Resource and patient management system



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2.2CPRS Setup


Once the EHR is loaded, several CPRS options for setup are available.

2.2.1Allocate OE/RR Security Keys


You assign OE/RR security keys to those users going live. A user needs one and only one of three keys to release orders:

  • ORES – clinician key

  • ORELSE – nurse key

  • OREMAS – clerk key

Refer to the section “Allocate OE/RR Security Keys (ALL)” below for more information (under the Order Entry Configuration section).

2.2.2Miscellaneous Parameters


These miscellaneous parameters need to be set immediately after loading.

Miscellaneous OE/RR Definition for System: TCDEMO.NAV.IHS.GOV

--------------------------------------------------------------------

Active Orders Context Hours 24

Allow Clerks to act on Med Orders NO

Auto Unflag YES

Confirm Provider YES (Exclude ORES)

Default Provider

Error Days

Grace Days before Purge

New Orders Default Sign & Release

Restrict Requestor YES (ORELSE & OREMAS)

Review on Patient Movement

Show Lab #

Show Status Description

Signature Default Action Release w/o Signature

Signed on Chart Default NO

--------------------------------------------------------------------

See the section “Miscellaneous Parameters (MSC)” below for more information (under Order Entry Configuration | Order Parameters).


2.2.3Notifications


Notifications must be reviewed and decisions made regarding:

  • Which notifications will be Mandatory, Enabled, or Disabled

  • What is the priority of the notification

  • Who will receive the notification

  • What makes the notification go away

Notifications come with a default, but sites need to review these defaults to decide if that is what they want to use.

Refer to the section “Notification Configuration” below for more information.


2.2.4Order Checks


Order checks also must be reviewed and changes can be made from the default settings.

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).


2.2.5Quick Orders


Each site will need to make the quick orders for the service that is going live.

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).


2.2.6Teams


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.

Teams are lists of patients, providers, or both.

Refer to the section “Team List Management Menu” below for more information (under Patient Context Configuration).

2.2.7Print/Report Parameters


If you want to print copies of the orders as chart copies, work copies, or service copies, or if you want to print lab requirements and labels, you need to choose print formats and assign them to printers in the locations where the EHR will be running.

  • 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.

2.3IHS Setup


The IHS Setup consists of assigning keys, creating pick-lists and super-bills, as well as setting up consult services.

2.3.1Assign Keys


To assign the BGOZ keys in RPMS, go to Menu Management | Key Managers | Allocation of Security Keys.

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

Notes about the keys:


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

2.3.2Pick-Lists and Super-Bills


Before providers can choose ICD9 codes and CPT codes to complete the visit, the sites will probably want to create some pick-lists and super-bills that the providers can use to make these selections.

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.





Figure 2 2: Manage Super-Bills Dialog

2.3.3Consults


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


ART Adverse Reaction Tracking Configuration ...

CCX Chief Complaint Configuration ...



CON Consult Tracking Configuration ...

EDU Patient Education Configuration ...

ENC Encounter Context Configuration ...

EXM Exam Configuration ...

FRM VueCentric Framework Configuration ...

HFA Health Factor Configuration ...

IMM Immunization Configuration ...

LAB Lab Configuration ...

MED Medication Management Configuration ...

NOT Notification Configuration ...

ORD Order Entry Configuration ...

PAT Patient Context Configuration ...

PHX Personal Health Hx Configuration ...

PLS Problem List Configuration ...

POV POV Configuration ...

PRC Procedure Configuration ...

REM Reminder Configuration ...

RPT Report Configuration ...

SPL Spellchecking Configuration ...

TIU TIU Configuration ...

VIT Vital Measurement Configuration ...
Select RPMS-EHR Configuration Master Menu Option:

The basic steps of a consults are:



  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

  1. Create the progress note title name.

  2. Make the templates for the following:

  • Reason for request

  • Note to complete the consult

  1. Create a quick order for ordering the consult.
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