EHR Reminders - Sharing Local Reminders & Dialogs LCDR
Susan Pierce-Richards, MSN, ARNP
Slide 2
Introduction Local Reminders and Dialogs include: Copied
National Reminders with modifications Locally created Reminders and
Dialogs that solve a particular clinical problem Locally created
Reminders and Dialogs providing support for a particular standard
of care or protocol Can be shared between sites with a little
modification Reminder and Dialog development is labor intensive for
the CAC. Well developed Reminder and Dialog tools have very
positive impacts on both patient care and provider documentation.
So. SHARE tools that work.
Slide 3
Objectives At the end of this presentation, the CAC will be
able to: Pack and export a reminder (.PRD file) to the Pub folder
of your RPMS server Attach a packed reminder to an email Move a
packed reminder/dialog (.PRD file) to an accessible location for
import Usually the Pub folder of your RPMS folder Import a packed
reminder/dialog Install a packed reminder/dialog Customize
installed reminder/dialog for your site
Slide 4
Need to know and do before you begin What can I export from
Reminders: Reminder Reminder with linked dialog Check to see that
the dialog you want exported is properly linked If you want to
export just the dialog: Create blank reminder called Blank with
name dialog Export the blank reminder with dialog What can I import
into Reminders: Reminder Reminder and linked dialog Any reminder
part Any dialog part TIU template fields embedded in dialogs
Slide 5
Need to know and do before you begin What does NOT import:
Local TIU objects Local Quick orders Local Lab, Med, etc During
import, youll be prompted to substitute your local items. Have
these exact names ready. ASK YOUR SITE MANAGER: Where is the Pub
folder for your RPMS server It will look something like this
g:\pub\ What is the IP address of your RPMS server Pub folder. It
will look something like this
ftp://10.243.168.54/pub/ftp://10.243.168.54/pub/ ADD this FTP site
to your My Network Places folder (see next slides)
Slide 6
Add RPMS pub folder to your My Network Places Go to the Start
Menu Choose My Network Places
Slide 7
Click on Add a network place to bring up the add network place
wizard, then click next
Slide 8
Click on Choose another network location, then next to open the
next window: You may see other entries, but use the one that looks
like a folder with a bar underneath it.
Slide 9
Input the address you got from your Site Manager (see earlier
slide) In this example, some numbers are replaced with # for
security. Also, a specific Reminders folder was created in the pub
folder by the Site Manager. You can name the folder whatever you
like, to help you remember what it is.
Slide 10
Finish, and open the folder if desired:
Slide 11
1.Go to your Outlook mail, select new message and attach
2.Click on My Network Places on the left side of the Insert File
dialog box. 3.The Add Network Place Wizard will come upclick next
Alternative method
Slide 12
Click Next.
Slide 13
Here enter the address of the Pub folder your Site Manager gave
you (see slide 5). Click Next.
Slide 14
Click Next.
Slide 15
Enter a name. Click Next.
Slide 16
Click Finish.
Slide 17
Now you can more easily move files in and out of your Pub
folder
Slide 18
Exporting Reminder: Scenario: You have begun using reminders.
You already made modifications to the National Mammogram reminder
and dialog. Another CAC likes your format and has asked that you
send him the reminder and dialog.
Slide 19
Steps to Export a Reminder Verify dialog is linked to reminder
if you want to export an associated dialog Pack the reminder Use
Create Exchange File Entry in Reminder Exchange Add notes with
pertinent info like local Quick Order names, objects used Export
the reminder Use Create Host File This places a.prd file on your
Pub drive
Slide 20
Step 1 Verify Reminder Dialog Linked If you want a dialog
packed with the reminder, check to make sure the dialog is linked
you can look at the reminder definition: YAK-MAMMOGRAM 2007 No. 108
-------------------------------------------- Print Name: Mammogram
Class: LOCAL Sponsor: Review Date: Usage: CPRS, DATA EXTRACT,
REPORTS Related VA-* Reminder: Reminder Dialog: IHS-MAMMOGRAM
2007
Slide 21
Step 2 Pack the Reminder Go to Reminder Exchange (BEH-REM-EXC)
Clinical Reminder Exchange Sep 11, 2008 09:37:22 Page: 1 of 8
Exchange File Entries. Entry Source Date Packed 1 BLANK for TO
Dialogue RICHARDS@YAKAMA HEALT 06/25/2008@17:45:56 2 IHS-ALCOHOL
SCREEN 2007 HAGER@DEMO HOSPITA 07/24/2008@11:46:22 3 IHS-ALLERGY
HAGER@DEMO HOSPITA 07/24/2008@09:57:25 4 IHS-ASTHMA PLAN 2007
HAGER@DEMO HOSPITA 07/24/2008@09:57:50 5 IHS-ASTHMA PRIM PROV 2007
HAGER@DEMO HOSPITA 07/24/2008@09:58:07 6 IHS-ASTHMA SEVERITY 2007
HAGER@DEMO HOSPITA 07/24/2008@09:58:22 7 IHS-ASTHMA STEROID 2007
HAGER@DEMO HOSPITA 07/24/2008@09:58:45 8 IHS-BLOOD PRESSURE
HAGER@DEMO HOSPITA 07/24/2008@09:59:12 9 IHS-COLON CANCER 2007
HAGER@DEMO HOSPITA 07/24/2008@10:09:19 10 IHS-DEPRESSION SCREEN
2007 HAGER@DEMO HOSPITA 07/24/2008@10:01 + + Next Screen - Prev
Screen ?? More Actions CFE Create Exchange File Entry IH
Installation History CHF Create Host File LHF Load Host File CMM
Create MailMan Message LMM Load MailMan Message DFE Delete Exchange
File Entry LR List Reminder Definitions IFE Install Exchange File
Entry RI Reminder Definition Inquiry Select Action: Next Screen//
cfe Create Exchange File Entry
Slide 22
Select Reminder Definition to pack: YAK-MAMMOGRAM 2007 LOCAL
Enter a description of the reminder you are packing. ==[ WRAP ]==[
INSERT ]================== =================[ H=Help ]==== Females
40 to 70 should have yearly mammograms. Mammograms are found by CPT
code, radiology exam or from the women's health pack Contains quick
order: GMRQO CHS Mammogram prior to install either create this
exact quick order OR have ready the exact name of your site's
Mammogram consult ***add information about site specific items in
the reminder quick orders, objects, lab names, etc. This will
assist the CAC who imports this reminder/dialog*** ====== Enter
keywords or phrases to help index the reminder you are packing.
Separate the keywords or phrases on each line with commas. ==[ WRAP
]==[ INSERT ]================== =================[ H=Help ]====
MAMMOGRAM
--------------------------------------------------------------------------------
Do you want to save changes? Yes
Slide 23
This is the Exchange File Entry you created that now can be
exported == ==== Clinical Reminder Exchange Sep 11, 2008 09:41:19
Page: 7 8 Exchange File Entries. + Entry Source Date Packed 61
YAK-DM ACE/ARB RICHARDS@YAKAMA HEALT 08/13/2007@14:35:43 62 YAK-DM
ASPIRIN RICHARDS@YAKAMA HEALT 08/13/2007@14:36:02 63 YAK-DM EYE
EXAM RICHARDS@YAKAMA HEALT 08/13/2007@14:36:21 64 YAK-DM
THIAZOLIDINEDIONE MO RICHARDS@YAKAMA HEALT 01/25/2008@14:00:34 65
YAK-HF ACE/ARB RICHARDS@YAKAMA HEALT 08/13/2007@14:37:32 66 YAK-HF
B BLOCKER RICHARDS@YAKAMA HEALT 08/13/2007@14:37:47 67 YAK-HF
DIURETIC RICHARDS@YAKAMA HEALT 08/13/2007@14:38:02 68 YAK-MAMMOGRAM
RICHARDS@YAKAMA HEALT 03/19/2008@08:19:15 69 YAK-MAMMOGRAM 2007
RICHARDS@YAKAMA HEALT 09/11/2008@09:37:54 70 YAK-PAIN CONTRACT DRUG
SCRE RICHARDS@YAKAMA HEALT 12/07/2007@11:08:13 + + Next Screen -
Prev Screen ?? More Actions CFE Create Exchange File Entry IH
Installation History CHF Create Host File LHF Load Host File CMM
Create MailMan Message LMM Load MailMan Message DFE Delete Exchange
File Entry LR List Reminder Definitions IFE Install Exchange File
Entry RI Reminder Definition Inquiry
Slide 24
Step 3 Exporting Reminder ====== Clinical Reminder Exchange Sep
11, 2008 09:41:19 Page: 7 8 Exchange File Entries. + Entry Source
Date Packed 61 YAK-DM ACE/ARB RICHARDS@YAKAMA HEALT
08/13/2007@14:35:43 62 YAK-DM ASPIRIN RICHARDS@YAKAMA HEALT
08/13/2007@14:36:02 63 YAK-DM EYE EXAM RICHARDS@YAKAMA HEALT
08/13/2007@14:36:21 64 YAK-DM THIAZOLIDINEDIONE MO RICHARDS@YAKAMA
HEALT 01/25/2008@14:00:34 65 YAK-HF ACE/ARB RICHARDS@YAKAMA HEALT
08/13/2007@14:37:32 66 YAK-HF B BLOCKER RICHARDS@YAKAMA HEALT
08/13/2007@14:37:47 67 YAK-HF DIURETIC RICHARDS@YAKAMA HEALT
08/13/2007@14:38:02 68 YAK-MAMMOGRAM RICHARDS@YAKAMA HEALT
03/19/2008@08:19:15 69 YAK-MAMMOGRAM 2007 RICHARDS@YAKAMA HEALT
09/11/2008@09:37:54 70 YAK-PAIN CONTRACT DRUG SCRE RICHARDS@YAKAMA
HEALT 12/07/2007@11:08:13 + + Next Screen - Prev Screen ?? More
Actions CFE Create Exchange File Entry IH Installation History CHF
Create Host File LHF Load Host File CMM Create MailMan Message LMM
Load MailMan Message DFE Delete Exchange File Entry LR List
Reminder Definitions IFE Install Exchange File Entry RI Reminder
Definition Inquiry Select Action: Next Screen// chf Create Host
File Select Entry(s): (61-70): 69 Enter a path: c:\tmp\// g:\pub\
this is the Pub folder (see Ask your site manager slide) Enter a
file name: MAMMOGRAM 2007_YAKAMA use consistent nomenclature with
name, date, site Will save selected entries to host file
g:\pub\MAMMOGRAM 2007_YAKAMA.PRD?: Y// ES
Slide 25
Now the file is ready to send Open email and click on the paper
clip to attach Go into My Network Places Click on the Network Place
you created earlier Attach the PRD file as you would any other file
and send via email
Slide 26
Importing a Reminder SCENARIO: Your Clinical Director wants
some changes to the National Mammogram Reminder and Dialog. He was
at a CD Meeting and learned that another site had exactly what he
wants for your site. That sites CAC attached the reminder file to
an email. Youre not sure what to do next
Slide 27
Open the email with the attached PRD file Right click on the
file, click SAVE AS Click on My Network Places and navigate to the
Pub folder you set up earlier Step 1: Move file to the Pub
folder
Slide 28
Now save it to the Pub folder here You will be able to load
this to the Reminders Exchange
Slide 29
Step 2: Load Host File to the Reminders Exchange Clinical
Reminder Exchange Sep 12, 2008 14:42:34 Page: 1 of 8 Exchange File
Entries. Entry Source Date Packed 1 BLANK for TO Dialogue
RICHARDS@YAKAMA HEALT 06/25/2008@17:45:56 2 IHS-ALCOHOL SCREEN 2007
HAGER@DEMO HOSPITA 07/24/2008@11:46:22 3 IHS-ALLERGY HAGER@DEMO
HOSPITA 07/24/2008@09:57:25 4 IHS-ASTHMA PLAN 2007 HAGER@DEMO
HOSPITA 07/24/2008@09:57:50 5 IHS-ASTHMA PRIM PROV 2007 HAGER@DEMO
HOSPITA 07/24/2008@09:58:07 6 IHS-ASTHMA SEVERITY 2007 HAGER@DEMO
HOSPITA 07/24/2008@09:58:22 7 IHS-ASTHMA STEROID 2007 HAGER@DEMO
HOSPITA 07/24/2008@09:58:45 8 IHS-BLOOD PRESSURE HAGER@DEMO HOSPITA
07/24/2008@09:59:12 9 IHS-COLON CANCER 2007 HAGER@DEMO HOSPITA
07/24/2008@10:09:19 10 IHS-DEPRESSION SCREEN 2007 HAGER@DEMO
HOSPITA 07/24/2008@10:01 + + Next Screen - Prev Screen ?? More
Actions CFE Create Exchange File Entry IH Installation History CHF
Create Host File LHF Load Host File CMM Create MailMan Message LMM
Load MailMan Message DFE Delete Exchange File Entry LR List
Reminder Definitions IFE Install Exchange File Entry RI Reminder
Definition Inquiry Select Action: Next Screen// LHF
Slide 30
Enter the path for the Pub file Enter a path: c:\tmp\// g:\pub\
this is the Pub folder (see Ask your site manager slide) The
following PRD files were found in g:\pub\ Lead test 24 months.PRD
Lead test 36_72 months.PRD Lead test 9_12 month old.PRD MAMMOGRAM
2007_YAKAMA.PRD PNEUMOVAX.PRD PRENATAL SCREENING.PRD Tobacco_6 25
08_yakama.PRD WSP ADULT IMM TEST.PRD YAK PRENATAL PLAN.PRD
YAK_MAMM_2007.PRD Enter a file name: YAK_MAMM_2007.PRD you must
type this exactly
Slide 31
Step 3: Install from the Exchange like you would any other
reminder Clinical Reminder Exchange Sep 12, 2008 14:49:46 Page: 7
of 8 Exchange File Entries. + Entry Source Date Packed 61 YAK-DM
ACE/ARB RICHARDS@YAKAMA HEALT 08/13/2007@14:35:43 62 YAK-DM ASPIRIN
RICHARDS@YAKAMA HEALT 08/13/2007@14:36:02 63 YAK-DM EYE EXAM
RICHARDS@YAKAMA HEALT 08/13/2007@14:36:21 64 YAK-DM
THIAZOLIDINEDIONE MO RICHARDS@YAKAMA HEALT 01/25/2008@14:00:34 65
YAK-HF ACE/ARB RICHARDS@YAKAMA HEALT 08/13/2007@14:37:32 66 YAK-HF
B BLOCKER RICHARDS@YAKAMA HEALT 08/13/2007@14:37:47 67 YAK-HF
DIURETIC RICHARDS@YAKAMA HEALT 08/13/2007@14:38:02 68 YAK-MAMMOGRAM
RICHARDS@YAKAMA HEALT 03/19/2008@08:19:15 69 YAK-MAMMOGRAM 2007
RICHARDS@YAKAMA HEALT 09/11/2008@10:51:12 70 YAK-PAIN CONTRACT DRUG
SCRE RICHARDS@YAKAMA HEALT 12/07/2007@11:08:13 + + Next Screen -
Prev Screen ?? More Actions CFE Create Exchange File Entry IH
Installation History CHF Create Host File LHF Load Host File CMM
Create MailMan Message LMM Load MailMan Message DFE Delete Exchange
File Entry LR List Reminder Definitions IFE Install Exchange File
Entry RI Reminder Definition Inquiry Select Action: Next Screen//
IFE Select Entry(s): (61-70): 69
Slide 32
READ the Reminder description. Hopefully the exporting site
identified items you need to either create or have ready when you
install Exchange File Components Sep 12, 2008 14:52:59 Page: 1 of 3
ComponeFile Entry Category Exists Reminder: YAK-MAMMOGRAM 2007
Source: RICHARDS,SUSAN P at YAKAMA HEALTH CENTER IHS Date Packed:
09/11/2008@10:51:12 Description: Females 40 to 70 should have
yearly mammograms. Mammograms are found by CPT code, radiology exam
or from the women's health pack Contains quick order: GMRQO CHS
Mammogram prior to install either create this exact quick order OR
have ready the exact name of your site's Mammogram consult
Keywords: No keywords given Components: + Enter ?? for more actions
IA Install all Components IS Install Selected Component Select
Action: Next Screen//IA
Slide 33
Install Reminder, Accept Defaults Select Action: Next Screen//
ia Install all Components Only programmers can install routines.
REFUSAL TYPE entry MAMMOGRAM already EXISTS, what do you want to
do? Select one of the following: C Create a new entry by copying to
a new name I Install or Overwrite the current entry Q Quit the
install S Skip, do not install this entry Enter response: S// kip,
do not install this entry Only programmers can install Reminder
Computed Findings. REMINDER TAXONOMY entry IHS-MAMMOGRAM 2007
already EXISTS, what do you want to do? Select one of the
following: C Create a new entry by copying to a new name I Install
or Overwrite the current entry Q Quit the install S Skip, do not
install this entry Enter response: S// kip, do not install this
entry
Slide 34
REMINDER TAXONOMY entry IHS-BILATERAL MASTECTOMY already
EXISTS, what do you want to do? Select one of the following: C
Create a new entry by copying to a new name I Install or Overwrite
the current entry Q Quit the install S Skip, do not install this
entry Enter response: S// kip, do not install this entry REMINDER
DEFINITION entry YAK-MAMMOGRAM 2007 already EXISTS, what do you
want to do? Select one of the following: C Create a new entry by
copying to a new name I Install or Overwrite the current entry Q
Quit the install S Skip, do not install this entry Enter response:
I//nstall or Overwrite the current entry
Slide 35
Install the dialog Dialog Components Sep 12, 2008 15:02:22
Page: 1 of 1 Packed reminder dialog: IHS-MAMMOGRAM 2007 Item Seq.
Dialog Findings Type Exists 1 IHS-MAMMOGRAM 2007 dialog X 2 1 HD
MAMMOGRAM element X Finding: *NONE* 3 3 HD ELIGIBILITY element
Finding: *NONE* 4 5 OI MAMMOGRAM element Finding: GMRQO CHS
Mammogram (ORDER DIALOG) X + Next Screen - Prev Screen ?? More
Actions DD Dialog Details DT Dialog Text IS Install Selected DF
Dialog Findings DU Dialog Usage QU Quit DS Dialog Summary IA
Install All Select Action: Quit//IA Install reminder dialog and all
components with no further changes:Y//YES
Slide 36
Replacing Item on Install If you had not created the GMRQO CHS
Mammogram, you would be prompted to make a change: Install reminder
dialog and all components with no further changes:Y// ES FINDING
entry Q.GMRQO CHS Mammogram does not exist. Select one of the
following: D Delete (from the reminder/dialog) P Replace (in the
reminder/dialog) with an existing entry Q Quit the install Enter
response: p Replace (in the reminder/dialog) with an existing entry
Select ORDER DIALOG NAME: GMRZ Mammogram Now that element maps to
your quick order
Slide 37
Tips Installing an imported reminder is really no different
from installing a National Reminder and Dialog Local terms will
need to be mapped (add local labs, meds, etc) Taxonomies may error
out if the reminder contains taxonomies, make sure that the
exporting site provides you with the codes they used so you can
recreate it (just like National Template installs) Like TIU
templates, sites may have used a locally created Object you will
need to either replace this with your own, or create one with the
identical name TEST TEST TEST TESTjust as you would with a newly
loaded National Reminder
Slide 38
Backing up Local Reminders Strongly consider using the export
instructions to back up your local reminders and dialogs. Place
them in a folder on a server that is backed up regularly (consult
with IT).
Slide 39
Take Home Message. Avoid duplication of effort If someone else
has created a tool that works, then import and customize If you
have created a tool that works, then share with others DO include
brief notes alerting other sites of terms, quick orders, objects
and other site specific data that will need to be adapted when
imported
Slide 40
We are developing a forum for collaboration, sharing and
information exchange. If you are a CAC who has developed or is
developing local Reminders and Dialogs at your site and is
interested in collaborating with others, please send your contact
information to Susan Pierce-Richards. [email protected]
Slide 41
Resources Clinical (EHR) Reminders Manual
ftp://ftp.ihs.gov/pubs/EHR/Training/Guides/EHR Reminders Guide.doc
Clinical (EHR) Reminders Patch 1005 National Reminder Set Up guide
will be released with the patch and patch notes. Other reminders
resources:
ftp://ftp.ihs.gov/pubs/EHR/Training/Guides/EHR%20Reminders/
Recorded WebEx trainings:
https://ihs-hhs.webex.com/mw0305l/mywebex/default.do?siteurl=ihs-hhs&service=7
EHR Reminders Copying and Customizing National Reminders EHR
Reminders Customizing National Dialogs Future WebEx trainings on
creating reminders, dialogs and report will be announced via the
EHR ListServ and Area CACs. Please send suggestions for future EHR
Reminders WebEx trainings to: [email protected][email protected]
