6.0 Dictionary Training Manual

What is the purpose of Scanning and Archiving?

The purpose of Scanning and Archiving is to ultimately eliminate the need for the paper chart. For physicians and coders, the paper chart currently provides them with the patient information necessary for clinical decision making and medical reimbursement to take place. Scanning & Archiving will allow physicians, coders, and other members of the hospital staff, to perform their everyday, life saving tasks more efficiently and effectively by placing patient documentation online.

What is the difference between Scanning and Archiving?

Documents that do not originate from MEDITECH's software, or documents that are altered in some way, are SCANNED into the MEDITECH system. An example of an altered document may be physician notation on a MEDITECH generated report. The notation on the report requires that the image be scanned.

Documents that originate from the MEDITECH system and are not altered in any way are examples of ARCHIVED documents. The following applications currently have the ability to archive reports:

1. Abstracting7. Medical Records

2. Admissions 8. Nursing

3. Emergency Department Management9. Order Entry

4. Imaging and Therapeutic Services10. OR Management

5. Laboratory11. Pharmacy

  1. Radiology

Hardware Requirements

  • Scan Station PC: Must be running Windows 2000(+).
  • Scanner: Must be installed with a TWAIN driver. This driver type is the only type MEDITECH supports.

Storage device: Typically a SAN (an array of disks) which hold the images being Scanned/Archived. There will be shared folders on the SAN which determine where a document is in the scanning process as well as if it has been archived. These forms must remain in a static UNC path once created.

Your MEDITECH Application Specialist sets up the following steps:

Step 1:

MT Staff>Toolboxes>6.0> MIS>System Dictionaries>Multimedia Storage

Sever/Share dictionary (6.0 Master/NPR Slave)

This dictionary designates the path to which scanned documents are saved. Temp and Perm folders are recommended.

The Temp folder is used until the scanned image is transferred to AFI.

The Perm folder is utilized when the image is transferred to permanent storage.

POC and Conversion folders are optional.

The Arch folder stores MEDITECH generated .tif images of Archived reports.

ANP is used in 6.0, not SMB

On storage server, go to the following folder: C:\ProgramFiles\meditech\anpserver

Open ANP-root file with any text editor. It contains a mapping network folder to the actual location of on a particular hard drive.

An ANP-root entry can be setup for a single drive in on which images are to be stored. This can simplify setup and allow new server share entries to be added without updating the root file.

Example:

There are 3 server share entries all filing to the same drive, so there are 3 ANP-root entries

\\devfs9\folder1 folder1=G:\folder1

\\devfs9\folder2 folder2=G:\folder2

\\devfs9\folder3 folder3=G:\folder3

If you specify the following in the server share dictionary

\\devfs9\G\folder1

\\devfs9\G\folder2

\\devfs9\G\folder3

1 ANP- root entry of G=G:\ will service all three, and allow new entries to be made without updating the root file as long as the drive letter is specified in the share path. Also prevents any need for creating base folders (ANP always implicitly creates new folders if they don't already exist).

Step 2:

MT Staff>Toolboxes>NPR> MIS>System Dictionaries>Multimedia Storage

MT Staff>Toolboxes>6.0> MIS>System Dictionaries>Multimedia Storage (currently, only the NPR dictionary needs to be set up)

Application Storage dictionary: (6.0/NPR independent dictionary)

This dictionary links application to the correct server/share – ADM, BAR, & MRM

MRM purposes include Perm and Temp.

The Perm purpose points to the MRM.PERM Share.

The Temp purpose points to the MRM.TEMP Share.

ADM and BAR both need a POC purpose defined. The POC purpose points to the MRM.POC Share.

Step 3:

MT Staff>Toolboxes>NPR> MIS>Installation>MIS Parameters

General Info Page-Archive Path (pg1)

Define the path where archived images are stored.

Step 4:

MT Staff>Toolboxes>NPR> MIS>System Dictionaries>Inbox/Outbox Dictionaries>

Message Type Dictionary

Run the Initialize routine. This routine will build the MRM DOC FOC Message Type.

Step 5:

MT Staff>Toolboxes>NPR> MIS>System Dictionaries>Inbox/Outbox Dictionaries>

Event Table Dictionary

Run the Initialize routine. This routine will build the following Event Tables for the MRM application:

MRMFOCFORM, MRMFOCDEL, MRMFOCICR, and MRMFOCMAIN.

Step 6:

MT Staff>Toolboxes>NPR> MIS>System Dictionaries>Inbox/Outbox Dictionaries>Interface Wizard

Build NPR<->6.0 Connections without UNV Component

Step 7:

MT Staff>Toolboxes>NPR> MIS>System Dictionaries>Inbox/Outbox Dictionaries

Message Generator

Make sure the MRM-FO DOC delivery service job is active

Step 8:

Info SystemsMISBackground Jobs (NPR) Enter/Edit Client

Define Background job client

Make sure the MRM database is defined on a background client.

Step 9:

MT StaffToolboxes6.0 MISSystem Dictionaries

Medical Record Document Source dictionary:(6.0 Master/NPR Slave)

This dictionary defines the different archive image application sources. Initialize the standard entries. Confirm that these entries file to the NPR MRF Source Dictionary (NPR MIS Toolbox>System Dictionaries). This will be used to define the where archive images are coming from the application source.

Step 10:

MT StaffToolboxes6.0 MISSystem DictionariesFacility dictionary (6.0 Master/NPR Slave)

Setting the Electronic Chart parameter to Yes will make the E-Chart desktop available.

Make sure MRM database is defined for the Facility.

Step 11:

MT StaffToolboxesNPR UNVSystem Dictionary MenuPrinter Model

The EMF printer entry must be defined. The network name must be "MeditechPrinter". This printer will be referenced as the EMF printer in the HIM toolbox parameters.

This means that the Background machine running MRM jobs must be Windows 2000 or higher since we need to install the MeditechPrinter on this machine. This printer is the virtual printer that is used to change files to .tif images

Step 12:

MT StaffToolboxesNPRMRMApplication Installation MenuForms Queue Databases

Include the NPR databases that will generate scanned documents. This includes ADM, BAR and MRM.

Note: The 6.0 Forms Queue Databases will be defined in the HIM Toolbox>Echart parameters.

Step 13:

MT StaffToolboxesNPRMRMApplication Installation Menu

Forms Queue Status Data

In this routine databases must be switched to on to archive documents from applications and the data must be filed (even if the data is all set to on).

Step 14:

Info SystemsMISBackground JobsBackground Jobs NPR

Process Unique Bkg Jobs

Make sure the following jobs are set up to run:

MRM Chart

MRM Folder Xfer

MRM Forms Queue Job

On the machine that the MRM Chart job will run install the MeditechPrinter (with the same name as used in the MRM Parameters).

Step 15

MT StaffToolboxes6.0HIMInstallation Toolbox Parameters

HIM Toolbox parameters:

  • E-chart Application: Define the 6.0 applications that will generate reports to the Electronic Health Record.
  • Number of Days to Auto Compile Images after Discharge/Service Date: Define the number of days for which images will be compiled to the E-chart after the discharge/service date.
  • Number of Days After Discharge/Service Date to Close Chart: Define the number of days when a chart will be considered Closed after the discharge/service date. After that date, new images will be compiled to the Closed Chart worklist.

PERSON/PROFILE

DICTIONARY

6.0

The following dictionaries are set up by the Healthcare facility:

Step 16:

Info SystemsMISDictionariesPerson/ProfileAccess

Menu Procedure Access dictionary

Define the menus that will be utilized for the Limited User and HIM User. These menus should contain menu access to the HIM E-Chart Desktop as well as the Medical Record Management application. The Medical Record Management application is only needed for users who process scanned documents.

Step 17:

Info SystemsMISDictionariesPerson/Profile Person dictionary

Associate the Menu Procedure Access defined above to your person. Make sure the MRM application is available for the user. The MRM application access is defined in the Person Profile dictionary.

MEDICAL RECORD FORMS

DICTIONARY

6.0

Medical Record Forms Dictionary

The Medical Record Forms Dictionary is used to define all unique documents used within the hospital, whether generated by MEDITECH or scanned into the system. Any document that is now in your paper chart that you wish to scan or archive must have an entry within this dictionary.

The Electronic Chart’s Categories and Subcategories correspond to the separators currently used to organize the current paper chart.

Step 18:

Info SystemsMISDictionariesAdministrativeMedical Record Subcategory

Define the different Medical Record Subcategories that will be utilized to organize documents in the Electronic Chart.

Step 19:

Info SystemsMISDictionariesAdministrativeMedical Record Category

Define the Medical Record Chart Categories that will be used to organize documents in the Electronic Chart. Subcategories are associated underneath each category.

Step 20:

Info SystemsMISDictionariesAdministrativeMedical Record Documents

Define ALL Documents that will be scanned or archived.

ELECTRONIC CHART

SET UP & ACCESS

DICTIONARY

6.0

Medical Record Chart Order Dictionary

Once you have defined the majority (at least 80%) of your forms, the next dictionary to build will be the Medical Record Chart Order Dictionary. This dictionary determines the organization of the electronic chart. Within this dictionary you will need to put all of the categories in the order you want them to appear in the chart. Under each category, you need to then order your subcategories. Within each subcategory you will enter each form.

Holding the shift key and hitting up or down arrow will allow you to reorder the categories, subcategories or forms easier. The Insert key will allow you to insert a new form, category or subcategory within the order.

Step 21:

AdministrativeHIMDictionariesMedical Record Chart Order dictionary

Define the specific order to which documents are organized in the Electronic Health Record. Documents must be defined here in order to file to the Chart.

Step 22:

Administrative HIMDictionariesParameters>E-Chart page

Medical Record Document for AOD Report:

  • Define the entry from the Medical Record Document dictionary that will be utilized for the HIM Accounting of Disclosures report.
  • Chart Request Message: Define the message that will be sent when a user processes a request. *A message will first need to be defined in the MIS 6.0 Message dictionary.
  • Days to Remove Completed Requests from My Request Worklist: Define the number of days for which a completed request will be removed from the Limited User's My Request Worklist.
  • Suppress Accts with this Status: Select any account statuses that will be eliminated from the E-Chart visit page.

Step 23

AdministrativeHIMDictionariesAccess Dictionary

Define access settings for the HIM User and Limited User access groups.

Associate this access setting to your user in the Person dictionary.

SCANNING ACCESS

SCAN STATION

DICTIONARY

6.0

Step 24

Info SystemsMISDictionariesPerson/ProfileAccessDesktop Function Set

Define the function set to utilize the MRM application.

Step 25

AdministrativeMRMSystem ManagementDictionariesScanning

Access Dictionary

Associate your user to an access group.

Step 26

AdministrativeMRMSystem ManagementDictionariesScanningScan Station

Define the scan station to be utilized for your client.

Connection Trouble Shooting Tips:

Master/Slave Dictionary data flow:

Info SystemsMISConnections menu

File the entry in the master dictionary (example: Medical Record Document dictionary).

  • Check the Dictionary Event Queue to see if the entry was processed.
  • Check the NPR Interface Manager, (FOC MIS), to see if the dictionary entry was read to the NPR Slave dictionary.
  • Access the corresponding NPR dictionary to confirm the entry was filed.

Forms transferred between MRM and HIM:

Info SystemsMISConnectionsInterface Manager (NPR)

  • Check the NPR Interface Manager to make sure the message was sent out the NPR outbox.

Info SystemsMISConnectionsManage Inbox (6.0)

  • Select the HimSca Document message type. Confirm the incoming message was read into 6.0.