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RPMS Package Optimizations RPMS Package Optimizations

Learning Objectives • Review the RPMS Clinical Applications that Impact RPMS EHR Functionality. • Learning Objectives • Review the RPMS Clinical Applications that Impact RPMS EHR Functionality. • Discuss the Importance of Identifying RPMS Package Owners. • Delineate the Steps for Optimizing the Identified RPMS Packages.

Are Your Patches Current? How do I find out? • Look in Kernel Installation Are Your Patches Current? How do I find out? • Look in Kernel Installation and Distribution Package • May need to contact local Site Manager • Check this website for the latest Software Versions and Patches List at the IHS website: http: //www. ihs. gov/Cio/RPMS/index. cfm? module=home&option=software

Patches for RPMS packages • • • Lab. Pharmacy. PCC Data Entry. Women’s Health. Patches for RPMS packages • • • Lab. Pharmacy. PCC Data Entry. Women’s Health. Immunization. PIMSRadiology. Patient Reg. Behavioral health. Health Summary (IHS) Health Summary Components – Health Summary (VA) - LR APSP APCD BW BI PIMS RA AG AMH APCH BHS GMTS

Adverse Reaction Tracking • Assign “GMRA” keys to Data Entry and utilize “ALG” mnemonic Adverse Reaction Tracking • Assign “GMRA” keys to Data Entry and utilize “ALG” mnemonic to document allergies (instead of using Problem List) • Run “Allergy Reports” in PCC Data Entry and enter allergies into “Adverse Reaction Tracking Package” and remove from problem list • Assign Pharmacist to review all new Allergies that will be entered using EHR. This person should learn the RPMS Adverse Reaction Tracking Package (how to verify allergies).

Asthma Registry System • Setup Asthma Registry and update with new Asthma Patients • Asthma Registry System • Setup Asthma Registry and update with new Asthma Patients • Setup Medication Taxonomies – Consult with Pharmacy for medications used at your facility • Add Asthma Supplement to Health Summary • Run Asthma Quality Reports

CHS/MIS • CHS, Case Managers and Medical Records staff should collaborate to identify a CHS/MIS • CHS, Case Managers and Medical Records staff should collaborate to identify a process to include notice that outside referral and diagnostic reports have been returned to the facility and are available for Provider review. • This process may be included in notifications so that both the Provider, Case Managers and the CHS staff will be informed of the completed contract health service item.

Diabetes Management System • Review Setup Diabetes Registry and update with new Diabetic Patients Diabetes Management System • Review Setup Diabetes Registry and update with new Diabetic Patients • Review Setup Lab Taxonomies – Consult with Lab Manager for names of lab tests at your facility • Review Setup of Medication Taxonomies – Consult with Pharmacy for medications used at your facility • Add Diabetes Supplement to Health Summary • Conduct “Automated Diabetes Audit” and compare to “Hand Audit” using same patient cohort

Immunization • Assign BIZMENU and BIZ Patient Edit keys to all users who enter Immunization • Assign BIZMENU and BIZ Patient Edit keys to all users who enter immunizations. • Review all vaccines in the VAC table – “Activate” vaccines in use. – “Inactivate” vaccines not used • Review all vaccine lot numbers – “Activate” lot numbers in use – “Inactivate” lot numbers no longer in use • Review “Vaccine Information Sheet” (VIS) dates within VAC table

Immunization (continued) • Review the Site Parameters to ensure Lot Numbers are required • Immunization (continued) • Review the Site Parameters to ensure Lot Numbers are required • Determine who will enter new lot numbers into the Immunization Package when they arrive • Teach users (nurses or providers) how to enter immunizations in the Immunization Package

Laboratory • Review Laboratory Exam CPT codes (Lab menu> BLR Menu>CPT) • Review Accession Laboratory • Review Laboratory Exam CPT codes (Lab menu> BLR Menu>CPT) • Review Accession Test Groups (menu of tests) and Create New Accession Test Groups to be Used by Clinics and Wards • Ensure that setup for both “Point-of-Care” and “Reference Lab” tests results display in the Lab Package

Laboratory (continued) • Review All Tests in the Laboratory Test file (#60) and Inactivate Laboratory (continued) • Review All Tests in the Laboratory Test file (#60) and Inactivate Tests no Longer in Use (Set the TYPE to NEITHER and delete synonyms) • Review Holders of the “LRLAB” Key • Assign LOINC Codes to Lab Tests in the Laboratory Test file (Contact OIT for assistance) • Review Setup of Label Printers for Clinics, ER, and Inpatient to be Used for EHR orders

Laboratory (Prep for POC Lab component) • Identify what point of care labs you Laboratory (Prep for POC Lab component) • Identify what point of care labs you plan to use at your facility – Give list to Lab Package Administrator – Review EHR v 1. 1 p 5 notes and implementation guide – Lab Package Administrator should make sure the labs are set up correctly in the lab package according to the POC documentation provided with EHR v 1. 1 p 5 and the Lab Package. • Determine process for POC labs – Where (clinics) – Who (what personnel will perform tests and enter results – Ensure policies and procedures are in place to support POC lab use • POC Lab component is added to the GUI like any other component in Design mode • Final configuration is done in a file called BLR BEHO POC CONTROL file in File. Man. Strongly consider having Lab Informaticist configure this file.

POC Lab component POC Lab component

BLR BEHO POC CONTROL FILE BLR BEHO POC CONTROL FILE

Pharmacy • Maintain drug file in Pharmacy 5/7 • Work with Pharmacy Consultant on Pharmacy • Maintain drug file in Pharmacy 5/7 • Work with Pharmacy Consultant on “Pharmacy Data Management” • Utilize “Paperless Refill” Option • Utilize “EHR Coding Queue” for Managing “Paperless Refills” • Have all NDF patches been installed and verified?

Radiology • Review Radiology Order Menu (List of Radiology Procedures) • Inactivate Procedures no Radiology • Review Radiology Order Menu (List of Radiology Procedures) • Inactivate Procedures no Longer in Use • Review Radiology Exams in the Radiology Package> Supervisor’s menu> Utility File Maintenance Menu> Procedure Edit Menu • Review CPT Codes

Radiology (continued) • Review Process for Radiology Orders that Need to be “Overridden to Radiology (continued) • Review Process for Radiology Orders that Need to be “Overridden to Completion” if Radiology Report is not Entered into Radiology Package • Review system for getting Radiology Reports into Radiology Package

RCIS • Delineate the Steps of the Referral Process (e. g. , Are Referrals RCIS • Delineate the Steps of the Referral Process (e. g. , Are Referrals Entered into the System by the Provider or CHS staff • Check the Link between RCIS and PCC • Review the Template within the RCIS Application to be Utilized by Your Facility to Populate Data on the Purchase Order (Local Category Prompts) • Review RCIS Site Parameters • Review Parameters According to Local Practices and Data/Report Needs

Scheduling (PIMS) • Review Clinic setup for Locations within Your Facility – Visit Type: Scheduling (PIMS) • Review Clinic setup for Locations within Your Facility – Visit Type: Phone Call, Chart Review, Coordination of Care or Case Management, Pharmacy, Lab & Radiology – Use Correct “Service” Category • Ensure Clinics “Create Visit at Check-in” • Review your process to “Check In” Patients

Third Party Billing/Medical Records • Review the PCC Master Control file and make sure Third Party Billing/Medical Records • Review the PCC Master Control file and make sure that all of the Packages are set to pass data to PCC • Review the Third Party Billing Package site parameters

Medical Records • Review EHR Coding Queue (PCC Data Entry Patch 8) • Review Medical Records • Review EHR Coding Queue (PCC Data Entry Patch 8) • Review Coding Paperless Refills Process • Review all Fields of Health Summaries • Review Process for Tracking Providers Utilizing EHR

Women’s Health • Review Site Parameters • Ensure Link to Pass Procedures to PCC Women’s Health • Review Site Parameters • Ensure Link to Pass Procedures to PCC • Review Case Managers setup • Review letters setup • Review Pap Smears Process - Lab Package and/or the Women’s Health Package • Review the System for Entering PAP Results in Women’ Health Package

Women’s Health (continued) • Review System for Entering Mammography Exam, Breast Exams, and Biopsies Women’s Health (continued) • Review System for Entering Mammography Exam, Breast Exams, and Biopsies into Women’s Health • Review System for Printing Letters and Tracking Delinquent Reports

Questions & Discussion Questions & Discussion

Are You Feeling Overwhelmed? Are You Feeling Overwhelmed?

Don’t Panic • RPMS-EHR is a TEAM effort! • The CAC does not own Don’t Panic • RPMS-EHR is a TEAM effort! • The CAC does not own every RPMS Package.