Helpful Pre-requisites:

1.Refer to the Quick Guide to Tips & Tricks in VistA EHR Data Management

2.Complete the Scavenger Hunt Level III: Meaningful Use

Objectives

1.Demonstrate the technical skills necessary to access an EHR text-based data system and trouble-shoot and resolve access difficulties.

2.Locate and open the correct menu options.

3.Successfully create a report of all patients needing Colon Cancer screening from the EHR.

Overview:

The EHR is preprogrammed with health maintenance criteria from clinical practice guidelines. Every registered patient is automatically and continuously evaluated by the Clinical Reminder system in the EHR to assess for specific health needs. These health needs then prompt action items called Clinical Reminders in each patient’s chart. Clinical Reminders are health maintenance that can be due now or scheduled for the future.

In a patient’s chart, you can see what Clinical Reminders are due now on the Cover Sheet.

  1. Log into CPRS (i.e. the EHR) and open patient Meaningful, Use Summer 2013 (0629) (does not matter which copy or what number is attached to the patient’s name).
  2. What Clinical Reminders does this patient have Due Now?
  3. Click on the Alarm Clock icon in the upper right-hand area of the chart to view available reminders. Expand all folders (Evaluated and Not Applicable). All of these different Reminders are tracking many aspects of patients’ health and can be used for clinical care and tracking/reporting purposes.

  1. Close the Available Reminders box and double click on the Reminder for Colon Cancer Screening on the Cover Sheet. Read about this preventative health maintenance practice.
  2. Now right-click on the Colon Cancer Screening Reminder and choose “Reminder Inquiry.” Read through the Inquiry report carefully. This is describing the actual logic that is programmed into the EHR for triggering and resolving this reminder. The Resolution logic for Colon Cancer Screening is a multiple. What are the three ways to resolve the Colon Cancer Screening Clinical Reminder?

Now that you have seen the Clinician’s view of the Colon Cancer Screening Clinical Reminder, you are going to run a report in VistA to find out how many patients currently need Colon Cancer Screening.

  1. Go back to your Citrix Applications page and select the VistA icon.
  1. Log into VistA using the access code mine001 and verify code mine001.edu
  2. You will see the Registration Menu and a prompt “Select EHR Registration Menu Option:”
  3. At the prompt, type FM and press Enter. You will see the following menu:

Enter or Edit File Entries

Print File Entries

Search File Entries

Modify File Attributes

Inquire to File Entries

Utility Functions ...

Data Dictionary Utilities ...

Transfer Entries

Other Options ...

Select EHR Registration Menu Option:

  1. At the prompt, type REMIND and press Enter. You will see the following menu:

Select EHR Registration Menu Option: REMINDer Managers Menu

CF Reminder Computed Finding Management ...

RM Reminder Definition Management ...

SM Reminder Sponsor Management ...

TXM Reminder Taxonomy Management ...

TRM Reminder Term Management ...

LM Reminder Location List Management ...

RX Reminder Exchange

RT Reminder Test

OS Other Supporting Menus ...

INFO Reminder Information Only Menu ...

DM Reminder Dialog Management ...

CP CPRS Reminder Configuration ...

RP Reminder Reports ...

MST Reminders MST Synchronization Management ...

PL Reminder Patient List Menu ...

PAR Reminder Parameters ...

XM Reminder Extract Menu ...

GEC GEC Referral Report

  1. The next prompt asks you to Select Reminder Managers Menu Option. Type RP for Reminder Reports as seen below.

Select Reminder Managers Menu Option: RP Reminder Reports

  1. The Reminder Reports menu looks like this:

D Reminders Due Report

R Reminders Due Report (User)

U User Report Templates

T Extract EPI Totals

L Extract EPI List by Finding and SSN

Q Extract QUERI Totals

V Review Date Report

G GEC Referral Report

  1. At the Reminder Reports Option, type D to create a report for Reminders Due as pictured below.

Select Reminder Reports Option: D Reminders Due Report

Select one of the following:

I Individual Patient

R Reminder Patient List

L Location

O OE/RR Team

P PCMM Provider

T PCMM Team

PATIENT SAMPLE: L//

  1. At the Patient Sample prompt, type L for location. **If L is the default (as pictured above by L//) just hit Enter to select the default.
  2. Next you will be asked to select the Facility you want to run this report for. Type VOE OFFICE INSTITUTION and hit Enter. You will then be prompted to select another Facility. Just press Enter to move on with only the VOE facility as shown below.

Select FACILITY: CENTRAL ALABAMA HCS (619)// VOE OFFICE INSTITUTION MC(M) 100

Select another FACILITY:

  1. You will want to Determine encounter counts for All Hospital Locations, so type HAI at the next prompt. (Or if HAI is defaulted with HAI// just hit Enter.)

Select one of the following:

HA All Outpatient Locations
HAI All Inpatient Locations

HS Selected Hospital Locations

CA All Clinic Stops(with encounters)

CS Selected Clinic Stops

GS Selected Clinic Groups

Determine encounter counts for: HS//HAI

  1. Next, you will need to select a date range for Admissions or all Current Inpatients. You should select Admissions to Location in date range, so type A at the next prompt or press Enter to select the default if A// is listed at the prompt.

Select one of the following:

A Admissions to Location in date range
C Current Inpatients

CURRENT INPATIENTS OR ADMISSIONS: C// Admissions to Location in date range

  1. Use short-hand for the date ranges. Enter ADMISSION BEGINNING DATE type T-365 (for one year ago as of today). T-365 is a calculated field that will take today’s date and subtract 365 days from it. Type T for today at the prompt for Enter ADMISSION ENDING DATE. You are asking for your reported population to include all Admissions in the last year.

Enter ADMISSION BEGINNING DATE: T-365 (e.g. FEB 09, 2012)

Enter ADMISSION ENDING DATE: T (e.g.FEB 08, 2013)

  1. Next, you will need to enter the EFFECTIVE DUE DATE of the Clinical Reminder you are going to query. Select the default or type T for TODAY.

Enter EFFECTIVE DUE DATE: Feb 08, 2013// (FEB 08, 2013)

  1. You want this to be a Detailed report.

Select one of the following:

D Detailed

S Summary

TYPE OF REPORT: S// Detailed

  1. You will want a Combined report for all Locations.

Combined report for all Locations : Y//

  1. Sort by Inpatient Location/Bed.

Sort by Inpatient Location/Bed: N// YES

  1. Print the patient’s full SSN.

Print full SSN: N// YES

  1. Now you will need to Select the individual REMINDER you want to look for. Type VA-MHV COLORECTAL CANCER SCREEN ***in ALL CAPS (or copy and paste this from this guide or the Reminder Inquiry report in CPRS on the patient’s Cover Sheet). **Important to type in all caps exactly as written.

Select individual REMINDER: VA-MHV COLORECTAL CANCER SCREEN

  1. Do not Create a new report template, so type or select NO.

Create a new report template: N//

  1. Do not Print delimited output only, so type or select NO.

Print delimited output only: N//

  1. Do not Include deceased patients on the list, so type or select NO.

Include deceased patients on the list? N//

  1. Do not Include test patients on the list, so type or select NO.

Include test patients on the list? N//

  1. Do not Save due patients to a patient list, so type of select NO.

Save due patients to a patient list: N// N

  1. At the next prompt to select your device, choose the default of HOME// by pressing Enter. It will automatically fill in the word TELNET.

DEVICE: HOME// TELNET

  1. Now your report will begin to run. You will see a report header similar to this:

Feb 13, 2013 11:48:42 am Page 1

Clinical Reminders Due Report - Detailed Report

Patient Sample: Location

Location: All Inpatient Locations (Admissions)

Reminder: VA-MHV COLORECTAL CANCER SCREEN

Appointments: Next Appointment only

Date Range: 2/14/2012 to 2/13/2013

Effective Due Date: 2/13/2013

Date run: 2/13/2013 11:43:03 am

Combined report: Combined Locations

  1. Press Enter to view your report results and continue to press Enter to page through your report. An example report is shown below. Continue to press Enter to progress back to the main menu.

Feb 08, 2013 3:36:37 pm Page 2

Clinical Reminders Due Report - Detailed Report

Facility: VOE OFFICE INSTITUTION 100

Reminders due x/x/2013 (today’s date) - COMBINED LOCATIONS admissions from x/xx/2012 to x/xx/2013

Colon Cancer Screening: xxx patients have the reminder due

Date Due Last Done Ward/Bed

------

1 BOWERS,SUSAN (100000385) DUE NOW N/A NONE

2 BRENNER,PATRICIA WISC0 (100000362) DUE NOW N/A NONE

3 BRENNER,PATRICIA WISC0 (100000363) DUE NOW N/A NONE

4 BRENNER,PATRICIA0001 (100000355) DUE NOW N/A NONE

5 BRENNER,PATRICIA (100000215) DUE NOW N/A NONE

6 GOLDMAN,RICHARD (100000390) DUE NOW N/A NONE

7 HEFETZ,SHARON (100000391) DUE NOW N/A NONE

8 IGNATAV,COLIN (100000392) DUE NOW N/A NONE

9 LEVEL,TWO SCAVENGER (100000423) DUE NOW N/A NONE

10 MARKS 1,ESTHER DORIS (100000437) DUE NOW N/A NONE

11 MARKS 2,ESTHER DORIS (100000424) DUE NOW N/A NONE

Enter RETURN to continue to display all fields or '^' to exit:

  1. HOW MANY PEOPLE NEED SCREENING?
  2. WHAT % OF THE PATIENTS ARE UP TO DATE FOR COLORECAL SCREENING?