EHR_ScavengerLabLesson.REV.01.18.13
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EHR_ScavengerLabLesson.REV.01.18.13

Course: HINT 110, Winter 2013

School: Davenport

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EHR: Scavenger Hunt View Only Cases 1 Last Revised Date: January 2013 Metadata Author: Date Submitted: Editor: Competency Domain(s) Competency Subdomain(s) Competency Task/Skill(s) Kay Folk 03/21/07 Kathie Owens & Sandra Kersten Health record data collection tools IA. Health Data Structure, Content and Standards AS IA1. Collect and maintain health data (such as data elements, data sets and databases)....

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Scavenger EHR: Hunt View Only Cases 1 Last Revised Date: January 2013 Metadata Author: Date Submitted: Editor: Competency Domain(s) Competency Subdomain(s) Competency Task/Skill(s) Kay Folk 03/21/07 Kathie Owens & Sandra Kersten Health record data collection tools IA. Health Data Structure, Content and Standards AS IA1. Collect and maintain health data (such as data elements, data sets and databases). Knowledge Cluster Content(s) Competency Level Associate, Baccalaureate, or Both? Suggested Course Usage V-Lab Technology(ies) Used Estimated Completion Time (in 15-minute intervals) Necessary Prerequisite Knowledge Data Requirements IA2. Conduct analysis to ensure that documentation in the health record supports the diagnosis and reflects the patients progress, clinical findings and discharge status. N/A Both Fundamentals of HIM EHR Application 45 to 60 Minutes Basic Understanding of EHR Loading Citrix Records in EHR 2 Last Revised Date: January 2013 Objectives: After completing this activity, you will be able to... Conduct a patient lookup in the Cerner Powerchart EHR Navigate the various screens in Powerchart Change data views in Powerchart Find and review patient demographics Find and review a patients diagnosis 3 Last Revised Date: January 2013 Introduction As you embark on a career as an HIM professional, it is imperative that you understand how information is stored in EHR applications. This exercise will introduce you to basic navigation and features in the ATHENS/Cerner EHR. Warning: Before starting this activity you must download Citrix. Refer to the EHR Student Guide provided to you by your instructor for additional instructions. You must also have your Virtual Lab student registration confirmed in the Web Registration System. If you have not done that, please see your instructor for additional assistance. 4 Last Revised Date: January 2013 Lab Activity Task # 1 Task Logging into the EHR Detailed Steps If you have downloaded Citrix to your computer, log into the Cerner EHR to get started: 1. Go to your pc internet browser and type the URL: https://cernaes.cernerworks.com/ahima 2. Type the username: cernaes 3. Type the password: Cern@es123 At the next screen: 4. Click on the Power Chart icon: 5. Enter the school Account _______ 6. Type the current VLAB password _______ **The username and password are CASE SENSITIVE Please do not make a mistake in entering this information or all students could be locked out of the system. STOP and CONTACT Your INSTRUCTOR if you are unable to log-in after the second attempt. Let me know what screen you are at (a screen-shot is preferred) and the username and password you are attempting to enter. 2 Getting Started in the EHR In this exercise you will identify patients in the EHR by using the Patient Search. Note: all patients with last names beginning with Vlabxx (e.g., Vlabfemale, Ortho; Vlabmale,Vasc) are shared patients. These records are based on actual hospital cases, and intended for use by all schools. Never enter any data on these patients, or the program will risk losing Vlab privileges. To conduct a Patient Search: Click the Patient at the top of the toolbar. Then select Search, OR Enter the information in to the white box next to the search icon. . 5 Last Revised Date: January 2013 Patient Search Exercises and Questions: 1. 2. 3. 4. 5. Type or Enter br in the last name search box Click the search button at the bottom of the screen. What is the first name on the list? What is the last name on the list? Do they all begin with br? (Record your answer on the worksheet). 6. Refine your search further by adding gender to the search. Choose female in the gender box, then click the Search button again. 7. What happens to the list? Does the number of found entries increase or decrease? 8. Now, SEARCH Jayna Broadston then click OK at the bottom right corner of the Patient Search screen. Select Relationship 9. When you open a record for the first time, you may be prompted to select your relationship with this patient/record. Highlight any relationship to select. Click OK. 10. Next click on the Patient Information, located under MENU on the left side of the screen. 6 Last Revised Date: January 2013 9. What is Jaynas religion? 10. Close Jayna Broadstons record by clicking the X next to the patient name on the tool bar. Next Search: Search for patient Vlabfemale,ORTHO2 (or search using MRN 70025291). 11. Enter vlabf, ortho2. Note: When searching by patient name in most databases, entering a partial name is recommended. If the user misspells the name, or mistypes a letter, the search may not produce any matches. Enter the first three or four letters of each name, using the comma to separate the first and last names. 12. Highlight the record for Vlabfemale, Ortho2 and click ok 13. Which chart tab does the record open to? (This would be called the default view). 14. The first section at the top shows lists allergies. Which indicates the patient is allergic to something. Looking at the screen to the left of the page, name four things the patient is allergic to. a. b. c. d. 15. From the information on this screen, does it appear that the patient has an Advance Directive? Yes or No Now that youve demonstrated how to search for patients in the EHR, lets start reviewing the patients record in the next step. 3 Reviewing Patient Diagnosis Part I While at the current page of the application, look at the table in the middle of the screen; it gives a snapshot of data and documentation on the patient. Switch views by selecting one of the radio buttons in the middle of the page. Describe how the data is organized in each view: 1. Table: 2. Group: 3. List: 7 Last Revised Date: January 2013 4 Reviewing Patient Diagnosis Part II Now, go to the Results Review tab. The Key Results tab should be open. Look familiar? This is the same data that appeared in the table at the bottom of the Chart Summary screen you were just on. Flowsheets are powerful tools but can be overwhelming in the amount of data they present. So EHRs provide the user tools with to sort and filter the data based on the needs of the user. Lets try a couple things: 1. Under the Key Results tab go to the Flowsheet drop-down menu 2. Select Physician Office/Clinic View. 3. What happens to the Navigator panel on the left? 4. Go back to the ALLRESLTSECT view in the Flowsheet dropdown menu (last item in list). Do you see a tab labeled Respiratory Assessment in the Navigator panel on the left? 5. To help answer this question, return to the Physician Office/Clinic View in the Flowsheet drop down menu. Are you able to view the Respiratory Assessment button? 6. Why do you think respiratory documentation is not included in the physician clinician view? 7. Do you remember what happened when you clicked on the Navigator button labeled Respiratory Assessment? So what would be a quick way to get to the Diagnostic Radiology results? 8 Last Revised Date: January 2013 8. Once you do this, then double click on the folder titled Radiology and open the General Radiology Diagnostic Report dated 4/19/2009 @ 9:46 PM (to the right of the page). a. What type of x-ray is displayed? b. Was this x-ray completed pre or postop? 5 Reviewing Vitals, Part I Vitals View is the next chart tab in Results Review. Select Vitals Signs from the Navigator menu. Briefly explain what this option shows: 1. Just as there are ways to sort and filter large amounts of varied data, there are also ways to sort and view specific sets of data such as vitals. 2. Right mouse click on the date bar above the Navigator and Vitals View and you will see an option to Change Search Criteria. 3. Highlight and left mouse click. 4. Which result option is the default (selected radio button)? 5. If a doctor was looking for the patients blood pressure values for the past 10 days, what option would she select? Do this. 6. What results do you find? 7. Now suppose a nurse doesnt care about a specific encounter but wants to trend all the BP values recorded over the length of the stay. 8. What option would he/she choose? (HINT: Change the search criteria date range to the admission and discharge dates of this case). 9. Do this and click ok. Now, to trend the results you need to run a graph. To do this: 10. Click the little gray box preceding the systolic blood pressure and the diastolic blood pressure the box will now appear checked. 9 Last Revised Date: January 2013 11. Select the graph icon at the top of the screen in the Results Review -> First icon from the end. 12. What happens? 13. How many systolic values are there? 14. What happens when the two graphs are combined? 15. Can you think of a time when it would be helpful to be able to compare two values together? 16. Click close to close graph and return to the chart. 6 Reviewing Reports To review reports on a patient in the EHR, click on the Reports button under Menu. Select the radio button for sorting By Type: 1. What do you see? 2. Look at the date bar just above the blank view panel, what date range appears here? 10 Last Revised Date: January 2013 Note: This is the default date range set for retrieving reports stored on this patient. 3. How do these dates compare with the dates of the data youve been working on in the previous flowsheets? 4. What would you do here to get to the reports in the database on this patient? 5. Now, do it. What happens in the panel list on the left? Before proceeding, note the five (5) radio buttons at the bottom on the navigator panel. Select each one and note what you see: Note: By type is selected. a. By type b. By status c. By date d. Performed by 7 Reviewing Report Type e. By encounter Now, reset the report navigation to by type. What six (6) document type folders appear a. b. c. d. e. 8 Reviewing Report Info Now open the Surgical Documentation sub-folder (under Clinical Documents). 1. What three types of surgical documentation do you see? a. b. c. 2. Open the 4/18/09 operative report and note the type of surgical wound drain placed in the patient 3. Using the teal/green arrow at the bottom of the Navigator bar, click the down arrow to the Anesthesia Record (this is the second document in the Operative Report folder). 4. What kind of document is this and how can you tell? 11 Last Revised Date: January 2013 5. Locate and record the post-op blood pressure 6. What does the yellow dot in the middle of the pink box beside the report name in the Navigator panel indicate? 9 Reviewing Report Info (cont) Lets continue reviewing patient vitals in the EHR application. To do this... 1. Right click within the white report index area in the Navigator panel and determine whether documents are displayed in chronological or reverse chronological order. 2. Finally, why are the boxes preceding each report colored and what do the colors mean? (read below) To find out... 3. Right click in the Navigator panel again and select color legend. Authenticated/verified means the report has been reviewed and electronically signed by the author and stored in the database as final. 4. Now, what color box would a document have that still requires author esignature? 5. What is the clinical significance/importance of flagging the status of reports? 10 Exiting Cerner EHR Great job! Now its time to close the chart and do a clean exit of the system. 1. Close the chart by clicking on the X next to the patients name. 12 Last Revised Date: January 2013 Note: this closes the chart youve been working on but not the EHR application. 2. Close EHR Click on the icon that looks like a door with the arrow pointing at it says exit. 3. Select Exit and shut down application and then click on YES 4. At this point it is safe to X-out of (close) the screen Thank You! Assessment <<The answers are short enough for a student to complete in the lesson in the blanks provided. The blanks may be locked so that the student can enter only into these spaces. This can be done by protecting the document.. It is recommended though, that an answer sheet be provided for instructors. .>> 13 Last Revised Date: January 2013

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University of Toronto - ECON - 202
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University of Toronto - ECON - 202
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University of Toronto - ECON - 202
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University of Toronto - ECON - 202
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University of Toronto - ECON - 202
ECO202: Solutions to Worksheet 31. Money Demanda. i=0.05: Money demand = $18,000; Bond demand = $32,000i=0.10: Money demand = $15,000; Bond demand = $35,000b. Money demand decreases when the interest rate increases because bonds, whichpay interest, b
University of Toronto - ECON - 202
ECO202: Tutorial Worksheet 41. A bond promises to pay $100 in one year.a. What is the interest rate on the bond if its price today is $75? $85? $95?b. What is the relation between the price of the bond and the interest rate?c. If the interest rate is
University of Toronto - ECON - 202
ECO202: Solutions to Worksheet 41. Bonds and the Interest Ratea. i=(100/$PB) - 1; i (rounded) = 33% ; 18% ; 5% when $PB =$75; $85; $95.b. Negative.c. $PB =100/(1.08) $932. The Multiplier Revisiteda. Y=[1/(1-c1)]*[c0-c1T+I+G]The multiplier is 1/(1-c
University of Toronto - ECON - 202
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University of Toronto - ECON - 202
ECO202: Solutions to Worksheet 51. Policy Recommendationsa. Fall in T shifts IS right. Increase in M shifts LM right. Output could increasewithout an increase in the interest rateb. A contractionary fiscal policy (IS left) would decrease the deficit e
University of Toronto - ECON - 202
ECO202: Tutorial Worksheet 61. Consider the following open economy. Suppose is fixed and equal to one.Consumption, investment, government spending, and taxes are given by:C = 10 + 0.8(Y T)I = 10G = 10T = 10Imports and exports are given by:M = 0.3Y
University of Toronto - ECON - 202
ECO202: Tutorial Worksheet 61. Coordination and Fiscal Policya. Y = C + I + G + X Q = 20 + 0.8*(Y - 10) + G + 0.3Y*- 0.3YY = [1/(1 - .8 + .3)](12 + G + 0.3Y*) = 2*(12 + G + 0.3Y*) = 44 + 0.6Y*The multiplier is 2 (=1/(1-.8+.3) when foreign output is fi
University of Toronto - ECON - 202
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University of Toronto - ECON - 202
ECO202: Solutions to Homework Assignment 21. True, False or Uncertaina. Uncertain, as this statement may be True or False depending on the assumptions made.If we assume that individuals did not transfer from the employed pool to theunemployed pool (me
University of Toronto - ECON - 202
ECO202: Solutions to Test 21. Phillips Curve:t - t-1 = -(1/5)(ut 3)6 9 = (-1/5)(ut 3)-3(-5) = ut 315 + 3 = ut18% = utOkuns Law:ut ut-1 = (-2/3)(gyt -10)18 8 = (-2/3)(gyt 10)(10)(-3/2) = gyt 10-15 = gyt 10-5% = g ytAD Relation:gmt = gyt + tg
University of Toronto - ECON - 202
ECO202: Tutorial Worksheet 71. Consider the following prices for government bonds and foreign exchange in Canada andthe United States. Assume that both government securities are one-year bonds, paying theface value of the bond one year from now. The ex
University of Toronto - ECON - 202
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University of Toronto - ECON - 202
ECO202: Tutorial Worksheet 81. Consider the following IS and LM equations in the open economy:Ee IS : Y C (Y T ) I (Y , i ) G NX Y , Y *,1 i i *MLM : YL(i )Pa. Show the effect of a decrease in foreign output Y* on domestic output Y. Explainin wo
University of Toronto - ECON - 202
ECO202: Solutions to Worksheet 81. The Effects of Changes in Foreign Variablesa. IS shifts left, because domestic exports fall given any exchange rate (and henceany value of the interest rate). Output falls.b. E increases, given any value of the home
University of Toronto - ECON - 202
ECO202: Tutorial Worksheet 91. Consider two fictional economies, one the domestic country and the other the foreigncountry. Construct a balance of payments for each country given the following list oftransactions:a. The domestic country purchased $100