Women’s Health Newsletter
November 2015
In This Edition Model Experience Release 2 CHC Wrap Up Did You Know Pregnancy Risk Factors and ICD-10
FAQ MPage View Builder
Community Involvement Living in Vitality
Reporting Package Release Pregnancy MPages 5.6 Release In The News Tips & Tricks Multiple Fetal Heart Rate Waveforms
Women’s Health Newsletter On the Cover
Cerner Model Experience Release 2
Easton John Dougherty
This month’s cover baby is Easton John Dougherty.
His dad is Cerner Associate Adam Dougherty, Technical Engagement Leader with the Women’s Health team.
The Model Experience represents Cerner’s documented best prac ces to help achieve your organiza on’s goals. It includes the op mal EHR workflows, content and capabilies as well as the methodology to introduce change into your organiza on. This datadriven op miza on methodology, called Con nuous Advancement, helps your organiza on iden fy opportunity, enact change and measure progress to your goals in an itera ve fashion. The Model Experience is the combina on of Cerner’s Model System and a con nuous op miza on methodology. These sets of best prac ces are sourced from Cerner clients, such as Intermountain Healthcare, known for its evidence-based care and use of technology, and other exper se across health care, technology, regula on and more. The Model Experience Release 2 is designed for organiza ons opera ng Cerner solu ons in the United States; and many components of it can benefit non-U.S. organiza ons as well. All Cerner clients can immediately access the Model System recommenda ons on the Model Experience uCern Wiki. By harves ng input from health systems and other contributors, Cerner expands and refines the Model System on an ongoing basis. Con nuous advancement is a long-term approach to frequently increase the value of your EHR. As its two components are constantly progressing, the nature of the Model Experience is a journey, not a des na on. The most important step is the first one. While the Model System includes many venues, departments, service lines and roles, you should expect adop on of advancements contribu ng to physician experience and produc vity to be our ini al recommenda ons. That is because…
Improvements in these areas can significantly contribute to clinical and business goals.
Robust analy cs are currently available to target and track progress.
This highly influen al audience can spread enthusiasm for the ongoing work across your roles and organiza on.
Cerner offers sophis cated, extensive and proven system recommenda ons, data analy cs and services to improve physicians’ experience and produc vity.
Whatever your goals and level of EHR sophis ca on, commit to the journey and work with Cerner to determine your first areas of focus. Ask your CRE or other Cerner representa ve for more informa on. You can find the Illumina on session recording and related informa on here.
November 2015
CHC Wrap Up
End of Support
Thank you to all of the 13,000+ a endees who a ended CHC 2015, the conference was a great success and we enjoyed networking with many of you in person! This year the Women’s Health team had 8 educa on sessions covering a variety of topics, a leadership council mee ng, Special Interest Group mee ng and live-demos on the award-winning solu on gallery floor. A special thank you goes to all of our presenters, without you this event would not be possible.
End of Support for MPage
Please visit the CHC resources page to access slides from CHC 2015 educa on sessions, as well as recordings of Monday and Tuesday's General Sessions. Recordings from select educa on sessions will be posted to that page in mid-November. You can also visit the Cerner.com Blog for daily recaps and photos from CHC 2015. Are you interested in presen ng at or a ending CHC 2016? Official abstract and conference dates have not yet been established, but we will be pos ng updates to our Women’s Health Collabora on Community.
Components
Cerner has set MPages 6.0 as the end-of-support release for summary MPage components. The planned GA date is tentatively scheduled for February, 2016. In addition, Cerner is modifying our
minimum-supported technical dependencies to enhance workflows and improve performance. Refer to flash PR15-0211-0 for further details.
Women’s Health Newsletter End of Support
Did You Know
End of Support for FetaLink 2013.01 Cerner has set June 30, 2016, as the end-of-support date for FetaLink
Pregnancy Risk Factors and ICD-10 How does the system work when the physician adds a pregnancy risk factors when it comes to ICD-10? You will love how simple this is! When a pregnancy risk factor is added, it can automa cally be added into the pa ent’s problem list by a rule. Once the physician converts that problem to a diagnosis (by selec ng the convert “Dx” bu on), the Diagnosis Assistant tool is in the background suppor ng the physician in finding the appropriate and clinically relevant ICD-10 code.
2013.01. As of that date, only critical defects will be corrected for FetaLink 2013.01. As of October 15, 2015, Cerner has ended support for CareAware iBus 2.0, and FetaLink 2013.01 is only supported on that version of CareAware iBus. Please refer to the following flash on the Flashes page of Cerner.com for more details: PR15-0320-0 End of support for FetaLink 2013.01
While reviewing the problem list, the diagnosis assistant tool will show a gray icon beside the problem if further coding can be specified. By selec ng that icon, the physician can further specify the coding – without being required to scan down a list of poten ally thousands of terms.
November 2015
Did You Know continued
Physician Blog
The physician can select appropriate responses in each column to specify the condi on for that pa ent. As you select responses (this can be done in any order in the columns), the qualifying list of terms is updated to the appropriate specified code.
by William K Hahn Jr MD FACOG
In our latest edition of the Physician
Blog, Dr. William Hahn describes the
PowerChart Maternity and Power-
By selec ng the row of the problem, a right hand panel opens that shows the details. In this example, the problem was added by a rule and the physician has added the specified ICD-10 coding. If the physician would like to add narra on about the problem, a comment box is available. This is viewable on the workflow MPage.
Chart Ambulatory Integration Project at Southwest General Health Center.
You can read the entire blog post here.
Women’s Health Newsletter Save The Date
FAQ
SIG Call
MPage View Builder and Filter Configuration Reminders Are you in the process of upgrading to 5.6 MPages? If so, here are several reminders to look for when upgrading your Pregnancy and Neonate MPages. Pregnancy Workflow MPage View Builder Please ensure that the following components are added to your View Builder configura on and turned “on” or “off” per the Model Experience Content Guide:
Prenatal Visits (if using PowerChart Maternity Ambulatory)
Our next Women’s Health Special
Secondary Assessment
Interest Group (SIG) call is scheduled
Ter ary Assessment
Delivery Summary
Results Timeline
Add Pregnancy
Workflow MPage Level Se ngs**
for Wednesday, December 2nd at 11:00 CST. Agenda topics include:
Postpartum RhIG build
(**Please note that star ng with 5.0 there was a Pregnancy MPage Flag filter that needed to be turned on for Pregnancy MPages. Beginning with 5.5 the Pregnancy MPage Flag was obsolesced and there is a new filter called View Type that needs to be set to Pregnancy for all Pregnancy MPages.)
Charging in the OB Space.
Contact our SIG co-chairs, Christy
Pregnancy MPage Filters Please ensure that the following filters are configured:
Willis or Kim Gracey if there is a topic you would like to discuss.
ROM Date, Time
ROM Dura on, abnormal result
Maximum gesta onal age at delivery when mul ple gesta on indicator should decrement
Father of Baby
November 2015
FAQ continued
Save The Date
Neonate Summary MPage
Illuminations
Please ensure that the following components are added to your View Builder configura on and turned “on” or “off” per the Model Experience Content Guide:
MPage Level Se ngs
Neonate Overview
Task Timeline
Neonate Summary MPage Filters
Newborn Birth Date, Time – This filter is located in the Neonate Overview, Task Timeline, and Hyperbilirubinemia components.
Join Women's Health strategists Emily Vano and Jessica Alford on Tuesday, November 10th at 12:00
Community Involvement
CST as they review the enhance-
ments included in MPages 5.6, Pre-
Living in Vitality
natal Labs and Tests and Prenatal
The Women’s Health team at Cerner was invited by Shawnee Mission Health and community partners to be a part of the LIV: Living in Vitality, an annual conference that focuses on the health and empowerment of women through educa on, wellness events, ac vi es and more. During the conference, we had the pleasure of a ending one of the keynote sessions: Stop Global Whining by Chris ne Cashen. Chris ne delivered a hilarious but realis c approach to ge ng what we want with what we have. Our team had such a great experience during her one hour presenta on that we wanted to share her informa on. Please visit h p://chris necashen.com/ for further informa on on who she is and what types of programs she hosts. We hope you enjoy her as much as we did!
Visits workflow components. They will also review the enhancements included in MPages 5.7 with the addition of the Results Timeline workflow component and enhancement to the Neonate Summary Overview.
Women’s Health Newsletter Post Purple for Babies March of Dimes When it comes to babies, our love knows no bounds. As moms, dads, aunts, uncles, grandparents and friends, we are a community of people forever changed by a little life. This month we celebrate babies
Reporting
Package Release
The following packages were made available on October 21, 2015:
85984 – PowerChart Maternity Inpa ent Reports (October2015)
85986 – PowerChart Maternity Ambulatory Reports (October 2015)
They include both correc ons and enhancements to the Labor and Delivery Summary, Prenatal Summary and Pregnancy Summary generic views. CR 1-9894260280 is a correc on to the Labor and Delivery Summary that allows the Problem sec on to display in the report when it is launched from the PowerChart Table of Contents.
by inviting you to Post Purple. Share a memory, offer a wish or celebrate an unforgettable moment.
CR 1-9787236165 is a correc on for the Pregnancy Summary report to remove an error message when viewing the report from Clinical Notes or launched from the Pregnancy History
Together we will show the power of
our community and the strength of
our commitment to solve the mystery of premature birth.
CR 1-9511602338 is an enhancement to the Prenatal Summary report that allows the fetal heart rate to display in the Prenatal Exams & Notes sec on from documen ng either FHR: or FHR Baseline: in IView.
You can submit your post here.
CR 1-8235828435 is a correc on to the Prenatal Summary to allow results to qualify for the report from the Laboratory or LABORATORY event set.
November 2015
Reporting Package Release continued CR 1-10159443491 is an enhancement to the Prenatal Summary to support XR prin ng To get the script “xr_prenatal_summary_r ” visible to the XR report genera on service perform the following:
Content Suggestions The Women’s Health team under-
1. From interac ve CCL type the name of the script and "add" it.
stands your time is valuable and we
Example: Execute xr_prenatal_summary_r go
want to ensure you are receiving
(type add)
2. Now the script is compiled and available in the Clinical View Manager.
benefit from this newsletter.
3. Open Clinical View Manager.exe and select new sec on, custom content. a. Create a new sec on by clicking on Edit Sec ons. b. Click on New.
We would love to hear about topics
c. Choose custom content. d. Click OK. e. Provide the name and label of the sec on. f.
you would like to see covered in future issues.
Select the script name as prenatal summary.
g. Click on OK and apply. 4. The following are the steps to create template: a. Click on Edit templates.
Please send your topic suggestions
b. Click on New. c. Provide the name of the template.
to WomensHealth@Cerner.com
d. Set the page layout and symbols if any. e. Add the page master. f.
Add the sec on which is created in the previous step.
g. Click on OK, apply and publish. Now the template should be ready to use. 5. Open reportrequest.exe. a. Search for the pa ent. b. Select the required purpose. c. Select the previously created template. d. Click on the preview report. Now the XR print report should be available to view for the Prenatal Summary report.
We look forward to hearing from you!
Women’s Health Newsletter Maternity Stats
Pregnancy MPages 5.6 Release
49: The number of countries that
have lower maternal mortality ratios than the US. Women in the US are more likely to die of pregnancy relat-
This release includes an enhancement to the Prenatal Labs & Tests component that allows the end user to add an order to the scratchpad directly from the component. Any configured lab/test that hasn’t be resulted or ordered to date can be added to orders for signature from within the workflow component allowing providers to quickly act on missing informa on without switching to another view.
ed complications than in 49 other countries, including nearly all European countries, Canada and several countries in Asia and the Middle East. 4 million: The number of women who give birth each year in the US. Childbirth related care is the most common reason for hospitalization
Also included in this component is an enhancement that allows the provider to make a clinical decision to accept a lab value that was completed outside of the recommended gesta onal age, but is valid for the range and no repeat is necessary. Example: Hgb/Hct is recommended between 24 – 28 weeks gesta on, but the pa ent had labs collected at 29 weeks. In this instance the component will display not display the result/status column because it occurred outside the gesta onal age defined. With the enhancement the provider can highlight the lab row and mark the specific value that it “Fulfills Range” which will then refresh the component and display the lab result in the component.
in the US. 3 to 4x: African-American women are 3 to 4 times as likely to die from pregnancy-related causes as white women.
November 2015
Pregnancy MPages 5.6 Release continued
Maternity Stats
The Prenatal Visits component has been updated to allow the card or column (depending on your view preference) to be manually created by the nurse or provider instead of being linked to an outpa ent encounter type. Selec ng the + will add a card/column in documenta on mode.
$98 billion: The total amount spent in the US each year on hospital bills related to childbirth. The average
health care provider fees for mater-
nal care are twice as high as any
other country.
60: The number of years that the
disparity between African-American
women and white women has not
Informa on documented by the nurse will display in black font, and the provider can chart and sign.
improved.
Only one card/column can be added per calendar day, and a message will appear to the end user if this is a empted.
4x: The maternal mortality ratio for
American Indian/Alaska Native
women was 4 times higher than the
Healthy People 2010 goal (the national target set by the government).
Women’s Health Newsletter Most Popular Baby Names from 1901
Pregnancy MPages 5.6 Release continued
20. Rose
If a card/column is created in error, it can be removed by right clicking on the desired view and selec ng “Delete visit”, but note that this ac on only removes the container and NOT the charted data.
19. Bertha
18. Clara
17. Emma
16. Annie
15. Grace
14. Mildred
13. Edna 12. Alice
11. Gladys 10. Lillian
6. Elizabeth
If you are already live with PowerChart Maternity, the exis ng prenatal visit card/ columns will con nue to be available to view within the component, but there will be a filter in the component menu to 'display visits based on encounter' verses the newly manually created ones. This new filter is needed in order to allow the 'old and 'new' code to be visible in the same shared component. Any new pregnancies added a er upgrading to MPages 5.6 will not require the use of this filter to toggle between the visits.
5. Ruth
9. Ethel 8. Florence 7. Marie
4. Margaret 3. Anna 2. Helen 1. Mary
November 2015
In The News Children’s Mercy Hospital It’s a boy! Children’s Mercy recently announced the 500th birth at its Elizabeth J. Ferrell Fetal Health Center. The Center provides on-site delivery services for families of high-risk infants, giving them immediate access to the region’s only Level IV neonatal intensive care unit. Read more here. Memorial Hospital at Gulfport Memorial Hospital at Gulfport is home to south Mississippi's only Neonatal Intensive Care Unit. About a month ago, it opened a brand new NICU - a beau ful, tranquil space for babies and their families. Memorial Hospital's NICU cares for an average of 15 babies a day. That's largely due to the fact it serves all six southern coun es of Mississippi. According to Neonatologist, Dr. David Kuhlmann, 45% of pa ents are transferred from other hospitals. Read the en re story here. Imperial College Healthcare NHS Trust The first womb transplant in the UK will take place within months a er doctors were given the go-ahead for the procedure.
Most Popular Baby Names from 1901 20. Roy 19. Paul 18. Fred 17. Clarence 16. Willie 15. Albert 14. Arthur 13. Harry 12. Walter 11. Thomas 10. Henry 9. Edward 8. Frank 7. Robert
Ten Bri sh women without wombs will get the chance to carry their own babies a er approval was granted by a special research commi ee which covers Imperial College Healthcare NHS Trust.
6. Joseph
A clinical trial will launch in the spring and more than 100 women have been iden fied as poten al recipients of donor wombs. Read more here.
4. George
CoxHealth CoxHealth’s High Risk Breast Clinic is now open. The clinic, the first in the Springfield area, will exclusively treat women with an increased life me risk of developing breast cancer. It will also work with women who have a personal history of breast cancer and would benefit from specialty care. Read the en re story here.
5. Charles
3. James 2. William 1. John
Women’s Health Newsletter
November 2015
Tips & Tricks
Social Media
Multiple Fetal Heart Rate Waveforms in FetaLink
Become a member of our Women’s
FetaLink supports the ability to display mul ple fetal heart rates in one view when caring for pa ents with twins, triplets or quads. The fetal heart rates are represented in FetaLink in the order in which the leads are plugged and unplugged. It is important to understand this logic when working with mul ple fetal heart rates. For example, if you are only plugging one lead into a fetal monitor device, it will display in FetaLink as FHR1, (blue waveform). If monitoring twins, you will plug in the second lead into the second port on that same device to display FHR2 (pink waveform). When adding a second device to display triplets or quads, you will want to sequen ally plug in the third lead into the first port on the second fetal monitor device for FHR3 (orange waveform), and then plug in the fourth lead into the second port on the second fetal monitor device for FHR4 (purple waveform).
Health Collaboration Community on uCern. uCern is a great way to stay up to date on the latest developments around PowerChart Maternity and FetaLink, hear about upcoming events, network and share tips and tricks with your peers. If you are not already a member, we hope you’ll sign up soon!
When unplugging the leads, you should follow the same logic in reverse chronological order so that the waveform display colors remain consistent. More informa on can be found here.
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If you are interested in printing this newsletter, you can download a printable PDF on our Women’s Health Collaboration Community uCern page.