s & a day 1 app training

Maureen Russell MSn, RN-BC

PCCI- Connected Care Solutions

November 2013

IntelliSpace Perinatal

Surveillance & Archiving Training

Revision H



November 2013

Introduction

PCCI- Connected Care Solutions, Maureen Russell, November 2013 3

Application Training

• Objective: to provide new product introduction training for IntelliSpace

Perinatal revision H. Upon course completion, the student will be able to

demonstrate the new feature set and explain the clinical use models.

• Prerequisite: Student must have basic understanding of product

features and OB GYN clinical workflow

• Teaching model: Instructor led hands on product training sessions

using rev H VMware image via RDP.

PCCI- Connected Care Solutions, Maureen Russell, November 2013

Rev H Training Agenda

Day 1: Tuesday

• Introductions

• Product overview

• Obstetrical clinical environment

• Clinical documentation workflow

• User roles and permissions

• User interface

• Navigation

• Patient search

• Lab sessions



Day 2: Wednesday

• Patient profile

• Chalkboard

• Single trace

• Flowchart

• Notes browser

• Audit trail

• Printing

• Lab sessions



Day 3: Thursday

• System Manager configuration

• General overviews

• PC and default sets

• Maternal locations

• Alarm defaults

• Screen layouts and print maps

• Lab sessions


Resources – Product Documentation

1. Data Field Reference Guide

2. External Database Guide

3. Integration Guide

4. Installation and Service Guide

5. Instructions for Use

6. Site Prep and IT Guide

7. System Administration and Configuration Guide

8. Trainer Toolkit


Philips Learning Center

• https://theonlinelearningcenter.com


Philips Learning Center

IntelliSpace Perinatal eLearning Modules:

Module 1 - System Hardware

Module 2 - Configuration of General and Hospital tabs

Module 3 - Configuration of Users

Module 4 - Configuration of Maternal/Newborn Locations and Multi-bed

Overview

Module 5 - Configuration of Alarms

Module 6 – Configuring PCs

Coming soon:

Module 7 - Flowchart Fundamentals

Module 8 - Flowcharting Patient Assessments and Medications


Summary of Major Features rev H

• Introducing IntelliSpace Perinatal - Product rebranding

• Updated user interface

• Comprehensive Patient profile

• Improved navigation and clickable links

• User account deactivation/expiration

• Improved scalability and manageability

• Enhancements for IT, EMR interfacing/integration

• New service layer infrastructure

• New high availability

• New Excel Log and Word Reports

10


Revision H Main Take Aways!

Improved Care Team Communication

- Patient Profile

- Patient-Centric Clinical Workflows

Perinatal

Excellence

- Maternal Statistical Reports

- Newborn Statistical Reports

Usability

- Updated User Interface

Streamline Navigation

-

Manageability

- Separation of Services

- System Console

- Virtualization

11



• A new name- the same

commitment

• IntelliSpace Perinatal joins the

family of Philips IntelliSpace

clinical informatics solutions

• Customer-facing literature name:

‘IntelliSpace Perinatal’.

• Parts of internal documentation

will have ‘ OB TraceVue’ name


New Product Logo and Splash Screen


Product Number and Option Structure

Product

Number

Description

866131 IntelliSpace Perinatal Advance system:

Surveillance, Archiving, HL7, OBTV link, attachment,

advanced charting (Forms) and reporting

866132 IntelliSpace Perinatal Advanced System, Integration Edition:

Surveillance, Archiving, HL7, OBTV link, attachment

866133 IntelliSpace Perinatal - Surveillance and Archiving System :

bundled with Server HW, pre-installed

866138 IntelliSpace Perinatal Optional Components


Surveillance & Archiving (S&A)

Data Storage & Archive

Surveillanceand Alarming

WebAccess

ADT Interface to HIS

MaternalFlowchart(intrapartum)

Newborn Documentation (flowchart & Forms)

Reports andStatistics

Lab data interface

Maternal Documentation (Forms & Gyn)

Data Export (ORU interface)


Surveillance &

Archiving System


Advanced System Integration Edition

Data Storage & Archive

Surveillanceand Alarming

Newborn Documentation (flowchart & Forms)

Reports andStatistics

WebAccess

ADT Interface to HIS

MaternalFlowchart(during birth)

Maternal Documentation (Forms & Gyn)

Lab data interface

Data Export (ORU interface)


Advanced System

Integration Edition


IntelliSpace Perinatal S&A; two possibilities

Standard S&A

On rp5800 desktop PC

no RAID, single CPU, single power supply

H*W*D in mm: 100*340*380

Weight in kg: 8.9

Max 10 concurrent web sessions

Max 16 FM

No document export

High-end S&A

On DL380 G7 server

RAID-hot swap, dual CPU, dual power supply

H*W*D in mm: 86*445*700

Weight in kg: 27.27

Max 16 concurrent web sessions

Max 32 FM

Event-triggered automatic document export

accompanied by HL7 MDM message (if

wanted) “DOX”


Improved Manageability and Scalability

• Increased scale

– Max users configured 3000

– Max users concurrent 250

– Max episodes, 4,000,000

• Improved remote management

– Convert most processes to Microsoft services

– MMC-style management module

– System management – ping, reboot, stop/start IntelliSpace

Perinatal

• More efficient administrator workflow

– Multi-admin access to configuration pages

– Ability to deactivate/expire user accounts

– Support for IPV4 and IPV6

18


Obstetrical Clinical Environment

• Fast paced clinic or high risk hospital setting

• Multiple caregivers- Midwives, Consultants, Physicians

• Fetal and maternal surveillance- critical for optimal patient outcome

• Archiving of trace data and documentation

• Pregnancy documentation: multiple visits during pregnancy

• Patient may have several pregnancies


ObstetricsTerminology

0

Antepartum

40

Conception

Weeks of Gestation

Birth delivery

Intrapartum

( during delivery )

Postpartum

( after delivery)

20


When is Electronic Fetal Monitoring(EFM) UsedAntepartum Monitoring

• Used during the last of three trimesters, use of CTG is recommended

from week 25

• Non-invasive external monitoring of both mother and fetus

• The prime goal is to prevent fetal death

• Routine basis throughout pregnancy

• Special importance for high risk pregnancies

21


Avalon Fetal Monitor


When is Electronic Fetal Monitoring Used Intrapartum Monitoring

• Used for fetal and uterine monitoring during the onset of labor and the

actual birthing process until delivery

• Both external and internal (invasive)

• Performed on all mothers upon admission to the labor ward

• Special importance during labor and delivery when there is a suspicion

of complications.

23


Avalon Fetal Monitor - Monitoring Twins and

Triplets


Antepartum – Before Birth


Intrapartum- During Labor


Postpartum- After Birth


Patient Data Storage


S&A

S&A Intrapartum documentation


Documentation Workflow-Maternal Newborn


What is an Episode?

• Each encounter is an ‘episode’

• A pregnancy can have multiple episodes

• A patient may have multiple pregnancies

• A patient may have multiple newborns within 1 pregnancy

• Each Newborn is linked to a Maternal record

• Automatic closure of pregnancy record or newborn documentation = 18

months from the last closed episode


Working with Episodes

Open

• Create patient

• Open episode

Chart

• Surveillance-fetal trace

• Flowchart/Forms documentation

Close

• Transfer patient Home

• Episode closed/archived


Working with Episodes

• Can configure data elements to be mandatory before allowing closure

• Can retrieve closed episodes for review and/or correction

• Can re-open a closed episode to continue documentation

• Can merge and un-merge patient records

• All episode corrections are listed in the audit trail

• Total number of simultaneously open episodes = 1100

• Total number of episodes = 400,000


Mother

Pregnancy 1 Pregnancy 2 Pregnancy 3

Baby 1 Baby 2

Episode 1 Episode 2 Episode 3

GYN

Patient Data Overview


User Roles and Permissions

• Philips User

• System Administrator

• System Manager (SM)

• Super User (SU)

• User


User, Roles and Permissions

Philips User

• responsible for initial setup,

including giving access to the

System Manager

• has full system permission

• the institution can change the

password for this user



System Administrator

• uses special Perinatal support

tools such as database repair

System Manager (SM)

• responsible for overall clinical

administration of system

• can grant System Manager,

Super User, and User

permissions to other users

• there must be at least one System

Manager per system



Super User (SU)

• responsible for day to day clinical

administration (adding new users)

• can change system defaults

(alarm, storage parameters)

• cannot grant permissions

• there must be at least one Super

User per shift.

User

• clinically trained nurse or

healthcare provider who uses the

system.

• may change her own overview

screen, password



November 2013

User Interface


IntelliSpace Perinatal Revision HWhy Main UI changes?

Harmonize with Philips: User Experience Identity (UEI)

40


IntelliSpace Perinatal Revision HWhy Main UI changes?

41

Harmonize with Microsoft: (MSCUI):


User Interface


Comparison of G to H


Improved User Experience

44


Multi-Bed Overview

•


System Toolbar

• Functions that relate to multiple patients and quick admit function

• Administrative functions


Patient Banner

“Patient in Focus”

• Key concept for Rev H

• Wherever you navigate in the application you can keep the patient in

focus

• Middle name initials now in banner


Patient in Focus

• Open drop down to show patient list

• Patient selected is highlighted

• Can ‘Clear patient selection’ to remove patient in focus

• Can filter to show only: all departmental patients(----) or ‘Own Patients’

48


Patient Panel

• Divided into 4 sections

1. Patient medical data

2. Current pregnancy status information

3. Current episode data

4. Alerts for LAB reminders and flagged data

Clickable link navigates to the page that contains the data

4


Patient Panel

• New in H.10: once the delivery date is documented the panel changes

from AP/IP to PP

• User can create Newborn from here

• User must manually change Flowchart to PP


Create Newborn


Patient Toolbar

• All functions are for the ‘Patient in Focus’

• Left side – clinical functions

• Right side – administrative functions


Patient Toolbar Icons – Clinical Functions


Patient Toolbar – Administrative Icons



November 2013

Navigation


New Navigation


Navigation

• ‘Patient in Focus’ stays in focus as you navigate unless you ‘Clear

patient selected’

• Patient-centric information/navigation is contained within the ‘Patient in

Focus’ view


Navigation Comparison

G

H


Patient in Focus• Patient remains in focus, can choose to navigate to a different patient or

can clear patient in focus


Patient Panel

• User can hover over item to reveal a tooltip

• User can click on data and be linked to the source of documentation


Patient Panel Links to Record/Tab

Patient Panel Label Links to Record / tab

Born Admission/Demographics/Date of Birth

Patient identifier Admission/Demographics

Problems Prenatal or Admission/Problems

Allergies Prenatal or Admission /Allergies

G/P Prenatal or Admission /Pregnancy

GA Prenatal or Admission /Pregnancy

Membr. Flowchart/Vag.Exam/Membranes

A.Fluid Flowchart/Vag.Exam/A.Fluid

Dilation Flowchart/Vag.Exam/Dilation

Station Flowchart/Vag.Exam/Station

Position Flowchart/Vag.Exam/Position

Attending Provider Maternal Chalkboard

Admission date/time Admission/Admission


Patient Panel - Maternal Newborn Link


Patient Toolbar

• User can navigate to patient specific documentation or actions


Patient Search

• Able to navigate between maternal and newborn with 1 click

• An include newborns from the maternal search


Patient SearchADT: Enhanced Patient Search

65

• Use Case: Find any patient in the system

Newborn

HIS pre-admit


Patient Administration

• New LAB icon

• Archive Search –

• Removed Super User permission for ‘Open for Correction’

• Rolodex filter supports non-SU view of open for corrections episodes

66


Patient Search Notification Buttons

• Background is highlighted when information requires action/viewing


Review Episodes and Retrieve Episodes


One View - Complete Patient Record

69


Quick retrieval of Archived Episodes

70

1. Click

icon

2. Select

episode for

review

3. Click select or double click episode


Able to View if Data Exists in Previous Episodes

71


Patient Administration Updates

• Added icon to show if prior episode has trace data

Trace exists -

for Revision

H episode or later

?

Unknown trace data – would show for Revision

G and earlier

<blank>

No trace exists

72


Retrieved EpisodesADT: Find any Patient in archived episodes

73


Closed Episodes- Archived Episode

• If an archived episode is being reviewed or open for correction, the

panel displays:

Period of time and length

Visit Number

Responsible physician at time of episode close

• By clicking ‘Hide Episode’ it is removed from screen and the user is

taken to the current data of the selected patient


Open for Correction

• “Close Episode” button is displayed

• Clicking the button opens a dialog to confirm closure

• If message is confirmed, episode is closed and the user is taken to the

current data of the selected patient


No Archiving

• Panel displays:

Start time of the episode + length as elapsed time

A button “Convert to Quick Admit”


Lab

• Create a patient

• Open pregnancy

• Document several episodes with data on the flowchart

• Close each episode

• Open Review episodes dialog

• Retrieve the last episode from archive for correction & continued

charting

• Retrieve a episode, open and change data, delete data-note what

happens prior to closing

•


Labs

• Create several users with different permissions

• Log in as System Manager, Super User, User- note

• Note where the source documentation exists

• Review Pt Search/Identify

• Review Chalkboard- click on Flags

• Clear patient selection in patient focus dropdown

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