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5.2Other Users


The other users setup consists of assigning CPRS keys, user class, parameters, electronic signature, and BGOZ keys.

5.2.1CPRS Keys


The other two CPRS keys are ORELSE and OREMAS.

The ORELSE key is given those who are credentialed to release telephone and verbal orders. Generally, this is RNs and pharmacists.

Clerks who do transcription of orders get the OREMAS key. For those who enter orders with this key, they must have a written, signed order in front of them. If you do not plan on your clerks doing transcription, especially in an outpatient setting, do not give them this key.

See the above instructions on assigning CPRS keys. Say “NO” to editing the ORES key holders and go onto the ORELSE key. Enter the person’s name. If that person doesn’t have the key, it will be given immediately. If that person does have it, you’ll be asked to delete it.


5.2.2User Classes


All users need a user class. There are several user classes available and sites can add their own if needed. See the above instructions

You can add, edit, or remove user classes on assigning User Classes.


5.2.3Electronic Signature


Any user who can write a progress note will need an electronic signature. See the setup above for creating the electronic signature.

5.2.4BGOZ Keys


Depending upon the user, that person also needs the BGOZ keys to edit the problem list, POVs, and CPT codes. Assign them accordingly. The BGOZ keys are as follows:

BGOZ EDIT DIAGNOSIS

BGOZ EDIT PROBLEM LIST

BGOZ VCPT EDIT

BGOZUSER

Other keys might be necessary, such as the BIZ and GMRA keys, to allow access to other packages.

If the user has the Provider key, you will not have to assign the BGOZ keys.

6.0TIU Configuration (TIU)


Select the TIU Configuration (TIU) option on the RPMS-EHR Configuration Master Menu to display the following:

TIU Configuration


CLN TIU Menu for Clinicians ...

HIS TIU for Medical Records ...

PAR TIU Parameters ...
Select TIU Configuration Option

6.1TIU Menu for Clinicians (CLN)


Select the TIU Menu for Clinicians (CLN) option on the TIU Configuration Menu to display the following:

*****************************************

* INDIAN HEALTH SERVICE *

* TIU CLINICIAN'S MENU *

* VERSION 1.0, NOV 10,2004 *

*****************************************


DEMO INDIAN HOSPITAL

EED Enter/edit Document

EUV Edit/Update Visit

HLP TIU Help for Clinicians ...

IPD Individual Patient’s Documents

MPD Multiple Patient Documents

MYU All MY UNSIGNED Documents

SPT Search by Patient AND Title

TRD Transcribe Document

TRM TIU Reports Menu ...


Select TIU Menu for Clinicians Option:

Generally, the CAC does not use this menu in the basic setup for the EHR.


6.2TIU Menu for Medical Records (HIS)


Select the TIU Menu for Medical Records (HIS) option on the TIU Configuration Menu to display the following:

*****************************************

* INDIAN HEALTH SERVICE *

* TIU MEDICAL RECORDS MENU *

* VERSION 1.0, NOV 10,2004 *

*****************************************


DEMO INDIAN HOSPITAL

IPD Individual Patient Document

LAD List of Active Document Titles

MPD Multiple Patient Documents

PDM Print Documents Menu ...

SIG Awaiting Signature Listing

SSD Search for Selected Documents

STR Statistical Reports ...

TMM TIU Maintenance Menu ...

UPL TIU Upload Menu ...

VUA View a User’s Alerts
Select ITU Menu for Medical Records Option:

The CAC uses the TIU Maintenance Menu (TMM) in the basic setup.


6.2.1TIU Maintenance Menu (TMM)


Select the TIU Maintenance Menu (TMM) option on the TIU Medical Records Menu to display the following:

TIU Maintenance Menu


(DEMO INDIAN HOSPITAL)
DDM Document Definitions (Manager) ...

TAT TIU Alert Tools

TPM TIU Parameters Menu ...

TTM TIU Template Mgmt Functions ...

UCM User Class Management Menu ...
Select TIU Maintenance Menu Option:

This section addresses only the Document Definitions (Managers) DDM option. This option lets you manage document definitions, user classes, business rules and system parameters.


6.2.1.1Document Definition (Manager)


Select Document Definition (Manager) (DDM) option on the TIU Maintenance Menu to display the following:

Document Definitions (Manager)
(DEMO INDIAN HOSPITAL)
DDM1 Edit Document Definitions

DDM2 Sort Document Definitions

DDM3 Create Document Definitions

DDM4 Create Objects

DDM5 List Object Descriptions

DDM6 Create TIU/Health Summary Objects

This option offers a variety of ways to manage the Document Definition Hierarch.

TIU uses a document storage database called the Document Definition hierarchy. This hierarchy provides the building blocks for Text Integration Utilities (TIU). It allows documents (Titles) to inherit characteristics of the higher levels, Class and Document Class, such as signature requirements and print characteristics. This structure, while complex to set up, creates the capability for better integration, shared use of boilerplate text, components, and objects, and a more manageable organization of documents. End users (clinical, administrative, and MIS staff) need not be aware of the hierarchy. They work at the Title level with the actual documents.

6.2.1.1.1Edit Document Definitions (DDM1)

Select the DDM1 option on the Document Definition (Manager) menu to display the following:

Edit Document Definitions Nov 26, 2007 09:26:09 Page: 1 of 1

BASICS
Name Type

1 CLINICAL DOCUMENTS CL

2 +PROGRESS NOTES CL

3 +ADDENDUM DC

4 +DISCHARGE SUMMARY CL

5 CLINICAL PROCEDURES CL

6 +LR LABORATORY REPORTS CL

?Help >ScrollRight PS/PL PrintScrn/List +/- >>>

Expand/Collapse Detailed Display/Edit Items: Seq Mnem MenuTxt

Jump to Document Def Status... Delete

Boilerplate Text Name/Owner/PrintName... Copy/Move

Select Action: Quit//

This option lets you view and edit note titles. Entries are presented in hierarchy order. ITEMS of an entry are in Sequence order, or if they have no Sequence, in alphabetic order by Menu Text, and are indented below the entry. Because Objects do not belong to the hierarchy, they cannot be viewed/edited using the Edit option.

Example of expand an entry: Enter E for expand, then enter 2 for progress notes. You can combine these requests into E=2.


6.2.1.1.2Sort Document Definitions (DDM2)

Select the DDM2 option on the Document Definition (Manager) menu to sort the document definitions list according to the following attributes: type, owner, status, in use, parentage, or all document definitions.
6.2.1.1.3Create Document Definitions (DDM3)

Select the DDM3 option on the Document Definition (Manager) menu to create new note titles. The following displays:

Create Document Definitions Nov 26, 2007 09:27:36 Page: 1 of 1

BASICS
Name Type

1 CLINICAL DOCUMENTS CL

2 PROGRESS NOTES CL

3 ADDENDUM DC

4 DISCHARGE SUMMARY CL

5 CLINICAL PROCEDURES CL

6 LR LABORATORY REPORTS CL

New Users, Please Enter '?NEW' for Help >>>

Class/DocumentClass Next Level Detailed Display/Edit

(Title) Restart Status...

(Component) Boilerplate Text Delete

Select Action: Next Level//

You use this option to create progress note titles; titles are needed before users can write progress notes.

This option lets you create new entries (Classes, Document Classes, Titles) of any type except Object, placing them where they belong in the hierarchy. This option presents entries in hierarchy order, showing ONE line of descent, starting with Clinical Documents at the top.

The Create Document Definitions option lets you view, edit, or create entries, but only in the current line of descent. This option does not let you copy an entry.

Remember, status must be active before anyone can use the note but status must be inactive before you can edit or change the note.

TIU note titles are hierarchical with CLINICAL DOCUMENTS being the parent class of all documents.



Figure 6 3: Overview of Hierarchy of Notes

Business rules as well as basic and technical fields for progress notes follow this relationship. If a title does not have a field defined, the program will search for the document class. If the document class has nothing defined, it will search for the class.

So, you can overwrite any field at a lower level. Otherwise that field has inherited values.

As an example, bring up the technical fields for progress notes.

Technical Fields Note: Values preceded by * have been inherited

Commit Action:

Release Action:

Verification Action:

Delete Action:

Package Reassignment

Action:

Entry Action:



Exit Action:

Post-signature Code:

Edit Template: [TIU ENTER/EDIT PROGRESS NOTE]

Print Method: D ENTRY^TIUPRPN

Print Form Header: Progress Notes

Print Form Number: Vice SF 509

Print Group: 2

Visit Linkage Method: D ENPN^TIUVSIT(.TIU,.DFN,1)

Validation Method: S TIUASK=$$CHEKPN^TIULD(.TIU,.TIUBY)

+

Allow Custom



Form Headers: NO

Upload


Upload Target File: TIU DOCUMENT

Laygo Allowed: YES

Target Text Field: REPORT TEXT

Upload Look-up Method: D LOOKUP^TIUPUTPN

Upload Post-filing Code: D FOLLOWUP^TIUPUTPN(TIUREC("#"))

Upload Filing Error Code: D PNFIX^TIUPNFIX

You would change anything only if you wanted to change any of these fields for a particular document or title. Otherwise, each progress note will follow the rules for the entire class.

Considerations for Naming Notes

For IHS EHR sites, there needs to be a systematic document naming nomenclature for naming notes. Local sites will customize and add note titles that improve patient care.

We recommend that you start the note title with a specialty, then add CONSULT, for example. If CONSULT were used first, the list could become quite long and the search would be time consuming.

Because all are NOTES, it is not necessary to add “NOTE” to the end of each title; for example, PHARM REFILL rather than PHARM REFILL NOTE.

Use note titles defined by role/event/location rather than by disease state. DM might be the exception due to its prevalence and importance in IHS. Examples:

DM EDU DM QUARTERLY DM ANNUAL

DM NUT DM PROGRAM DM CASE MGMT

Change, delete, or rename Note Titles that do not add any significant or useful information; for example, DICTATED XXX.

Unique Note Titles

There are some Note Titles that are unique for different reasons. Examples:

ADDENDUM ADVANCE DIRECTIVES

ADVERSE REACTION ALLERGY

BLOOD TRANSFUSION CHART REVIEW

CONSCIOUS SEDATION CONSENT

DELIVERY DISCHARGE SUMMARY

HISTORY & PHYSICAL PREOP PE

PROCEDURE TRANSFER

Codes to Combine Role, Event, Service, Location

A combination of two and three linked “names” from the categories of ROLE, EVENT, SERVICE, and LOCATION might satisfy the basic naming conventions for both Outpatient and Inpatient notes to help quickly identify the information that the note contains.

ROLE + EVENT

PHARM REFILL for Pharmacy Medication Refill

NURS PICC LINE for Nurse PICC line placement

NRS INTAKE for Nurse admission intake assessment

SERVICE + EVENT

CARDS CONSULT for Cardiology Consult

PULM F/U for Pulmonary follow up

PT PFT for Physical Therapy pulmonary function test

LOCATION + ROLE

INPT DOC for Doctor Inpatient daily progress note

INPT NURS for Inpatient Nurse note

EVENT (could stand alone without additional specifications)

COLPO for colposcopy

EGD for esophogogastricduodenoscopy

ETT for exercise tolerance test/treadmill

Sample Titles for Each Provider



Every provider needs at least one Note Title at a minimum. Additional Note Titles are added when it will enhance initial patient care or contains significantly different information and will enhance the retrieval of this information at future visits. Below are some examples:

Discipline

Sample Note Title

Social Service

SS DV INTAKE




SS SUICIDE




SS FAMILY MEETING

Cardiologist

CARDIO CONSULT




CARDIO F/U

Pharmacist

PHARM REFILL




PHARM CONSULT




PHARM ANTICOAG




PHARM ASTHMA

Clinical Nurse

NURS CLINIC

Inpatient Nurse

INPT NURS INTAKE




INPT NURS DAILY

Primary Care Clinic Provider

GEN MED




WELL BABY




PRENATAL FIRST




PRENATAL F/U




DM QUARTERLY




CONSCIOUS SEDATION

Doctor with expanded duties

H&P




DISCHARGE SUMMARY




TRANSFER




PROCEDURE




CONSENT




CONSCIOUS SEDATION




BLOOD TRANSFUSION




DELIVERY




DEATH SUMMARY

Surgeon

SURG CONSULT




SURG F/U




SURG PROCEDURE




PREOP PE

Codes for Various Hospital Areas

Because screen view space has some limitations, below are some examples of note titles, in alphabetic order:



Code

Meaning for

CARDIO

Cardiology

CHR

Community Health Representative

COLPO

Colposcopy

DDS

Dental

DM

Diabetes Mellitus

ENDO

Endocrinology

ER

Emergency Room

EYE

Optometry or Ophthalmology

INPT

Inpatient

MCH

Maternal Child Health

MH

Mental Health (Psychologist)

NEURO

Neurology

NURS

Nursing

NUT

Nutrition

ORTHO

Orthopedics

PHARM

Pharmacy

PHN

Public Health Nursing

POD

Podiatry

PSYCH

Psychiatrist

PT

Physical Therapy

RAD (or XRAY)

Radiology/Radiologist

SURG

Surgery

SS

Social Service

Codes for General Medicine or Primary Care

General Medicine and Primary Care are acceptable alternative for a simple Note Title to share between most primary care providers. However, it seems that the local EHR team is in the best position to determine where the similarities and differences are across their primary care providers (Internal Medicine, Family Practice, etc.)

National Note Titles

The national Note Titles were part of the original setup of the software within the VA. Some are still valuable to the VA while others are no longer used but must be included for the package to run properly. Even though we do not want to use some of the national titles, we did not want to delete them. Instead, we simply made them inactive, so they are not used inadvertently or clutter our options.

Here is the recommended inactive list:

ASI-ADDITION SEVERITY INDEX

CLINICAL WARNING, CRISIS NOTE

LR AUTOPSY REPORT

LR CYTOPATHOLOGY REPORT

LR ELECTRON MICROSCOPE REPORT

LR SURGICAL PATHOLOGY REPORT

NOTE WITH BOILERPLATE

NOTE WITH COMPONENTS

RISK OF CJD

SAMPLE DICTATED NOTE

SAMPLE EVENT NOTE

TRANSITIONAL PHARMACY BENEFIT NOTE.

Clinical Warning Note Title

Notes created with a clinical warning note titles will appear on the Overview page in the clinical warning window. The note title and date will appear in the window. If you click on the window, the entire note associated with this note title and date displays. To create a clinical warning note title, go to the TIU menu and create a new document title under the clinical warning document class.

When providers choose this note title, their note links with a clinical warning and will appear in the Crisis Alerts window.


6.2.1.1.4Create Objects (DDM4)

Select the DDM4 option on the Document Definition (Manager) menu to display the following:

Objects Nov 26, 2007 09:30:29 Page: 1 of 14

Objects
Status

1 ACTIVE MEDICATIONS A

2 ACTIVE MEDS COMBINED A

3 ACTIVE MEDS ONE LIST A

4 ACTIVE PROBLEMS A

5 ACTIVE PROBLEMS W/O DATES A

6 ADDRESS-ONE LINE A

7 ADMITTING DX A

8 ADMITTING PROVIDER A

9 ALLERGIES/ADR A

10 BEHDICTATE HEADER A

11 BEHDICTATE NOTE IEN A

12 BMI A

13 BMI WITH CAPTION A

14 BPXRM ALCOHOL SCREEN A

+ ?Help >ScrollRight PS/PL PrintScrn/List +/- >>>

Find Detailed Display/Edit Copy/Move

Change View Try Quit

Create Owner

Select Action: Next Screen//

You use this option to create objects; objects can then be placed into templates.

This option lets you select Start With and Go to values. It then displays Objects within these values in alphabetic order by name. The user can create new objects or edit existing objects.

Example: Creating a Lab Result Object (you must have programmer access to do the following):

Find the object Last Lab Test (Sample) and note its number.

Select Action | Copy/Move. Enter the number of the last test. Select the entry to copy (Last Lab Test).

Replace: Lab Test Sample with HGB (this must match your test name in Lab file 60).

The object will be copied into the file and assigned an entry number. The object will now display in the Objects list, with a status of Inactive.

Select Detailed Display/Edit and select the entry number of the new object.

Select Technical Fields and under Object Method replace Lab Test Name with HGB (actual lab test name).

Select Basics and change the status to Active.

You must logout of the EHR and re-enter for your object to show up.

6.2.1.1.5List Object Descriptions (DDM5)

Select the DDM5 option on the Document Definition (Manager) menu to display the following:

Object Descriptions Nov 26, 2007 09:32:12 Page: 1 of 81


Object Name Status Owner

1 ACTIVE MEDICATIONS ACTIVE CLINICAL COORDINATOR

Method: S X=$$LIST^TIULMED(DFN,"^TMP(""TIUMED"",$J)",1)
Returns list of patient's active medications, sorted alphabetically.
2 ACTIVE MEDS COMBINED ACTIVE CLINICAL COORDINATOR

Method: S X=$$LIST^TIULMED(DFN,"^TMP(""TIUMED"",$J)",1,0,0,1)


Returns list of active medications for a patient, sorted alphabetically,

one line per medication.


3 ACTIVE MEDS ONE LIST ACTIVE CLINICAL COORDINATOR

Method: S X=$$LIST^TIULMED(DFN,"^TMP(""TIUMED"",$J)",1,0,0,1,0,1)


DESCRIPTION

Includes the list of active and pending meds and supplies all in one list

+ Enter ?? for more actions
Select Action: Next Screen//

This option lists a description of each patient/visit object so TIU Application Coordinators can decide which objects to use in templates and boilerplates. The CAC can see what national objects are supposed to do. Descriptions are always written for national objects.


6.2.1.1.6Create TIU/Health Summary Objects (DDM6)

Select the DDM6 option on the Document Definition (Manager) menu to display the following:

TIU Health Summary Object Nov 26, 2007 09:33:36 Page: 1 of 1

TIU Object Name Health Summary Type

1 HS MEDS-CHRONIC No Health Summary Type Found

2 PERSONAL HISTORY No Health Summary Type Found

3 TIU TPBN FUTURE APPTS TIU TPBN FUTURE APPTS

Enter ?? for more actions

Create New TIU Object Find

Detailed Display/Edit TIU Object Detailed Display/Edit HS Object

Quit


Select Action: Quit//

This allows you to create a TIU object from a health summary.


6.2.2TIU Alert Tools (TAT)


The TIU Alert Tools (TAT) option on the TIU Maintenance Menu allows you to search for documents using a variety of search criteria.

6.2.3TIU Parameters Menu (TPM)


Select the TIU Parameters (TPM) option on the TIU Maintenance Menu to display the TIU Parameters Menu. This menu shows those things to do or review before the EHR is installed.

TIU Parameters Menu


TPM1 Basic TIU Parameters

TPM2 Modify Upload Parameters

TPM3 Document Parameter Edit

TPM4 Progress Notes Batch Print Locations

TPM5 Division – Progress Notes Print Params

6.2.3.1Basic TIU Parameters (TPM1)


Select the TPM1 option on the TIU Parameters Menu to display the following: (you need to do all of these)

First edit Division-wide parameters


Select INSTITUTION: TUBA CITY HO

ENABLE ELECTRONIC SIGNATURE: YES//

ENABLE NOTIFICATIONS DATE: DEC 1, 2003//

GRACE PERIOD FOR SIGNATURE: 4//

FUTURE APPOINTMENT RANGE: 1//

CHARACTERS PER LINE: 80//

OPTIMIZE LIST BUILDING FOR: security//

SUPPRESS REVIEW NOTES PROMPT: NO//

DEFAULT PRIMARY PROVIDER:

BLANK CHARACTER STRING: @@@//

This option allows the user to enter the basic (or general parameters) that govern the behavior of the Text Integration Utilities for a selected institution.

INSTITUTION: This is the institution name.

ENABLE ELECTRONIC SIGNATURE: Using YES will activate the electronic signature component of TIU for the designated institution.

ENABLE NOTIFICATIONS DATE: This date indicates when the system will begin sending signature notifications.

GRACE PERIOD FOR SIGNATURE: This indicates the number of days (1 to 10) following transcription or hand entry before an author or expected cosigner is notified of a deficiency. If no grace period is entered, clinicians are not notified of overdue signatures.

FUTURE APPOINTMENT RANGE: This is the number of days that determine how far in advance a future appointment can be selected when entering a document for outpatient care. Allowable values range from 1 to 180 days, defaulting to 1 day.

CHARACTERS PER LINE: This is the number (10 to 80) you want to use as a divisor in determining line counts of transcribed documents.

OPTIMIZE LIST BUILDING FOR: This indicates whether you want to optimize the list for either performance or security. The following table describes the differences between these options.



Item

Description

Performance

When a performance-optimized system creates a list, the system bypasses business rules so even notes the user cannot view are listed.

Security

When a security-optimized system creates a list, the system excludes any documents you are not authorized to view.

SUPPRESS REVIEW NOTES PROMPT: Use YES to suppress the prompt that asks if you want to see available Progress Notes before entering a new note. Use NO if you want the system to display this prompt. If you answer NO here, each user can override it under Personal Preferences.

DEFAULT PRIMARY PROVIDER: This indicates how the system should prompt for provider information. The following table details the differences among the options.



Item

Description

0

The system does not prompt you to enter a primary provider for a standalone encounter.

1

The system prompts you to enter the default provider for the given location associated with a standalone encounter.

2

The system prompts you to enter the default author, if the author is a provider. If the author is not a provider, the prompt has no default.

BLANK CHARACTER STRING: This indicates the string of characters used by Transcriptionists to represent a blank when a word or phrase in the dictation cannot understood for inclusion in the transcription. Example: @@@

6.2.3.2Modify Upload Parameters (only for dictation sites)


Select the TPM2 option on the TIU Parameters Menu to display the following:

Select INSTITUTION: TUBA CITY HO

ASCII UPLOAD SOURCE:

UPLOAD HEADER FORMAT:

RECORD HEADER SIGNAL:

BEGIN REPORT TEXT SIGNAL:

RUN UPLOAD FILER IN FOREGROUND: NO//



Now Select upload error alert recipients:



Select ALERT RECIPIENT:



IHS UPLOAD PARAMETERS



UPLOAD FILE DIRECTORY:

ARCHIVE FILE DIRECTORY:

UPLOAD FILE NAME:





Now edit the DOCUMENT DEFINITION file:

DOCUMENT DEFINITION:

This option allows you to define and modify parameters for the batch upload of documents into RPMS.

INSTITUTION: This is the institution name.

ASCII UPLOAD SOURCE: This indicates the source from which you will upload documents. The following table details the different source options.



Note: This only applies when the ASCII upload protocol is used.

Item

Description

Host

Indicates to the upload processor that the source of the data is an ASCII host file.

Remote

Indicates to the upload processor that the data is an ASCII stream coming from a terminal emulator on a remote computer.

UPLOAD HEADER FORMAT: This indicates whether you will be uploading captioned or delimited string formats for the header of each document.

RECORD HEADER SIGNAL: This indicates the text tag you will use to signal to the upload process that it has encountered a new document record header. This can be as simple as a three-letter acronym.

BEGIN REPORT TEXT SIGNAL: This indicates the text tag you will use to signal to the upload processor that it has fully read the fixed-field header for a given report record, and that the body of the narrative report follows.

RUN UPLOAD FILER IN FOREGROUND: This indicates whether or not to run the process in the foreground.

ALERT RECIPIENT: This is the name of the person you want to receive upload error notifications. This individual will receive notifications when a document cannot be filed or located, or has missing fields.

ARCHIVE FILE DIRECTORY: This is the path and file name of the file that the upload process should look for.

UPLOAD FILE NAME: This is the file name for the upload.

DOCUMENT DEFINITION: This is the name of the appropriate document.


6.2.3.3Document Parameter Edit (TPM3)


Select the TPM3 option on the TIU Parameters Menu to display the following:

Select DOCUMENT DEFINITION: PROGRESS NOTES
DOCUMENT DEFINITION: PROGRESS NOTES//

REQUIRE RELEASE: NO//

REQUIRE MAS VERIFICATION: UPLOAD ONLY//

REQUIRE AUTHOR TO SIGN: YES//

ROUTINE PRINT EVENT(S):

STAT PRINT EVENT(S):

MANUAL PRINT AFTER ENTRY: YES//

ALLOW CHART PRINT OUTSIDE MAS: YES//

ALLOW >1 RECORDS PER VISIT: YES//

ENABLE IRT INTERFACE:

SUPPRESS DX/CPT ON ENTRY:

FORCE RESPONSE TO EXPOSURES:

ASK DX/CPT ON ALL OPT VISITS:

SEND ALERTS ON ADDENDA: YES//

ORDER ID ENTRIES BY TITLE: NO//

SEND ALERTS ON NEW ID ENTRY: NO//

SEND COSIGNATURE ALERT:
If document is to be uploaded, specify Filing Alert Recipients:



Select FILING ERROR ALERT RECIPIENTS:
Now enter the USER CLASSES for which cosignature will be required:

Select USERS REQUIRING COSIGNATURE: STUDENT//
Now enter the DIVISIONAL parameters:

Select DIVISION:

CHART COPY PRINTER:

STAT COPY PRINTER:

This option allows the user to enter the parameters that apply to specific documents (e.g., Titles), or groups of documents (e.g., Classes or Document Classes).

DOCUMENT DEFINITION: This is the name of the Class, Document Class or Title, such as Crisis Note or Discharge Summary.

REQUIRE RELEASE: This indicates whether or not to require the individual entering a document to release the document from a draft state upon exit from the entry and editing processes.

REQUIRE MAS VERIFICATION: indicate when verification by Medical Records staff is required. The following table details the available options.


Item

Description

0

No verification required.

1

Always require verification.

2

Require verification for uploads only.

3

Require verification for direct entries only.

REQUIRE AUTHOR TO SIGN: This field indicates whether or not the author should sign the document before the expected cosigner If YES, this indicates the author is alerted for signature, and if the expected cosigner should attempt to sign the document first, he is informed that the author has not yet signed. If NO, this indicates only the expected cosigner is alerted for signature. Although the unsigned document appears in the author’s unsigned list, and the author is ALLOWED to sign it, the author’s signature is not REQUIRED.

ROUTINE PRINT EVENT: This indicates at what stage (before signature) you want the document to print, if any: upon release, upon verification, or both.

MANUAL PRINT AFTER ENTRY: This indicates whether or not to have user prompted to print a copy on exit from that person’s preferred editor.

ALLOW CHART PRINT OUTSIDE MAS: Use YES to allow non-Medical Records staff you to print either work or chart copies. Use NO to limit chart copies to Medical Records only.

ALLOW >1 RECORDS PER VISIT: Use YES to allow users to create a given document more than once per visit, such as multiple Progress Notes for a single Hospitalization. Use NO to limit you to creating only one document to only once per visit, such as a Discharge Summary.

ENABLE IRT INTERFACE: leave blank. This parameter is not used by IHS. Interface with IHS Incomplete Chart module is automatic, if the appropriate chart deficiencies are linked to TIU titles.

SUPPRESS DX/CPT ON ENTRY: Use YES to suppress system prompts for diagnosis and procedure information after signing or editing an outpatient document. Use NO to receive these prompts. The answer to this question does not affect how TIU in List Manager runs in IHS, because we are linked to PCC and not the VA PCE coding.

SEND ALERTS ON ADDENDA: leave blank because IHS does not use this field.

ORDER ID ENTRIES BY TITLE: leave blank because IHS uses PCC to code visits and not. This prompt applies only to notes with interdisciplinary entries under them

SEND ALERTS ON NEW ID ENTRY: Use YES to have authors and cosigners of a document receive an informational alert when other persons add addenda. Use NO to suppress alerts. This parameter applies only to interdisciplinary parent notes.

SEND COSIGNATURE ALERT: This parameter controls the sequence in which alerts are sent to the expected cosigner of a document. Use 0 to enable the system to alert the cosigner only after the author has signed a document. Use 1 to enable the system to alert the cosigner immediately.

FILING ERROR ALERT RECIPIENTS: This indicates the individuals who will receive alerts from the upload filer process when a document of the given type cannot be filed or located, or has a missing field. These are Medical Records staff members who process and verify uploaded documents.

Select USERS REQUIRING COSIGNATURE: You may enter a new USERS REQUIRING COSIGNATURE, if you wish. Specify which user class(es) require cosignature.

Select DIVISION: You may enter a new DIVISION, if you wish.

CHART COPY PRINTER: Select the printer for chart copies of routine documents.

STAT COPY PRINTER: Select the chart copy printer for STAT documents.

The “Select DIVISION” prompt displays (again).

6.2.3.4Progress Notes Batch Print Location (TPM4)


Select the TPM4 option on the TIU Parameters Menu to display the following:

Select Clinic or Ward: ACU

OK? Yes// (Yes)
PROGRESS NOTES DEFAULT PRINTER: ACU PRINTER//

EXCLUDE FROM PN BATCH PRINT:

This is the hospital location to which the parameters apply. You can enter new parameters.

Select Clinic or Ward: enter a location.

PROGRESS NOTES DEFAULT PRINTER: enter the printer name. You can override this default at the time a job is printed.

EXCLUDE FROM PN BATCH PRINT: Use YES to have progress notes for this location will not be included in the progress outpatient batch print job [TIU PRINT PN BATCH]. Do this if you want to print the CHART copies of the notes for this location in the clinic and not in the file room.


6.2.3.5Division – Progress Notes Print Params (TPM5)


Select the TPM5 option on the TIU Parameters Menu to display the following:

Select Division for PNs Outpatient Batch Print: tuba CITY HO IHS 3987

OK? Yes// Yes
LOCATION TO PRINT ON FOOTER: Tuba City HO IHS//

PROGRESS NOTES BATCH PRINTER: acu PRINTER ACU IP PRINTER 161.223.42.97

|PRN|\\NAVTCB\ACUPRINTER

Select Division for PNs: enter the appropriate division name.

LOCATION TO PRINT ON FOOTER: type the number of the division, using 3 to 26 characters, as it should display on the footer of Progress Notes; however, you can override this default at the time a job is printed.

PRN: one print for all outpatient notes.

Footer is the bottom part of the note that remains the same on each page of the note.

These parameters are used by the [TIU PRINT PN BATCH INTERACTIVE] and [TIU PRINT PN BATCH SCHEDULED] options. If the site wants a header other than what is returned by $$SITE^VASITE, the .02 field of the 1st entry of this file will be used. For example, Waco-Temple-Martin can have the institution of their progress note as ‘CENTRAL TEXAS HCF.’

If you want to print the outpatient notes as a batch program, someone in IRM needs to setup the TIU PRINT PN BATCH SCHEDULED option to run every day. The location chosen will need plenty of paper, and this should probably be scheduled for a time when someone will be around to watch the printer.

EHR Printing Option

Because there is no good batch print option for both inpatient and outpatient notes, another routine has been created that allows for batch printing. An option will need to be created to run BATCH^DIAVIHHS(FLAG) where the flag can be set for printing:

Everything

All notes

Signed progress notes

Orders

PCC data


This job will need to be scheduled to run everyday in Taskman. The output is printed to the default host file server directory.

Please note that progress notes, orders, and other information can be printed manually from the EHR.


6.2.4TIU Template Mgmt Functions (TTM)


Select the TIU Template Mgmt Functions (TTM) option on the TIU Maintenance Menu to display the following:

1 Delete TIU template for selected user

2 Edit auto template cleanup parameters

3 Delete template for ALL terminated users


Select TIU Template Mgmt Functions Option:

6.2.4.1Delete TIU template for selected user


Select the “Delete TIU template for selected user” option on the TIU Template Mgmt Functions menu to display the following:

Enter/select user for whom templates will be deleted: DEMO,DOCTOR

Delete all non-shared templates for user USER,CLEAR (Y/N)? NO//

Choose YES to delete all non-shared templates for the specified user. This option accepts user input for an individual from the NEW PERSON file, then deletes non-shared TIU templates for that user. The application prompts for confirmation of the deletion.


6.2.4.2Edit auto template cleanup parameters


Select the “Edit auto template cleanup parameters” option on the TIU Template Mgmt Functions menu to display the following:

Y/N auto cleanup upon termination may be set for the following:


1 Division DIV (DEMO HOSPITAL)

2 System SYS (DEMO.CIAINFORMATICS.COM)


Enter Selection:

You use this option to automatically delete non-shared TIU templates for a user upon termination (or skip any such automatic action). Enter Y or N, where Y turns on auto-template cleanup.


6.2.4.3Delete templates for ALL terminated users


Select the “Delete templates for ALL terminated users” option on the TIU Template Mgmt Functions menu to display the following:

Delete all non-shared templates for all terminated users (Y/N)? NO//

This option allows the CAC or other manager to remove all non-shared TIU templates for all users who have been terminated.

6.2.5User Class Management Menu (UCM)


Select the User Class Management Menu (UCM) option on the TIU Maintenance Menu to display the following:

User Class Management Menu


(DEMO HOSPITAL)
UCM1 User Class Definition

UCM2 List Membership by User

UCM3 List Membership by Class

UCM4 Manage Business Rules


Select User Class Management Menu Option:

You use this menu of options to manage User Class Definitions and Membership as well as manage business rules.


6.2.5.1User Class Definition (UCM1)


Select the User Class Definition (UCM1) option on the User Class Management Menu and the application asks you to select user class status (Active, Inactive, All), Start with class, and Go to class. Then it displays the following:

User Classes Nov 26, 2007 09:37:25 Page: 1 of 8

ACTIVE USER CLASSES 117 Classes

Class Name Abbrev

1 Allergist ALLRG Active

2 Allergy & Immunology ADR Active

3 Anesthesiologist ANES Active

4 Associate Chief Of Staff ACOS Active

5 Attending Physician ATT Active

6 Audiologist AUD Active

7 Cardiologist CARD Active

8 Chaplain CHAP Active

9 Chief Resident CR Active

10 Chief, MIS CMIS Active

11 Chief, Medical Service CMED Active

12 Chief, Psychiatry Service CPSYCH Active

13 Chief, Surgical Service CSURG Active

14 Clinical Clerk CLCLRK Active

15 Clinical Coordinator CLPAC Active

+ + Next Screen - Prev Screen ?? More Actions

Find Expand/Collapse Class Change View

Create a Class List Members Quit

Edit User Class

Select Action: Next Screen//

You will use this option to view user classes and their hierarchy. Also, you will create, edit, or remove user classes from this option.

Provider User Class

All users need a user class. The user class is set in the TIU menus. There is an automatic option that allows a site to populate all holders of the PROVIDER key into the Provider user class, but this has not been enacted because of the time needed to clean up this list at many sites. So individuals will have to be added as they start using the EHR.

6.2.5.2List Membership by User (UCM2)


Select the List Membership by User (UCM2) option on the User Class Management Menu and the application asks you to select a user. Then it displays the following:

Current User Classes Mar 27, 2006 16:18:32 Page 1 of 1

DOCTOR,DEMO
User Class Title Effective Expires

1 Physician 01/02/00

2 Provider 01/02/00
+ Next Screen - Prev Screen ?? More Actions

Add Remove Quit

Edit Change View

Select Action: Quit//

You will use this option to view, add, edit, or remove user classes for a specified user.

6.2.5.3List Membership by Class (UCM3)


Select the List Membership by Class (UCM3) option on the User Class Management Menu and the application asks you to select a class. Then it displays the following:

User Class Members Nov 26, 2007 09:39:02 Page: 1 of 2

PROVIDERs 24 Members

Member Effective Expires

1 BAROFF,SCOT A 07/26/04

2 BARRETT,KARI E 07/26/04

3 BISHOP,BRADLEY M 07/26/04

4 BROWN,GERALD R 07/26/04

5 BRUNING,BJ 08/28/06

6 CHEATHAM,IVANNE L 07/26/04

7 COOKSON,DEBORAH M 07/26/04

8 COX,PATRICK

9 DEMO,DOCTOR (?SBPN) 11/09/07

10 GUZIC,CARLA D 07/26/04

11 HOGAN,SHERA M 07/26/04

12 INGRAM,DENA G 07/26/04

13 JONES,KERRI A 07/26/04

14 KLEPACKI,STEPHANIE 09/16/07

15 MCLEMORE,MISTY B 07/26/04

+ (?SBPN) missing SIGNATURE BLOCK PRINTED NAME >>>

Add Remove Change View

Edit Schedule Changes Quit

Select Action: Next Screen//

You use this option to view members of a specified class.


6.2.5.4Manage Business Rules (UCM4)


Select the Manage Business Rules (UCM4) option on the User Class Management Menu to display the following:

Select User Class Management Option: ucm4 Manage Business Rules

Select SEARCH CATEGORY: DOCUMENT DEFINITION//

Select DOCUMENT DEFINITION: PROGRESS NOTES

ASU Rule Browser Jun 10, 2004 14:30:39 Page 1 of 2

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

List Business Rules by DOCUMENT DEFINITION 24 Rules

for CLASS PROGRESS NOTES
-------------------------------------------------------------------

1 A COMPLETED (CLASS) PROGRESS NOTE may be VIEWED by a USER

2 An UNSIGNED (CLASS) PROGRESS NOTE may be EDITED by a STUDENT who is also

an AUTHOR/DICTATOR

3 An UNSIGNED (CLASS) PROGRESS NOTE may BE DELETED by an AUTHOR/DICTATOR

4 An UNSIGNED (CLASS) PROGRESS NOTE may BE VIEWED by an AUTHOR/DICTATOR

5 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE VIEWED by an AUTHOR/DICTATOR

6 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE VIEWED by an EXPECTED COSIGNER

7 An UNSIGNED (CLASS) PROGRESS NOTE may BE PRINTED by an AUTHOR/DICTATOR

8 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE PRINTED by an AUTHOR/DICTATOR

9 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE EDITED by an EXPECTED COSIGNER

10 An UNSIGNED (CLASS) PROGRESS NOTE may BE EDITED by an AUTHOR/DICTATOR

11 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE PRINTED by an EXPECTED COSIGNER

12 An UNSIGNED (CLASS) PROGRESS NOTE may BE SIGNED by an AUTHOR/DICTATOR

13 An UNCOSIGNED (CLASS) PROGRESS NOTE may BE COSIGNED by an EXPECTED

COSIGNER
+-------------+ Next Screen - Prev Screen ?? More Actions ---------------

Find Edit Rule Change View

Add Rule Delete Rule Quit

Select Action: Next Screen//

This option allows you to add, edit, or delete business rules for a specified document definition, as appropriate.


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