Women’s Health Newsletter
July 2014
In This Edition AWHONN Technical Corner Archived Fetal Strips
FAQ Cerner Direct
FetaLink+ iOS7 Updates
Meet the Team Jessica Alford
Journey to Baby-Friendly Designation All About Delivery Summary Report
Women’s Health Newsletter On the Cover
Cerner at AWHONN Recap
Brielle Suzanne Alford
On June 15th through 18th the Cerner Women’s Health team staffed booth space at the AWHONN 2014 Annual Conven on. We had great conversa ons with over 200 of the a endees who came through the exhibit space and distributed thousands of s ckers to those filling up their bingo cards to win a trip to AWHONN 2015! Our booth space allowed us to showcase all of Cerner’s capabili es in the Women’s Health space. We had team members on‐hand to demonstrate PowerChart Maternity, FetaLink, and FetaLink+ as well as some of addi onal Women’s Health offerings: Bridge Breast Milk Management which u lizes bar code scanning technology to give the correct mother’s milk to the correct infant at the me of feeding; CareAware mySta on, an interac ve pa ent educa on offering that incorporates televisions in the pa ent’s room, and CareAware Connect, a nursing mobility solu on that delivers communica ons (voice, text) and EHR workflow tools to a single smartphone device.
This month’s cover baby is Brielle Alford.
Her mom is Cerner Associate Jessica Alford, a Content and Solution Alignment Strategist with the Women’s Health team.
We love the opportunity AWHONN provides us to showcase our latest and greatest and meet the nurses who use our system. If you stopped by the booth at AWHONN let us know what you thought by emailing Clare at Clare.Holahan@cerner.com: would you have liked to see something more or different? Did you find value in your discus‐ sions? Let us know! See you in Long Beach, CA in 2015! Jessica Alford, Cerner Women’s Health Content and Solu on Alignment Strategist, and Patrizia Smouse, Cerner Women’s Health Director, pose with some of our friends from the Adven st Health System, headquartered in Florida.
Our mobility bar displaying our mobile solu on, FetaLink+, as well as our President’s Circle Partner signage.
July 2014
All About AWHONN
Got News?
By Jill Meier and Jessica Alford
Recently, a few members of Cerner’s Women’s Health team had the privilege of a ending AWHONN’s 2014 Annual Conven on, which was held in Orlando, Florida June 15‐18. This na onal conven on offers educa onal sessions, networking oppor‐ tuni es, and presenta ons which help to enrich the professional lives of nurses working in women’s health,
perinatal, and neonatal areas.
Do you have good news to share about your facility? We’d love to share it with our community
Cerner’s presence at AWHONN allowed us to showcase our solu ons, meet with clients, and expand our knowledge of latest trends and recommenda ons for care. Jessica and I are able to bring this knowledge back to our team, driving our roadmap for development to ensure that our solu ons align with our clients’ needs.
members.
Several of the educa onal sessions we a ended focused on the documenta on and management of Category II fetal heart rate tracings. Industry experts shared their thoughts on the best approach for documenta on of fetal heart rate assessments, and how that documenta on impacts the legal record.
WomensHealth@Cerner.com
Other educa onal sessions we a ended included the management of hypertension during pregnancy, normal weight gain in pregnancy, and the latest recommenda ons regarding the labor curve (sugges ng that ac ve labor really starts at 6 cm instead of 4 cm). In discussions with nurses who a ended our booth, we heard many ques ons about the Baby Friendly Ini a ve, which seems to be a current hot topic. Over all, the AWHONN conference was a fun and educa onal experience. It was a fantas c way to network and share our ideas with others. I came away from the event with a feeling of pride that I can be a part of the wonderful community of perinatal nurses.
Send your information to
and we will include it in our monthly newsletter.
Women’s Health Newsletter FetaLink 2014.01
Technical Corner
The next major FetaLink release, known as FetaLink 2014.01, is in the final stages of testing with our solution partners. This release will offer the following:
Consumption of iBus configuration services
Service consolidation and optimization
Centralized iBus system authentication to streamline maintenance
Solution deploy utility
Monitoring of comprehensive core service state
Validation with CareAware iBus 5.2
Retrieve archived FetaLink strips from the Pregnancy Summary faster! With updates to the FetaLink architecture, there are now methods to lower these load mes and get your archived strips quicker – helping to eliminate those holdups seen in the past. FetaLink’s original applica on architecture has the iBus servers si ng within the hospital data center to have the central data source as close to the facility as possible to maximize the FetaLink user experience while in the hospital. This allows for faster live data storage and display, however, this method causes delays in data retrieval since it must travel to a remote data center from the hospital when a emp ng to view archived strips through PowerChart Maternity. Facili es may now choose to contract for a lightweight standalone virtual iBus server, called the FLARCHVIEW server, that is installed in the remote data center alongside all other Cerner hardware. The FLARCHVIEW server’s primary task is to pull archived strips and display them from the PowerChart Maternity Pregnancy Summary MPage. Since the FLARCHVIEW servers resides in the remote data center, the me necessary to pull this data is significantly shorted because all architectural components are physi‐ cally close together. By consolida ng all of the architectural components, the number of data hops to the archived strips is reduced, thus archive strips can be displayed more quickly.
July 2014
Technical Corner continued
trip es iev retr o t st ed que lay Re isp ip D Str
FetaLink 2014.01 continued
Configuration for multiple beds in one room
Medical record number (MRN) displayed in FetaLink Census
Each site that has implemented the FLARCHVIEW server with FetaLink has seen significant archive strip retrieval boost when loading from the Pregnancy Summary. Please contact your Women’s Health Client Service Manager to discuss lowering strip retrieval mes with the virtual Archive View Server and other system and workflow improvement possibili es.
Updates to the exported PDF to remove extraneous chart decorations
64-bit OS is now supported
FAQ
This release is expected to be
made generally available in July.
Cerner Direct Cerner Direct enables providers to exchange clinical data through simple, secure email u lizing the NPI (na onal provider index). Cerner Direct meets Meaningful Use Stage 2 requirements by providing the ability to send HIPAA compliant informa on between providers when using Direct Secure messaging email addresses. This allows secure delivery of clinical reports to non‐EHR prac ces, as well as those who are u lizing a different EHR vendor. There is no need for the Cerner provider to exit the Message Center in order to “push” that vital informa on to another provider. From the Mes‐ sage Center, when sending that secure message, the provider can a ach text docu‐ ments, films, videos, and CCD documents. When receiving a secure message via Cerner Direct, any a achment can be saved to the pa ent’s chart using one or more note types defined by the organiza on. For more informa on about this solu on, please contact your Cerner Client Results Execu ve.
An announcement and a Flash will be published at that time. For more information on this and other FetaLink releases, please see our Solution Portal.
Women’s Health Newsletter Maintaining Industry Awareness Cord Blood Awareness Month
Cord blood is the blood left in the umbilical cord and placenta follow-
FetaLink+ iOS7 Updates FetaLink+, Cerner’s mobile fetal monitoring solu on, recently released Version 2.0, which allowed us to take advantage of the iOS7 pla orm to add a more robust view of clinical informa on. In this latest release, users can tap a bu on to bring into view an Informa on Pane, which shows details of the pa ent’s latest cervical exam (including date and me of last exam), an EDD/EGA meline, and date and me of rupture of membranes and color of fluid. Previous version of Pa ent List:
ing the birth of a child. It’s a potent and noncontroversial source of stem cells, which are currently being used
to treat and cure more than 80 life-
threatening illnesses, including
many cancers, immune deficiencies and genetic disorders. Just as important, neither the mother nor child is harmed in the collection of cord blood, and the collection does not interfere with the birthing process. Read more here.
Updated iOS7 version of Pa ent List, with Informa on Pane:
July 2014
Meet the Team Jessica Alford I have been at Cerner for almost 7 years, but have been on the Women’s Health team since March. My role with the Women’s Health Team is a Content and Solu on Alignment Strategist. What that means is that I take the recommenda ons from our IP Strategists about func onality that is coming, and then coordinate the release of all of that infor‐ ma on and recommenda ons to the consult‐ ants for our clients. I also coordinate all of the development, packaging, and release of our content. Currently I am working on a new content release strategy as well as ge ng much needed content to support new ini a‐ ves and guidelines like the ACOG checklists, the AWHONN Postpartum Hemorrhage Project, and the CMQCC Preeclampsia Project. I am from the Kansas City area, and I have a bachelor’s degree in Nursing from Graceland University in Iowa. I was a labor and delivery nurse for 8 years as well as cross‐trained to the NICU. I also worked in a Perinatology office for about 2 years. I am married to my high school sweetheart and love of my life and we have 3 children together all under the age of 5! We are busy! I spend my free me playing with my kids, spending me with family, and going to my husband’s rodeos (which my li le boys LOVE). I feel very grateful to be a part of such a great team at Cerner, and look forward to developing addi onal content that is valuable to our clients!
Maintaining Industry Awareness GBS Awareness Month
Group B streptococcus (GBS) is a type of bacterial infection that can be found in pregnant women. This bacteria is normally found in 15 percent to 40 percent of all healthy, adult women. GBS is responsible for affecting about 1 in every 2,000 babies in the United States. Cerner offers three decision support rules for GBS, which are available in
both the Acute (#70898) and the Ambulatory (#70897) packages.
Women’s Health Newsletter Fascinating Facts
Journey to Baby-Friendly Designation
Why Doctors Wear Green Scrubs Scrubs used to be white — the color of cleanliness. Then in the early 20th century, one influential doctor switched to green because he thought it would be easier on a
Truman Medical Center When and how did this process begin? We applied for the Best Fed Beginnings Ini a ve in February 2012 and found out we were selected in June 2012. The ini a ve is a collabora ve effort between the CDC, Baby Friendly and NICHQ (Na onal Ini a ve for Children’s Health Quality). We were one of 90 hospitals selected across the United States to par cipate in this 2 year project. How were you able to accomplish this? What hurdles did you face and overcome?
Green could help physicians see
It takes a team effort to become Baby Friendly. One of the biggest hurdles we faced during the ini a ve was not having a Director for our unit for several months at the beginning of the project. What we learned from this is how importance it is for senior leadership to “cast the Baby Friendly vision” to staff. At mes, it seemed we encountered resistance from staff because leadership was not involved in holding staff accountable to the required process changes to meet Baby Friendly guidelines. Fortunately, a new Director was hired mid 2013, Karen Henson, who totally supports the Baby Friendly ini a ve and has been instrumental in our journey to designa on.
better for two reasons. First, looking
surgeon’s eyes, according to an article in a 1998 issue of Today’s Surgical Nurse.
How (if at all) was Cerner able to assist you in gathering documenta on you needed? at blue or green can refresh a doctor’s vision of red things, including the bloody innards of a patient during surgery. Looking at something green from time to time can keep someone’s eyes more sensitive to variations in red, according to John Werner, a psychologist who
We have been so fortunate throughout this en re process to work with Kim Nash, Truman Medical Center, IT Dept. The project has required many specific changes to our EMR documenta on in order to evaluate Baby Friendly care. Kim was quick to respond to make necessary changes when requested as we were required to provide audit reports (on 30 pa ent charts) to the NICHQ project every month. We modified EMR documenta on including: skin‐to‐skin contact documenta on, infant loca on, our breas eeding assessment, breas eeding educa on, and infant intake sec on. Kim was also able to pull all the required elements that we were to report in the “results review” sec on on the mom and baby chart. She made the monthly data collec on a breeze!
July 2014
Journey to Baby Friendly Designation continued
Fascinating Facts continued
What advice would you give other hospitals looking to follow your footsteps and become baby friendly?
studies vision at the University of
The advice I would give hospitals regarding Baby Friendly is “Go for it!” Enlis ng senior leadership is the most important first step in cas ng that vision of Baby Friendly designa on to their hospital staff. Secondly, you need to engage staff in the change processes. With staff involved in planning, developing and implemen ng the changes in prac ce, you’ll have their buy‐in and compliance with prac ce changes. Thirdly, don’t give up! Baby Friendly doesn’t happen overnight, but we can now look back and say….”Remember when all the babies used to go the nursery for the pediatrician assessments in the morning?” – now our babies room in 24 hours/day. “Remember when all our babies went to a radiant warmer a er delivery?” – now our babies transi‐ on skin‐to‐skin a er delivery whether they delivery vaginally or by C‐sec on. John F. Kennedy stated “Things don’t happen, things are made to happen.” The improvement process never ends. We will con nue to look for ways to improve the quality of care we provide our families so they experience wonderful birth experiences at Truman Medical Center‐Hospital Hill.
California, Davis. Second, such deep focus on red, red, red can lead to distracting green illusions on white surfaces. These funky green ghosts could appear if a doctor shifts his gaze from reddish body tissue to something white, like a surgical drape or an anesthesiolo-
Read the press release here.
gist’s alabaster outfit.
However, if a doctor looks at green or blue scrubs instead of white ones, these disturbing ghosts will blend right in and not become a distraction, according to Paola Bressan, who researches visual illusions at the University of Padova in Italy.
Women’s Health Newsletter Content Suggestions The Women’s Health team understands your time is valuable and we want to ensure you are receiving benefit from this newsletter.
We would love to hear about topics you would like to see covered in future issues.
Please send your topic suggestions to WomensHealth@Cerner.com
We look forward to hearing from you!
All About Delivery Summary Report Purpose The Delivery Summary Report is designed to be launched from ExplorerMenu.exe within a Millennium environment. The intent of the report is to provide a summary view of all qualifying data within a start and end period. The report consists of a three block output. The first block provides detail around when the report was ini ated and what the start and end dates for qualifying data are. Delivery count informa on is also provided. This informa on is separated into counts based on the mother's gesta on (Singleton, Twins, etc.). Count values are provided for Birth, Mothers Delivered, Nulliparous Mothers, Greater than 37 weeks, and Less than 1500 grams at birth weight. The second block provides detail informa on regarding Cesarean Sec ons and Vaginal Birth A er Cesarean (VBAC) deliveries. The block begins by providing the total number of Cesarean Sec on deliveries followed by the Overall Cesarean Sec on Rate within the specified date range. Below this informa on the block is subdivided into four squares. The upper le square provides Repeat/VBAC informa on including number of prior cesarean sec ons, number of single prior cesarean sec ons, number of VBAC a empted deliveries, number of successful VBAC deliveries and the VBAC rate along with the calcula ons for each. The square is finalized by providing the number of repeat Cesarean Sec ons within the specified me frame. The upper right square provides informa on specific to the Primary Caesarean Sec on numbers and rates. First defined is the number of Total Primary C‐Sec ons. The report further clarifies the number by providing the count informa on for each classifica on as follows: CPD/FTP, Fetal Distress, Malpresenta on, and Other. The lower le box provides informa on regarding the number of live births greater than 37 weeks of es mated gesta on, Caesarean Sec on deliveries for Singleton, Term, Vertex primps, and the Caesarean Sec on rate for nulliparous, singleton, term vertex births. The lower right most square provides informa on specific to Singleton, Term, Vertex (without prior Caesarean Sec on) deliveries. The table is provides rows for Primps and Mul ps with values for Total Births, C‐Sec ons, and the C‐Sec on rate as a percentage for the report me frame.
July 2014
All About continued
End of Support
The third block provides detail informa on regarding the Vaginal Deliveries during the report meframe. The first value provided is the total vaginal delivery count. Followed by this value is a breakdown of opera ve assistance (Low Vacuum, Mid Vacuum, Low/ Outlet Forceps, Mid Forceps) in number and rate. Below this informa on the report provides a count of the number and rate of Oxytocin Induc ons and Oxytocin Aug‐ menta ons with a sum below. Lastly the report also provides informa on specific to Episiotomies, with and without shoulder dystocia, and Epidurals (vaginal delivery only) in the form of number and rate for the me frame specified.
End of Support for FetaLink 1.9.3 Cerner has set October 15, 2014, as the end-of-support date for FetaLink 1.9.3, which corresponds to the
Report Driver
announced end-of-support date for
The report pulls list of pregnancies based on Date, Time of Birth from code set 72, 93, 14003.
CareAware iBus 2.0.
Pa ent Qualifica on
Before October 15, 2014, you must
The report pulls all pregnancies that have a "Date, Time of Birth" documented within the given user date range parameters. The actual delivery date and me value in IView must be between the date range provided by the user. The date range comparison is inclusive and the start date is forma ed to be DD‐MMM‐YYYY 00:00:00 with the end date forma ed to be DD‐MMM‐YYYY 23:59:59.
upgrade to FetaLink Release 1.9.4 or later and CareAware iBus 2.1 or later.
Things to note When a date range is entered, the search criteria for pregnancies will consider:
All pregnancies that have been entered into the system (not to be confused with pregnancy onset date) as far back as 300 days prior the start date entered.
If pregnancy org security is turned off, the report will consider pregnancies will a delivery date and me documented 7 days prior to the user start date and 7 days a er the user end date.
The documented delivery is on the encounter a ached to the loca on (s) in which the report is being executed.
If specific organiza ons are selected by the user from the report prompts, the mother must be registered at that par cular organiza on AND the documented delivery date and me must be documented on that loca on encounter.
Please refer to Priority Review Flash PR14-0083-0 for additional details.
Women’s Health Newsletter
July 2014
All About continued
Social Media
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The Delivery Summary Report populates 42 clinical events and/or calcula ons that have been documented PowerChart Maternity IView content. The delivery must be documented in IView for the delivery to qualify for the report. This focus of this report is focused more so on the mother rather than each baby's delivery informa on; this report is considered mother‐centric. Things to note
A pa ent must have had a pregnancy instance created at some me using the Pregnancy Component or MPage summary view and a delivery date/ me docu‐ mented for at least one baby.
The DATE/TIME OF BIRTH value must fall within the date range specified.
Qualifying result values are the most recent value documented with a status of AUTH, MODIFIED, or ALTERED.
The report gathers and groups some data results by the mother's dynamic label name. For example, Baby A and Baby B will be considered as two babies for a Mother; however, if there are two Baby A groups, the report will treat it as one Baby A. Even though the system currently allows you to name two dynamic labels the same name, it is strongly discouraged to do so.
An downloadable excel sheet of what clinical events are populated and where to docu‐ ment these events, as well as calcula ons and their formulas can be located on the Women's Health Reference page, All About the Delivery Summary Report ‐Source Data sec on.
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