Cerner Women's Health Newsletter_February 2014 by Cerner

Women’s Health Newsletter

February 2014

In This Edition What We’re Doing Ideas

FAQ Extended View

Did You Know Documentation Integration

Client Spotlight Palomar Health

Nursing Playbook In The News FetaLink+

Did You Know Prenatal Cards

Maintaining Industry Awareness National Heart Month

Women’s Health Newsletter Did You Know End of Support for FetaLink on CareAware iBus 1.3

What We’re Doing Ideas

Cerner has set an end-of-support date of June 30, 2014 for all versions of FetaLink on CareAware iBus 1.3. Additionally, support for FetaLink Release 1.9.2 and earlier releases will end on that date. Please refer to Priority Review Flash PR13-0083-0 for additional details.

Ever have a great idea for new functionality that you would love to see Cerner develop? Have you ever wondered if other sites have the same ideas that you do? Have you ever logged a change request but wanted to see what plans we have for it? On January 3, Cerner introduced a new way for clients to communicate their innovative ideas and suggest ways to enhance Cerner solutions. The Ideas space within uCern Connections is changing the way we manage requests for new functionality. As a strategist, I use Ideas daily. I can go to the Women’s Health Ideas page to see feedback on several of our key initiatives that we are currently planning, and I can see comments on those ideas. If the idea is newly added and under discussion, I can see the level of interest generated for that particular idea. The Women’s Health Team has posted some ideas to get everyone started. We have several projects that are slated for us to work on in 2014. Because of this, they have already been flipped to a status of “On Roadmap.” You may notice that you cannot select your level of interest on those items. That is because we have already established that those ideas are priorities for us to work on over the next year. However, you can still add comments, and we encourage you to do so. Many of these projects are in the design stages, so the more feedback we get from you, the more we can ensure that we are on the right track as we work to create the new functionality. Adding comments also gives you a direct way to communicate with Cerner and with other clients who are also interested in that idea.

February 2014

What We’re Doing Continued

Content Releases

Over the next few months, Cerner will be managing the backlog of enhancement CR’s that are in a Postponed, Not Planned status. The change request queue will be cleared up so that only those projects that are currently being worked on will be listed, with a status of Open, Approved. This will allow you to have better visibility to our development plans. If a CR is not scheduled for development over the next year, it will be cancelled. If you have a project idea that you feel strongly about, please know that you can post it on the Ideas page to get visibility to it and to provide a way for other clients to add their level of interest and their comments.

PowerChart Maternity

Although we won’t be able to develop all the great ideas submitted, every idea will be considered. If we cannot add it to the roadmap to develop within a year, after giving others chance to add their level of interest and comments, the status may be changed to “Declined.” This does not mean that we will never do it, just that it cannot be added to the current roadmap. Once we start our development planning for the upcoming year, those ideas will still be available for us to reevaluate and consider for a future release. Those that are selected for development will have a status change to “On Roadmap.” Be assured that if a change request is identified as a defect, it will be handled outside of the Ideas space in the traditional manner. Defects require a different level of interaction from Cerner as we work to prioritize corrections to ensure patient safety and system performance. Remember, the Ideas concept is for enhancements only, not for defects. Please take a few minutes to review the information on the main Ideas page and listen to the recorded Illuminations session entitled “Ideas: Cerner’s New Collaborative Approach for Enhancement Requests” on cerner.com. There are also Help files to get you started.

Package number for the January content releases for PowerChart Maternity are now available.

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PowerChart Maternity: Ambulatory and Inpatient (January 2014) - 70897

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PowerChart Maternity: Inpatient (January 2014) - 70898

Refer to the January 2014 newsletter for the content details for

Here’s to great Ideas! each package. Jill Meier, RN, BSN | Senior Strategist

Women’s Health Newsletter Tips and Tricks Duplicate Dynamic Groups In the case where a duplicate dynamic group is created, such as two Baby As, there is a specific workflow to resolve this issue.

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Unchart all the results under the duplicate label(s)

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Unchart the label

Following these steps will change the label_status_cd to “In Error” on the CE_dynamic_lable table, so the result will no longer copy over.

FAQ Extended View In FetaLink, the Extended View option allows you to see a scrollable view of your historical fetal strip while still allowing you to keep an eye on the Live View. When you open Extended View, you will see that the two perspectives divide the screen equally. The Live View will continue to move across the screen at the top, and shows the most recent results in the boxes on the right side. You can tell that the Extended View is differentiated from the Live View by the yellow background. It is possible to drag the border of the Extended View up, which enlarges it while the Live View becomes smaller. This is accomplished by hovering over the divider between the two views, until a two-sided arrow displays.

February 2014

FAQ continued Some clinicians find this helpful when scrolling back to review details, during strip assessment documentation. When the windows are adjusted, the height/width ratio of the waveforms stay the same so the FHR variability remains consistent. Navigating away from the single patient view and back again will prompt the system to return to the default. We recommend that if you choose to enlarge the Extended View, the best approach is to keep the Live View visible in the top 1/3 of the screen, while the Extended View occupies the lower 2/3 of the screen. This will allow for optimal viewability of both perspectives.

Tips and Tricks continued Previously, an error occurred when inactivating or uncharting the dynamic group and the â&#x20AC;&#x153;In Errorâ&#x20AC;? results still displayed from the uncharted label. A resolution is now available with Service Package #71328, which will become available on February 5th. We recommend taking this SP as it will resolve the issue and the recommended workflow for handling duplicate dynamic groupers can be utilized.

Women’s Health Newsletter FAQ How do I print the newsletter? A PDF version of each newsletter is posted to the Women’s Health Collaboration Community uCern group.

Did You Know Documentation Integration In FetaLink Version 1.9.4, which became available in Q2 2013, we introduced functionality known as “Documentation Integration,” (or “Doc Integration” for short.) This allows for the display of certain results in FetaLink as they were charted in PowerChart Maternity. The three types of results that now display are: 1. Cervical exam results (dilation, effacement, and fetal station) 2. Medications 3. Rate changes to titratable IV medications.

Why am I receiving the newsletter? Either you are a member of our uCern group or your name was provided to us.

FetaLink queries the Millennium tables every 60 seconds and looks for new results for those values, and then automatically pulls them in as read-only annotations on the appropriate place on the strip. This allows the clinician to view those results in context with the fetal tracing without the need for an additional FetaLink annotation. Currently, the IV titratable display in FetaLink is based on the rate change that the nurse makes to the infusion pump, regardless of what type of medication is running. When a rate change is made, the nurse will document it in PowerChart, and FetaLink will pull in the updated result and display it as an annotation. For example, if an oxytocin drip is started on a patient, the rate is documented in IView.

My role has changed. Can I be removed from the newsletter mailing list? Yes. While we hate to see you go, we will respect your wishes. Please email us.

PowerChart will display both the rate and the dose, based on the type of medication that was ordered. In FetaLink, the annotation will display the medication and the infusion pump rate.

February 2014

Did You Know continued

FAQ continued

FetaLink will display any changes to the result. For example, if the rate was increased, the nurse documents the result in IView:

Can I have members of my staff added to the mailing list? Yes! Having them join the uCern group is best, but we can accommodate your email request.

FetaLink would then get the new result and display it on the strip, as the rate changed from 1 mL/hr to 2 mL/hr. How do I request an article topic? We would love to cover topics of interest to you. Please email us. We have received requests to update the way the IV titratables display in FetaLink so that the dose displays instead of (or in addition to) the IV infusion rate. As one of our initiatives for 2014, projects are underway to further enhance the integration between FetaLink and PowerChart Maternity. We will be reevaluating the current functionality and making changes as needed. Because the underlying system logic will most likely change as we redesign this, we expect that the Doc Integration functionality will be revised as well. The ultimate goal will be to allow nursing documentation from within FetaLink, which will then display in the expected results fields in PowerChart Maternity. We would love to hear more about how you envision this. If you have any ideas to share, please add your comments to the Ideas page for this specific project at https:// connect.ucern.com/ideas/1097

I have good news about my unit or facility. Can this be featured in the newsletter? Absolutely! Good news is always worth sharing. Please email us.

Women’s Health Newsletter Save The Date FetaLink+ Web Demo

Client Spotlight Palomar Health

Palomar Health has two facilities that deliver Obstetrical Care, Pomerado Hospital and Palomar Health Downtown Campus. Palomar Downtown is the larger of the two facilities, averaging 3500 deliveries a year, while Pomerado averages 1200. Please join Jill Meier on Wednesday, February 12, 2014 for a web demo of our mobile solution, FetaLink+.

Further details will be posted to the Women’s Health Collaboration Community uCern group soon.

Prior to the implementation of PowerChart Maternity and FetaLink, both locations used a hybrid approach to the Electronic Medical Record. PowerChart was used for labs, orders, medications and some nursing documentation. All the Obstetrical documentation, however, was charted in Centricity Perinatal. There was no integration between the two records, and many times required duplicate documentation between the two. Palomar began discussion to convert to PowerChart Maternity in 2010 to help address these issues. The business case was revised in early 2012, and the project kicked off in June of 2012. After nine months of designing, building, redesigning, testing and training, PowerChart Maternity and FetaLink went live in March of 2013. We used a Command Center model, with 24/7 support for two weeks, staffed by IT, and champions on the floor, who had phones to be able to communicate directly with the command center. We implemented the solutions in a rolling manner, as each room became available, the cart was configured and the computers were swapped out. Palomar’s training consisted of classroom instruction for over 300 clinicians. Physicians, nurses, and ancillary staff who all attended anywhere from 2 to 12 hours of training, in no more than 4-hour blocks. Labor nurses, for example, attended classes that split up learning into FetaLink, Labor, and Postpartum components. Meanwhile, Postpartum and Nursery nurses attended the postpartum classes only. There were also separate classes for Obstetricians and Pediatricians, and some physician training was conducted at their offices and on site at the hospitals, in order to accommodate their schedules.

February 2014

Client Spotlight continued

Save The Date

We utilized Learning Live, and created a separate Learning Live OB page with FAQâ&#x20AC;&#x2122;s short videos, and job aides for different work flows and new functionality. In addition, we created hard copies of check lists and the job aides that were electronically available in the Learning Live space.

Women's Health SIG

Our trainers and champions were the same nurses who had participated in the design and testing of the project, and they came to IT from bedside care. The directors at the facilities were very supportive, and allowed the OB nurses who would ultimately be using the solution to focus on training 100%. They developed and taught the training material, and then they supported it during conversion, and post Go-Live. This, we believe, is the biggest factor in our success with PowerChart Maternity and FetaLink. These nurses lived this solution for 9 months. The worked to create a design that was both meaningful and made sense. And they owned their decisions, and worked with the staff to overcome any resistance to change that was demonstrated. One big lesson learned for Palomar was around hardware implementation. We waited until late in the game to get the Fetal Monitor cart set up functioning, and found we were struggling to make it work. In addition, we deployed new fetal monitors the day of conversion and were scrambling to get parts we thought we had. We would definitely recommend deploying any new hardware you can, prior to conversion. We continue to have onboarding classes and training with preceptors. We are still using the original training materials, as they are as relevant today as they were over a year ago. We have just taken the 5.0 MPage, including the newest Pregnancy Summary MPage, which gives back the much desired face up open/close pregnancy functionality. We are also planning to take the 2013.01 FetaLink upgrade in the near future, from code version 1.9.3. We are also hoping to take a closer look at the reports provided with the package, and there is also a desire to pilot not running a paper fetal strip. Palomar clinicians have really embraced PowerChart Maternity and FetaLink. There really was only a short period of mourning for the old application. They very quickly realized the value that our new solutions provided to them. They no longer had to duplicate document, they had improved processes, and realized a ROI for charging. They like the hardware, and have experience very little network or IT related issues. Overall, this has been one of the most successful implementations of a new solution that Palomar Health has had of an IT application.

The first Women's Health SIG call for Q1 of 2014 has been scheduled for Wednesday, March 12, from 11001200 Central. If you have any ideas for topics you would like to discuss, or you have exciting things that your organization has done that you would like to share with others, we would love to hear from you! Please email the SIG chairs if you are interested in presenting. Angie Conner: aconner@floyd.org Susan Nigro: susan.nigro@olathehealth.org

Women’s Health Newsletter Physician Playbook WBT now available On January 2, 2014 the Women’s Health Physician Playbook added a WBT designed to enhance the learning experience of the OB/GYN physicians. Visit the reference page listed below for information regarding access to this course. https://wiki.ucern.com/display/

Nursing Playbook Nursing Playbooks Released

We are excited to announce the release of the Inpatient Women’s Health Nurse and Ambulatory Women’s Health Nurse Playbooks on December 31, 2013!

The Women's Health Nursing Playbooks provide a comprehensive approach to maximizing the nurse's productivity through optimal design and configuration based on the best practice observed by Cerner across our client base. Both playbooks include the following: Standards – settings for preferences and privileges that are derived from the accumulated experience of implementing PowerChart Maternity. Content – configuration of the Tracking Shell, Table of Contents, MPages, Favorites Folders, and Rules Workflows – optimal documentation workflows by venue

In the Spring, we will be releasing training materials that guide the nurse in the practical application of the Inpatient and Ambulatory Women’s Health Nurse.

eutmaterials/ Physician+Specialty+WebBased+Training+%28WBTs%29

Both Women’s Health Nursing Playbooks can be access from the Nurse Experience site. https://wiki.ucern.com/display/NE/Nurse+Experience

February 2014

In the News

ACOG Committee Opinions

FetaLink+ Oocyte Cryopreservation We are so excited to announce that FetaLink+, Cerner’s new FDA regulated mobile fetal monitoring solution is officially live at 5 facilities!

ACOG is endorsing the document “Mature Oocyte Cryopreservation: A

Harrison County, a community hospital went live November 13th and Universal Health Services, (UHS) a multi-facility hospital system has 4 facilities using the application -the first of which went live December 3rd.

Guideline” and is encouraging its

Between the 5 facilities, there are 32 physicians using FetaLink+ and accessing patient data through the application over 600 times per week.

Click here to read more.

It is proving to be an invaluable addition to their daily workflows. Even physicians who had previously used Airstrip are recognizing the benefits of the additional features and functionality that come with FetaLink+, making statements like, “I have downloaded FetaLink+ and I love it.”

Predispute, Voluntary, Binding Arbitration

use by Fellows.

Weighing the potential advantages If you would like to learn more about FetaLink+ or how your facility and physicians could benefit from the solution, email WomensHealth@Cerner.com

and disadvantages, predispute arbitration may represent a valid alternative dispute resolution strategy for physicians and patients. Click here to read more.

Women’s Health Newsletter In The News Children’s Mercy Hospital

Did You Know Prenatal Cards

Did you know that you can change the formatting of the way that the EGA displays on the Prenatal Visit cards? Instead of seeing a 37 2/7 weeks, the view can now display 37w2d. This is done by associating a concept_cki of CERNER!A434C472-C705-4F82-882766F0A66D8B66 to the event code that you have associated to the WH_EGA_AT_DOCUMDTTM rule. How this is accomplished:

As part of an affiliation with Freeman Health System, Children's Mercy Hospital in Kansas City says it

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Log into your domain’s backend

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Type: CCL, then hit Enter

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Then type: Update into code_value set concept_cki = "CERNER!A434C472-C7054F82-8827-66F0A66D8B66" where code_value = xxxxx go Commit go

plans to open a pediatrics care clinic

Plug in the red x’s above with the appropriate event code found in Core Event Manager.

in Joplin, Missouri.

The card should then begin to appear with the new view