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System Review CORE Concepts Ilham Hobba December 15, 2012 King Saud University Hospitals.

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Presentation on theme: "System Review CORE Concepts Ilham Hobba December 15, 2012 King Saud University Hospitals."— Presentation transcript:

1 System Review CORE Concepts Ilham Hobba December 15, 2012 King Saud University Hospitals

2 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 1 What is Core? The common processes or tasks that are shared multiple times across clinical domains, technical activities, or project tasks. It is those things that are required in order to get a Cerner Millennium™ application or applications installed.

3 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 2 What is Core? Organizations Security Locations Alias Pools Code Sets Event Codes/Event Sets

4 Organizations Core Services

5 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 4 Organizations in Millennium Organization: Any business entity that is affiliated with the health system. Organization Types Organizations are classified into different Organization Types Each type drives functionality within the Solutions Examples of Organization Types : ClientFacility EmployerInsurance Company HospitalPhysician Offices Multiple Organization Types can be used to define an organization. Example: Cerner Hospital can be a Facility, Client, Hospital, and Employer

6 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 5 Organizations Facility Organizations Client Ins. Company Employer Hospital

7 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 6 Organization Types Possible “Employment/Billing” Organizations: Employers Insurance companies Clients (e.g. Industrial accounts) Employer: An organization that may be given as a place of work or health plan sponsor Insurance Company: An organization with one or many health plans associated underneath it.

8 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 7 Organization Types Client: An organization that is used to represent a specific patient population for patient numbering, billing or report distribution. Organization is a Client if : Charging processes occur (designation needed in order to show is Charge Services tools) The organization is used for client/industrial billing Destination for Clinical Reporting

9 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 8 What are Core Organizations? Possible “Patient Care” Organizations: Hospital Physician Office/Clinic Home Health Hospice Facility Physician Office/Clinic: Areas where health care services are given to patients who do not need to stay overnight. May include services usually provided in a Physician Office or Clinic.

10 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 9 Core Organization Types Facility An organization at which patient care activity takes place. Organization is a facility if: Patient care takes place Patient registration occurs Identifiable patient population (Charting, Security) ProFit billing entity (one tax id) Facilities can contain: One Pharmacy formulary One Order Catalog One Charge Description Master (CDM)

11 Security Core Services

12 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 11 Security Design Security Risks in Healthcare Unauthorized disclosure of patient information Unauthorized disclosure of sensitive information Substance abuse treatment, abortion, mental health, HIV/AIDS, genetics Unauthorized disclosure of intellectual property Security is not… An add-on to your solutions Built after workflow is designed Software that protects the configuration Recommended to be set up at an user-level

13 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 12 SECURITY Vital for Access Control in Millennium What Solutions Can You Access? What Tasks Can You Perform? What Data Can You View? What Organizations Do You Have Access To?

14 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 13 Positions Defined Role based access to Cerner Applications Should be based on the role the user has within scope of Cerner Solutions Not based on job title Position determines authorization within Cerner NOT the same as a job class or employee title

15 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 14 Position Collection Positions will be collected on Core Systems Positions DCW Start positions are outlined on the deliverable This deliverable is assigned to the Core team to complete two weeks prior to Design Review Solution teams will be required to assist the client in designing their positions based on Start content This is to be completed on weekly calls between System Review and Design Review Address position integration points between solutions as they arise The completion of this deliverable will ensure the successful design of position based security at Design Review

16 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 15 Encounter/Organization Security Broad Level of Security Limits what Patient visits (encounters) each User can view, based on what organization the visit occurs at. Users are “tied” to Organizations Users may view information from Patient visit, if the visit occurs at an Organization they are associated with Users can be associated to one or many Organizations Will specific patient populations, such as behavioral health, need to be secured? If yes, each applicable location will be built as a separate facility and therefore require its own organization.

17 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 16 Encounter Organization Security Information Available across all encounters/visits: Allergies Problems PowerNote Clincal Notes Procedures Form Browser (results) Histories (past medical, family, social) Immunizations Medication List (prescriptions and administrations) Encounter/visit-specific information: PowerOrders Diagnoses Provider Relationships

18 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 17 Confidentiality Code Security User associated to Facility AND User assigned a Confid. Level Patient encounter occurs at Facility AND Encounter assigned a Confid. Level User has access to view patient encounter User’s Confid. Level Meets or exceeds Encounter Confid. Level IfAnd Then And >

19 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 18 Cerner ClinicCerner HospitalC.H. Psych Unit Encounter 1 Encounter 2 Encounter 3 Encounter/Organization Security Dr. ADr. C Dr. B

20 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 19 Confidentiality Levels Prerequisite - Encounter Organization Security Compare user and patient encounter codes to determine access Levels are client defined

21 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 20 Examples of Levels: Encounter Psych 7 Security 5 Sensitive 3 Routine Clinical 1 7 Psych users 5 Partial Restricted/Regular Users 3 Clinical Staff 1 PMLocator Users (patient directory) User with a Confid. Level of 5 can view any Encounters with a level 5, 3, or 1 Maximum of 4 levels recommended due to maintenance considerations Users

22 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 21 Within ERM:

23 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 22 Without Cerner ERM Confidentiality Codes can be sent from ADT (Registration System) Sent in HL7 Message- PV2:22

24 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 23 After Encounter Org/Confid Level:

25 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 24 Positions Defined Role based access to Cerner Applications Should be based on the role the user has within scope of Cerner Solutions Not based on job title Position determines authorization within Cerner NOT the same as a job class or employee title

26 Locations Core Services

27 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 26 Locations Generic term used to denote physical place in health care organization. Area where Patient Care takes place. Locations exist in the Location Hierarchy. Any Organization that is a Facility can have locations tied to it.

28 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 27 Location Hierarchy Facility (type of organization) Room Buildings Nurse Unit Bed Cerner Hospital West Pavilion 2 South 202 A

29 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 28 Buildings Buildings Defined A physical structure on hospital property “Houses” registration locations Drives no product functionality (security, billing, etc.) Facility (type of organization) Room Buildings Nurse Unit Bed

30 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 29 Nurse/Ambulatory Unit, Rooms, and Beds Core Units Defined Nursing Unit Ambulatory Unit Facility (type of organization) Room Buildings Nurse Unit Bed Rooms and Beds Represents physical Rooms and Beds Hierarchy format allows for multiple Rooms and Beds with the same name

31 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 30 Facility LOCATION HIERARCHY INPATIENT Building Nurse Unit Room and Beds

32 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 31 Facility LOCATION HIEARCHY DAY REHAB & OUTPATIENT Building Ambulatory Loc

33 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 32 Two Sides Core Locations Facilities Buildings Nurse units Rooms Beds Service Resources Institutions Departments Sections Subsections Exam Rooms

34 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 33 What solutions use Core Locations? Registration Scheduling PowerChart CareNet INet Charge Services PharmNet ProFile ProFit FirstNet Clinical Reporting PathNet AP

35 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 34 Encounter/Organization Security Controls access to patient information by organization. Confidentiality Level Security Additional function available with Encounter Org Security that can be set per facility What solutions use Core Locations?

36 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 35 Registration Patients registered to Facilities If an inter-facility transfer needs to occur, the alias pools for those two orgs must be set up exactly the same Registration can filter out patients by facility PMLocator (Cerner’s patient directory) Auto-discharge can be set up differently per facility (and by patient type) - but not per building, nurse unit, room, or bed Certain code sets can be filtered by facility Patient Type Medical Service Accommodation Code Discharge Disposition Discharge Location What solutions use Core Locations?

37 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 36 What solutions use Core Locations? Registration

38 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 37 Person Search Window Search by location or facility Customize encounter results window with location hierarchy fields. What solutions use Core Locations?

39 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 38 What solutions use Core Locations? Scheduling Patients will get scheduled to a “location”, this is typically an ambulatory location. The location and the facility can be passed into registration if the conversation is launched from the appointment. Relevant to outpatient process only

40 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 39 What solutions use Core Locations? PowerChart Encounter Organization level security. An encounter that is hidden by the use of this type of security will not be accessible on the PowerChart Visit List tab or anywhere else in PowerChart/PowerChart Office. Encounters will also be hidden in the Patient Search for that organization Locations (nurse units/ambulatory) can be used to specifically lock down patient lists on individual computers Set up with a default location list Location patient lists can also be used to help organize work

41 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 40 Organize Patients by Location What solutions use Core Locations? PowerChart

42 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 41 What solutions use Core Locations? CareNet Orders Locations used for routing and printing Orders requisitions Consent forms Reports Printed charts Patient location and ordering location can be used to flex order entry formats. Orderables can be virtualized to specific facilities Ordering is then controlled depending on whether patient is registered at that facility.

43 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 42 What solutions use Core Locations? Inet can flex views based on the patient’s location Patient on the left is located in the adult ICU Patient on the right is located in the NICU

44 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 43 What solutions use Core Locations? Charge Services Any organization that will be used for charge purposes will need to be built as an organization type of “Client” Charges can be flexed based on a multitude of fields Patient location Performing location Facility

45 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 44 What solutions use Core Locations? RadNet Service areas will be tied to existing locations from the hierarchy for routing. Organizations and facilities need to be built prior to building accession number site prefixes

46 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 45 What solutions use Core Locations? PharmNet Formulary products can be flexed based on availability of products per each facility. If a formulary product is stocked on a floor and available via Omnicell/Pyxis, the product can also be associated with a nurse unit/ambulatory location to indicate this.

47 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 46 What solutions use Core Locations? ProFile HIM Chart Tracking has the ability to track a paper chart based on both user-defined locations and locations defined in the hierarchy.

48 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 47 What solutions use Core Locations? ProFit Revenue can be reported by: Patient location Performing location

49 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 48 What solutions use Core Locations? FirstNet Any area where an emergency patient needs to be tracked (beds, hallways, waiting room, etc) will need to built as a location within the emergency department Lab label printing can be routed to different printers in the ED based on location, if necessary Tracking List tabs can be organized based on location Only displaying patients in Fast Track area

50 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 49 What solutions use Core Locations? Clinical Reporting Chart distributions and expedites can be routed by patient location, which includes routing by facility, nurse unit, ambulatory location, or outpatient location. Keep in mind that if you are routing a distribution or expedite by patient location and you would like the ability to print charts to 2 locations within the ED, for instance, you would need to create 2 patient locations for the ED so that the chart can be printed to the respective device in that location. The location where the patient is registered to can also be printed in the chart header/footer. Again, this includes the facility, nurse unit, ambulatory location, and/or outpatient location.

51 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 50 What solutions use Core Locations? Anatomic Pathology (AP) Uses the functions of Orders for all orders placed outside the pathology lab AP uses the functions of Charge Services and Profit to charge based on patient location AP uses Registration and Patient search functions Service resources are used to route internal orders to work lists and work queues Processing orders are added to work queues based upon routing Worklists and Labels are printed based on routing Reports are sent to review queues based on routing Calendars and Service Areas added to benches allow internal AP orders to be sent to the proper lab if there are multiple pathology labs working from the same database.

52 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 51 What solutions use Core Locations? Outreach OSM Requisition Order Entry (ROE) Only Organizations built as clients and facilities are viewable.

53 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 52 What solutions use Core Locations? Outreach Things that can driven by client for Outreach: Encounter type Financial class MRN assignment Insurance, health plan, subscriber (required vs not required) Registrations defaults (Client vs patient bill) Flexible registration Insurance companies Charting Billing

54 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 53 What solutions use Core Locations? ePathLink Organizations built as clients and facilities can be used in ePathLink. Things that can driven by client for ePathLink: Encounter type Financial class MRN assignment Insurance, health plan, subscriber (required vs not required) Registrations defaults (Client vs patient bill) Flexible registration Insurance companies Charting Billing Options for utilization of ePathLink (new orders, results view only etc..)

55 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 54 What solutions use Core Locations? Registration Scheduling PowerChart CareNet INet Charge Services PharmNet ProFile ProFit FirstNet Clinical Reporting PathNet AP

56 Alias Pools Core Services

57 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 56 Alias Pools? Sets of alphanumeric identifiers These numbers are used as boundaries for checking for duplicate persons, encounters, orders, personnel, and organizations. How are alias pools related to organizations? Assigned at organization level

58 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 57 Alias Pools Cerner Hospital CH MRN: Cerner Clinic CC MRN: 223 Patient Pete Smith Pete checks into Cerner Hospital. Hospital assigns Pete a MRN and a FIN Hospital adds his SSN and CMRN CH MRN Pool CH FIN Pool SSN Pool CMRN Pool CC MRN Pool CC FIN Pool Pete visits Cerner Clinic. Clinic assigns Pete a MRN and a FIN Matches SSN and CMRN Pete visits Cerner Clinic for a second time. Matches MRN Adds FIN CH B890 B CM CH FIN: CH3334 SSN: CMRN: 34543CM CC FIN: B890 CC FIN: B2343 SSN: CMRN: 34543CM

59 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 58 Types of Alias Pools Person SSN MRN Organization Insurance company Employer Personnel Organization Dr. # UPIN Provider Numbers Encounter FIN number Visit number Order Placer order number “Buckets” of numbers Examples of data elements that require alias

60 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 59 Alias Pools Association Think of aliases in terms of the organization types rather than at the organization level. Does every Organization need alias pools? No, just certain types of Organizations need pools. Define what pools will be needed for the different types of Organizations Occasionally, there will be an identifier that is unique to one organization, but not apply to all others of the same type.

61 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 60 Alias Pools Explained Fin Number - If patients are being registered to the organization they will always have a FIN number pool. It will be system-assigned only if a client implements Cerner ERM. If it is system assigned you can identify a start number. The FIN number is an encounter alias. MRN - If patients are being registered to the organization they will always have a MRN pool. This works the same way as FIN as far as the start number and system assign. MRN is a person level and an encounter level alias pool. Some applications will look to the encounter specific MRN where other situations you will want to utilize person level or all MRNs. Health Plan - This is required if importing health plans. It is associated to the facility. This pool is used to store Health Plan aliases.

62 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 61 Alias Pools Explained cont… Employer Code - This does not need to be associated to each Employer because this is one of the values that we know ahead of time what will be sent. The Employer Code alias pool should be tied to the main facilities. Encounter Organization Alias - This will need to be associated to all facilities. This is required to correctly stamp the encounter table. Insurance Code - This is the same as the Employer code. You need to have the pool built, but only need to tie to the main facilities. SSN - This pool will be shared by all organizations that patients are registered too. Masking is typically used so the SSN displays with the proper format. DOCDEA, DOCUPIN, External ID, and Organization Doctor - These are all personnel aliases that need to be tied to all facilities.

63 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 62 Shared Alias Pools Alias pools may be shared across organizations Social security number Community medical record number Community doctor number

64 Code Sets including Code Values and Code Value Aliases Core Services

65 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 64 Code Sets - Defined What are code sets and what do they do? Code Sets are groupings of like sets of reference data For example: Gender is a code set. Male, Female, Unknown are all possible reference data elements within the Gender code set. Code Sets also allow you to normalize information to be used across all solutions For example: By using code sets, the end user will see Female in both PowerChart and FirstNet, not Female in PowerChart and Woman in FirstNet

66 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 65 Code Sets Two types of code sets Standard Gender, state, marital status, Units of Measure Solution-specific Laboratory Code Sets (Body Site, Organisms)

67 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 66 Code Sets - Interfaces Code Sets are also used to map information via an Interface Every data element coming into or out of Cerner from a foreign system must have an alias Think of these standard values coming in and out as descriptors Demographic descriptors – race, religion, gender Order Information descriptors – collection priority, mode of transportation, and report priority

68 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 67 Code Sets - Interfaces Patient = John Smith Gender Code SetInbound Values Foreign ADT: “M” Foreign ADT: “F” Foreign Lab: “1” Foreign Lab: “2” M = Male 1 = Male F = Female 2 = Female gender display = Male

69 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 68 Benefits of Code Sets Allow for site customization of data elements Cerner provides Start data elements for you to use Provide for standardization or normalization of data display across all solutions Common display values

70 Event Codes and Event Sets Core Services

71 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 70 What is a Flowsheet?

72 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 71 What is a Clinical Event? Often called a result Result of a question Result of a diagnostic test Result of an assessment Result of a consult

73 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 72 What is an Event Code? Event Code: It is the reference data element against which each clinical event is stored ResultEvent Code Reference Data Element Activity Data Element

74 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 73 More about Event Codes Only ONE event code should ideally exist per concept. It is not a good idea to purposely build more than one event code that conceptually means the same thing. The GOAL and RECOMMENDATION is to strive for ONE event code for each result-able concept.

75 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 74 Event Code Integrity Once an event code is paired with a production result, the two must be an inseparable pair forever. Therefore, event codes that have a result against them on production patients on the clinical event table should: NOT be changed (meaning should not be changed) BE viewable ResultEvent Code Reference Data Element Activity Data Element

76 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 75 Flowsheet – Event Codes Event Code is the placeholder for result

77 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 76 Viewing Event codes and results? Event codes are how results are stored in the system. For most solutions, however, we do NOT view event codes. Thus, we introduce the Event Set. Event Codes need to be paired with an Event Set for viewing. Event Code Event Set

78 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 77 What is an Event Set? Event Set: Event Sets are used to group/organize event codes for viewing and printing (clinical reporting). The organization of event sets is hierarchical, thus called the event set hierarchy. No activity data is stored against an event set.

79 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 78 Flowsheet – Event Sets All rows here, BOTH dark and light blue bars, are event sets. Event Sets are What You Can See

80 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 79 More about Event Sets Event Set Hierarchy: The event sets are organized in a hierarchical structure called the event set hierarchy (ESH). Grouper Event Sets: Like event sets are grouped together into grouper event sets. Primitive Event Set: At the lowest level of the hierarchy, there must be a connection to an event code in order for results viewing to occur. This lowest level event set is called the primitive event set. Therefore, an event set within the ESH can be EITHER a grouper event set OR a primitive event set. It cannot be BOTH. ESH

81 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 80 Diagram of the Required Event Sets All OCF Event Sets All Specialty SectionsAll Result Sections All Service SectionsAll Document Sections Other ResultsOther Documents

82 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 81 ESH Structure Event Codes Primitive Level Child All Service Sections Laboratory UrinalysisHematology Parent Child Parent Child Grouper Event Sets UA Dipstick CBC Bilirubin Urine Dipstick POC WBC RBC Hgb WBC RBCHgb Bilirubin Urine Dipstick POC Blood Urine Dipstick POC Glucose Urine Dipstick POC Blood Urine Dipstick POC Glucose Urine Dipstick POC Parent Child Parent Child All Result Sections All OCF Events

83 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 82 Flowsheet – Grouper and Primitive Event Sets Vital Signs would be considered a Grouper Event Set while Temperature Tympanic, Respiratory Rate etc. are Primitive Event Sets. Vital Signs is the Parent of these primitive event sets The Event Code of Respiratory Rate is tied to the Event Set Respiratory Rate There are no Event Codes tied to Grouper Event Sets

84 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 83 “All Results” Organization Analogy Grouper Event Sets = Sections & Drawers WBC, RBC & Hgb are filed into CBC. CBC goes to “Hematology” Divider in the “Laboratory” Drawer. Event Codes = Paper (Results of WBC, RBC, Hgb are written on different sheets of paper) Primitive Event Sets = Files All WBC, RBC & Hgb papers are filed into separate WBC, RBC, & Hbg files All papers, files, dividers, and drawers are logically organized and sequenced in appropriate SIDE of the “All Results” cabinet.

85 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 84 “All Results” Organization Analogy Event Codes Primitive Level All Service Sections Laboratory UrinalysisHematology Grouper Event Sets UA Dipstick CBC Bilirubin Urine Dipstick POC WBC RBC Hgb WBC RBCHgb Bilirubin Urine Dipstick POC Blood Urine Dipstick POC Glucose Urine Dipstick POC Blood Urine Dipstick POC Glucose Urine Dipstick POC All Result Sections All OCF Events FILES PAPER SECTION SECTIONS DRAWER FILE Cabinet Side of the FILE Cabinet

86 © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 85 Questions


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