4 – cONGENITAL HEART DISEASE application guide
Volume
4
CCAD Suite of User Guides
Congenital Heart Disease Application Guide
0207 108 1978
nicor-helpdesk.ucl.ac.uk
www
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4 – cONGENITAL HEART DISEASE application guide
Document Control
Published by: / NICORDistribution: / CCAD Users
Title: / CCAD Suite of User Guides
Reference: / Volume 4 – Congenital Heart Disease Application Guide
Further
copies from: / NICOR Helpdesk
Tel: 0207 108 1978 - Email:
Status: / Final
Version: / 1.0
Originator: / Bradley Owen
Change History
Date / Version / Author / Comments20 May 2004 / 1.0 / Bradley Owen / Final Version
4 – cONGENITAL HEART DISEASE application guide
Contents
PURPOSE OF THIS MANUAL...... 4
USING LOTUS NOTES (GENERAL)...... 4
Overview...... 4
What are Notes databases?...... 5
What are documents?...... 5
What are views?...... 6
What is replication?...... 7
Paediatric Replication Diagram...... 7
What are twisties?...... 8
Collapsing a couple of twisties can make the view a bit more understandable .8
Where can I find on-line help on how to use Lotus Notes?...... 8
How to halt an operation that takes too long?...... 8
How to delete a document...... 9
How to exit a database, document or view...... 9
How to refresh a view...... 10
USING THE PAEDIATRIC DATABASE...... 10
Creating New Records...... 10
Importing Paediatric data from other local/commercial database systems...13
Paediatric import file format...... 14
Exporting Paediatric data...... 15
The Life Status Document...... 15
ONLINE VIEWS...... 16
ONLINE HELP...... 17
4 – cONGENITAL HEART DISEASE application guide
4 – cONGENITAL HEART DISEASE application guide
PURPOSE OF THIS MANUAL
CCAD, Central Cardiac Audit Database is one of a number of national clinical audit projects and services supported by the National Clinical Audit Support Programme (NCASP) of the NHS Information Authority.
There are 6 CCAD applications in various stages of development that are used to facilitate in the collection of data for the purposes of auditing the provision of care to patients with Coronary Heart Disease (CHD) in the NHS. They are:
MINAPMyocardial Infarction National Audit Project (all patients admitted to hospitals in England and
Wales with suspected Acute Myocardial Infarction or Acute Coronary Syndromes).
BCISBritish Cardiovascular Intervention Society (all patients in UK hospitals undergoing coronary
angioplasty)
NPDBNational Pacing Database (all patients in UK/Eire hospitals receiving implanted pacemakers and
implantable Cardiac Defibrillators)
PAEDSPaediatrics (all children in UK hospitals undergoing surgery or catheter based intervention for
heart disease)
SCTSSociety of Cardiothoracic Surgeons (all adults in UK hospitals undergoing cardiac surgery)
EPSCardiac ablation procedures (all patients in the UK receiving ablation treatment for arrhythmias)
This manual is intended to get you connected to the Central Cardiac Audit Database (CCAD) servers, and to show you how to import or input Paediatric data you have collected locally into the central database, and how to use the Paediatric application in general.
You need to get connected in order to:
1.Transmit your clinical data securely to the central CCAD servers;
2.Create your data directly in the BCIS database;
3.View and analyse your data to compare it with national aggregate data.USING LOTUS NOTES (GENERAL)
Overview
The Lotus Notes interface can be less than intuitive for some users. That being said, once you learn a few simple rules it is quite functional. This section of the manual will show you how to:
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v' Halt an operation that is taking too long v' Delete one or more documents,
v' Exit a database
v' Replicate a database
v' Refresh a view
Before we delve further into using Lotus Notes functions, let us first look at the basics of starting up and using Lotus Notes. If you already know about the Lotus Notes Workspace, Documents, Viewsand Replication, you can skip this next section and move straight to the Section How to halt an Operation that takes too long on page 9.
What are Notes databases?
A Notes database is a single file with an “nsf” extension e.g. log.nsf or names.nsf or BCIS.nsf. They appear as square icons on the Notes Workspace. (See below)
What are documents?
Lotus Notes stores its data in documents.
For instance you create a patient record by clicking the ‘New Patient’:
This will present you with a Patient Document where you fill out as much detail as possible (see below):
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When you fill in this document you need to save the information before it becomes permanent. Clicking the ‘Close’ button or hit ‘Esc’ on the keyboard, and select Yes to save. Once it is saved you can see it in the main Notes view, ‘View / Edit Patient Data’. Double-clicking the record in the view will re-open the patient document.
What are views?
/ Tip: Partial Key Search - To quickly locate a document in a view just click in the view and then start typing the value in the first column e.g. in the Patients by Surname view the patient’s name. In large views this can be very helpful in quickly locating documents.4 – cONGENITAL HEART DISEASE application guide
What is replication?
Replication is the way that Lotus Notes synchronises your local database with the master database on the CCAD server and with all other local (replica) copies. In this way, documents you have created or modifications you have made to existing documents are sent to the server. Documents that you are allowed to access, which have been created or modified in other hospitals, are also sent back to you in this way.
You may have many replica databases within your Trust- each on a different PC. You can work in one and even if the network goes down you can continue. When the database is replicated your changes are sent to the server and these changes will be sent to other users in your Trust – if they are working on different PCs. Naturally, you receive their changes as well, in the same way. In this way, all the work done in each local Paediatric databases is distributed back to all concerned.
Replication is automatically scheduled, but it will be worth learning how to replicate manually if you sometimes want to send urgent information immediately, or if you want to grant access to patient documents to staff in another Trust. For more information about manually replicating, see page 31 on how to create a Paediatric database replica.
Lotus Notes replication is extremely efficient. If you make changes to a single field on a document for instance, all that is sent to the server is the actual changed data and a reference to where it is to be updated – nothing else.
The central Paediatric database makes sure that recipients are replicated back only the information that they are eligible to view.
Paediatric Replication Diagram
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What are twisties?
Lotus Notes will display movable triangles next to anything that can expand or collapse. These are called “twisties”.
A twisty symbol in a view denotes, the document has children document/s, clicking this symbol expands the document showing all procedure, letter, discharge summary's etc. Anything related to the patient (parent) demographic document.
= Collapsed= Expanded.
Note: Twisties are also shown as + and – signs.
To collapse or expand all twisties, use the +++ or --- buttons below.
Collapsing a couple of twisties can make the view a bit more understandable
Where can I find on-line help on how to use Lotus Notes?
To find more information about the functionality of Lotus Notes, click on Help - Help Topics from the Lotus Notes menu.
How to halt an operation that takes too long?
This may occur sometimes when you are opening a database after a design change or when manually replicating a lot of changes to, or from, the main database on the server. If you want to stop it and go onto another task, click on the red icon (or hit Ctrl+Break) as shown below:
Fig 5
/ Tip: You may have to do it more than once. It is very similar to the same button on the Internet Explorer web browser./ Caution: Stopping an operation may have unintended effects. For instance, if you do it when opening a document you may then find it blank or with some fields missing. Once you stop an operation you should not continue.
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How to delete a document
When using Lotus Notes, you delete documents in three steps.
Select one or more documents for deletion. To do this, use your mouse and click once on each one. A tick should appear next to each document selected, as shown in the next screenshot. An alternative way is to highlight the document and press your space bar (this method is usually used when the column on the left hand side is hidden).
How to exit a database, document or view
Click the Esc key on your keyboard. It is usually in the top, left-hand corner. This key will close any window you are in (e.g. an open document, a view, or a database etc.). Keep on clicking, and you will eventually close all open views and documents and then exit the database.
OR Lotus Notes puts all your open databases and documents into “tabs” along the top of the Window. Click on the “X” on the tab to close it.
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How to refresh a view
To Lotus Notes, a collection of documents or patient records is a “view”. If you have made some changes and they do not appear to be reflected in the list then it may be worthwhile to “refresh the view”. This makes Notes update the index and helps make the on-screen representation reflects the latest data.
To refresh a view click on the following icon at the top of the Notes window:
USING THE PAEDIATRIC DATABASE
Creating New Records
There are two methods in creating new patient and procedure records in Pediatrics, depending on weather you use a third party application which produces BCIS data or input data directly into the Pediatric database.
1. Manually
To create a new patient, press the 'New Patient' button which can be viewed from the main default view, 'View/Edit Patient Data'
CREATING THE PATIENT DOCUMENT
1.1.From the Paediatric Main view, click on ‘New patient’.
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To create a new procedure, you must first create a patient document
1.2 Follow the screen and fill-in the fields to complete the document.
1.3 SELECTING 'CLOSE'WILL SAVE THE CURRENT PATIENT DOCUMENT AND RETURN YOU TO THE MAIN PAEDIATRIC VIEW SCREEN.
CREATING THE PATIENT DOCUMENT
1.4 To create a procedure for a particular patient, you should select the patient from the 'View/Edit Patient Data' view, and click the 'New Procedure' button.
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1.5 Follow the screen and fill-in all the fields to complete the document
1.6 SELECTING 'CLOSE'WILL SAVE THE CURRENT PATIENT DOCUMENT AND RETURN YOU TO THE MAIN PAEDIATRIC VIEW SCREEN.
2. Importing Records
Many cardiac departments in the NHS already use database software, such as HEARTSUITE©, PATS©, DATACAM© to collect collect Paediatric audit data. The Paediatric application allows data to be exported from these systems, and imported into CCAD
The specification for the export files can be found in the next section and is available to download from the CCAD website
CCAD supports file imports in a CSV (Comma Separated Value) format. A CSV line (record) consists of variables (fields) containing information separated by commas and enclosed by double-quotes. Each line (record) is made up of 103 variables (fields) in the prescribed order.
To import records, click the 'Import Data (bcis.csv)' button on the left. The default location and file name for import is 'C:\TEMP\PAEDS.CSV', but you may change this to any other convenient location/filename.
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Upon completion of an import, you will be presented with an import log informing you of the success of your import, i.e. how many new/modified records were imported, and how many records were rejected or need re-validating. You can revise previous logs by clicking the 'View Import Logs' button to the left.
For more detailed import information on individual field requirements, see sections below on 'Importing Pediatric Data'
Importing Paediatric data from other local/commercial database systems
You will need to have an export module written by the software developer / vendor.
Your database must contain all of the relevant fields based on V4.03 of the Paediatric dataset.
All dates should be exported using 4-digit years. Where a date needs to include a time (i.e. for treatment delays), the 2 should be exported as a single fields for instance:”12/04/2000 14:35”
All fields must be separated by a comma and must be enclosed in quotation marks like this: “1234567890”,”12/04/1948”,”M”,”69” etc
Further information on the exact format is available on our website
The data should be exported to a text file called PAEDS.CSV, located in directory C:\TEMP
NB: when exporting, if data is not available on a parameter, a blank “placeholder” must be exported.
Further information on the exact format is available on our website
The export file must contain the following fields in this exact order:
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Paediatric import file format
The file is a CSV (comma separated variable) file. All values (even empty ones) must be enclosed in quotes ("").
Each line (record) of the file must be properly terminated with a CRLF (carriage return and line feed, ASCII characters 13 and 10 in decimal, 0D and 0A in hex).
Each line (record) is made up of 103 variables (fields) in the prescribed order.
A complete list of variable is shown below. The first number is the position of the variable followed by a comma then a tab, the next number is the dataset number, then a hyphen, followed by the field description, followed by a full stop then the datatype.
Details about the legal values for the fields can be found in the dataset,
1,1.01 - Hospital - Hospital identifier. Text (single value)
2,1.02 - HospitalNumber - Patient Case Record Number. Text (single value) 3,1.03 - NHSNumber - NHS Number. Text (single value)
4,1.04 - Surname - Patient Surname. Text (single value)
5,1.05 - Forename - Patient Forename. Text (single value)
6,1.06 - Dateofbirth - Patient Date of Birth. Date (dd/mm/yyyy) 7,1.07 - Gender - Patient Gender. Text (single value)
8,1.08 - Ethnicgroup - Patient Ethnic Group. Text (single value) 9,1.09 - PatientStatus - Patient Admin status. Text (single value) 10,1.10 - FullPostCode - Patient Post Code. Text (single value) 11,2.01 - Diagnosis1 - Diagnosis. Text (single value)
12,2.03 - Weight - Weight. Numeric (real)
13,2.04 - AntenatalDiagnosis - Antenatal Diagnosis. Text (single value) 14,2.05 - PreProcedureSeizures - Pre-procedure seizures. Text (single value) 15,2.06 - PreProcedurePCPC - Pre-procedure PCPC. Text (single value)
16,2.07 - ComorbidConditions - Comorbid conditions. Text (single value)
17,3.01 - ProcedureDate - Date/Time arrival at hospital (for MINAP) or Procedure Date (for all other datasets). DateTime (dd/mm/yyyy hh:mm)
18,3.02 - consultant - Consultant Responsible for Procedure. Text (single value) 19,3.03 - Operator1 - First operator. Text (single value)
20,3.04 - Operator1Status - First operator grade. Text (single value) 21,3.05 - Operator2 - First assistant. Text (single value)
22,3.06 - Operator2Status - First assistant grade. Text (single value) 23,3.07 - ProcedureType - Type of Procedure. Text (single value) 24,3.08 - SternotomySequence - Sternotomy sequence. Text (single value) 25,3.09 - PrimaryProcedure - Operation performed. Text (single value) 26,3.10 - BypassTime - Total bypass time. Numeric (integer)
27,3.11 - XClampTime - Total bypass cross clamp time. Numeric (integer) 28,3.12 - CircArrestTime - Total circulatory arrest time. Numeric (integer) 29,3.13 - CathProcTime - Catheter procedure duration. Numeric (integer) 30,3.14 - CathFluroTime - Total fluoroscopy time. Numeric (integer)
31,3.15 - CathFluroDose - Total fluoroscopy dose. Numeric (integer) 32,3.16 - ProcedureComment - Operation report/comment. Text (single value)
33,3.17 - BenchmarkProcedure - Is this a benchmark procedure?. Text (single value)
34,4.01 - DateOfDischarge - Date of Discharge. Date (dd/mm/yyyy) 35,4.02 - DateOfDeath - Date of Death. Date (dd/mm/yyyy)
36,4.03 - DischargeStatus - Discharge status. Text (single value)
37,4.04 - DischargeDestination - Discharge destination. Text (single value) 38,4.05 - PostProcedureSeizures - Post-procedure seizures. Text (single value) 39,4.06 - PostProcedurePCPC - Post-procedure PCPC. Text (single value)
40,4.07 - DurationPostOpIntubation - Duration of post-operative intubation. Numeric (integer)
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Format / of an export / file:"value / 1","value 2", / "","", . / "value / 39","Value / 40"
"value / 1","value 2", / "","", . / "value / 39","Value / 40"
"value / 1","value 2", / "","", . / "value / 39","Value / 40"
Note:
Empty quotes ("") to highlight how to handle empty values.
.. signifies the continuation of the values
Exporting Paediatric data
The Paediatric application enables you to extract data from the system for local analysis using a number of analysis tools e.g. SPSS, Excel etc
To export all your hospital's data into a CSV (Comma Separated Value) file, this can be opened in Microsoft Excel. Click the 'Export Data (analysis)' button which will open the 'Export View'. Once in the view, click the 'Export to local CSV file for further analysis' button in the top bar.
The default location and file name for export is 'C:\TEMP\PAEDSEXPORT.CSV', but you may change this to any other convenient location/filename, as long as the directory (i.e. 'temp') exists.
Note: The export view will not show data which is encrypted, i.e. names, DOB etc, but this data will appear in the export file.
Opening Export File in Microsoft Excel
To open the CSV file in Microsoft Excel, you should first open Microsoft Excel, then open the file from there.
Step 1. Open Microsoft Excel
Step 2. Goto FILE > OPEN
Step 3. Navigate to 'C:\TEMP', select 'All Files' from the 'Files of Type' option at the bottom of the window, then select the 'PAEDSEXPORT.CSV' file, and click 'Open'.
Step 4. If you get the message 'This file is not in a recognizable format', click OK and continue to step 5.