Seton Health Information Exchange (HIE) Unifies Inpatient & Ambulatory .

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Seton Health Information Exchange (HIE) unifies inpatient & ambulatory patient data On July 16, clinicians working at Seton hospitals will be able to access the Seton Health Information Exchange (HIE) directly through COMPASS. Rationale: Provide access to ambulatory patient data from eClinicalWorks (Electronic Medical Record used in Seton‐based Clinics) through Seton HIE to inpatient clinicians using COMPASS Align with Meaningful Use Requirements Summary of the Change: New icon in COMPASS to launch Seton HIE Ability to access patient data from the ambulatory and inpatient setting to include: o Medications o Summary o Laboratory o Encounters o Imaging o Problems o Clinical Documents o Allergies Key Points: Contains information from both eClinicalWorks and COMPASS o If the patient’s provider does not use eClinicalWorks, then only information from COMPASS will display Seton HIE is view only – no actions can be taken in Seton HIE Position in COMPASS determines what information is viewable in Seton HIE Information available in Seton HIE is from July 2012 forward Information contained in Seton HIE should not be printed and given to patients; patient requests for medical records must be made through Health Information Management (HIM) Information sent from COMPASS will post to the Seton HIE within 5 minutes Problems/Allergies/Immunizations/Medications from eClinicalWorks is sent in a batch report daily at 2300 o Laboratory results and Imaging from eClinicalWorks will post to the Seton HIE 5 minutes after provider reviews

Participating Clinics/Offices (as of July 7, 2013) Austin Dermatologic Surgery Center Blackstock Community Health Centers Kyle Parkway OB GYN Associates Seton Cancer Institute at Hays Seton Heart Institute ‐ Far West Seton Heart Institute ‐ Hays/Lockhart/SSW Seton Heart Institute ‐ MPT Seton Heart Institute ‐ SNW Seton Heart Institute ‐ Williamson/Burnet Seton Mind Institute Seton Orthopedic and Sports Medicine Seton Surgical Group ‐ Williamson/CEC Seton Total Health Partners SFOD Bastrop and Elgin Clinics SFOD Forest Creek SFOD Georgetown SFOD Hays SFOD Lockhart Family Practice SFOD Lockhart Internal Medicine SFOD Luling SFOD Smithville Annex and 9th Street SFOD Stone Hill SFOD Surgery Associates Luling SFOD Williamson Texas Child Study Center (TCSC) Trinity Clinic Trinity Clinic – Hays Trinity Clinic – OB Logging In Seton HIE is accessed from the tool bar in COMPASS. NOTE: You must be in a patient chart to access the HIE. Logging Off Click on the “x” to exit Seton HIE 2

Navigation All sections of the Seton HIE contain the following: Navigation Bar Patient Details Main Menu Bar Navigation Bar Navigation Arrows: Click to navigate between clinical views that were opened in current session Print Preview: Click to display a report print preview. This is only available when a report is able to be generated. Refresh: Click to refresh patient data Help: Click to access online help Patient Search: Function not available Filter Options Filtering by column This icon indicates information in a column can be filtered Check mark appears when a filter is in use Filter by date There are 2 options to filter by date: Date range – select a From date and a To date Define time interval – select time interval, for example 2 years Date Range Time Interval Data Retrieval Status The top right corner of each clinical view contains a data retrieval indicator: Green. All available patient data has been received. Yellow. Data is still being retrieved. Click refresh to update. Red. System unable to retrieve all the data. Contact the ServiceDesk at x41675. White. System unable to retrieve any data. Contact the ServiceDesk at x41675. 3

Summary Page Seton HIE opens to the Summary Page which contains a sampling of data including allergies, home medications, laboratory results, and problems entered in the ambulatory setting. Please note this view should not be used as a single source for information. Chart tabs will be bolded if there is information to display Click on the chart tabs or the grid icon to display more information Summary The Summary view contains the following information: Summary Demographics Annual Review Clinical Summary Selected Items Diabetes View 4

Demographics: Source displays from where the information was obtained Annual Review: View is limited to Nurses and Providers Displays activity information for Encounters, Laboratory, and Imaging for the past 3 months. Note: The Annual Review indicates the date of occurrences for the past 3 months. For example, if the patient had 5 lab draws in the past three months, the information reflects the date of lab draws. Select the checkboxes of the items to include In this example, imaging was done on the 7th and labs on the 14th‐19th 5

Clinical Summary Selected Items Items selected throughout the chart can be checked Summary Selected Items. and will display in the Clinical Diabetes View A disease‐specific view that displays information related to diabetes including lab results, medications, and problems related to Diabetes Note: Displays problems entered through eClinicalWorks Graphs HgA1C results 6

Encounters The Encounters tab displays all the ambulatory and inpatient encounters in the HIE. Click on the blue hyperlink to see more specific encounter information Location displays the inpatient unit from where the patient was discharged Problems At this time, problems displayed come from the clinic only: 7

Allergies Displayed by therapeutic drug class: 1. Several documented allergies within the same therapeutic class will display with the number of entries next to the therapeutic class name. Click on to see more information. Therapeutic class based classification system used in the United Kingdom Example: Antihyperlipidemics (American) is listed under Antilipemics Agents (UK) 2. Within each therapeutic class, allergies display in order of severity (Severe, Moderate, Mild) 3. Allergies not assigned to a therapeutic class display at the bottom 1 2 3 8

Medications Displayed by therapeutic category: 1. Multiple medications in a therapeutic class will display the number of entries next to the class; click on to display more information. 2. Only Active medications will display from eClinicalWorks, while Active and Inactive medications will display from COMPASS. Therapeutic class based on the classification system used in the United Kingdom 3. Highlight a medication to display special instructions in the description box 4. Medications not classified by a therapeutic category will display at the bottom “Unknown Sig” will display if dose and frequency is not entered 5. Current filter set to display medications from the past year. Filter to change the date range. 5 1 4 2 3 9

Laboratory Has 2 available views: Labs Displays results by lab order. 1. Click on the red lab order name to display all results for all lab orders with this name. 1 2 3 2. Click on the blue highlighted collection date to view results of lab collected on that specific date. 3. Clicking on the icon will display results in a report format. 10

Lab Result History Displays results in a flowsheet by date and lab result name. 1. Multiple tests done on the same day will display the time of the result posting next to the result. 1 2 2. Clicking on the graph icon next to the lab result name will graph all available results. 11

Immunizations Immunizations received in the ambulatory setting will display below. Note: Immunizations documented in COMPASS will not display in the HIE. Highlighting an individual immunization will display the manufacturer and lot number. Imaging 1. Reports display by modality (Diagnostic Radiology, CT, Nuclear Medicine, etc) Cardiology reports are also displayed Change filter to display results by ordering provider or date 2. Clicking on the report name will open the report on the right Reports are listed by the date and time posted to the source Electronic Medical Record 3. Status of the report is displayed at the bottom 1 2 3 12

Clinical Documents Contains only clinical documents from COMPASS (History and Physical, OP report, Consultations, Discharge Summaries, Procedure Notes) Imaging reports will also display Reports default to display by Type and can also be filtered by Author, Date, and Facility Clicking on the document name opens the report to the right 13

Seton Heart Institute ‐ Far West Seton Heart Institute ‐ Hays/Lockhart/SSW Seton Heart Institute ‐ MPT Seton Heart Institute ‐ SNW Seton Heart Institute ‐ Williamson/Burnet Seton Mind Institute Seton Orthopedic and Sports Medicine Seton Surgical Group ‐ Williamson/CEC Seton Total Health Partners

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