HIE Clinical Portal Non-Provider Manual 1 Last update: 2016/08/30 Alaska ehealth Network

HIE Clinical Portal Non-Provider Manual 1 Last update: 2016/08/30 Alaska ehealth Network

Table of Contents Overview... 2 Patient Privacy Policy & Access... 3 User Levels... 5 User Homepage... 7 Common... 8 Logging In & Out... 9 My Details & Password Activity... 10 Important Message Notification... 11 Additional Attributes... 12 Worklists... 13 Manage Worklists... 14 Adding Patients... 15 Patient Context Bar... 16 Patient Summary... 17 Windowlets... 18 EMPI Demographics... 19 Allergies & Alerts... 20 Encounter History... 21 Messaging... 22 Send & Delete a Message... 24 Document Tree... 25 Display Configuration... 26 Filter Results... 27 Patient Search... 29 Patient Results... 30 Lab Reports... 31 Microbiology... 32 Radiology... 33 Numeric... 34 Cumulative View of Numeric Results... 35 Notifications... 36

View Notifications... 37

Overview Introduction The AeHN Clinical Portal is a framework for providing security, user account management and a single, seamless view of a patient s data. Purpose The purpose of this document is to identify the key concepts within AeHN Clinical Portal that will effectively allow the utilization of the application. Specifically, this document provides Level 1 Primary Provider details. See User Levels section for more details. Roles & Responsibilities The Primary Provider level is assigned to clinical staff that provide patient care in either primary care provider, referring provider, emergency provider or referred to provider. The functions include: Search for patients View all clinical information Break the seal Configure subscription notifications Send Direct Secure Messages Page 2 of 37

Patient Privacy Policy & Access Patient Privacy Policies have been enabled to control access to patients. This access is based on the following: The user s relationship with the patient The patient s opt-out status Access Descriptions Locked: Patient s name will be visible in a list of search results, but can t be selected Privacy sealed: Patient s name will be visible and can be selected, but a reason for access will be required before the patient can be placed in context and their medical details viewed. Providing an access reason is referred to as opening or breaking the privacy seal Full Access: Clinical users have unrestricted access to clinical data/documents in the patient s medical record Status Descriptions There are two defined consent states for a patient s record, depending on whether the patient has opted in to the HIE or not. These two states are: Complete Opt-Out (patient has opted out) Privacy Administration Clerk partial access to allow ability to opt-in/out All others no clinical data can be access for the patient Partial Opt Out (patient has not yet opted in/out) Privacy Administration Clerk partial access to allow ability to opt in Level 1 User ability to break privacy seal to access information (emergency) All other users locked Page 3 of 37

Breaking the Privacy Seal The expiration for providers that break the privacy seal is five (5) minutes. List of reasons to breaks the seal : Direct patient care clinician or primary care provider Direct patient care consultant Direct patient care emergency Direct patient care clinician requested Page 4 of 37

User Levels Level 1: Primary Provider (e.g. Doctor, PA, APRN) A provider at this level can: Access all clinical applications See all clinical views Can register a patient and add a new encounter A provider at this level can t: Access application administration screens Level 2: Secondary Provider (e.g. Registered Nurse, Phlebotomist, Occupational Therapist) A provider at this level can: Access some clinical applications See all clinical views Register a patient and add a new encounter A provider at this level can t: Access application administration screens Level 3: Care Support (e.g. Medical Assistant, Clinical Unit Clerk, HIM, Clinical Coder) A provider at this level can: Can register a patient and add a new encounter See all clinical views A provider at this level can t: Access clinical applications Access application administration screens Page 5 of 37

Level 4: Front Desk (e.g. Billing Clerk, Registration Clerk) A provider at this level can: Register a patient and add a new encounter A provider at this level can t: See clinical views Access clinical applications Access application administration screens Level 5: Systems Administrator (e.g. IT applications specialist) A provider at this level can: Access user administration and auditing screens A provider at this level can t: Access clinical applications See clinical views Register a patient and add a new encounter Level 6: Orion PSG Level A user at this level can: Access all application administration screens A user at this level can t: See clinical views Access clinical applications Register a patient and add a new encounter Page 6 of 37

User Homepage The User Homepage automatically appears when a user logs in to AeHN Clinical Portal. It displays summary information relevant to a user. The layout of each user s homepage is composed of one or many windowlets. Windowlets allow a screen to be partitioned allowing a user to see more than one view on a single screen. The homepage is divided into windowlets: Recent Patients My Worklist Received Messages Recent Patients Windowlet This windowlet provides a system generated list of the patient records most recently viewed by the user. The list of patients is sorted into the following categories: Today Last seven days Last four weeks Last twelve months My Worklist Windowlet This windowlet displays the homepage worklist(s) selected on the My Details screen. Page 7 of 37

Common My Details My Details located in the Common tab of the menu bar. It allows the user to change passwords, set the inactivity timeout period, and select or enter information in the My Attributes section. Page 8 of 37

Logging In & Out Logging In To AeHN Clinical Portal The AeHN Clinical Portal Login screen is shown below. A username and password are required to gain access to the application. A default password will be assigned when the account is first set up. Once the user has entered the username and default password the system will prompt the user to change the password. Note: The username is not case-sensitive, the password is case-sensitive. Logging Out of AeHN Clinical Portal The Logout button is used to exit AeHN Clinical Portal. It is located in the upper portion of the menu bar, just above the Common menu. It is important to use the Logout button as opposed to clicking on the X button located in the upper right hand corner of the browser. The logout button will log the user out of the system. If it is not used, the session will remain active for a pre-defined period of time before the auto-logout feature is activated. Inactivity Timeout In order to provide a secure environment, a default timeout of 30 minutes has been set by the administrator. On this screen, a user can set up an inactivity timeout period for his/her account that is less than the 30 minute maximum timeout. This setting ensures that the user will be logged out of AeHN Clinical Portal if he/ she does not use his/her computer for the number of minutes equal to the inactivity timeout value. If a timeout of less than 30 minutes is preferred by the user, he or she can re-set the timeout to 2, 3, 4, 5, 10, 15 or 20 minutes. AeHN Clinical Portal counts mouse movement over the menu or context bar as activity. As such, if a user is viewing a document and the mouse pointer does not move over these areas, a timeout may be triggered. Page 9 of 37

My Details & Password Activity My Details My Details is located in the Common tab of the menu bar. It allows you to change your password, set the inactivity timeout period, and select or enter information in the My Attributes section. The following fields are available on the My Details page: Change My Password Selecting the Change Password button allows you to change your password.! Password must be at least eight (8) characters long. The password must contain at least: one alpha character [a-za-z] one numeric character [0-9] one special character from this set: `! @ $ % ^ & * ( ) _ = + [ ] ; :, <. > /? Homepage Select the format of the homepage (Start Screen) to display following login. Selecting one option will override the default homepage view. Page 10 of 37

Important Message Notification An important message is one that has been tagged important by the user who sent it. Message recipients will see an alert at the bottom of the screen for new incoming messages. The message that displays is based on the alert selected on the My Details screen. The following options are available: Show alert until dismissed: If selected, displays the message until the alert is closed by the user Show alert for seconds: If selected, displays the message for the set number of seconds. Options include 10, 20, 30, 45, 60 and 120 seconds Do not show alert: If selected, the important message alert will never be displayed Use default (Display for seconds): If selected, displays for the period of time set by the administrator Page 11 of 37

Additional Attributes Group attributes may be added to a group to allow an administrator to gather additional information about the user or to provide additional features to the user. The following attributes have been preconfigured for a user. Email This field specifies the your email address. Clinician Homepage Set the content for the following windowlets appearing on the homepage: Worklists to how on My Homepage: Allows you to set the worklist the patients that will appear on it) on the homepage. Select the Worklist to show on My Homepage icon to perform a search for and select the worklist. If you don t select a worklist on this screen all six worklists will appear on the homepage. HIE Users This field is set to your primary facility. Patient Search This default field is used to set the preferred patient identifier to display on the patient search. Page 12 of 37

Worklists Worklists allow users to quickly access and manage patient records that may be of special interest. Six worklists are available to each user within AeHN Clinical Portal. You can t see the names of pap(banner important). p(banner tip). tients on another user s worklist, nor can they see the name that you ve assigned to any of your woklists. Up to 50 patient names can be added to a worklist. If you add more than 50 patients, the ones that have been on the list the longest are dropped. By default, the following worklists and their display names are available: Red Blue Yellow Green Orange Purple Page 13 of 37

Manage Worklists Renaming a Worklist You can rename a worklist to make it more specific to your needs and organizational preference. To rename a worklist: 1. Select one of the worklist icons (e.g. Blue) from the Worklists menu. (Another way is to select the Worklists option on the Patients menu) 2. Select the Rename option 3. Type in the new name of the worklist 4. Click Save This will change the name of the worklist in all locations. Edit the Columns that Appear on a Worklist Click on the Column icon in the far right corner of the worklist. Selecting EMR (Local) Identifier, Sex, or Age from the dropdown list will remove the coresponding column from the worklist display. Remove a Patient from a Worklist You can remove one or more patients from a worklist by clicking the check box next to the patient record and clicking Remove. Page 14 of 37

Adding Patients Adding Patient Names from the Context Bar The Context Bar displayed for a selected patient includes a Worklist icon, which can be used to manage your worklist content. If the patient is currently on a worklist, the flag s background color will match the color of the flag associated with that worklist. If the patient is on two or more worklists, the background color will match the first worklist the patient has been added to based on the order displayed in the drop down list (red, blue, yellow, green, orange and purple). Adding Patient Names from a Patient Search You can add patient names to a worklist from the results of a patient search. 1. Select the checkbox next to the patient s identifier. 2. To add the patient, select the worklist option from either of the drop-down lists at the bottom of the screen. 3. Add checked results to worklist. 4. Add the selected patient names to the top of the worklist without affecting the names that are already on the list. If the results of this action increase the list past the maximum number of 50, the names which have been on the list the longest will be dropped off the list 5. Replace worklist checked results 6. Replaces all patient names in the worklist the names selected from the patient search. Page 15 of 37

Patient Context Bar The Patient Context Bar is visible once a patient has been selected (placed in context). The patient context bar displays the worklist, the patient s basic identification details, the context icon, the next and previous patient icons, the patient summary icon, patient task list icon and the current date/time. Worklists Allows the user to place a patient in a worklist. Patient Information This area will display the patient details and includes: Patient Identifier [bold], Last name [caps] Suffix, First name Middle name (Sex/Age years). Note: The years field may display as days, weeks, months. If the patient is deceased, the label will appear in replacement of the age. Context This will show the user a list of the patients they have in context. Previous This will take the user to the previous patient in the search results (context) list. Next This will take the user to the next patient in the search results list. Patient Summary This will take you back to the patient summary screen for the selected patient. Time & Date This area will display the current time and date Long Patient Lists You will receive a warning when you reach the end or beginning of a list while using the Context icon to scroll through the names in a list of patients. This could occur when, for example, you perform a patient search and more than the default number (typically, 15) of patient names were returned. To view the remaining names, return to the originating search select a different search results page. Page 16 of 37

Patient Summary The Patient Summary is displayed when you select a patient from the patient search results, the recent patient list, or a worklist. It includes the following windowlets: EMPI Demographics Allergies & Alerts Encounter History If the patient summary is not currently on screen, it can be displayed by clicking the Patient Summary link at the top of the Document Tree or by clicking the Patient Summary icon located at the top right corner of the screen. Page 17 of 37

Windowlets A windowlet is a panel of a specific type of patient information. Page 18 of 37

EMPI Demographics The EMPI Demographics windowlet displays the patient s personal and contact details, which can be used to verify the identity of a patient. In this windowlet, you will find: Patient s name Other identifiers (e.g., nickname, maiden name, junior, senior, etc) Emergency contact Demographics (e.g., sex, date of birth, address, phone number) Primary care provider name and clinic location Page 19 of 37

Allergies & Alerts The Allergies & Alerts windowlet displays details about the patient s allergies. In this windowlet, you will find: Allergy type Reaction to allergy Severity of allergy Date allergy was entered Page 20 of 37

Encounter History The Encounter History windowlet displays the patient s visits with other providers and organizations. In this windowlet, you will find: Date of and reason for admission Date of and diagnosis at discharge Type of visit (inpatient, outpatient, or emergency) Specialty Facility where encounter occurred Clinician responsible for patient s care and treatment during encounter A patient may have more than one discharge diagnosis for an encounter. To view the entire encounter history, click the icon located to the left of the encounter record. Page 21 of 37

Messaging The HIE Portal includes a messaging system that allows users to securely exchange information.! In order to utilize the messaging component of HIE Portal, you must be set up as a user. Also, you will not be able to send messages to or receive messages from people who are not HIE Portal users. Received Messages The navigation bar allows users to browse through pages or to jump directly to a specific page. Received messaged may be filtered by selecting one or more of the options from the navigation bar. Urgent Messages: Messages tagged as urgent Unread Messages: Messages that have not yet been read User Messages: Messages sent by other HIE Portal users System Messages: Messages sent by the administrator Reset: Allows you to reset the filter criteria You may also perform a text search to identify text in the message s subject line. To do this, enter text and click the Search button. How To Use It Icons: The closed envelope icon indicates an unread message. The opened envelope indicates a read message. The paperclip icon indicates an attachment is included in the message. From: Provides the name of the HIE Portal user who sent the message. Subject: Displays the subject line of the message. ID: Displays the identification of the patient, e.g., name or MRN. Event: Indicates the type of event, e.g., blood test, scan, etc. Received: Displays the date the email was received. Page 22 of 37

From this screen, you can also delete a message that is no longer required, or send a new message to an HIE Portal user. When the message is selected, the user may reply to the received message, forward to message, print the received message, and/or mark the message as unread. Users can use the navigation icons to easily view the next or previously received message. Page 23 of 37

Send & Delete a Message Send a Message You can send new messages to other HIE Portal users. The recipient s User ID can be entered directly into the To: field, or by clicking the To: button. A recipient can be identified from the resulting User Search screen. Delete a Message A message can be deleted by checking the box next to the message you wish to delete and then clicking the Delete button.! Deleting a message must be confirmed and can t be undone. Page 24 of 37

Document Tree The Document Tree is located to the left of the Patient Summary screen and provides links to view all of the patient s documents. Page 25 of 37

Display Configuration All available folders and documents are listed in the Document Tree default. You can apply filter options by selecting or entering information into the filter section displayed at the top of the document view screen. A user has several filter options that are listed when the configure the Document Tree icon is selected. The options are as follows: Show: Options are All, Last 72 Hours, Last 14 Days, Last 3 Months, Last, Specific Range. Last allows you to specify a specific quantity and time unit (days, weeks, months). Specific range allows you to enter a specific date range. Group by: Options are Category, Date (date document received from external system), Service, Author (the provider responsible for creating the document) Sort by: Options are Date, Title, and/orauthor You may also perform a search on reports in the Document Tree by selecting the Look For icon, which allows a search for any text contained in the Title (document name), Author, Category, Date and Service. The search can be further refined by selecting the Important icon, or the Read or Unread buttons; the Sign- Off icon will not be active. Page 26 of 37

Filter Results By Category By default, folders in the document tree are sorted by category. If you select the category filter, the category and subcategory folders will be available in the document tree. Some folders that may be available are: Laboratory Pathology Microbiology Radiology An abnormal report the document tree will have the date and title displayed in red with one asterisk (*). A critical report in the document tree will have the date and title displayed in red with two asterisks (**). A normal report in the document tree will have the date and title displayed in black, normal font. An unread report in the document tree will be displayed in bold font. Reports in the document tree that you have already viewed will be displayed in normal font (not in bold). By Date If you select the date filter, the following folders will be available in the Document Tree: Today Last week Last month Last 12 months All previous By Service If you select the service filter, the folders and documents will be displayed based on the type of associated service. By Author If you select the author filter, the folders will be displayed by the provider responsible for the document. Page 27 of 37

Tooltip Based on the data available for specific results, each document listed in the document tree will have an associated tooltip which can be viewed by hovering the mouse pointer over the document s title. Page 28 of 37

Patient Search The patient search allows you to find a patient using a variety of different search criteria. Once the patient is found, you can easily access the patient record. Patient Search Criteria The patient search allows a user to search for a patient using one or more of the following search criteria. All results are ranked on closeness of fit. Patient s EMR (local) Identifier: The identification must be an exact match. If entered as a part of the Search Criteria, this will override all other search criteria. System Name: This defaults to the Preferred Patient ID type set in the My Details page. * NOTE: If you enter the EMR (local) identifier, the System Name must be entered as well. OR Patient s date of birth. Click on the Calendar icon and select a date from the result screen to ensure the correct format is used. Patient s last name must also be entered with this search criteria. Patient s sex or gender. Patient s last name must also be entered with this search criteria. Patient s last name. Patient s first name. Patient s last name must also be entered with this search criteria. Patient s middle name. Patient s last name must also be entered with this search criteria. The % symbol can be used in the Last, First, and Middle Name fields to perform a partial name searches. For example: enter John% to return John, Johnson, Johnston, etc. Page 29 of 37

Patient Results Up to 15 patients per page will appear in a Demographic Patient Search. The results are sorted by the patient s last name and will display the patient s identifier, name, date of birth, and gender. The Patient Search allows users to save, or favorite, common patient search criteria when navigating through patient records. A Favorite Search is a saved set of criteria that can be recalled for later use. A favorite search is personal to the clinician who created it and can t be seen or accessed by any other user. To save a Favorite Search: 1. Enter your search criteria to ensure the specified criteria return the expected patient names. 2. Enter a name for the favorite search and then click the Add icon. Page 30 of 37

Lab Reports Page 31 of 37

Microbiology The following information may be found on the header section of a microbiology report: Title: Description of the microbiology report Collected: Date and time the microbiology report was requested Received: Date and time the clinic received the request Reported: Date and time the clinic returned the report Source system: Location of where the specimen was collected Status: Status of the report Ordering provider: Name of the clinician that requested the report Order number: Order number associated with the report The Results section will display the text of the report. Page 32 of 37

Radiology The following information may be found on the header section of a radiology report: Title: Description of the report Performed: Date and time the radiology test was performed Ordering provider: Name of the provider that ordered the radiology test Order number: Order number associated with the report Status: Status of the radiology report The Results section will display lines of textual information. The Comments section (if applicable) will also be displayed. Page 33 of 37

Numeric When a user selects a numeric lab report, the results will display based on what was returned from the source. Numeric lab reports are read-only. Numeric reports contain the following sections: Header Comments Results The following information may be found on the header section of a lab report: Title: Description of the laboratory report Collected: Date and time the test was collected Order Number: Order number for the test Ordering Provider: Name of the ordering provider Status: Status of the results The results column displays the following information: Test: Name of the test Result: Numeric laboratory result Ref. range (units): Reference or normal range and unit of measurement Abnormality: Red displays if it is an abnormal test result along with an (*); red displays if it is a critically abnormal test result along with an (**) Status: Status of the result Comments will also be displayed if available Page 34 of 37

Cumulative View of Numeric Results The cumulative report allows users to track trends over time by displaying a series of historical results for the same tests. Each is displayed as a separate column. Cumulative reports are only available for numeric laboratory results. Tooltip information for each cumulative report column headers will display the following: Date and time collected Date and time received Date and time reported Source system Order number The cumulative report will display the units of measure and the reference range for the result. If there is a mismatch on reference ranges across reports in the cumulative view, the symbol ( ) will appear in the reference range column. The user will be able to chart selected results of a cumulative report. The following chart options will be available: All: to select to generate the chart using all available test series Displayed: To select the checkboxes which will generate the graph using the displayed test series Each column in a cumulative report will represent a corresponding unique report (date and time) for the test results of the type indicated on the left hand side. Each order number value at the top of each column in the cumulative report will contain a link so you can click on the link and open that specific report. Charting Numeric Results Once you select the test results you wish to chart, click the Chart button. Hover over any point on the chart for more information about that particular data point. Information presented in the tooltip is the value, the abnormality, the date/time collected, the reference range, and the source. Page 35 of 37

Notifications The My Subscriptions link under the Notifications :#notifications menu allows a user to subscribe to notifications :#notifications in order to receive notifications when a specific event occurs for a patient or group of patients. When this link is selected, the user is able to subscribe to various notifications based on the relationship :#notifications he/she has with the patient or patients. Subscribe to Notifications The My Subscriptions screen, as shown below, displays when selected. My Email Address: The email address to receive notifications. If a user modifies the field from this screen, the My Details screen will be updated to ensure both fields are in sync By default: Select one of the following options to receive notifications: * Notify by Concerto User Messaging: Sends the detailed notification (containing patient information) securely to Received Messages in HIE Portal * Notify by Email: Sends the summary notification (without patient information) to the email address identified above * Notify in Daily Summary Email: Sends a daily summary email (without patient information) of the notifications as opposed to individual notifications * Notify in Daily Summary HIE Portal User Messaging: Sends a daily summary of the notifications (containing patient information) securely to Received Messages in HIE Portal as opposed to individual notifications Subscriptions for patients I have a relationship with Check one or more of the following options to receive notifications: Inpatient Admission Inpatient Discharge Patient is admitted to ED Final Radiology Report is available Final Laboratory Report Result is available Final Microbiology Report available Page 36 of 37

View Notifications The Send To field defaults to the option selected in the By Default field. Each subscription can be manually changed, if required. A summary message will be sent for each of the subscribed notifications. An example of a summary email that doesn t contain patient information is displayed below: The Send Detail To field defaults to Notify by HIE Portal User Messaging sends the detailed notification securely to Received Messages in HIE Portal. A detailed message will be sent for each of the subscribed notifications. If the notification message contains an attachment select the View the attached document to place the patient in context and view the report. Notifications Based on Relationship Type If a user would like to subscribe to notifications based on the type of relationship he/or she has to the patient or patients, he or she must select the Change to subscribe by Relationship Type link at the bottom of the screen. This action allows a user to subscribe to notifications for patients where he/or she is the PCP and/or the referring MD (as per the screenshot below). Page 37 of 37