Women’s Health Newsletter
September 2015
In This Edition FetaLink 2014.01 Service and Exception packages Fall Daylight Savings Time
Best Practice Managing fetal monitor alarms
Cerner Health Conference Tips & Tricks EDD Maintenance
Client Spotlight Memorial Hospital at Gulfport
In The News What We’re Doing Living in Vitality
Did You Know Logging Service Requests
Community Involvement
Women’s Health Newsletter On the Cover
FetaLink
Lincoln Otto Sheely
This month’s cover baby is Lincoln Otto Sheely.
FetaLink 2014.01 Service and Exception packages FetaLink 2014.01 is the latest version of FetaLink currently available on Package #71874. This runs on the CareAware iBus 5.2. Recently, we have provided some addi onal packages that can be taken along with FetaLink 2014.01 to offer updates and correc ons. FetaLink 2014.01 Service Package #80085 (OpƟonal)
His dad is Associate Stevan Sheely, senior systems engineer for the North Atlantic region.
Persistent maternal heart rate (MHR) displayed if configured to do so
Supports the correct display of pa ents in the Census when those pa ents are associated to a monitor that is configured at the nurse unit level
Supports the correct display of pa ents in the Census when a retroac ve associaon occurs over a pa ent in a HOLD bed loca on
FetaLink 2014.01 ExcepƟon Package #83670 (Dependent on #71874)
Enhanced Pa ent Device Associa on Service Call Updates for FetaLink to enhance performance
DeviceWorks Excep on Package #83146
Updates to the Pa ent Device Associa on func onality to enhance FetaLink performance
Fall Daylight Savings Time and FetaLink It’s me to start planning for the switch from Daylight Savings Time to Standard Time! Sunday, November 1, 2015, marks the day that we set our clocks back 1 hour, from 2:00 AM to 1:00 AM. This repea ng hour creates some challenges with electronic documenta on. FetaLink is designed to stay up and running during this repea ng hour. The date/ me stamp will automa cally adjust on the fetal strip, allowing you to con nue monitoring your labor pa ents during this me.
Lisa Gerken Photography
However, because Millennium services, including PowerChart Maternity, will go into down me during the ambiguous me frame, it is important to understand how this might impact some FetaLink workflows. Of par cular note is the retroac ve device associa ons and disassocia ons which could occur in areas of quick pa ent turnaround, such as Triage. We have updated our recommenda ons for you with a flow chart in the Maintain Daylight Savings Time in FetaLink reference page. Please refer to this for further informa on.
September 2015
Best Practice
FetaLink+
Managing fetal monitor alarms
FetaLink+ is now CE Marked!
Some fetal monitor devices provide the ability for the bedside clinician to set audible alarms for out-of-range results. The types of alarms vary depending upon the fetal monitor device manufacturer. It can be confusing to know how to best use those device alarms in tandem with FetaLink.
As you know, FetaLink has its own aler ng func onality that supports visual and audible alarms for results that are out of range. These results include: fetal heart rate high and low, maternal heart rate high and low, maternal SPO2 low, maternal systolic blood pressure high or low, and maternal diastolic blood pressure high or low. In addi on, FetaLink provides a visual indicator for low signal quality. One of the benefits of FetaLink is that is allows the clinician the ability to be alerted to changes in the results when outside the pa ent’s room. However, there may be mes when it is helpful to use the addi onal alarms that can be set on the individual bedside fetal monitor machine. For example, when procedures are occurring that require clinicians to be in the room, such as during the placement of a labor epidural, it may beneficial to have the alert for maternal SPO2 ac vated, which would help to call a en on to any changes in the pa ent’s SPO2 levels that would require immediate interven on. Clinical judgment is needed to determine when or when not to use the aler ng capabili es that are part of the bedside medical devices. Our published descrip on of FetaLink contains the following statements: “FetaLink is a diagnosƟc aid that does not replace the clinician’s judgment concerning interpretaƟon of data or appropriate treatment. …The configurable supplemental visual and audible alerts that are available within FetaLink are not intended to replace alerts and alarms provided by the actual monitoring devices that are connected to the paƟent.” This informa on can be found in our FetaLink Reference Pages in the Overview sec on under Contraindica ons for Use.
We are happy to announce that FetaLink+, our mobile fetal monitoring solution for OB Providers, has received its CE Mark. This means that it has been cleared for market and sale in the European Union. This opens up opportunities for FetaLink+ to be available globally. There may be additional regulatory and technical requirements needed to allow FetaLink+ to be used in various countries. Please reach out to your Cerner contact for more information.
Women’s Health Newsletter ICD-10 The Lighter Side For your enjoyment, we present the 16 most absurd ICD-10 codes: 16. V97.33XD: Sucked into jet engine, subsequent encounter. 15. W51.XXXA: Accidental striking against or bumped into by another person, sequela. 14. V00.01XD: Pedestrian on foot injured in collision with roller-skater, subsequent encounter. 13. Y93.D: Activities involved arts and handcrafts. 12. Z99.89: Dependence on enabling machines and devices, not elsewhere classified. 11. Y92.146: Swimming-pool of prison as the place of occurrence of the external cause. 10. S10.87XA: Other superficial bite of other specified part of neck, initial encounter.
Cerner Health Conference
September 2015
CHC sessions
ICD-10 continued
Advocate Healthcare's Corporate and Site Implementation of FetaLink+ This presenta on will cover the corporate meline, as well as the specific implementaon details for one Advocate site. The presenta on will include the collabora on between Advocate Healthcare and Cerner to map data fields for applica on build. Addi onally, Advocate Illinois Masonic Medical Center will cover the two phased implementa on approach. Discussed will be the process for accessing the applica on, educa on and u liza on graphs. Post implementa on physician feedback including benefits and lessons learned will be outlined.
9. W55.41XA: Bitten by pig, initial
FetaLink Ask the Experts A panel of Cerner FetaLink experts will offer insight into frequently asked ques ons and topics gathered from different client projects across the world, as well as provide answers to clients' main technical ques ons surrounding the FetaLink solu on. This unique panel session is your opportunity to interact with peers and experts focused on the technical support and maintenance of FetaLink.
with in-laws.
From Here to Maternity – Releasing Time to Care The Royal United Hospitals Bath NHS Founda on Trust implemented PowerChart Maternity in 12 short weeks. This presenta on will explain how this was achieved through the use of a small in-house team and the lessons learned. Inception to Implementation of Bridge Breast (Human) Milk Management Join Advocate Health Care as they present the documenta on of their successful journey toward the implementa on of the Bridge Breast (Human) Milk Management system into eight Advocate hospitals. The Birth of PowerChart Maternity in a Large, Multi-Center Health System Banner Health System will provide insight on building, designing and implemen ng the PowerChart Maternity and FetaLink solu ons across a mul -hospital system. They will discuss strategy, major successes and lessons learned from rollouts at 22 facili es having more than 30,000 deliveries each year. Women's Health: The Integrated Journey of an Ambulatory to Acute Care Delivery Carolinas Healthcare and Southwest General Hospital present their integrated Women's Health journey from the ambulatory office to the acute care se ng using many Cerner's applica ons including PowerChart Maternity and FetaLink. This session includes a review of Southwest General Hospital's mul -system previous state, integrated current state and the next steps towards reaching an ideal state, along with the benefits and lessons learned. Carolinas Healthcare will also report on a healthy go-live, and like any new parent, share their birth experience by detailing their design process, implementa on strategy and metrics by which they evaluated success.
encounter. 8. W61.62XD: Struck by duck, subsequent encounter. 7. Z63.1: Problems in relationship
6. W220.2XD: Walked into lamppost, subsequent encounter. 5. Y93.D: V91.07XD: Burn due to water-skis on fire, subsequent encounter. 4. W55.29XA: Other contact with cow, subsequent encounter. 3. W22.02XD: V95.43XS: Spacecraft collision injuring occupant, sequela. 2. W61.12XA: Struck by macaw, initial encounter. 1. R46.1: Bizarre personal appearance.
Women’s Health Newsletter Maintaining Industry Awareness September is both Gynecologic Cancer Awareness Month (GCAM) and Ovarian Cancer Awareness Month. In women age 35-74, ovarian cancer is the fifth leading cause of cancerrelated deaths. An estimated one woman in 75 will develop ovarian cancer during her lifetime. The
Tips & Tricks EDD Maintenance Workflow and Purpose When the pregnancy is added you are able to enter a EDD. This EDD is marked as authorita ve and it is the one that drives the pregnancy. If during the pregnancy the pa ent requires addi onal ultrasounds and the EDD has to reflect a change in dates, this can be completed by adding a new EDD in the EDD Maintenance window. Within the Pregnancy Workflow/Summary the EDD Maintenance component allows the user is to:
Add, Modify, View, or Delete the EDD/EGA.
All EDD/EGAs are displayed from the start date of the ac ve pregnancy unless deleted.
To add a new EDD using the EDD Maintenance window, the user will navigate to the Pregnancy Summary and choose the (+) to add the new value. 1. Click Add to open the Add EDD Maintenance dialog box.
American Cancer Society estimates that there will be over 22,000 new
2. Select the method of EDD to be recorded. Based on the method selected, certain fields are required as indicated by a yellow background. 3. Complete all required fields as well as any addi onal informa on.
cases of ovarian cancer diagnosed
4. Click OK in the lower right hand por on of the dialog box.
this year and that more than 15,000
women will die from ovarian cancer this year.
September 2015
Tips & Tricks continued When mul ple values exist, the system calculates off of the “Authorita ve” EDD. The first EDD is always considered the Authorita ve value as that is the only EDD added. For an EDD added a er the first, the end user will need to choose “Use this es mate for EDD calcula ons” (see above) for the new value to become the Authorita ve EDD.
Maintaining Industry Awareness continued Women who have symptoms almost daily for more than a few weeks should see their gynecologist.
Prompt medical evaluation may
Once the user has chosen the value that is to be authorita ve, it will then be reflected within the component designated by a checkmark and the new EDD and EGA will display on the Pregnancy Overview component.
lead to detection at the earliest possible stage of the disease. Early
stage diagnosis is associated with an improved prognosis.
Modifying an EDD/EGA
These symptoms include:
Bloating
Pelvic or abdominal pain
Difficulty eating or feeling full
1. Click the EDD date that is in the EDD Maintenance component. 2. Modify value in the displayed window. 3. Click OK.
quickly
Urinary symptoms (urgency or frequency)
Women’s Health Newsletter In Case You Missed It Workflow MPages and Direct Entry of Prenatal Visits The Workflow MPages View supports direct entry of clinical results within the Prenatal Visits component. The
Tips & Tricks continued
design of the component includes both a table and card layout to supDeleƟng an EDD/EGA port provider preference when viewing previous prenatal documenta-
If an EDD/EGA has been entered and needs to be removed it is possible to delete within the component. Complete the following steps to remove a value: 1. Select the EDD/EGA value from the tool.
tion. Direct entry enhances the experience of the provider by eliminating the need to navigate away from the workflow into IView to complete this
2. Click Modify. 3. Verify the correct line is selected; once certain, click Delete in the lower right hand por on of the EDD Maintenance window. 4. Confirm the removal of the item by clicking OK on the Delete EDD Warning message. 5. Once confirmed the line no longer appears in the viewable component.
documentation making it faster and
easier.
Read the entire uCern post here.
September 2015
Tips & Tricks continued
Got News?
Do you have good news to share about your facility? We’d love to share it with our community members.
The University of Missouri Women's and Children’s Hospital shared their
story! You can too.
For addi onal informa on please visit our All About EDD Maintenance reference page.
Send your information to WomensHealth@Cerner.com and we will include it in our monthly newsletter.
Women’s Health Newsletter End of Support
Client Spotlight
End of Support for FetaLink 1.9.4
Memorial Hospital at Gulfport
Cerner has set October 15, 2015, as the end-of-support date for FetaLink 1.9.4, which corresponds to the announced end-of-support date for CareAware iBus 2.1. Only critical defects will be corrected after October 15, 2015, for FetaLink 1.9.4. Please refer to the following flashes on the Flashes page of Cerner.com for more details: PR15-0034-0 End of support for FetaLink 1.9.4 PR14-0264-0 End of support for CareAware iBus 2.1
Women’s and Children’s Services here at Memorial Hospital at Gulfport is THE place to go on the Mississippi Gulf Coast with a higher risk pregnancy or the need for NICU care. We are a level 3b NICU and as such, about 60% of the pa ent popula on is transported in from other facili es. Our Labor & Delivery unit delivers approximately 1,400 babies per year and sees about 4,000 observa on pa ents in that same me frame. We also run an in-house Breas eeding Center, where our IBCLCs see inpa ents and provide outpa ent appointments for breas eeding support a er discharge. Addi onally, for those infants who are discharged from our NICU, there is a Neonatology follow-up clinic available, as well. On August 25th, we moved our li lest pa ents from a 2,300 sq. . and “ward” style NICU to a brand new, state-of-the-art, 26-bed (13,000 sq. .) space. This new space boasts semi-private rooms with enough space for family to room in. It will also have a dedicated milk prepara on room and brand new monitoring and aler ng capabili es, through the use of AlertLink and CareAware Connect. Because the NICU is being moved to the 7th floor of our hospital, our visitors will be able to enjoy beau ful views of the Gulf, in the event their spirits need a li . OB made the move from paper to an EHR over 15 years ago when we implemented OB TraceVue and since that me, the Women’s Health EHR has been customized to support workflows in caring for higher acuity pa ents. In March 2013, the memo went out that we’d chosen Cerner as our “vendor and product of choice.”
September 2015
Client Spotlight continued From the beginning of our “Cerner project,” one of the main tenets was that we are a team working to build a be er Memorial and as such wanted clinicians included in the decision-making process. In that spirit, throughout the design, build and tes ng process, many of our Subject Ma er Experts (SMEs) traveled to KC with the IS team in order to make sure the documenta on that they needed was available to them. Our Women’s Health team specifically, got very close and worked very well together in making design decisions and comple ng DCWs. Then during tes ng events, a handful of our Women’s Health SMEs were totally immersed in the system, all with the goal of confirming that PowerChart Maternity contained the documenta on and func onality the bedside nurses needed, specific to their Women’s Health world, in order to ease the transi on to a new EHR. Now that we are Cerner toddlers, being about 1 year out from our implementa on, we are star ng to see the benefits of having this integrated system. We’ve had our first return mom with a second pregnancy and the clinicians were really excited to see that her historical informa on was “s ll there.“ Even with all the hard work, there were most certainly some growing pains at implementa on. FetaLink was not well received early on. Problems from both network and aler ng standpoints, threatened the adop on of the system we’d worked so hard to create. We decided to upgrade FetaLink to 2013.01 SP2 at about 6 months in, so that we could take advantage of Signal Strength indicator func onality. This was the best decision we could’ve made, as the availability of the visual signal strength indicator has made a huge difference for adop on. While Labor and Delivery is the only unit that uses the Tracking Shell to provide pa ent care, we do currently track our Mother-Baby unit, Transi on/IM Nursery and NICU. This has not been without its difficul es. But we have a fantas c Women’s Health team here and for anyone asking advice, I’d say, “Please make sure to create and foster a rela onship among your IS and clinical folks.” The analysts need to see who they are working to support and the clinicians need to be able to trust that their analyst is working to help them by making the system efficient and effec ve.
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!
Women’s Health Newsletter New Cerner Faces
In the News University of Missouri Women’s and Children’s Hospital University of Missouri Women’s and Children’s Hospital has become the fourth hospital in Missouri to earn the Baby-Friendly designa on from the World Health Organizaon (WHO) and the United Na ons Interna onal Children’s Emergency Fund (UNICEF). MU Women’s and Children’s Hospital joins Fitzgibbons Hospital in Marshall, Hannibal Regional Hospital in Hannibal and Truman Medical Center in Kansas City.
Neeva Patel
Celebra ng the designa on this morning were MU Chancellor R. Bowen Lo in, Dean Patrick Delafontaine, MU Health Care CEO Mitch Wasden, Women’s and Children’s Hospital Execu ve Director Keri Simon, and Courtney Barnes, MD, physician champion of the project, along with many physicians, nurses and other health professionals, and several bow- e clad babies with their parents. MU Women’s and Children’s Hospital has been working toward this designa on for more than two years, reviewing and revitalizing the care given to new mothers and their babies, making changes to ensure both mothers and babies are off to the best start. “The Baby-Friendly designa on required our en re medical team to implement a comprehensive, detailed plan,” said Courtney Barnes, MD, assistant professor of obstetrics and gynecology at the MU School of Medicine. “The staff’s dedica on, willingness to listen to the pa ents’ wants and needs, and everyone’s efforts to make this happen mean our hospital now has been recognized for having the highest standards when caring for mother and baby, especially related to breas eeding.” In order to receive the Baby-Friendly designa on, the medical team at MU Women’s and Children’s Hospital completed and must con nue to follow 10 steps outlined by the World Health Organiza on. These steps include
Emma Alves
Lacey and Bexley Geis
Having a wri en breas eeding policy that is rou nely communicated to all health care staff
Training all health care staff in the skills necessary to implement this policy
Informing all pregnant women about the benefits and management of breas eeding
Helping mothers ini ate breas eeding within one hour of birth
Showing mothers how to breas eed and how to maintain lacta on, even if they are separated from their infants
September 2015
In the News continued
New Cerner Faces
Giving infants no food or drink other than breast milk, unless medically indicated
Prac cing “rooming in” — allowing mothers and infants to remain together 24 hours a day
Encouraging breas eeding on demand
Giving no pacifiers or ar ficial nipples to breas eeding infants
Fostering the establishment of breas eeding support groups and referring mothers to them on discharge from the hospital or birth center
“Being together gives parents more opportuni es to learn about normal baby behavior,” Barnes said. “And they get to do this knowing there is a knowledgeable staff that is readily available to answer their ques ons, no ma er if it is about breas eeding, baby movements or uneven breathing pa erns. Our staff is able to talk with families about what they should expect from their new babies, and this gives everyone more confidence and can be especially comfor ng for moms when they are trying to breas eed.” The babies born at MU Women’s and Children’s Hospital are never taken far from their mothers, unless health concerns warrant it. This gives moms and babies the best chance to get to know each other. The first few days of life are believed to offer an op mum opportunity for bonding to take place between mother and baby. Studies have also shown giving infants human milk gives them the most complete nutri on possible; breas ed children have far fewer and less serious illnesses than those who never receive breast milk, including a reduced risk of Sudden Infant Death Syndrome (SIDS), childhood cancer and diabetes. By keeping the mother and baby together, the baby is able to breas eed whenever the baby wants. If a mother decides not to breas eed, the staff supports her decision and provides the best feeding op ons for the infant’s needs.
Oscar Even
Addison Smith
Billings Clinic As a nurse in Billings Clinic’s Neonatal Intensive Care Unit, Chelsea Heine knew breast milk’s health benefits for infants and was keenly aware of the need for it in NICUs. So when her son, Kane, now 2, was born late preterm and had trouble gaining weight from feeding, she quickly began to pump and save milk for her son and soon a er realized she could help others along the way. Con nued…...
Claire Fritzal
Women’s Health Newsletter KLAS Survey
In the News continued
As you know, satisfaction for PowerChart Maternity/FetaLink users is very important to us. Of the many mechanisms we utilize to measure and monitor client satisfaction, we wanted to provide additional details around KLAS‐‐an organization that publishes user satisfaction data by reporting accurate, honest and impartial vendor performance so that members in healthcare, your peers, can make informed decisions. We at Cerner hold KLAS in a very high regard and look at their published reports, study the feedback and use that to enhance Cerner solutions and improve satisfaction. Your feedback directly helps pave the way to improving healthcare.
Billings Clinic “I was fortunate enough to have the supply to help,” she said. A er about four months of pumping and storing, Heine began to donate her extra breast milk to the Mother’s Milk Bank in Denver, which provides donated breast milk for premature and sick babies across the country, including those at the Billings Clinic NICU. About nine months later she’d donated 5,021 ounces, or a li le more than 39 gallons, to the bank. -Zach Benoit for the Missoulian
Vassar Brothers Medical Center Vassar Brothers Medical Center opened a $4.2 million expanded breast health center Monday, Aug. 3. The Dyson Breast Center will provide pa ents with one-stop access to experts and technology required for rou ne and comprehensive breast imaging. The new center has separate and discrete areas for pa ents who need addi onal diagnos c procedures. “We have built a calming, comprehensive, spa-like breast center to promote services for both benign breast disease and breast cancer,” said Dr. Angela Keleher, breast surgeon and director of the Dyson Breast Center. “We also provide the exper se of well-trained caregivers, the advanced technology and facili es needed for accurate screening and diagnosis of breast disease, and programs and support services that assist pa ents in naviga ng the challenge of breast cancer.” The Dyson Breast Center also features a dedicated imaging suite with new technology to bring it to the cu ng-edge of detec on of breast cancer. Two new, state-of-the-art mammography/tomosynthesis units are the first of their kind in the region. These produce high-quality 3-D images of the breast, using the equivocal safe dosage of radia on as standard digital mammography. “This highly sensi ve 3-D equipment decreases the need for calling pa ents back in for addi onal screenings and increases the cancer-detec on rate,” Keleher said. -Kathy Welsh for HVNN.com
September 2015
What We’re Doing LIV: Living in Vitality
KLAS Survey continued If you are interested in providing feedback to KLAS, please visit www.klasresearch.com and select the “Rate Your Vendor” button. The
Having a baby is one of the biggest decisions that a woman may ever make. This July, the Cerner Women’s Health team and Shawnee Mission Medical Center teamed up to host Baby Blueprint – Your Guide to Pre-Pregnancy Planning, a Living in Vitality event. This free event was open to women in the Kansas City community, and was an evening hosted at Shawnee Mission’s Birth Center. It consisted of a panel of health experts including an OB/Gyn, Naturopathic Doctor and Maternity Navigator, as well as a J Lynn Nelson, a Cerner Breas eeding Consultant, for an open discussion on planning a pregnancy from beginning to end. A endees also got behind-the-scenes tour of the Shawnee Mission Birth Center. It was a fun and educa onal evening with both men and women from the Kansas City community. The mission of Living in Vitality is to empower Kansas City women live healthier lives physically, mentally and spiritually. Find out more on their website.
survey will take just 5‐10 minutes of your time. After you’ve submitted a survey, an analyst from KLAS will reach out to you to verify your credentials and collect verbatim comments from you. Cerner and KLAS sincerely appreci-
ate your time to provide this invaluable feedback.
Women’s Health Newsletter Did You Know
Social Media
Logging Service Requests Have you tried to log a Service Request and wondered what team it should be logged to? PowerChart Maternity func onality crosses many solu ons, and to assist with mely turn around please use the below informa on as a guide when logging a service request.
Issue
SoluƟon Family
SoluƟon
FetaLink
Pa ent Monitoring
FetaLink
Become a member of our Women’s Health Collaboration Community on uCern. uCern is a great way to stay up to
Tracking Shell
Emergency Medicine
FirstNet
Related Records
Access Management
Registra on Management
Add Newborn or PM Conversa on
Access Management
Registra on Management
around PowerChart Maternity and FetaLink, hear about upcoming
date on the latest developments
September 2015
events, network and share tips and tricks with your peers. If you are not already a member, we hope you’ll sign up soon!
Join us on Facebook
Community Involvement Members of the Women’s Health team recently enjoyed ladies night at the Thirsty Pale e, a local pain ng lounge for an evening of fun and pain ng.
Join us on uCern
If you are interested in printing this newsletter, you can download a printable PDF on our Women’s Health Collaboration Community uCern page.