DLM 450 Release. Vision 3. User Guide

Transcription

1 Vision 3 DLM 450 Release User Guide Copyright INPS Ltd 2013 The Bread Factory, 1A Broughton Street, Battersea, London, SW8 3QJ T: +44 (0) F:+44 (0) W:

2 Copyright Notice 2013 INPS All Rights Reserved. No part of this document may be photocopied, reproduced, stored in a retrieval system or transmitted in any form or by any means, whether electronic, mechanical, or otherwise, without the prior written permission of INPS. No warranty of accuracy is given concerning the contents of the information contained in this publication. To the extent permitted by law, no liability (including liability to any person by reason of negligence) will be accepted by INPS, its subsidiaries or employees for any direct or indirect loss or damage caused by omissions from or inaccuracies in this document. INPS reserves the right to change without notice the contents of this publication and the software to which it relates. Product and company names herein may be the trademarks of their respective owners. INPS Ltd. The Bread Factory 1a Broughton Street London SW8 3QJ Website:

3 Contents DLM 450 VISION RELEASE 5 Summary of Changes 5 Introducing Vision+ 8 Overview 8 "Real Time" Alerts 9 Simple Data Entry Tools 10 Templates 11 Additional Templates - Download Web Files 12 Inbuilt Calculators and Questionnaires 13 Vision+ Recall Management 14 Vision+ Reports 14 Getting Started with Vision+ 15 Installation and Vision+ Versioning 15 Vision+ Modules 17 Initial Set-up 18 Forward Dating Explained 18 Vision User Rights to Vision+ 21 Clinical Audit and Vision+ 21 Mail Gateway and Vision+ 22 Multiple Consultation Managers and Vision+ 22 Patient Preview Changes 23 Immunisation Changes 25 Immunisation SDA Additions 25 Rotavirus and Shingles Medical History to Immunisation Conversion 25 Immunisation SDA Editions 27 New Immunisations Method Option 28 Populate GPES Staff Group 29 INDEX 31 iii

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5 DLM 450 Vision Release Summary of Changes DLM 450 Vision release brings the following exciting changes to Vision: Vision+ - DLM 450 introduces a new free of charge QOF management and practice protocol tool called Vision+. This exciting new update to Vision includes real-time alerts for additional QOF points, practice-based protocols and a simple but powerful recall and reporting facility. When a patient record is open in Consultation Manager, Vision+ shows missing or incorrect contract information and provides intelligent templates for fast data recording. There are also additional reporting facilities to help with QOF and protocol management. Practices can also create their own protocols that alert users to missing information during consultations alongside the existing QOF related alerts. Click here (page 8) for an introduction to Vision+. Click here (page 15) for information about what happens when you receive DLM 450 with regards to Vision+. Note - Once DLM 450 is installed, all QOF reminders in Clinical Audit will be inactivated. This is because Vision+ will now be the principal tool for QOF alert and data entry. See Clinical Audit and Vision+ (page 21) for more information. 5

6 Consultation Manager Immunisation Changes Read codes have been added to the immunisations SDA for: Intranasal Seasonal influenza, Hepatitis A adult and junior, Shingles and Rotavirus. On receipt of DLM 450, previous medical history entries for Shingles and Rotavirus will be automatically converted to the immunisation SDA. Read codes have been changed for Influenza, Hepatitis and Varicella. You can now select Intranasal from the immunisation method list. See Immunisation Changes (page 25) Patient Preview Enhancements Last Surgery Consultation - Full details of the last patient consultation are now displayed in the Last Surgery Consultation section of the Patient Preview screen. Significant Medical History - Date Display - The Read codes and Problem entries in the Significant Medical History section of the Patient Preview screen now display the event dates. Procedures - Procedure history items with a priority 0 or 1 no longer display in Significant Medical History (priority 1 items display in the medical history section). Also, the following chapter 7 codes are no longer displayed in the procedure section: 7L1% Other miscellaneous operations, 7M% Subsidiary classification of methods of operation, 7N% Subsidiary classification of laterality and operation sites, 7P% Diagnostic imaging, testing and rehabilitation, 7Q% Drugs. Current Prescription Section - Current prescriptions are now categorised and grouped into acute and repeats and the associated text displayed now wraps. Recalls section - Completed inactive recalls no longer display in Patient Preview. Examination Findings Section - The Examination Findings section of the Patient Preview screen now displays the event dates. Cervical Cytology Section - Previously the cytology section only displayed cytology in the last three years, it now displays the last cytology entry for the selected patient regardless of when it was recorded. See Patient Preview Changes (page 23) SDA Change - To better categorise oximetry recording and allow for a percentage value to be entered, the Read codes 44YA0, 44YA0, 44YA1 oxygen saturation at periphery have now been removed from Blood Gases SDA and put into Pulse Oximetry SDA. This applies to new and historical entries. The percentage value for historical entries is added as <none> however there will be a data quality clinical audit to help identify such entries. Please update any practice searches or guidelines to reflect this. 6

7 Mail Manager Epilepsy Register - A new code for F25H. Generalised Seizure was added to the Read dictionary in April 2013 and has now been excluded from the QOF Epilepsy register in v26 business rules. Because of this, we have stopped this code from invoking the Vision Epilepsy Register when entered on the patient record in Consultation Manager. AMS Prescribing (Scotland) Urgency Status - You can now flag AMS messages as urgent if you right click on the item within Prescription Manager in the Consultation - Therapy screen. New A&E Message Types are now accepted in Mail Manager. Changes Preparing for General Practice Extraction Service - England Control Panel - File Maintenance - Staff Groups - In preparation for GPES, when you receive DLM 450, a staff group is automatically created in File Maintenance which determines the members of staff who will receive GPES notifications in Daybook (and on the front screen Daybook panel). Staff in this group can authorise or decline GPES extractions. You are therefore strongly advised to review the members of this group before GPES is enabled at your practice. Please be careful not to delete this staff group. See Populate GPES Staff Group (page 29). There is also a useful document on the INPS blog regarding Preparing for GPES CBDE860EF8A1C239DC5129. My Health Online - Wales Registration Letter - The My Health Online Registration letter which is normally printed from Vision and given to the patient to register online, now includes advice that they should register as soon as possible and not wait until they need to use the system - the registration details on the letter may expire. See the Vision 3 Registration help and the My Health Online help for more information. 7

8 Introducing Vision+ Overview DLM 450 contains a new, free of charge QOF management and practice protocol tool called Vision+. Vision+ provides an immediate way of capturing essential QOF data using real time alerts and templates. Vision+ also brings a comprehensive reporting site which includes a recall management programme and QOF Reporting Tools. The following topics outline the changes and provide an overview of the new functionality. Once the Vision+ installation has completed, you will see the new modules and icons and can start using Vision+ straight away. New icons in Consultation Manager New menu option in Consultation Manager New Reporting Module New Management Tools Modules 8

9 "Real Time" Alerts When a patient record is opened, Vision+ provides colour coded timely alerts that capture the patient's QOF (currently version 26) or other practice protocol requirements at a glance. Alert Screen Individual data items can be entered directly into the patient's journal from the alert screen. Once recorded, the alert is instantly updated to display the remaining outstanding alerts. The alerts can also be printed and taken on house calls. Smoking data entry screen 9

10 Simple Data Entry Tools One of the other major features of Vision+ is the ability to record key items of information quickly and efficiently using intuitive data entry tools. For example you can quickly access Contract codes from the Alerts screen in Consultation Manager: Choosing a Data Entry Screen Simply choose the Read term and click OK to enter data. Data Entry Screens 10

11 Templates In addition, Contract and Clinical Templates provide step-by-step protocols and links to other templates and screens. Contract Templates By a single click you can view a patient's historical data and graph it. Templates You can also edit existing QOF templates or create your own data entry templates using the Vision+ Template Designer module. 11

12 Additional Templates - Download Web Files Vision+ has access to a number of additional templates that can be used to improve patient care, creating a single template that holds all the relevant information and will also allow the user to input information from the template. These templates are similar to the QOF templates, but contain non-qof information such as NICE guidelines and Local Enhanced Services. It is up to the practice to download the ones that they choose to use. Note - You may not have access to all templates. This depends on your health board, where you are in the country and if you have purchased additional templates. To access downloadable files: 1. From the Vision front screen, go to Management Tools - Download Web Files: 2. A list of files available for download and files already downloaded is displayed. Download Web Files 12

13 Group Name - details the name of the download Web Version - tells you the version of the download available to import Local Version - tells you the version of the download you currently have installed on your system Status - tells you the status of the download Download - tick the box to select a download to import Delete - tick the box to select a download to delete 3. Select the file(s) you wish to download by ticking the box in the download column. 4. Then click Download. You do not need to log out of Vision whilst the files are downloading. 5. A splash screen will appear showing the progress of the download. Note - Templates that have been downloaded by the practice are available to all users providing that Disable User Defined Indicators is not checked in Configuration and Settings. 6. The status column quickly shows which templates have already been downloaded to the system, and which templates have a new version that may be downloaded. Template Version numbers can be compared between the Web Version and Local Version to see if a more recent version is available for download from the web. To remove a template from the system simply click to place a Tick in the Delete column alongside all the templates you wish to remove, then select Delete from the Toolbar. Inbuilt Calculators and Questionnaires There are numerous integrated calculators and questionnaires available within Vision+ to assist with the management of patient care. These are easily accessed from the Vision+ menu or icon in Consultation Manager. In Built Calculators and Questionnaires 13

14 Vision+ Recall Management A simple, comprehensive recall programme is built into the new Reporting module. The recalls can be per disease area or there is a facility to merge co-morbidity cohorts in order to facilitate streamlining of letter invites. Recalls Vision+ will keep a track of the number of letters sent to the patient and it will automatically update the invite status and record an entry in the patient's journal. The Vision+ recall functionality uses history entries rather than Vision recall entries. Vision+ Reports Contract Manager is also part of the new Reporting Tools. This is an essential tool for monitoring your practice QOF performance over the year. It can be used to track aspirations, help plan monthly workloads, compare year on year performance and show your practice prevalence and provide you with financial information. This module is part of the existing Search and Reports security group, so only those authorised will be able to view it. Contract Manager 14

15 Getting Started with Vision+ The following topics give some useful information regarding the installation of Vision+ and using it alongside existing Vision modules: Installation and Vision+ Versioning Vision+ will be automatically installed for all users when you receive DLM 450. You will know that this has happened as you will see Vision+ alerts in Consultation Manager and new icons on the Vision front screen see Vision+ Modules (page 16). However, you can also check the status of your installation and Vision+ versioning from the Vision front screen About Vision window: 1. Login to Vision. 2. From the front screen click Help - About Vision The Vision+ Details section tells you the version of Vision+ you have installed and the database status. Version - Details the version of Vision+ which is installed on your system. QOF Version - The version of QOF installed on your system. Country - Your practices country. Database Status - The database status tells you when the last synchronisation between Vision+ and the patient database was run. This ensures that patient data in Vision+ is completely up to date. Depending on your practice configuration, synchronisation runs automatically every 60 seconds. Practices with their own server must have Mail Gateway running for this to work. There are four possible status: Synchronised (date and time) - means that patient database is fully synchronised with Vision+. Sync Required - means Vision+ needs to synchronise. This is done automatically every 60 seconds. Practices with their own server should check that Mail Gateway is running to resolve this. In Progress - displays during installation and means that patient population is in progress. It may take a while to complete. 15

16 Not started - means a patient synchronisation has never happened. This suggests a Vision+ installation problem. 4. Click OK to close. Note - The Vision+ Installation is separate to the DLM 450 upgrade. If the Vision+ installation is unsuccessful, it will not affect the DLM 450 upgrade. 16

17 Vision+ Modules Depending on your security access rights, you can access Vision+ functionality in the following Vision areas: Consultation Manager Vision+ icons in Consultation Manager Vision+ menu option in Consultation Manager There are Vision+ icons and a menu in Consultation Manager which gives access to templates, registers, calculators and questionnaires and settings. Reporting Vision+ Reporting Module There is a Vision+ Practice Reports module within the reporting group from which you can monitor your QOF and other practice protocol performance and manage recalls. Management Tools Vision+ Management Tools Modules There are three Vision+ modules in the Management Tools group for the following: Template Designer - for creating new or modifying existing Vision+ templates. Download Web Files - for downloading distributed templates from INPS or your health board. Settings - for changing the Vision+ settings for your account only. 17

18 Initial Set-up Once you have Vision+ installed on your system, you can start using all the modules straightaway. However, there are some configuration and security options for Vision + which we advise you to to review beforehand: Within the Settings screen, there are configuration options which allow each user to customise how Vision+ works for their individual Vision account. Initially all users are set-up with a GP role profile which sets predefined options for that role but you may want to change this to Nurse, Admin or create custom Vision+ settings. See Configurations and Settings in the Vision+ Quick Reference Guides (page 23) for further details. Also within the Settings screen there is a forward dating option which determines the baseline date for the alerts and reports within your individual Vision account. The default is set to today which means in QOF terms that alerts and reports reflect today's data rather than projecting back from 1 April 2014, so you may wish to change this. See Forward Dating (page 18). There are also security access rights for Vision+ which are based on the current Vision security model. You (or the person who looks after the Management of Vision in your Practice) may also want to review access rights to certain Vision+ modules, see Vision User Rights to Vision+ (page 21). Forward Dating Explained The Forward Dating Tab within the Settings screen provides three different options for forward dating of indicators. These options will change the information that you see displayed in the Contract Indicators, Contract Templates and Patient Target Lists (the reference date is clearly shown on these screens).by default the Alert Indicator screen defaults to None (today s date). The diagram below attempts to explain the timeframes you may initially require for forward dating. 1. You can access the Settings screen from either: 18

19 From Management Tools choose Settings. Note - You cannot access settings from Management Tools if you have Consultation Manager or other Vision+ modules open. Alternatively, if your are in Consultation Manager you can access the settings from either the: menu Vision+ icon on the Toolbar Or by choosing Consultation - Options - Settings. 2. The Settings Configuration screen is displayed. Forward Dating Tab 19

20 3. To change the forward dating, select from the following options: None Only those indicators requiring completion as of today's date will be shown. This is the default setting when Vision+ is installed on your system. Forward Date Will also show those indicators that have already been completed as of today's date, but will need to be re-recorded before a specified reference date. You can set this date using the date picker or by typing in a date. Rolling Days Will also show those indicators that have already been completed as of today's date, but will need to be re-recorded within a specific number of days ahead. You can set the number of days using the Days field. If you choose the Forward Date or Rolling Days option, you also are able to select the Show Inactive Triggers checkbox to display those items that will need recording in the future, but cannot be recorded within the specified time period. Depending on which option you have selected, the indicators will appear in different colours in the other screens. For more information on the colour-coding of indicators, see Colour Coding for Contract Indicators. 4. Click OK to save. 20

21 Vision User Rights to Vision+ There are currently no specific security access rights to Vision+. When you receive DLM 450 and Vision+ is installed successfully, it will be available to all users however, access to Vision+ functionality is determined by the following existing Vision rights in Control Panel - Security: Vision+ Function Settings Reporting Template designer Download web files Rule designer (currently unavailable to all users) Vision Security Group Consultation Manager (full) Search and Reports Control Panel Control Panel Control Panel If you already have access to these Vision security groups, you will automatically have access to the corresponding Vision+ module when you receive DLM 450. If you would like to restrict access to the Vision + modules you need to remove users from the relevant group in Control Panel - Security. See Control Panel web help for details on how to change user security settings. Note - To disable the Vision+ alerts in Consultation Manager for a particular user, go to the users Vision+ settings in their Consultation Manager screen (this can also be accessed from the Management Tools menu on the Vision front screen) and tick Disable Auto Popup. See Configuration and Settings in Vision+ Quick Reference Guides (page 23). For practices in England, additional RBAC roles are not required to use Vision+. You may also notice that you have an inactive user in the security module called VPLUS. This is used for maintenance purposes and should not be amended or deleted. It will not appear on any practice reports or lists. Clinical Audit and Vision+ All functionality within Clinical Audit and QOF Guidelines remains unchanged with the introduction of Vision+, apart from QOF reminders which are automatically disabled once DLM 450 is installed. As Vision+ offers dynamic, up to the minute alerts on patient data, direct access to intuitive templates, real time reporting and simple yet effective recall management, it is intended to be the principal tool for QOF and practice protocols in Vision. We encourage you to take advantage of this new functionality. However, you can reactivate Clinical Audit reminders and use them alongside Vision+ alerts until you get used to the different screens. QOF Clinical Audits and guidelines will continued to be maintained for QOF 25/26. As Clinical Audit will still manage and transmit your end or year QOF reports, it is important that you keep check on how it is running and maintain your regular system management for this. 21

22 Mail Gateway and Vision+ Important - Please note that the Mail Gateway must be running for Vision+ services to run correctly. Whilst you are not able to close the Mail Gateway per se, the Mail Gateway program will close if the machine it is running on is turned off. Task exclusion times should only be set for times when your backup is running overnight, not during the day. If these services are not running during the day, Vision+ functionality will not work as expected and other messages will be delayed. Multiple Consultation Managers and Vision+ Please be aware that when opening multiple Consultation Managers, Vision+ functionality is only available in the most recently opened instance of Consultation Manager. As you close extra instances of Consultation Manager, Vision+ functionality becomes active in the most recent remaining Consultation Manager screens and alerts display for the relevant patient if they are selected. 22

23 Patient Preview Changes Following customer feedback, we have made the following enhancements to Patient Preview: 23

24 Last Surgery Consultation - Full details of the last patient consultation are now displayed in the Last Surgery Consultation section of the Patient Preview screen. Significant Medical History - Date Display - The Read codes and Problem entries in the Significant Medical History section of the Patient Preview screen now display the event dates. Procedures - Procedure history items with a priority 0 or 1 no longer display in Significant Medical History (priority 1 items display in the medical history section). Also, the following chapter 7 codes are no longer displayed in the procedure section: 7L1% Other miscellaneous operations, 7M% Subsidiary classification of methods of operation, 7N% Subsidiary classification of laterality and operation sites, 7P% Diagnostic imaging, testing and rehabilitation, 7Q% Drugs. Current Prescription Section - Current prescriptions are now categorised and grouped into acute and repeats and the associated text displayed now wraps. Recalls section - Completed inactive recalls no longer display in Patient Preview. Examination Findings Section - The Examination Findings section of the Patient Preview screen now displays the event dates. Cervical Cytology Section - Previously the cytology section only displayed cytology in the last three years, it now displays the last cytology entry for the selected patient regardless of when it was recorded. 24

25 Immunisation Changes Immunisation changes are listed below: Immunisation SDA Additions The following options have been added to Type of Immunisation within the Immunisation - Add Structured Data Area (SDA) Type of Immunisation Stage Read Code Read Description Influenza - Seasonal Intranasal 1 65EE0.00 Administration of first intranasal influenza vaccination 2 65EE1.00 Administration of second intranasal influenza vaccination Hepatitis A (Vaqta Adult) 1 65FA.00 1st hepatitis A vaccination 2 65FB.00 2nd hepatitis A vaccination Hepatitis A Junior 1 65FF.00 1st hepatitis A junior vaccination 2 65FG.00 2nd hepatitis A junior vaccination Hepatitis B Junior 1 65F st hepatitis B junior vaccination 2 65F nd hepatitis B junior vaccination 3 65F rd hepatitis B junior vaccination 4 65F th hepatitis B junior vaccination Rotavirus vaccination 1 65d0.00 First rotavirus vaccination 2 65d1.00 Second rotavirus vaccination Shingles vaccination 65FY.11 Shingles vaccination Shingles vaccination (OHP) 65FY000 Herpes zoster vaccination given by other health care provide Rotavirus and Shingles Medical History to Immunisation Conversion To support the earlier than expected start of the Shingles vaccination programme and to ensure the accuracy and completeness of the immunisation database with regards to the Rotavirus vaccination programme, the DLM 450 update converts any Medical 25

26 History entries for the following Read codes into Immunisation structured data area (SDA) entries with the corrected Read code as follows: From Medical History: To Immunisations SDA: Read Code Read Term Read Code Read Term Immunisation Type 65d0.00 First rotavirus vaccination 65d0.00 First rotavirus vaccination ROTAVIRUS 65d1.00 Second rotavirus vaccination 65d1.00 Second rotavirus vaccination ROTAVIRUS 65FY.11 Shingles vaccination 65FY.11 Shingles vaccination SHINGLES 65FY000 Herpes zoster vaccination given by another health care provide 65FY000 Herpes zoster vaccination given by other health care provide SHINGLESOHP 65FY.00 Herpes zoster vaccination 65FY.11 Shingles vaccination SHINGLES Additional information populated within the Immunisation SDA for each vaccination converted: Status - Given Due date - Completed automatically where appropriate In Practice - In this practice Reason - Routine Free text - Completed with free text entered within the Medical History entry Batch Number - Taken from free text if present 26

27 Immunisation SDA Editions The following immunisations have also been updated: Type of Immunisation Stage Read Code New Read Code Other Changes Influenza - Seasonal 65ED.00 The Read code for Refused has changed from 68NE.00 to 68NE000 Influenza - Seasonal OHP Influenza - Seasonal Pharmacist 65E ED00 0 The Read code for Refused has changed from 68NE.00 to 68NE000 The Read code for Refused has changed from 68NE.00 to 68NE000 Hepatitis A+B (Twinrix Paediatric) 1 65MD.00 65MD000 Start age changed to 1 year Stop age changed to 15 years Hepatitis A+B (Twinrix Paediatric) 2 65ME.00 65ME000 Start age changed to 1 year Stop age changed to 15 years Hepatitis A+B (Twinrix Paediatric) 3 65MF.00 65MF000 Start age changed to 1 year Stop age changed to 15 years Hepatitis A (Havrix Junior) Hepatitis A (Havrix Junior) 1 65FF.00 Next stage changed to FG.00 65FB.00 Next stage changed to B Hepatitis A (Havrix Junior) Hepatitis A (Havrix JuniorMonodose) B B 65FD.00 65FQ.00 65FD.00 65FQ.00 Hepatitis A (Vaqta Paediatric) 1 65FA.00 65FF.00 Hepatitis A (Vaqta Paediatric) B 65FD.00 65FG.00 Hepatitis A Junior 3 65FC.00 65FP.00 Next stage changed to B Interval changed to 5 years 27

28 Varicella 1 65FL.00 Name changed to Varicella (Chicken Pox) Varicella B 65FL.00 Name changed to Varicella (Chicken Pox) New Immunisations Method Option Intranasal is now an option in the Method pick list. 28

29 Populate GPES Staff Group To ensure the correct members of staff receive the notifications when GPES is live, you must populate the empty GPES group created as part of DLM 450. It is important that this is done as soon as possible and that the GPES staff group is not ignored or deleted: Note - You must have system security rights in Vision to access Control Panel - File Maintenance. 1. From the Vision front screen, go to Management Tools - Control Panel. 2. Next, go to File Maintenance and select Staff Groups. 3. From the Practice folder select Mail Groups. Staff Groups - Practice - Mail Groups 4. Right click on the group labelled Gpes and select Add Staff Member(s). 5. Select Staff Member - Add is displayed. 29

30 Whilst holding the <Ctrl> key, click on all members of staff that you want to add to the Gpes group then release <Ctrl>. Staff Groups - Practice/System - Gpes - Add Staff Member(s) - Select Staff Member - Add 6. Click OK. 7. The selected staff members are now added to the Gpes group and will receive stage 1 and 2 GPES notifications in their Daybook tasks. Warning - If you do not populate your Gpes staff group, every member of staff will receive Stage 1 and 2 Notification tasks sent by GPES. This means that any Daybook user can authorise extract notifications. The following message also displays on your notification messages: Gpes staff group reminder message 30

31 O Index Overview 8 P Patient Preview Changes 6, 23 Populate GPES Staff Group 7, 29 A Additional Templates - Download Web Files 12 C Clinical Audit and Vision+ 5, 21 Copyright Notice ii D DLM 450 Vision Release 5 F Forward Dating Explained 18 G Getting Started with Vision+ 5, 15 R Rotavirus and Shingles Medical History to Immunisation Conversion 25 S Simple Data Entry Tools 10 Summary of Changes 5 T Templates 11 V Vision User Rights to Vision+ 18, 21 Vision+ Modules 15, 17 Vision+ Quick Reference 18, 21 Vision+ Recall Management 14 Vision+ Reports 14 I Immunisation Changes 6, 25 Immunisation SDA Additions 25 Immunisation SDA Editions 27 Inbuilt Calculators and Questionnaires 13 Initial Set-up 18 Installation and Vision+ Versioning 15 Introducing Vision+ 5, 8 M Mail Gateway and Vision+ 22 Multiple Consultation Managers and Vision+ 22 N New Immunisations Method Option 28 31