ehr template making mary hager, rn, bs medsphere

EHR Template MakingEHR Template Making

Mary Hager, RN, BS

Medsphere

Template Editor

Personal

Shared

New

Create a New Template

Type

Editing Options

Enter objects or template fields

Finishing

Formatting Options

Template Fields

Old Fields

Create New

Template Fields

Types of Fields

Creating a Template Field• Click on the New Button

• Enter a Unique Template Field Name (can be up to 60 characters long)

• Select the desired Template Field Type

Creating a Template Field (continued)

• The right side of the template field editor will change depending on which template field type is specified.

Edit Box Fields

• Field Length is the size of the Edit Box in the dialog (up to 70 characters)

• Text Length is how much text can be typed into the field (up to 240 characters)

• Default is the optional edit box default text (up to Field Length characters)

Template Fields with Items• Four types of template fields can be

used to select from a list of pre-defined text items.– Combo Box Fields– Button Fields– Check Box Fields– Radio Button Fields

• Each of these template field types can specify an optional default field value from the pre-defined list of items.

Combo Box Fields• Combo Box Fields allow selection of one item

from a Drop Down List• Field Length is the size of the Combo Box in

the dialog (up to 70 characters)• Text Length (if not zero) allows other text, not

in the pre-defined items, to the typed into the combo box (up to 240 characters)

Button Fields

• Button Fields allow selection of one item by cycling through each item as the button is pressed.

• If the Default is blank, the button will initially appear without any text

• Button size reflects the longest text item

Check Box Fields

• Check Box Fields create a check box for each item, allowing as many items to be selected as desired

• The default item will initially be checked

• If multiple items are checked, the text will be separated by commas

Radio Button Fields

• Radio Button Fields create a radio button for each item, allowing only one item to be selected.

• The default item will initially be checked

• Can be unchecked, leaving no selection

Separate Lines Property• Check Box and Radio Button Fields have a Separate

Lines property, which will display each check box or radio button on a separate line of the dialog.

• Has no affect on generated text

Before Separate Lines After Separate Lines

Date Fields• Date Fields have six different date types

• Default will evaluate to the current date/time

Number Fields

• Number Fields allow numeric values between a specified range.

• They always have a default value.

• Minimum and Maximum Values can range from –9999 to +9999

• Button increment values as high as 999

Word Processing Fields

• Word processing fields allow an unlimited amount of text to be entered (scroll bars will appear if needed)

• Field Length and Number of Lines indicate how wide and high the field will appear in the dialog

Hyperlink Fields

• Hyperlinks Fields are text only fields that allow linking to web pages.

• Hyperlink text is either the Default (if specified) or the actual URL address

• Address specifies the URL link

Text Fields

• Text fields provide a mechanism for embedding predefined (non-editable) text into the dialog

• Predefined Text is entered in the Items property of the field

Common Field Properties

• Most template fields share several of the following common properties:– LM Text– Inactive– Required– Indent Field– Indent Text– Notes

Only applied to old roll-and-scroll TIU

Common Properties: Inactive

• Inactive Fields cause the following error:

• If you ignore the error the field will be treated as if it were not in the boilerplate

Hiding Inactive Fields

• You can Hide Inactive Fields in the Template Field Editor

Notice the Inactive fields

displayed in the Template Field list when the Hide Inactive

Fields option is not checked

Common Properties: Required• Most template fields can be marked as

required. Required fields are shown with an asterisk (*) in the dialog.

• If one or more required fields have no text, you will not be allowed to press the Template Dialog OK button (or the Finish button in Reminder Dialogs)

Common Field Properties: Indent Field

• The Indent Field property indents the template field as it appears in the dialog. This has no affect on the text generated from the template field.

By Indenting this field, we can make it line up with the required field

below it, without affecting how the text appears in the note.

Before Indent

After Indent

Common Field Properties: Indent Text

• The Indent Text property indents the text generated from the field. It has no affect on how the field appears in the dialog.

1) Dialog Containing Template

Fields

2) Generated Text. Notice the text does not line up

under the columns

3) Generated Text with Indent Text

set to 2 (text lines up under columns)

Common Properties: Notes

• Notes can be kept about specific Template Fields. This can be used to track changes or keep other kinds of notes. Currently, the only place Template Field Notes can be viewed is the Template Field Editor.

Object CreationObject Creation

Using Copy for a new object

• Copy can be used if the program that finds the object data is generic

• For the lab objects, the lookup routine passes the lab test name as a parameter so it can be used to copy.

• Copy can also be used for note titles, immunizations, health factors

Using Copy

Using copy only works if the routine has a parameter for the item to find.

S X=$$LASTHF^BTIULO2(+$G(DFN),"FACTORNAME")

Other object such as this one for allergies do not have a parameter that could be copied.

S X=$$MAIN^TIULADR(DFN,1,"^TMP(""TIULADR"",$J)",0)

Only Programmers may create/copy objects

New ObjectSelect Entry to Copy: (29-42): 40Copy into (different) Name: LAST

CALCIUM// LAST MAGNESIUM

OBJECT copied into File Entry

#1302Press RETURN to continue or '^'

or '^^' to exit:Please test the copy object and

activate it when it is ready for users to embed

it in boilerplate text.

• Pick the lab test to copy making sure its visible on the screen

• Give it a new name• Hit return a couple of times• It now needs to be edited

New Object

Edit the new object

Edit – part 2

• Edit the technical fields and change the name to the new one

• Be sure you know the real laboratory nameSelect Action: Quit// tech Technical Fields OBJECT METHOD: S X=$

$SLAB^BTIUPCC(DFN,"CALCIUM") Replace CALCIUM With MAGNESIUM

• Edit the Basic fields and make it active

Edit Objects

Making a New Object

• Objects can be created for any data that exists in RPMS

• Two basic types:– Single answer such as patient sex– Array answer such as active medications

Making Health Summary Objects

• A VA Health Summary type can be turned into an object without programming.

• The first step is to make a VA health summary type.

Health Summary Objects

• Use the Document Definitions Menu and item DDM6,

DDM1 Edit Document Definitions DDM2 Sort Document Definitions DDM3 Create Document Definitions DDM4 Create Objects DDM5 List Object Descriptions DDM6 Create TIU/Health Summary Objects

Create a new TIU Object

Create a new TIU health object

Enter a New TIU OBJECT NAME: RCISObject Name: RCISIs this correct? YES//Use a pre-existing Health Summary Object? NO// Checking RCIS (TIU) with Health Summary...Creating Health Summary Object 'RCIS (TIU)' Select Health Summary Type: REFERRED CARE REFERRED CARE Referred Care (Rcis Referrals) OK? YES//

HS Object

Do you want to overwrite the TIME LIMITS in the Health Summary Type 'REFERRED CARE'? N// O Print standard Health Summary Header with the Object? N// O Partial Header: Print Report Date? N// O Print Confidentiality Banner? N// O Print Report Header? N// O Print the standard Component Header? Y// ES Use report time/occurrence limits? N// O Underline Component Header? N// O Add a Blank Line after the Component Header? N// O

HS Object

Print the date a patient was deceased? N// O Print a LABEL before the Health Summary Object? N// O Suppress Components without Data? N// O OBJECT DESCRIPTION: No existing text Edit? NO// Create a TIU Object named: RCIS Ok? YES// TIU Object created successfully.

Putting Objects into GUI

• The new objects are available in the note editor as soon as they are created

• You do need to log off and log back in

Putting Objects in the GUI

• The CAC can add any of these objects to a template.

• General users will not have access to this object

Adding Objects to the GUI

• To make the object available to general users– Make a template only containing this object

using the template editor– Put it into the folder called Patient Data

Objects or Inpatient Data Objects

Objects in the GUI

When to use a Dialog?

• Information is elective i.e. Physical Exam – Does provider need to do all parts of an exam at every visit?

• You need more information than a template field will provide.

Example

How to Make a Dialog

• Create the parent and make it a dialog type

• Be sure to enter boilerplate text into the dialog

• You can also add template fields or objects to this boilerplate

Making a Dialog

• Put your cursor on this dialog

• Click New template and make the child

• Make as many as you need

• Enter boilerplate text on all the children

Dialog Example

Changing Type

• You may decide one of your templates needs to become a dialog

• You can change the type and then add children to this new dialog

Dialog inside Dialog

Preview

Format the Dialog

Template Dialogs• Templates now have five Dialog

Properties that determine how templates function within a Template Dialog.– Display Only– Only Show First Line– Indent Dialog Items– One Item Only– Hide Dialog Items

Template Dialogs (Continued)

• Display Only

No check box next to the text therefore text will not be added to the note.

Template Dialogs (Continued)• Only Show First Line

Notice the “…” at the end of the line, and the entire text of the item in the hover hint.

Template Dialogs (Continued)• Indent Dialog Items

Before and after Indent Dialog Items

Template Dialogs (Continued)• One Item Only

Items appear as radio buttons, and only ONE item can be selected at any given time.

Template Dialogs (Continued)• Hide Dialog Items

What the user sees after checking parent item.

Template Dialogs (Continued)

• Hide Dialog Items (Continued)

When you hide dialog items, you must have 2 things… TEXT at the dialog level…

Template Dialogs (Continued)

• Hide Dialog Items (continued)

…and you must have an item(s) to hide.

Template Notes

• Templates can be customized for many different services and uses.

• The ability to document to users what a particular template does.

Template Notes

User can make NOTES about the templates they are creating.

Template Notes (Continued)

User can see Template Notes while in the Template drawer; right-click on selected template...

Template Notes (Continued)

Hide Items inTemplate Drawer

Users can see and select the Social Work template w/o having access to the sub-items, therefore all items are included in the note.

Template Import/Export Template Import/Export UtilityUtility

Template Import/Export

• With the creation of very complex templates, it can be cumbersome to cut/paste templates from test accounts to production, or from one site and/or user to another.

• The import/export can also be very useful for moving personal templates into the Shared Template folder.

Template Import/Export(Continued)

• The TOOLS menu in the Template Editor contains the import/export actions.

• Users can EXPORT their templates into documents (with .txml extension) that can be sent to other systems/sites/users via MS Exchange.

Template Import/Export (Continued)

Template Import/Export (Continued)

IMPORT TEMPLATES from TOOLS menu

Template Import/Export(Importing WORD docs)

• After selecting a MS Word document to import, a “conversion” box may appear on the screen, after which the template is added to Shared or Personal Templates hierarchy (wherever cursor is placed), and available for editing.

Template Import/Export(Importing WORD docs con’t)

• Importing MS Word documents:– Graphics and other special features of

Word documents will not import into templates. Text and template fields will be imported, but there are often text formatting problems that need to be resolved after import.

Template Import/ExportImporting TEMPLATES

If the template being imported has a duplicate template field name that does not match the existing field properties, the field being imported is renamed, and the imported templates are changed to reflect the field name change.

Template Import/Export (Continued)

• Local Patient Data Objects cannot be exported w/this Template Import/Export utility

• It is possible to EXPORT a group of templates at a time; MY TEMPLATES directory can be selected, saved to a file (with .txml), then imported somewhere else.

Template Import/Export (Continued)

• Template fields are saved when imported, even if user cancels from the template editor w/o hitting APPLY; template is not saved.

Locking Shared Templates

• It was possible to edit Shared Templates by mistake; the template no longer met requirements.

• Locking the Shared Templates root folder will prevent any Shared Template from being edited.

Locking Shared Templates

LOCK box for this template is checked.

Locking Shared Templates(Continued)

LOCK prevents editing of name & template boilerplate even though on Personal Templates.

Relationships between Shared Templates & My Templates

Shared Templates My

Templates

The Template ‘History & Physical’ was copied over to ‘My Templates’

The copied Template is now an item under My Templates, which is a pointer back to Shared Templates

Relationships between Shared Templates & My Templates

Changes that are made to a template under Shared Templates, will be seen under ‘My Templates’, remember the pointer relation.

Shared Templates My Templates

Once the user edits this Shared Template within ‘My Templates’ the Pointer Relationship is broken.

Added text, changes the icon

My Templates

The icon for the Title has changed ---- Flipped corner

Shared Templates My Templates

The same process will be seen with Folders, Dialogs and Group Template

Shared Templates My Templates

Changes on Shared Templates will be reflected immediately on ‘My Templates’

The Icon on Joy Dialog is a Dialog Icon

Shared Templates My Templates

Once a change is made to the Entry on the ‘My Template’ side.

A new copy of Shared Joy Dialog is created under ‘My Templates’ and is now owned by that user.

The Joy Dialog is NO LONGER shared.

Shared Templates My Templates

Joy Dialog was changed on the ‘My Template’ side.

When a new Template is added to the Shared Template. The ‘My Template’ Joy Dialog is no longer pointing to the shared Template.

The New Template is not seen on the ‘My Template’ side.

Shared Templates My Templates

HOWEVER other templates under My Templates that still point to Shared Templates will reflect changes made.

The (Joy 1 Temp) was changed to (Joy1 Final)