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RPMS 101 RPMS 101

David Taylor MHS, RPh, PA-C, RN National Medical Informatics Consultant RPMS EHR Training and David Taylor MHS, RPh, PA-C, RN National Medical Informatics Consultant RPMS EHR Training and Deployment Special Thanks to: Chris Lamer, Pharm. D, BCPS, CDE National Medical Informatics Consultant Patient Education

RPMS • Resource Patient Management System INPUT STORAGE OUTPUT • A set of integrated RPMS • Resource Patient Management System INPUT STORAGE OUTPUT • A set of integrated computer applications designed to support the clinical and administrative functions of a health care program.

What is RPMS? What is RPMS?

RPMS Files RPMS Files

Fileman Labs Pt Ed Vitals Meds POVs Fileman Labs Pt Ed Vitals Meds POVs

Kernal Fileman Labs Pt Ed Kernal Vitals Meds POVs Kernal Fileman Labs Pt Ed Kernal Vitals Meds POVs

RPMS Inputs Fileman A 1 c Result Labs Pt Ed Vitals Diabetes Management System RPMS Inputs Fileman A 1 c Result Labs Pt Ed Vitals Diabetes Management System Meds POVs

Sample Input Tools PCC Data Entry Radiology Package Pharmacy Package DM Mgt System Laboratory Sample Input Tools PCC Data Entry Radiology Package Pharmacy Package DM Mgt System Laboratory Package Asthma Package

PCC Fileman Labs Pt Ed Vitals Meds POVs Bob’s visit 1/19/07 Mary’s visit 4/26/07 PCC Fileman Labs Pt Ed Vitals Meds POVs Bob’s visit 1/19/07 Mary’s visit 4/26/07

RPMS Outputs Fileman Labs Pt Ed Vitals Diabetes Audit Meds POVs RPMS Outputs Fileman Labs Pt Ed Vitals Diabetes Audit Meds POVs

Sample Output Tools Clinical Reporting System Diabetes Audit PCC Management Reports Case Management Reports Sample Output Tools Clinical Reporting System Diabetes Audit PCC Management Reports Case Management Reports QMAN PGEN / VGEN

RPMS Jeopardy RPMS Jeopardy

RPMS History Inputs 100 Outputs Tips & Tricks Getting Help 100 100 200 200 RPMS History Inputs 100 Outputs Tips & Tricks Getting Help 100 100 200 200 200 300 300 300 400 400 400 500 500 500

RPMS History 100 • RPMS runs on the MUMPS programming language. • What does RPMS History 100 • RPMS runs on the MUMPS programming language. • What does MUMPS stand for? AI/AN Population by State 2000

Massachusetts General Hospital Utility Multi-Programming System Massachusetts General Hospital Utility Multi-Programming System

RPMS History 200 • Is MUMPS a dead computer language? • Name at least RPMS History 200 • Is MUMPS a dead computer language? • Name at least 3 programs or companies that use the MUMPS computer language. • PS- Everyone should get at least one!!

Health Information Systems – – Indian Health Service Veterans Affairs Department of Defense Presbyterian Health Information Systems – – Indian Health Service Veterans Affairs Department of Defense Presbyterian University Hospitals • Reference labs – Quest – Dynacare – – – Ameripath Care Centric Team health Epic Systems Corporation EMIS • Banks • Credit Unions

RPMS History 300 • Name at least 2 programs that use RPMS. RPMS History 300 • Name at least 2 programs that use RPMS.

Over 250 programs around the world! 1. 2. 3. 4. 5. Indian Health Service Over 250 programs around the world! 1. 2. 3. 4. 5. Indian Health Service Community Health Network of West Virginia Presbyterian Hospitals Hawaii has entered an MOA with IHS Eastern Europe

RPMS History 400 Three part question: 1. Who is the current IHS RPMS program RPMS History 400 Three part question: 1. Who is the current IHS RPMS program manager? (who is responsible for RPMS? ) 2. Who is the current IHS Chief Information Officer? (who is responsible for all health information IT? ) 3. Who is the current RPMS EHR Training and Deployment Lead?

Howard Hays, MD, MSPH RPMS Program Manager, IHS Theresa Cullen, MD, MS Chief Information Howard Hays, MD, MSPH RPMS Program Manager, IHS Theresa Cullen, MD, MS Chief Information Officer, IHS David Taylor, MHS, RPh, PA-C, RN RPMS EHR Training & Deployment

RPMS History 500 DAILY DOUBLE RPMS History 500 DAILY DOUBLE

Who developed (created) the MUMPS programming language? Who developed (created) the MUMPS programming language?

Neil Pappalardo Neil Pappalardo

Where did Neil develop MUMPS? Where did Neil develop MUMPS?

Dr. Octo Barnett’s animal lab Dr. Octo Barnett’s animal lab

Inputs 100 • How do you document that your patient checks their home blood Inputs 100 • How do you document that your patient checks their home blood sugars? – Note, this patient gets their supplies from another company.

Health Factor Health Factor

Inputs 200 We often input groups of information into RPMS and call them registries Inputs 200 We often input groups of information into RPMS and call them registries and taxonomies. What’s the difference between a template (aka registry) and a taxonomy?

 • A registry is a list of people • A taxonomy is a • A registry is a list of people • A taxonomy is a list of things (stuff) such as medication, labs, CPT codes.

Inputs 300 You talk with your patient who has type 2 diabetes about the Inputs 300 You talk with your patient who has type 2 diabetes about the importance of incorporating some type of exercise in their lives and the patient states that they are going to try to walk for 20 minutes three times a week. What input data element do you use to document this?

Patient Education DM-EX-G-CL-10 min-GS-will walk 20 min 3 x/wk Patient Education DM-EX-G-CL-10 min-GS-will walk 20 min 3 x/wk

Inputs 400 What input tool is this, and where does the information go? Inputs 400 What input tool is this, and where does the information go?

Retinal Screen It goes electronically to PIMC where it is read and interpreted Need Retinal Screen It goes electronically to PIMC where it is read and interpreted Need to ensure it is entered into RPMS as an exam code

Inputs 500 As of July 2008 - how many sites have begun using the Inputs 500 As of July 2008 - how many sites have begun using the Electronic Health Record?

166 166

Outputs 100 How many areas run the diabetes audit? Outputs 100 How many areas run the diabetes audit?

All Twelve Area 7 Area 1 Area 2 Area 3 Area 4 Area 5 All Twelve Area 7 Area 1 Area 2 Area 3 Area 4 Area 5 Area 6 All. Areas Area 8 Area 9 Area 10 Area 11 Area 12

Outputs 200 Name 3 RPMS Output Tools that let you manage and control groups Outputs 200 Name 3 RPMS Output Tools that let you manage and control groups (registries) of patients.

1) Diabetes management System 2) Case Management System 3) Asthma Register System 4) Women’s 1) Diabetes management System 2) Case Management System 3) Asthma Register System 4) Women’s Health 5) HIV Management System 6) i. CARE

Outputs 300 What is the difference between CRS and GPRA? Outputs 300 What is the difference between CRS and GPRA?

CRS is the tool used to create outcome reports on many different measures. GPRA CRS is the tool used to create outcome reports on many different measures. GPRA is a group of outcome reports that goes to Congress. CRS is used to make this special report. Appropriated Dollars Activities Customer benefits or outcomes Consistent with Agency Goals Return on Investment

Outputs 400 What six things need to be documented to get credit for the Outputs 400 What six things need to be documented to get credit for the CRS measure called: Diabetes Comprehensive Care?

A 1 c checked Blood pressure checked LDL performed nephropathy assessment (estimated GFR and A 1 c checked Blood pressure checked LDL performed nephropathy assessment (estimated GFR and qualitative protein) Retinal eye exam Diabetes foot exam

Outputs 500 Name one output report that is specifically designed for patients. Patient centered Outputs 500 Name one output report that is specifically designed for patients. Patient centered care

Patient Wellness Handout Data extracted from RPMS Logic used to provide information about results Patient Wellness Handout Data extracted from RPMS Logic used to provide information about results Reviewed with patient by clinician, nurse, educator, or pharmacist

Tips & Tricks 100 • I entered some information on a patient named Myirial Tips & Tricks 100 • I entered some information on a patient named Myirial Pilkiniskersinin using the diabetes management system, but I forgot to add one thing to her record. • How can I choose her again in RPMS without typing in her name, chart number, or birthdate?

Press the space bar and hit the ENTER key. When you do this, RPMS Press the space bar and hit the ENTER key. When you do this, RPMS picks the last patient or item you were using

Tips & Tricks 200 When performing a QMAN search, how can you easily pick Tips & Tricks 200 When performing a QMAN search, how can you easily pick all of your diabetes diagnoses? ***** SEARCH CRITERIA ***** What is the subject of your search? // LIVING PATIENTS Subject of search: PATIENTS ALIVE TODAY Attribute of LIVING PATIENTS: DX Enter DX: ? ?

Enter DX: [SURV 1 SURVEILLANCE DIABETES DM SURV - USED BY HLTH SUMM 2 Enter DX: [SURV 1 SURVEILLANCE DIABETES DM SURV - USED BY HLTH SUMM 2 SURVEILLANCE HYPERTENSION USED BY HLTH. SUM. SURV. 3 SURVEILLANCE OBESITY USED BY HLTH. SUM. SURV. 4 SURVEILLANCE PHYSICAL EXAM USED BY HLTH. SUM. SURV. 5 SURVEILLANCE PNEUMOCOCCAL RISK 6 SURVEILLANCE TUBERCULOSIS USED BY HLTH. SUM. SURV. CHOOSE 1 -6: Some diagnosis taxonomies are already created for you to use. Just type “[surv” and hit ENTER

Tips & Tricks 300 What character (key on the keyboard) is the same as Tips & Tricks 300 What character (key on the keyboard) is the same as using the ENTER key?

The colon (; ) is like the enter key in RPMS Try it out… The colon (; ) is like the enter key in RPMS Try it out… Next time you log in, type your username a colon, then your verification code C lamer; mypassword

Tips & Tricks 400 How can you “jump” form one RPMS application to another? Tips & Tricks 400 How can you “jump” form one RPMS application to another? How can I go from the health summary menu to the EHR menu quickly?

Use the “Up-Hat” or “Carrot” or “Shift Six” Select Health Systems Option: ^EHR 1 Use the “Up-Hat” or “Carrot” or “Shift Six” Select Health Systems Option: ^EHR 1 2 3 4 5 6 7 EHR Cover Sheet Reminder List [BEHORM EHR COVER SHEET LIST] EHR Lookup Categories [BEHORM EHR LOOKUP CATEGORIES] EHR Setup Menu [CIA EHR MENU] EHR/PCC Coding Audit for One Patient [APCDCAF EHR AUDIT ONE PATIENT] EHR/PCC Coding Audit for Visits in Date Range [APCDCAF AUDIT VISITS] EHR/PCC Coding Audit Menu [APCDCAF EHR CODING AUDIT MENU] Edit Parameters for Use in BH EHR [AMH M EHRBH PARAMETER EDIT]

Tips & Tricks 500 What is the best tool to use to get a Tips & Tricks 500 What is the best tool to use to get a printout of multiple items: name, chart number, gender, and age?

Try PGEN or VGEN Try PGEN or VGEN

BH GENERAL RETRIEVAL Dec 16, 2007 22: 04: 34 Page: 1 of 1 Patient BH GENERAL RETRIEVAL Dec 16, 2007 22: 04: 34 Page: 1 of 1 Patient Selection Menu Patients can be selected based upon any of the following items. Select as many as you wish, in any order or combination. An (*) asterisk indicates items already selected. To bypass screens and select all Patients type Q. 1) Sex 15) Patient Flag Field 29) Pts w/Problem (MHSS 2) Patient Age 16) Case Open Date 30) Pts seen by a Provid 3) Patient DOB 17) Case Admit Date 31) Pts w/Education Done 4) Patient DOD 18) Case Closed Date 32) Pts seen for an Acti 5) Living Patients 19) Case Disposition 33) Pts seen w/Type of C 6) Chart Facility 20) Next Case Review Dat 34) Pts seen w/Axis IV L 7) Community of Residen 21) Designated MH Prov 35) Pts w/Inpatient Disp 8) County of Residence 22) Designated SS Provid 36) Pts Last Health Fact 9) Tribe of Membership 23) Designated A/SA Prov 37) Pts w/ A/SA Componen 10) Eligibility Status 24) Designated Other Pro 38) Pts w/ Days in Res T 11) Class/Beneficiary 25) Personal History Ite 39) Pts w/ Days Aftercar 12) Medicare Eligibility 26) Pts seen at a Locati 40) Pts w/ A/SA Type of 13) Medicaid Eligibility 27) Pts Seen in a Commun 14) Priv Ins Eligibility 28) Pts w/Problem (DX) Enter ? ? for more actions S Select Item(s) + Next Screen Q Quit Item Selection R Remove Item(s) - Previous Screen E Exit Report Select Action: S//

BH GENERAL RETRIEVAL Dec 16, 2007 22: 07: 03 Page: 1 of PRINT ITEM BH GENERAL RETRIEVAL Dec 16, 2007 22: 07: 03 Page: 1 of PRINT ITEM SELECTION MENU The following data items can be printed. Choose the items in the order you want them to appear on the printout. Keep in mind that you have an 80 column screen available, or a printer with either 80 or 132 column width. 1 1) Patient Name 12) Class/Beneficiary 23) Case Closed Date 2) Sex 13) Medicare Eligibility 24) Case Disposition 3) Patient Age 14) Medicaid Eligibility 25) Next Case Review Dat 4) Patient DOB 15) Priv Ins Eligibility 26) Designated MH Prov 5) Patient SSN 16) Mailing Address-City 27) Designated SS Provid 6) Patient DOD 17) Home Phone 28) Designated A/SA Prov 7) Patient Chart # 18) Mother's Name 29) Designated Other Pro 8) Community of Residen 19) Patient Flag Field 30) Designated Other (2) 9) County of Residence 20) Patient Flag Narrati 31) Personal History Ite 10) Tribe of Membership 21) Case Open Date 32) Pts Last Health Fact 11) Eligibility Status 22) Case Admit Date Enter ? ? for more actions S Select Item(s) + Next Screen Q Quit Item Selection R Remove Item(s) - Previous Screen E Exit Report Select Action: S//

BH GENERAL RETRIEVAL Dec 16, 2007 22: 09: 14 Page: 1 of 1 SORT BH GENERAL RETRIEVAL Dec 16, 2007 22: 09: 14 Page: 1 of 1 SORT ITEM SELECTION MENU The Patients displayed can be SORTED by ONLY ONE of the following items. If you don't select a sort item, the report will be sorted by patient name. 1) 2) 3) 4) 5) 6) Patient Name 7) County of Residence 13) Designated SS Provid Sex 8) Tribe of Membership 14) Designated A/SA Prov Patient DOB 9) Eligibility Status 15) Designated Other Pro Patient DOD 10) Class/Beneficiary 16) Designated Other (2) Patient Chart # 11) Patient Flag Field Community of Residen 12) Designated MH Prov Enter ? ? for more actions S Select Item(s) + Next Screen Q Quit Item Selection R Remove Item(s) - Previous Screen E Exit Report Select Action: S//

Getting Help 100 You are getting an error every time you run an RPMS Getting Help 100 You are getting an error every time you run an RPMS report. Who do you contact for help?

Step 1: contact your local RPMS site manager Step 2: contact your area RPMS Step 1: contact your local RPMS site manager Step 2: contact your area RPMS site manager Step 3: contact the IHS RPMS Help Desk

http: //www. ihs. gov/General. Web/Help. Center/Helpdesk/inde x. cfm http: //www. ihs. gov/General. Web/Help. Center/Helpdesk/inde x. cfm

Getting Help 200 We all love the EHR, but wouldn’t it be great if Getting Help 200 We all love the EHR, but wouldn’t it be great if it…. What do you do when you have an idea for a new enhancement for RPMS or the EHR?

First, share your idea with the package manager, RPMS site manager, or Clinical Coordinator First, share your idea with the package manager, RPMS site manager, or Clinical Coordinator at your local site. If they cannot help, or if they recommend it, you can post your request to the RPMS Feedback page.

http: //www. ihs. gov/CIO/RPMS/index. cfm? module=feedback&option=add&newq uery=1 http: //www. ihs. gov/CIO/RPMS/index. cfm? module=feedback&option=add&newq uery=1

Getting Help 300 I’m using the Diabetes Management System, but I’m not sure how Getting Help 300 I’m using the Diabetes Management System, but I’m not sure how to do something. Where do you go to find the manual?

The RPMS webpage makes all of the user and technical manuals available in PDF The RPMS webpage makes all of the user and technical manuals available in PDF format. You will need to have Adobe Acrobat or another PDF reader to see them.

http: //www. ihs. gov/Cio/RPMS/index. cfm? module=home&option=docum ents http: //www. ihs. gov/Cio/RPMS/index. cfm? module=home&option=docum ents

Types of Manuals • Install manual - used by the RPMS site manager to Types of Manuals • Install manual - used by the RPMS site manager to put the application on your RPMS system • User manual - tells you how to use the application and what the application does. • Technical manual - describes the fine details of how the application works in the system; generally for programmers • Other documents - may contain additional information that can help you to use the application

Other Documents Example Other Documents Example

Additional Materials If you cannot find the information that you are looking for in Additional Materials If you cannot find the information that you are looking for in the manual – Talk to your RPMS site manager – Ask if there have been any patches added to the system – Ask to get a copy of the installation notes – Sometimes new information such as recent enhancements my be in the patch documentation, but not yet added to the manual

Getting Help 400 I’m using EHR and want to get some more information. Where Getting Help 400 I’m using EHR and want to get some more information. Where do I go? Can you name 3 places to get EHR help?

1) EHR manuals 1) EHR manuals

2) EHR online help 2) EHR online help

Online Help Online Help

3) EHR List. Serv 3) EHR List. Serv

http: //www. ihs. gov/cio/listserver/index. cfm http: //www. ihs. gov/cio/listserver/index. cfm

Getting Help 500 Where can you go to find out about available RPMS training? Getting Help 500 Where can you go to find out about available RPMS training? Name two places.

1) RPMS training website 1) RPMS training website

2) Recorded Web. Exes 2) Recorded Web. Exes

www. ihs. gov/CIO/EHR www. ihs. gov/CIO/EHR

Basic RPMS 101 Hands-On Exercise RECORDING THAT AN ERROR OCCURRED --Sorry 'bout that $ZERROR= Basic RPMS 101 Hands-On Exercise RECORDING THAT AN ERROR OCCURRED --Sorry 'bout that $ZERROR= Halting at 10: 59 am Connection closed by foreign host.