at the developer's conference.
Kevin
kdtop
Mar 6, 2009, 12:04:58 AM3/6/09
to Hardhats
Oops. The title should be CPRS *Order* Signing, not 'Note' signing.
Kevin
Kevin
Sam Habiel
Mar 6, 2009, 2:15:03 AM3/6/09
to Hard...@googlegroups.com
key to sign is ORES.
the next answers are yes, yes, but i am going to sleep now. call me
during the wekend.
the next answers are yes, yes, but i am going to sleep now. call me
during the wekend.
Rich Vertigan, CPRS Developer (retired)
Mar 6, 2009, 7:46:17 AM3/6/09
to Hardhats
Yes, ORES is the correct key, but also see "Ordering Access/
Authorization" on page 76 of the CPRS Technical Manual.
For the alerts, I would start with "Enabling Notifications", on page
152 of the Consults User Manual.
For configuration of the "Add Orders" list, try "Writing Orders" on
page 79 of the CPRS Technical Manual.
Authorization" on page 76 of the CPRS Technical Manual.
For the alerts, I would start with "Enabling Notifications", on page
152 of the Consults User Manual.
For configuration of the "Add Orders" list, try "Writing Orders" on
page 79 of the CPRS Technical Manual.
kdtop
Mar 6, 2009, 6:27:35 PM3/6/09
to Hardhats
Rich and Sam
Thank you both so much for your help. We are lucky, as a community,
to have you both. Rich, I hope you had a good time at the developers
conference and will come back again sometime soon. :-)
================================================
For my (and others) future reference here are details about how to set
this system up.
1. Add the Consult Management menu (GMRC MGR) to a menu tree where you
can get to it.
2. Launch Set up Consult Services [GMRC SETUP REQUEST SERVICES]
3. When asked> Select Service/Specialty:, then enter "MAMMOGRAM" to
create a new 'service'.
4. I then edited the record to values below.
Record# 44,
.01-SERVICE NAME : MAMMOGRAM
.06-UNRESTRICTED ACCESS : YES
1.01-PROVISIONAL DX PROMPT : SUPPRESS
123.01-OE/RR DISPLAY GROUP : CONSULTS
123.03-PROTOCOL ACTION MENU BY USERS : GMRCACTM SERVICE ACTION MENU
123.08-SERVICE INDIVIDUAL TO NOTIFY : xxxxxxx,xxxxx (my nurse)
123.09-SERVICE PRINTER : S121-LAUGHLIN-LASER
123.3-UPDATE USERS W/O NOTIFICATIONS :
Multiple Entry #1
.01-UPDATE USERS W/O NOTIFICATIONS : WALTERS,MISTY L
123.5-SPECIAL UPDATES INDIVIDUAL : TOPPENBERG,KEVIN S
5. Next, there needs to be a note created to complete, or result, the
consult. So in the console, Edit Document Definitions [TIUFH EDIT
DDEFS MGR]. Navigate to find the DOCUMENT CLASS (DC) by name of
CONSULTS. I think that there should only be one such document class
in the tree. In my distro, I found it under progress notes.
(Initially it has been renamed to 'CONSULT' and that just wouldn't
work. I think I had broken the name when I was first installing my
system.) In this section, I create a note title that had a record
dump as follows. I will discuss boilerplate entry later.
FILE 8925.1
Record# 649,
.01-NAME : MAMMOGRAM RESULT
.03-PRINT NAME : MAMMOGRAM RESULT
.04-TYPE : TITLE
.06-CLASS OWNER : CLINICAL COORDINATOR
.07-STATUS : ACTIVE
.08-IN USE : YES
.11-ORPHAN : NO
.12-HAS BOILTXT : YES
3-BOILERPLATE TEXT :
MAMMOGRAM RESULTS
Patient: |PATIENT NAME| DOB:|PATIENT DATE OF BIRTH| |PATIENT
PHONE NUMBER|
{FLD:TMG MAMMOGRAM RESULTS}.
{FLD:TMG NOTES}
3.03-SUPPRESS VISIT SELECTION : NO
99-TIMESTAMP : 61424,30601
In my site, we kept having problems with the title not showing up.
The key factors are that the title has to have it's status set to
ACTIVE. And it has to have an entry in the ACL cross reference.
6. Now we want to create a default template that shows when the
consult is selected. Do this in CPRS on the Notes tab, Option->Edit
Templates. In the Shared Template window, find the top level node
named Consult Reasons for Request. Open this and select 'MAMMOGRAM'
In the Template boilerplate section, create some text as below. This
is the text that will print out on the 'consult request' (which we
will give to the patient as their study requisition form). It may
take a special key to be allowed to edit shared templates. Below is
an example of the form that have arranged. Notice that we changed the
template type from Template to Dialog. This cause a GUI window to pop
up, with check boxes etc.
.
From: Family Physicians of Greeneville, PC
1410 Tusculum Blvd, Suite 2600
Greeneville, TN, 37745
--====> M A M M O G R A M R E Q U I S I T I O N <====--
LOCATION: {FLD:TMG MAMMO HOSPITAL}
Patient: |PATIENT NAME| DOB: |PATIENT DATE OF BIRTH|
Scheduled Appointment: {FLD:TMG TEXT}
{FLD:TMG MAMMO TYPE} {FLD:TMG MAMMO TESTS}
{FLD:TMG MAMMO LOCATION}
Diagnosis: {FLD:TMG MAMMO DIAG}
Notes: {FLD:TMG NOTES}
Signed:
NOTE TO PATIENTS:
Please do not wear any powders or deodorant under the
arm or around the breast area. This will interfere with
the exam.
So here is the work flow process
========================
-- go to consults tab and select [New Consult]. In upper left corner,
the new Mammogram service should be selectable. When this is
selected, then a GUI appears and gives us the chance to select the
location where the study will get done, and what test is being ordered
etc. This is because of boilerplate text in the 8925.1 file record
dumped out above.
--The order is accepted, and the dialog is closed.
--Switch to the Orders tab, and sign the order. This needs the ORES
key assigned to the user.
--As soon as the order is signed, the form is printed out, and can be
given to the patient.
--Days later, when the paper report is returned from the hospital,
then this 'consult' should be completed. This will allow us to track
those that are still outstanding. Go to consult tab in CPRS, menu
Actions-->Consult Results-->Complete/Update Results. A dialog will
show up that allows you to select the 'consult' mammogram that is to
be completed. Select this on the bottom. In the top, select the note
title set up for note conclusion (the one in the CONSULTS class). In
my site we call this MAMMOGRAM RESULTS.
--As soon as the above note is selected, the boilerplate text launches
the GUI dialog that allows my nurse to enter the results, and
disposition of the test. After this note is signed, then the consult
will be consider to be completed.
--To track which mammograms have been ordered, but not completed, use
this menu from the console: Consult Tracking Reports ... [GMRC
REPORTS] --> Service Consults Pending Resolution [GMRC RPT PENDING
CONSULTS]. Then specify the 'mammogram' service, and it will show a
list of all outstanding consults.
Kevin
On Mar 6, 7:46 am, "Rich Vertigan, CPRS Developer (retired)"
Thank you both so much for your help. We are lucky, as a community,
to have you both. Rich, I hope you had a good time at the developers
conference and will come back again sometime soon. :-)
================================================
For my (and others) future reference here are details about how to set
this system up.
1. Add the Consult Management menu (GMRC MGR) to a menu tree where you
can get to it.
2. Launch Set up Consult Services [GMRC SETUP REQUEST SERVICES]
3. When asked> Select Service/Specialty:, then enter "MAMMOGRAM" to
create a new 'service'.
4. I then edited the record to values below.
Record# 44,
.01-SERVICE NAME : MAMMOGRAM
.06-UNRESTRICTED ACCESS : YES
1.01-PROVISIONAL DX PROMPT : SUPPRESS
123.01-OE/RR DISPLAY GROUP : CONSULTS
123.03-PROTOCOL ACTION MENU BY USERS : GMRCACTM SERVICE ACTION MENU
123.08-SERVICE INDIVIDUAL TO NOTIFY : xxxxxxx,xxxxx (my nurse)
123.09-SERVICE PRINTER : S121-LAUGHLIN-LASER
123.3-UPDATE USERS W/O NOTIFICATIONS :
Multiple Entry #1
.01-UPDATE USERS W/O NOTIFICATIONS : WALTERS,MISTY L
123.5-SPECIAL UPDATES INDIVIDUAL : TOPPENBERG,KEVIN S
5. Next, there needs to be a note created to complete, or result, the
consult. So in the console, Edit Document Definitions [TIUFH EDIT
DDEFS MGR]. Navigate to find the DOCUMENT CLASS (DC) by name of
CONSULTS. I think that there should only be one such document class
in the tree. In my distro, I found it under progress notes.
(Initially it has been renamed to 'CONSULT' and that just wouldn't
work. I think I had broken the name when I was first installing my
system.) In this section, I create a note title that had a record
dump as follows. I will discuss boilerplate entry later.
FILE 8925.1
Record# 649,
.01-NAME : MAMMOGRAM RESULT
.03-PRINT NAME : MAMMOGRAM RESULT
.04-TYPE : TITLE
.06-CLASS OWNER : CLINICAL COORDINATOR
.07-STATUS : ACTIVE
.08-IN USE : YES
.11-ORPHAN : NO
.12-HAS BOILTXT : YES
3-BOILERPLATE TEXT :
MAMMOGRAM RESULTS
Patient: |PATIENT NAME| DOB:|PATIENT DATE OF BIRTH| |PATIENT
PHONE NUMBER|
{FLD:TMG MAMMOGRAM RESULTS}.
{FLD:TMG NOTES}
3.03-SUPPRESS VISIT SELECTION : NO
99-TIMESTAMP : 61424,30601
In my site, we kept having problems with the title not showing up.
The key factors are that the title has to have it's status set to
ACTIVE. And it has to have an entry in the ACL cross reference.
6. Now we want to create a default template that shows when the
consult is selected. Do this in CPRS on the Notes tab, Option->Edit
Templates. In the Shared Template window, find the top level node
named Consult Reasons for Request. Open this and select 'MAMMOGRAM'
In the Template boilerplate section, create some text as below. This
is the text that will print out on the 'consult request' (which we
will give to the patient as their study requisition form). It may
take a special key to be allowed to edit shared templates. Below is
an example of the form that have arranged. Notice that we changed the
template type from Template to Dialog. This cause a GUI window to pop
up, with check boxes etc.
.
From: Family Physicians of Greeneville, PC
1410 Tusculum Blvd, Suite 2600
Greeneville, TN, 37745
--====> M A M M O G R A M R E Q U I S I T I O N <====--
LOCATION: {FLD:TMG MAMMO HOSPITAL}
Patient: |PATIENT NAME| DOB: |PATIENT DATE OF BIRTH|
Scheduled Appointment: {FLD:TMG TEXT}
{FLD:TMG MAMMO TYPE} {FLD:TMG MAMMO TESTS}
{FLD:TMG MAMMO LOCATION}
Diagnosis: {FLD:TMG MAMMO DIAG}
Notes: {FLD:TMG NOTES}
Signed:
NOTE TO PATIENTS:
Please do not wear any powders or deodorant under the
arm or around the breast area. This will interfere with
the exam.
So here is the work flow process
========================
-- go to consults tab and select [New Consult]. In upper left corner,
the new Mammogram service should be selectable. When this is
selected, then a GUI appears and gives us the chance to select the
location where the study will get done, and what test is being ordered
etc. This is because of boilerplate text in the 8925.1 file record
dumped out above.
--The order is accepted, and the dialog is closed.
--Switch to the Orders tab, and sign the order. This needs the ORES
key assigned to the user.
--As soon as the order is signed, the form is printed out, and can be
given to the patient.
--Days later, when the paper report is returned from the hospital,
then this 'consult' should be completed. This will allow us to track
those that are still outstanding. Go to consult tab in CPRS, menu
Actions-->Consult Results-->Complete/Update Results. A dialog will
show up that allows you to select the 'consult' mammogram that is to
be completed. Select this on the bottom. In the top, select the note
title set up for note conclusion (the one in the CONSULTS class). In
my site we call this MAMMOGRAM RESULTS.
--As soon as the above note is selected, the boilerplate text launches
the GUI dialog that allows my nurse to enter the results, and
disposition of the test. After this note is signed, then the consult
will be consider to be completed.
--To track which mammograms have been ordered, but not completed, use
this menu from the console: Consult Tracking Reports ... [GMRC
REPORTS] --> Service Consults Pending Resolution [GMRC RPT PENDING
CONSULTS]. Then specify the 'mammogram' service, and it will show a
list of all outstanding consults.
Kevin
On Mar 6, 7:46 am, "Rich Vertigan, CPRS Developer (retired)"
Sam Habiel
Mar 6, 2009, 6:47:32 PM3/6/09
to Hard...@googlegroups.com
Good job Kevin; and thanks Rich.
Rich Vertigan, CPRS Developer (retired)
Mar 7, 2009, 7:02:02 AM3/7/09
to Hardhats
Glad you got it going and glad we could help. I was really impressed
with the dedication and enthusiasm I saw in Pittsburgh. This group
and this project will go far, and I hope to stay involved at least at
some level.
> > > Kevin- Hide quoted text -
>
> - Show quoted text -
with the dedication and enthusiasm I saw in Pittsburgh. This group
and this project will go far, and I hope to stay involved at least at
some level.
>
> - Show quoted text -
kdtop
Mar 8, 2009, 10:30:06 AM3/8/09
to Hardhats
Rich (or anyone else)
I was looking at the CPRS technical manual. I had previously
overlooked that. I had printed out the user's manual, but could never
find much there. I understand why now.
In the VDL, there is the 'CPRS Technical manual', and then 'CPRS
Technical manual: GUI version.' The GUI one seems newer. I am
wanting to print out just one of these. Do you know what the
difference between these manuals is?
Thanks
Kevin
On Mar 7, 8:02 am, "Rich Vertigan, CPRS Developer (retired)"
I was looking at the CPRS technical manual. I had previously
overlooked that. I had printed out the user's manual, but could never
find much there. I understand why now.
In the VDL, there is the 'CPRS Technical manual', and then 'CPRS
Technical manual: GUI version.' The GUI one seems newer. I am
wanting to print out just one of these. Do you know what the
difference between these manuals is?
Thanks
Kevin
On Mar 7, 8:02 am, "Rich Vertigan, CPRS Developer (retired)"
Rich Vertigan, CPRS Developer (retired)
Mar 8, 2009, 11:01:58 AM3/8/09
to Hardhats
At one time, before there was a mandatory GUI, the non-GUI Technical
Manual covered only the roll/scroll List Manager functionality. It
appears they've been keeping it up to date with the parts of CPRS that
apply to both the GUI and non-GUI versions, though the non-GUI version
is technically no longer supported. It might not be a bad idea to at
least have an electronic copy of the non-GUI manual around in case you
can't find something in the GUI manual. Not sure I'd bother printing
it, though.
> > > - Show quoted text -- Hide quoted text -
Manual covered only the roll/scroll List Manager functionality. It
appears they've been keeping it up to date with the parts of CPRS that
apply to both the GUI and non-GUI versions, though the non-GUI version
is technically no longer supported. It might not be a bad idea to at
least have an electronic copy of the non-GUI manual around in case you
can't find something in the GUI manual. Not sure I'd bother printing
it, though.
kdtop
Mar 8, 2009, 11:29:25 AM3/8/09
to Hardhats
OK, Thanks. I'll stick with the GUI manual.
Kevin
On Mar 8, 11:01 am, "Rich Vertigan, CPRS Developer (retired)"
> ...
>
> read more »
Kevin
On Mar 8, 11:01 am, "Rich Vertigan, CPRS Developer (retired)"
>
> read more »
Roy Gaber
Mar 9, 2009, 9:55:27 PM3/9/09
to Hard...@googlegroups.com
Now all we have to do is convince the VA to stop ripping apart the fabric
and get out of maintenance mode so we can bring VistA into the 21st century.
and get out of maintenance mode so we can bring VistA into the 21st century.
Steven McPhelan
Mar 10, 2009, 8:22:33 AM3/10/09
to Hard...@googlegroups.com
Depends upon your viewpoint. The VA is doing exactly what you stated but not the way you want it.
Now all we have to do is convince the VA to stop ripping apart the fabric
and get out of maintenance mode so we can bring VistA into the 21st century.
--
Steve
FREEDOM, freedom is never as valued as when lost.
On Mon, Mar 9, 2009 at 9:55 PM, Roy Gaber <rga...@tampabay.rr.com> wrote:
Now all we have to do is convince the VA to stop ripping apart the fabric
and get out of maintenance mode so we can bring VistA into the 21st century.
--
FREEDOM, freedom is never as valued as when lost.
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