Immunotherapy Module

Transcription

1 Immunotherapy Module

2 Table of Contents 1. Skin Testing 2. Practice Setup Allergy Module a) Positive Skin Test Mapping b) Injection Schedule c) Extract Contents Vial Colors Manage Inventory Group Antigen d) App Settings Auto Charge Reorder Vial Extract Order Navigation Extract Mixing Navigation Edit Vial ID Vial Placement on Label Immunotherapy Schedule Off Rack Injections 3. Extract Orders a) Extract Requisition b) Pending Extract Requisition c) Extract Ordering Add Vial Duplicate Vial Reorder Vial Edit Vial ID d) Extract Mixing e) Print Labels f) Vial List g) Shot Identification h) Questionnaire i) Injection Administration j) Off Rack k) Immunotherapy Charge 4. Injection Tracking 5. Injection Reaction

3 Skin Testing

4 Practice Dashboard Status of skin tests can be tracked from the Practice Dashboard

5 New orders are created under Skin Tests Patient Chart

6 Select value under Available Tray Select Allergens Select Test Location & Testing Device Add last Antihistamine use date and type Submit skin test Skin Tests

7 Antihistamines Support Entity 1. Add antihistamines as a support entity: Practice setup Allergy Skin test Support Entities Antihistamines Antihistamines will populate in Skin Test Results Report

8 Skin test trays can be set-up according to provider. Skin Test/Tray Setup

9 Skin Test Trays Assigned to Specific Providers Practice Setup Allergy Skin Tests Click on Tray setup Select Provider Select the Panel/Trays that the provider will be using Submit

10 Click the drop under Available Trays Select the Provider Select the Panel/Trays Select Allergens Select Test Location & Testing Device Add last Antihistamine use date and type Submit skin test Skin Tests

11 Outstanding Orders On clicking the Administer button, the above window opens which displays who administered the skin test and at what date and time

12 Skin Test Administered Order status changes from Ordered to Administered with time tracking

13 Test can be saved and finalized later Wheal/Flare and Grade customizable Enter Skin Test Results

14 Enter Patch Test Results You can now enter a grade value for the patch test rather than only a negative/positive

15 Skin Test Results Report There have been new features added to the Skin Test Report: Antihistamine and last used were added. This will carry over from the skin test order screen. Test type has been changed from prick to percutaneous. Manufacturer and concentration have been added. Wheal/flare can now be entered as 2 numbers each.

16 On clicking the View Results button, the results are displayed in PDF and can be printed View Results

17 Positive Skin Test Mapping

18 1. Positive skin test allergens must be mapped to appropriate treatment allergen. 2. New Injection Ordering System will pick treatment allergens based on this mapping. Mapping

19 1. Practice Setup -> Allergy -> Skin Tests -> Allergens Used 2. Double click in Allergen Content and select the appropriate allergen. 3. Treatment allergen is now mapped to skin test allergen. Mapping

20 INDIVIDUALIZED PROVIDER INJECTION SCHEDULE

21 Injection Schedule 1. From Practice Setup, click Allergy, click Schedule 2. Fixed allows for same start/end doses, increments, interval 3. Variable allows for variable doses across variable intervals

22 To modify the verbiage in a template or make a template inactive: Practice setup Allergy Immunotherapy Injection Schedule Only active injection schedules will show in the injection schedule report. Injection Schedule Template

23 To view the Injection Schedule Template: Patient chart Immunotherapy Injections Immunotherapy schedule Print schedule (to see the template) Injection Schedule

24 Extract Contents

25 Extract Contents Vials can be assigned a color and inventory can be managed by tracking lot numbers as well as manufacturers. Custom group antigens can also be created.

26 Colors will now appear in Extract Order and Extract Mixing Extract Contents Vial Colors

27 Extract Contents Manage Inventory 1. Lot numbers, Manufacture ID and Name, Volume, Ingredients, and Effective Date can be recorded. 2. Practice Setup Allergy Contents highlight antigen click Manage Inventory

28 Extract Contents Vial Colors 1. Users may color code strengths. 2. Practice Setup Allergy Strengths. Select color from dropdown menu. Click Update and strength is now mapped to a color.

29 1. Click Add. Extract Contents Manage Inventory 2. Add required information, click Save. 3. Information has been added. Change app setting: Show Lot and Manufacturer see Apps Section

30 Extract Contents Group Antigen Groups can also be created for providers who make custom antigens. 1. Practice Setup Allergy Contents click Add Content name Content (ie, Mix C), click Update

31 Extract Contents Group Antigen 2. Select Content, (ie, Mix C), uncheck Inactive status (default), click Define Group.

32 3. Select desired contents for the group, click Save. Extract Contents Group Antigen

33 Extract Contents Group Antigen If an individual content is also included in the custom group, and if the group is mapped to the appropriate treatment allergen (slide 12), both will appear as a selection under Positive Results.

34 Comments History In screens, ExtractOrder, Extract Mixing, or Extract Requisition, you can now view previous comments that were entered: In comments section, click on history and it will shaow all entered comments.

35 App Settings

36 App Settings Six App settings are available to further customize the Immunotherapy module: 1. Auto Charge App Setting: When enabled, a charge edit screen will automatically generate when new extract orders are mixed. 2. Reorder Vial App setting: When enabled, it will allow vials to be reordered, which will keep the vial number the same. 3. Extract Order Navigation: Users may select the default screen after extract has been ordered. 4. Extract Mixing Navigation: Users may select the default screen after extract has been mixed. 5. Edit Vials ID: Users may edit the Vial ID after placing the Extract Order. 6. Injection Schedule Template: When enabled, custom text can be added to the report that is sent out with the vials.

37 App Settings Auto Charge To enable or disable the App Setting to automatically generate a charge edit screen for mixed extract orders: Practice Setup General App Settings Practice Settings Click on allergy.autocharge, then click on the Edit button In the Value field, change the value to either Enable or Disable

38 To enable or disable the App Setting to have the ability to reorder vials: Practice Setup General App Settings Practice Settings Click on Immunotherapy.ShowReorderVial, then click on the Edit button In the Value field, change value to either Yes or No App Settings Reorder Vial

39 App Settings Extract Order Navigation To create the default setting for Extract Order navigation: Practice Setup General App Settings Default Settings Search and click on Immunotherapy.ExtractOrderSubmitNavigation, and click Edit. In the Value field, select one of the below choices to set the navigation after clicking on Extract Order submit button: 0- Extract order Edit mode, 1- Pending Extract Requisition, 2- Extract Mixing, 3- Mixed Extract History, 4- Injection Tracking Repeat under Practice Setup General App Settings Practice Settings

40 App Settings Extract Mixing Navigation To create the default setting for Extract Mixing navigation: Practice Setup General App Settings Default Settings Search and click on Immunotherapy.ExtractMakeSubmitNavigation, and click Edit. In the Value field, select one of the below choices to set the navigation after clicking on Extract Order submit button: 0- Print Extract Order, 1- Pending Extract Requisition, 2- Extract Mixing, 3- Mixed Extract History, 4- Injection Tracking Repeat under Practice Setup General App Settings Practice Settings

41 App Settings Edit Vial ID To enable the ability to Edit Vial IDs after placing an Extract Order: Practice Setup General App Settings Practice Settings Search and click on Immunotherapy.ExtractOrder.EditVialNumber, and click Edit. In the Value field, select one of the below choices to either Enable or Disable the app setting: 1- Enable, 0- Disable

42 App Settings Result Preference Search for emr.skintest.resultpreference Set the value to 4 to allow tabbing for entering of 2 measurements each for wheal and flare.

43 Search for: emr.skintest.showpatchgradecolumn Set the value to true to view the column grade in patch testing results. App Settings Patch Grade

44 Search for: emr.skintest.gradelimit Set the value to the minimal number you would like to show a positive patch result. IE: Anything over 2 would be a positive reading; enter 2 in the value category. App Settings Grade Limit

45 App Settings Hide/Display Manufacturer Search for: emr.skintest.manufacturerand Concentration Set the value to yes to show the manufacturer and concentration on the skin test reports.

46 Search for: Immunotherapy.VialPlacementInLabel Set the value to yes to show the vial placement on the vial label. App Settings Vial Placement

47 You now have the ability to add text to the Injection Schedule Report that is sent with vials. Enable the menu privilege: Practice Setup User Select user Menu privileges Allergy Immunotherapy Injection Schedule Menu Privileges Injection Schedule Template

48 You now have the ability to give injections by Off Rack Enable the menu privilege: Practice Setup User Select user Menu privileges Administration - Allergy Treatment Set Patient Chart Immunotherapy Off Rack Injections Menu Privileges Off Rack Injections

49 Practice Dashboard Extract Ordering, Extract Mixing, and Injection Tracking can be incorporated into the office workflow from the Practice Dashboard.

50 Practice Dashboard: Extract Ordering 1. Extract Requisition 2. Pending Extract Requisition 3. Extract Order a. Add Vial b. Duplicate Vial c. Reorder Vial d. Edit Vial ID

51 Extract Orders

52 Extract Requisition is completed from the patient s chart Extract Requisition

53 Authorizations in Extract Order If the patient requires an authorization, you can now see the number of units available in the Extract Order screen.

54 Pending Extract Requisition Once an extract requisition has been completed, an extract order may then be placed by clicking the ORDER button under Pending Extract Requisition

55 Extract Order Add Vial 1. The Add Vial button will create a new vial starting with A1. Clicking on Add Vial again will start a new series with B1 select strength, volume, and schedule (schedules are created per provider preference, see Injection Schedule for steps). 2. Allergens are added from a Repository and/or from Positive Results.

56 Extract Order Duplicate Vial 1. The Duplicate Vial button will duplicate the selected vial exactly, including strength, volume, schedule, and contents, and increase the vial number. 2. The duplicated vial information can be edited as needed.

57 Extract Order Reorder Vial 1. The Reorder Vial button will reorder the selected vial(s) exactly, including strength, volume, schedule, and contents, and will keep the same vial number(s). The Reorder button is an app setting, to enable see App Settings Reorder Vial. 2. The reordered vial information can be edited as needed.

58 You can edit the Vial ID number when the app setting for Immunotherapy.ExtractOrder.EditVialNumber is set to 1: Create Vial Click in the Vial ID field Replace the current ID with an ID of your choice Extract Order Edit Vial ID

59 Practice Dashboard: Extract Mixing 1. Extract Mixing 2. Edit Extract Mixing 3. Mixed Extract History 4. Print Labels 5. Vial List 6. Shot Identification 7. Questionnaire 8. Injection Administration 9. Immunotherapy Charge

60 Extract Mixing Extract mixing is done by clicking the MIX button. Editing the order is a Menu Privilege and is done by clicking the EDIT button. Deleting the order is done by clicking the DELETE button.

61 Edit Extract Mixing You can edit the Extract Order if you have the Edit Extract Order Menu Privilege. 1: Select Practice Setup under Administration 2: General Setup User 3: Select User 4: Click on Menu Privileges 5: Put a check in the box for Edit Extract Order under Immunotherapy.

62 Mixed Extract History After the mixing is complete, Mixed Extract History can be viewed which displays the billed Units, Charges, and Shipping Address. 1. Under the Practice Dashboard click Procedures 2. Click Immunotherapy 3. Click Mixed Extract History

63 Labels are generated with QR code technology Print Labels

64 Print Labels We recommend the Seiko Smart Label Printer SLP620. Please follow the below steps to adjust printer settings if using IE: 1. Set the label printer as the default printer. 2. Anywhere on the blue background in ModuleMD Wise, right click and select Print Preview. 3. Click Page Setup (looks like a gear):

65 Print Labels 4. Change the settings as shown: 5. Click OK. You are now ready to print labels in IE.

66 From the Vial List screen you can make the vials inactive or active. Once done click on Update at the top right of the Vial List screen. The Vial List can be viewed in Injections, Extract Requisition, Extract Order, and Extract Mixing. Vial List

67 Shot Identification The date is editable for injection date accuracy. Shot Identification allows user to ensure proper patient and review Problem List, Current Medications, and Reaction/Special Instructions.

68 Questionnaire If needed, the Questionnaire can be accessed from the Injection Administration screen. Click Submit to submit the changes and Close when done.

69 Injection Administration Scan the QR code and the vial information will auto populate if it matches the patient. If the vial is expired, a validation box will pop-up to confirm. Also if the site of injection has already been used a validation box will also pop-up to confirm the site of the injection.

70 Injection Administration The Start Dose, End Dose, Injection Dose, Increment, and Interval are editable in case changes need to be made. Multiple options for Site of Injection.

71 Immunotherapy charge will auto generate. Immunotherapy Charge

72 Off Rack Injections

73 Off Rack Injection Setup 1: Practice Setup Allergy Treatment Set 2: Click Add Vial 3: Enter Strength, Volume, Vial Placement and Allergy Content 4: Click Submit ** Users can also duplicate the vial or delete the vial.

74 Off Rack Injections 1: Immunotherapy Off Rack Injections 2: Proceed through the Shot Identification and the Questionnaire 3: Click Treatment Set 4: Select the Vials that were made during setup accordingly 5: Click Submit

75 Off Rack Injections 6: Enter Start Dose, End Dose, Increment, Interval, Injection Dose, and Site of Injection for each vial. 7: Click Submit and Immunotherapy charge will auto generate. ** Users can change the Injection Number so more than vial can be included in the Injection. For example, you may want to give two injections and in each injection you want to add content from two vials in the treatment set, simply change the Injection numbers. Injection #1 will have to vials and Injection #1 will have vials from the treatment sets. The next time the patient comes in all the information that was entered previously will be saved.

76 Off Rack Injections Off Rack Injections can also be used to give and track Biological Injections 1: Practice Setup Allergy Treatment Set 2: Add Vial Select the appropriate content. For example: Xolair or Nucala 3: Click Submit 4: Search for patient 5: Immunotherapy Off Rack Injections 6: Proceed through Shot Identification and the Questionnaire 7: Click Treatment Set and select the appropriate vial. 8: Fill in all required information 9: Click Submit

77 Practice Dashboard: Injection Tracking 1. Injection Tracking 2. Injection Reaction

78 Injection Tracking Patients waiting to have reactions checked are followed on the Practice Dashboard: 1. Click on the appropriate patient.

79 Injection Reaction 2. Select Reaction from the drop-down menu. 3. Reaction/Instructions can also be added at the time of check or after should the patient have a late reaction. 4. Click Save to save the information and the patient will stay on the Injection Tracking screen or click Save & Check Out to save the information and remove the patient from the Injection Tracking screen.

80 Injection Reaction Systemic Reaction If a Systemic Reaction has been documented, the date will now highlight Red.

81 Questions? Please contact Support , option 2