Patient Instruction Content (PIC)
Manual
Patient Instruction Content (PIC)
Overview and Key Points
-PIC is synonymous with PDI (Patient Discharge Instruction).
-The purpose of PIC is to provide care providers with instructions to give to discharged
patients. These instructions are specific to a diagnosis or problem, and can be broken down by module.
-Currently only PCS, EDM, and Oncology use PIC. PIC is only available to PCS is 5.6.
-Meditech provided Patient Discharge Instructions
-640 Available PDI's in English and Spanish only
-Written in HTML
-Incorporates pictures
-Broken down into hard-coded categories
-Cannot be edited by the site
-Can view on the EDM Product and Resource Homepage, under 'Patient Discharge Instructions'
-Meditech will update or edit the instructions when the need arises (Customer requests,
obsolete information, typos, etc.)
-Customer Built Patient Discharge
-Built in the MIS Patient Instructions Dictionary
-Can be used when PIC module is either enabled or disabled
-Can be broken into categories, languages or available in certain applications
-Written in free text format
-Supplemental Instructions, built by the site
-Standard guidelines that apply to multiple or all PDI's or locations.
-Edited and created in the MIS Supplemental Instructions
-Attaches to specific PDI's or available for all patients in a location
-Written in free text format
-Regarding Setup
A site must purchase a dedicated web server for PIC to function properly. The site must provide Meditech with the server name, port through which the server can be accessed, and the virtual directory into which Meditech sends the standard Patient Discharge Instructions. Meditech sends the instructions in English and Spanish only. The PDI's are written in HTML with specific tags (HTML data fields) attached to each instruction. Each PDI has a language, category, application, and space for a site specified logo attached to it.
A site can opt to not use the Meditech standard PDI's by turning off the PIC module in the NUR Toolbox (Page 4). This will keep the routine the same, but will only allow custom-built text instructions to be available in lookups.
A site can opt to not include pictures on the Meditech standard PDI's. They must delete the 'Image' folder in their virtual directory. If they would like to only use certain images, they must delete all undesired images from the 'Image' folder.
For PDI's to print properly, the each client at the site must have an updated PPII version (5.0.2.7 or higher). To check the PPII level, go to the Program Files/MEDITECH/Print directory. Once there find the VMAGICPPII.exe file. Right click on the file and select 'Properties'. Click the 'Version' tab. The client's version will be listed.
-Regarding Edits and storing the MRI/EMR
If Meditech makes edits to the instructions, then they are sent to the site as an update, which can be taken anytime. Old versions of PDI's remain intact on the site's server. PDI's are stored in the patient's MRI and are never purged. PDI's can be sent to the EMR if that option is enabled in the MRI Toolbox. They will be available in the Other Reports panel, under the Selected Visit tab.
-Future Enhancements from Development
-Ability to delete images individually
-Ability to inactivate specific Meditech standard PDI's
-Allow HTML format for customer built PDI's
-EDM PIC Setup Canned Text - PDI.DELIVERY
EDM's canned text for setting up the PIC server and other technical information
-MIS Toolbox Force PIC Update and PIC Update Report
Force PIC Update is a routine in the MIS Toolbox that allows a specialist to rebuild the Meditech provided Patient Discharge Instructions index. This should be done each time a site receives a PIC update. Once the new and edited PDI's have been moved in, this routine will rebuild the index. If this is not done, then the first user to call a lookup after an update will have to wait for the index to rebuild.
The PIC Update Report allows users to view newly added and edited Patient Discharge Instructions. They can select a certain update version and choose if they want to see edits, newly added PDI's or both.
'Patient Instructions' Routine
Language
-Language in which you want the Patient Discharge Instructions printed. The first 'ENGLISH' is the MIS language, the second 'english' is the linked Meditech PIC module language (hard-coded) which is linked in the MIS Language Dictionary.
Patient Instructions
-Filed PDI's will sort alphabetically. Newly added PDI's must be filed before they can be printed. Once newly added PDI's are filed, they will fall alphabetically on the list.
Add Remove Instructions
-See next page
-Patient Discharge Instructions will print in the order they appear. Un-filed instructions will not print. If un-filed instructions are on the 'Patient Instructions' list, then clicking the 'Print' button will prompt the user to:
File, which files the new instructions and print all the listed instructions.
Cancel, which returns the user to the original screen.
Print Anyway, which prints previously filed instructions only.
Add/Remove Instructions
Search
-Two letter string search off of the first word in the name of the Patient Discharge Instruction
*Development is working on allowing the search to find any word in the PDI's name
Name
-If PIC is enabled then all Meditech supplied Patient Discharge Instructions and custom built PDI's with 'Y' in the 'Use with PIC' field in the MIS Patient Instructions Dictionary will populate in. If PIC is disabled then only custom built PDI's will populate in. Use the 'Next' and 'Prior' buttons to navigate within the list. Dimmed PDI's have already been added to the patient.
Selected
-Shows added and previously added PDI's. Checks indicate they will be added once the 'OK' button is clicked. To remove a previously filed or newly added PDI, remove the check next to the desired PDI and click 'OK'
Filter by Category
-This will bring up a list of Meditech provided categories. Select the desired category and the list of PDI's associated with that category will populate in. These categories cannot be edited or added to. Custom built PDI's can be added to a Meditech PDI category in the MIS Patient Instructions Dictionary.
MIS Toolbox - E/E MIS FS Parameters
Server
-Sites using PDI (PIC) must purchase a server with a virtual directory, the server is listed here for Meditech to move the Patient Discharge Instructions to (provided by site, DEVFS11 can be used for INHOUSE rings)
Port Number
-Port number for Meditech to access the sites' server (provided by site, 5601 can be used for INHOUSE rings)
Print Path with protocol
-Location of the virtual directory on the server. Since Patient Instructions are downloaded from a Meditech service and housed on a sites' server, there must be an established virtual directory in which Meditech can place the PDI's (provided by site, HTTP:\\DEVFS11\PICS56\PRINT\ can be used for INHOUSE rings)
Default PIC Logo Filename
-Patient Discharge Instructions originating from the Meditech PDI service must have a logo on the header. This logo must be a GIF file and the file name must be placed here.
PIC Logo Filename
-Header logos can be added to PDI's individually by location. Put the logo file name for each location here.
MIS Patient Instructions Dictionary
Under the Standard Data tab
Name
-Name of Patient Discharge Instruction, as it appears in lookups
-When naming a PDI, note that the name can be the same as a Meditech sent PDI. Because of this it is best to include an indicator in the customer created PDI's (like using all caps or '*')
Active
-Active in look ups, 'Y' or 'N'
Use with PIC
-Determines whether customer built PDI's can be used when PIC is enabled in the NUR Toolbox (Page 4 of Parameters)
-If 'Y', then a 'Y' in the 'Use PIC for Patient Instructions' in the Parameters will make this PDI available when using PIC is enabled
-If 'N', then this PDI will only be available if PIC is not enabled (Sites may not elect to use Meditech provided PDI's, therefore they will disable PIC)
Applications (only available with 'Y' in the 'Use with PIC')
-List which applications this PDI will be available in. Currently EDM, Oncology, and PCS are the only modules using PIC.
Categories (only available with 'Y' in the 'Use with PIC')
-Allows customer built PDI's to be assigned a category. Categories are non-editable groups of PDI's.
When Meditech sends PDI's, categories are sent attached to each instruction. If the site would like customer built PDI's to be available in the PIC 'Filter by Category' routine. PDI's can belong to more than one category.
Language
-Define languages for each PDI. Looks into the MIS Language Dictionary. Once a language is defined, then highlight the language and hit <ENTER>. This will open a text box, into which the custom PDI can be written or pasted.
*The Customer-Defined Data tab has no found functionality. Presumably this is for future functionality ('Maintaining Real Estate')
MIS Supplemental Information Dictionary
Supplemental Instructions are designed for hospital specific instructions for discharge patients. Both customer-built and Meditech sent PDI's are often specific to a diagnosis or problem. Supplemental Instructions print at the end of specific PDI's if they apply to that specific instruction (see below). They will print at the end of all the PDI's if they apply to all instructions (see below). Criteria for which PDI's Supplemental Instructions will print are listed below.
Mnemonic
-Unique identifier for Supplemental Instruction (free text)
Active
-'Y', will be available in lookups, 'N' will not be available in lookups
Name
-Free text, used for lookups
Apply to ALL Instructions
-Y/N prompt indicating if you want the Supplemental Instruction to be attached to all PDI's (both from PIC and custom built). If 'N', then you can define to which PDI's (both PIC and custom built) you want this attached*
Apply to ALL Locations
-Y/N prompt enabling Supplemental Instructions to be printed on all locations, independent of which PDI's are on the patients. If 'N' then you can specify which locations have this printed for all patients in that location*
Language
-Define languages for Supplemental Instruction. Looks into the MIS Language Dictionary. Once a language is defined, highlight the language and hit <ENTER>. This will open a text box, into which the custom PDI can be written.
*If there is a 'Y' in either 'Apply to All Instructions' or 'Apply to All Locations' and an 'N' in the other field, then the 'Apply to Instructions' field must be filled out.
MIS Language Dictionary
Under Standard Data tab
Maps to PIC Language
-This prompt must be filled out for PIC to function properly.
-Looks to PIC Language, which comes from Meditech's PIC server of Instructions.
-Links MIS Language to Meditech's Patient Discharge Instructions language.*
*Currently Meditech only sends Spanish and English Patient Discharge Instructions.
NUR Toolbox - E/E PCS Parameters (Page 4)
Use PIC for Patient Instructions
-If 'Y', then calls to PIC Module when clicking 'Patient Instructions' in PCS.
-This allows Meditech provided Patient Discharge Instructions (not editable) to be available in the Add/Remove Instructions routine.
-If 'N', then calls straight to the MIS Patient Instructions Dictionary when clicking 'Patient Instructions' in PCS.
Default Language
-Enter the language you want to default in the 'Language' prompt when click 'Patient Instructions' on the Status Board. This will be the default language if there is no patient information attached to the language EMR ID (as entered in a CDS or assessment).
Default Language EMR ID
-Define the EMR ID to which a patient's primary language query is mapped. This is often the 'Primary Language' EMR ID.
MRI Toolbox - E/E MRI Parameters
Under General tab
Send Patient Instructions to EMR
-Determines whether or not Patient Discharge Instructions go to the Other Reports panel in the EMR.
-If 'Y', then Patient Discharge Instructions go to the EMR.
-If 'N', then Patient Discharge Instructions do not go to the EMR*
*Patient Discharge Instructions permanently stay in the MRI in the PDI History. Past instructions can always be accessed again in PIC.