Table of Contents. I. Logging into Camden HIE... 3 II. Basic Home View... 4
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1 Clinical User Guide Revised April, 2018
2 Table of Contents HIE Basics I. Logging into Camden HIE II. Basic Home View... 4 Applications Dashboard III. My Patients List IV. Inside a patient s record 8 a. Dashboard b. Timeline c. Reports d. Lab Trends i. Hierarchy Options ii. Page Actions iii. Legend. 22 iv. Panel Shortcuts.. 22 e. Lab Reports. 23 i. Search Options V. Beacon Surveillance a. Filtering Beacon Reports b. Notifications Subscription VI. Direct Messaging. 35 a. Sending messages about a specific patient.. 36 b. Receiving messages on your personal c. Receiving messages about a specific patient d. Overview of messages dashboard
3 I. Logging into Camden HIE To access the Camden HIE use the link below: Enter your username and password (displayed below) 3
4 II. Basic Home View The home view gives a generalized view of everything you might need when entering the HIE including access to patient lists, beacon reports, and the inbox to all HIE sent or received messages. 4
5 III. Steps to Access My Patient Lists Click on My Patient Lists Simple Census - generic display of any and all relevant patient health information (PHI) My Census - Displays specific/targeted patients that you may currently be engaging or wish to engage 5
6 Enter the demographics to search for the patient. Census Search Criteria Use this search to look for specific PHI. You can search by MRN, or Last Name and First Name, or Date of Birth. Note: The default view will show the simple census. You must click the drop box and select My Census to look at your specific panel of active patients and their respective PHI. You can also search a patient by only entering the first few letters of their first or last name and ending it with an asterisk (*) at the end. This will provide a list of results that is identical to or contains the characters entered for searching a patient. 6
7 To add a patient to my census, hover the mouse over the patients name and right-click. A list of options will be provided and you can select Add to My Census which is located at the bottom. In addition, the list contains additional options as an easier navigation to view specific sections of the patients record. For quick reviews of recent admissions for specific patients, click the + symbol at the right end of each row. Displayed above is a list of the patients Recent Admissions. 7
8 IV. Inside a Patient s Record a. Dashboard Dashboard is the default tab. The Dashboard offers providers a high-level view of a patient s clinical picture in an easy-to-read, comprehensive view. Problems, Encounters, Medications, Reports, Lab Results, Providers, Immunizations, and Allergies are included by default. i. Place your mouse over the patients MRN, address or allergies to trace back where the information is coming from 8
9 ii. When Status shows active, it means that the Camden Coalition is currently in contact with the patient. An extension (ext.) of the lead Coalition care manager would be listed to encourage other HIE users to coordinate care with the Coalition staff. iii. Options are provided at the bottom of each grid on Dashboard: - The grid can be reloaded or refreshed - The grid can be expanded - You can look for specific information within the grid - You are able to print details from the grid 9
10 b. Timeline Timeline provides a longitudinal view of a patient s problems, providers, procedures, and medications across clinical encounters. Timeline represents the entire time period for which the patient s data is available within the HIE. By default, the top row of the timeline begins with the patient s first available encounter and continues to the present date. However, to improve performance, only the most recent 24 months of data will be displayed in the summary when the page loads. Any history prior to the default time period is represented by the faded portion of the colored line. 10
11 Click on the plus sign to view additional information listed under the primary problem. You can a filter by data source. 11
12 You can drag the arrow on either end of the timeline to narrow the timeline to view a specific period. For instance- dragging the timeline to focus on all primary problems for the patient from 2016 till today s date a) b) The bottom row of the timeline is an expanded representation of the same time period. Dragging the edges of the date range on the top row increases or decreases the visible date range of the summary. 12
13 Detailed Information Each data point within problems, providers, and procedures is represented on the longitudinal summary by one of the following icons to indicate the type of encounter for each. Medications are represented by a purple capsule-like icon. i. You can click on any icon within the Timeline tab, and a box will pop up with detailed information about that specific encounter. 13
14 You can also click on the drop down menu for medications and select by class to view the type of medication. a) b) 14
15 c. Reports The Reports section includes all available text-based reports such as: history and physicals, consults, ED reports, office visits, operative notes, imaging studies (radiology), and other correspondence regarding the patient. Click the title to display the text of the report. The contents will be displayed to the right of the list. 15
16 d. Lab Trends The Lab Trends tab is useful in viewing the trend of a condition over time. It is configured in descending timeline order with one result displayed per column, by default. The display may be configured by result type and time. Enter the date into the Date box at the top-right of the screen or use the date picker to search for results on a specific date. The directional buttons in the top left and right-hand corners allow you to scroll through the columns of results. 16
17 The figure below are red points along the top of the timeline that represent lab results. Placing the cursor over a result will display additional details. This includes any additional values that falls between the minimum and maximum values. 17
18 i. Hierarchy Options Hierarchy Options allow users to customize the sequence and grouping of the Labs display. Add New Hierarchy to create your own configuration. Time compression may be set to daily, weekly, monthly, quarterly, or yearly. Greater time compression (e.g. quarterly or yearly) might be more helpful in tracking the progression of a disease of longer periods of time, while a lesser time compression (daily or weekly) would be more appropriate when viewing results from an acute episode or single encounter. If a specific lab result exists more than once during the selected time compression, the row will show the min and max values of that lab result during that time period. 18
19 Checking the Report-based box organizes labs as they were ordered/resulted (i.e. in a Report form), not by the selected hierarchy. For example, checking this box groups related analytics, such as Hemoglobin, Hematocrit, and WBCs together. If unchecked, the labs will appear per the hierarchy options. ii. Page Actions Page Actions allow users to customize their current view of Labs. Panel Shortcuts facilitate navigation. Checking Display Most Recent Column inserts a column with the most recent result of each lab panel currently displayed to the left of all columns. Organize All Panels allows drag-and-drop organization of the lab panels. For example, after checking this box, you can grab the CBC Basic panel with your mouse and move it to a lower position. 19
20 Graphing lab results is possible by checking at least one box for a panel or the individual items within a panel and then clicking the Graph Checked Row Lab Data button. You can check off more than one box as well. 20
21 Graph for Glucose Graph for Potassium and Sodium Level Filter Results allows users to filter by a search term, such as blood. After searching for this term, only results with blood in the name of the lab will be displayed. After viewing the filtered results, click on the Remove Filter button that is displayed above the first lab panel. 21
22 iii. Legend Legend indicates the values other than normal lab results. iv. Panel Shortcuts Clicking on any of the Panel Shortcuts in the lower left-hand corner of the page will take you directly to the desired panel, instead of scrolling through the panels displayed above it. 22
23 e. Lab Reports The Lab Reports tab provides, in a modified format, the same information found in the Lab Trends tab. Results are defined by panel and ordered by date, starting with the most recent. i. Search Options The search bar allows users to filter panels by a specific lab value, where the labs were drawn, and the observation date. Note: Print Selected Lab Reports You can select the desired lab reports by clicking the check boxes for each and print. All lab reports that are printed will also have the CHIE watermark at the top of each page. 23
24 V. Beacon Surveillance Beacon Reports can be accessed for certain patients through the Analytics tab located at the top or it can also be found in the Basic Home View (main dashboard), specifically in the Analytics section. 24
25 Beacon shows all essential PHI including name, date of birth, visit type, admission and discharge date, and facility information. You can also click the drop down menu to select a specific report you need to view. Note: Access to a report is provided via role-based security and will only be available to approved users. Contact the HIE team to request access to a specific beacon report. 25
26 a. Filtering Beacon Reports You can also filter data by specific facility, unit, or provider. Other filtering options Searching is not case sensitive. I.e. searching on smith or Smith will yield the same results. i. [string] Search for all values that contain [string]. E.g. Vomit yields all values that contain vomit. 26
27 ii. [space] Search for empty values. Tap the space bar on the keyboard once to find empty values. iii. > [number] Search for all values greater than or equal to [number]. E.g. >4 ED encounters would yield 4 or more encounters for the past 6 months. 27
28 iv. < [number] Search for all values less than or equal to [number]. E.g. <5 inpatients admissions would yield all admissions less than or equal to 5 v. = [number] Search for all values that equal [number]. E.g. =6 ED visits would yield all patient encounters that equal to 6 ED visits. 28
29 vi. > [relative date expression] Search for all values after the relative date. E.g. >-3w yields all admission in the past 3 weeks. vii. < [relative date expression] Search for all values before the relative date. E.g. <1m yields all admissions earlier than 1 month from now. 29
30 viii.! [search expression] Invert the search expression specified. E.g. You can type!horizon that would yield all other insurance companies not including Horizon ix. [exp1] [exp2] Search for anything matching either [exp1] or [exp2]. E.g. Hypertension Diabetes yields all values that contain Hypertension or Diabetes. x. [exp1]&[exp2] Search for anything matching both [exp1] and [exp2]. E.g. smith&jane yields all values that contain Smith and Jane. 30
31 b. Notifications Subscription i. In order to receive message notifications, first decide if you want to filter out the specific data/metrics that you want to target. Example: to set up a notification subscription for all Cooper Hospital patients, simply filter the report by typing the name of the facility. ii. After you have filtered out your targeted data, click the subscribe button toward the top left corner of the screen. You will find three notification options to choose from: Real Time Notifications Digest Notifications Recipient Groups 31
32 Real-time notifications will message you once every hour (or whatever timeframe synchronization programmed for that report). You can filter by provider, facility or unit, or you can choose a specific column to filter. You can even lock in your filtered information for a specified notification, by clicking the use current filters checkbox. If you d like to change the order of your columns in your notification, you make the changes in the Sort Columns section or choose to use current sort column. 32
33 Add all staff and providers that you would want to see this message in the Recipients section using the address You can determine when you would like to receive notifications by clicking the any three of the check boxes in the Alert When section You can choose which days of the week you would like to receive notifications by checking off any days in the Alert On section A digest notification provides a summary of the last 24 hours worth of data and will be sent to your inbox once per day. Follow the same process as you would for a real-time notification and choose what time of day you would want to receive your digest notification. 33
34 notification You will receive an regarding an account set-up. Click the link provided and it will direct you to the HIE inbox. 34
35 VI. Direct Messaging The Direct Messaging feature will allow HIE users to securely message other HIE users through the system. Each user will have their own inbox in their HIE account. The goal of this feature is to improve care coordination of patients between and among providers who have treating relationships with the patients. Messages can be sent about a specific patient from their HIE record or a general message can be sent. 35
36 a. Sending messages about a specific patient Click the link to send a direct message to another HIE user about the patient. A messaging screen will pop up in the bottom right hand corner. o Enter the username of the HIE user that you would like to message. You can search for HIE usernames by clicking the address book. o Fill in the subject of the message in the subject line. Fill in the main text box with the details of your message. You can also add attachments to a direct message. o Click the paperclip icon to attach a document from your local computer server. o Click the arrow to attach a report or CCD from the data that is in the HIE. Click send to send message. 36
37 b. Receiving messages to your personal When you are sent a direct message in the Camden HIE, you will receive a notification via to the address that is associated with your HIE account. To view the message, open up the and follow the link provided. Log into the HIE and view the message. c. Receiving messages about a specific patient To open a direct message, go to your messages dashboard and click the message you wish to open. Bolded messages indicate that the message is unread. When the message is open, you can see who sent the message to you, the subject of the message and the main text of the message. This message also has a linked patient. To go to that patient s HIE record, click the link. 37
38 d. Overview of the Messages Dashboard You will find all of your messages in the HIE in your message dashboard. Folders include: o Inbox - all messages sent to you o MDNs- notification of messages that have been delivered successfully o Drafts - all messages you have prepared but have not sent o Sent - all messages you have sent to other users o Deleted - all messages you have deleted from your inbox. This folder can be completely cleared via the trashcan icon. You can compose a general message by clicking the compose button. 38
39 Questions? Contact with any questions or requests for an in-person training for you and/or your colleagues. 39
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