O3 Feature Overview (PIH)
- Fiona Anderson
- Grace Potma
These descriptions are given to PIH end users to provide an overview of each EMR feature with general functionality described. These are not intended to be the only training materials given. For global community use, the descriptions may need to be adapted.
Ward View
The Ward View shows all patients who are currently admitted to a specific location. The Admission Request list shows all patients who are waiting to be admitted to the ward. Each card on the Ward View represents a patient. The card displays demographic information and key clinical data collected during that visit including bed assignment, name, age, EMRID, time since admission, and time on this ward.
If a patient is admitted to deliver a baby the patient cards will update to show both mother and child information once the infant is born and registered as a patient in the EMR. If the mother and child are admitted to the same ward, the child information will appear connected to the mother’s card with the tag Mother/Child. If the child is admitted to a different ward, their information will appear as a row on the mother’s card with the admission location of the infant.
A patient may be admitted and not assigned to a bed. Their card will appear on the bottom of the ward view with no bed number. More than one patient can be assigned to a bed at the same time.
The ward metrics displayed on the top of the view show:
Patients: This is the number of patients admitted to this ward (assigned to a bed or not)
Free beds: This shows the number of empty beds
Capacity: This shows the number of patients admitted to this ward divided by the number of beds. This number could be over 100% if patients are sharing beds or are unassigned to beds
Pending out: This shows the number of patients who are waiting to be transferred to another ward.
The following actions are available in the Ward View by clicking on a patient card.
Patient dashboard: provides summary information about the patient that was documented during their pregnancy for women or while they were a neonate for infants. Clicking the Full Dashboard link will take the user to the full summary dashboard.
Visit Summary: Complete clinical forms and view/edit any clinical forms completed during this visit.
Inpatient Notes: Take notes during the patient’s visit and view any notes already documented for this patient.
Transfer: Transfer a patient to another ward or transfer a patient to a new bed on this ward.
Discharge a patient: Discharge a patient from the hospital. This will unassign them from a bed and end their visit.
Dispensing
The outpatient pharmacy will receive all Drug Orders created by clinicians during a patient’s visit. These Orders will appear in the Pharmacy app either in the “Active Prescriptions” or “All Prescriptions” tab. The Order will contain the drug name, formulation, route, duration, and quantity prescribed. Each Order may contain more than one prescribed medication. If there is more than one prescribed medication in the Order, each can be dispensed independently of each other.
If the prescribed medication or formulation needs to be modified, the pharmacy should ask the clinician to update drug order. Currently the pharmacy staff does not have the permission to change the drugs or formulation of prescriptions created by the clinicians (this is PIH specific).
In the pharmacy, the Prescriptions can have the following statuses:
Active: At least one medication in the Order has not been fully dispensed and is not paused
Completed: All medications have been dispensed
Paused: At least one medication in the Order is Paused and all others are either dispensed, closed, or completed
Expired: The Order is expired after 90 days, and it has not been dispensed
Closed: All medications have been closed
The Pharmacy can take the follow actions within the pharmacy app:
Dispense: This will indicate the medication has been dispensed to the patient. The Quantity will be auto populated with the Quantity prescribed. This can be edited to a number less than what was prescribed (in the case of stock outs). The Quantity cannot be changed to an amount that is greater than what was prescribed.
Pause: This will indicate the medication is not being dispensed right now but will be dispensed at a later date.
Close: This will indicate that this medication is not going to be dispensed.
Pharmacists can print out medication labels to stick on bags or bottles that contain the medication being dispensed.
Appointments
Upcoming appointments can be scheduled in the EMR using the Appointments App. Creating an appointment requires Patient’s name, Location and Service Type, Appointment Type and the Date and Time. Once the appointment is scheduled, it will appear on the list of Expected Appointments for that day and in the calendar view of all upcoming appointments.
The system will prevent any appointments being scheduled outside of clinical hours (before 8am and after 5pm).
Scheduling upcoming appointments can be used to determine how many patients are expected at a clinic on a specific day to manage caseloads. It also provides a list of patients who are expected today that can be downloaded to Excel to support staff in making reminder and follow-up calls to those patients.
When a patient arrives for their appointment, they should be checked in either through the Check-In form or in the Appointments App. At the end of the day all checked-in patient’s appointments will be marked as Completed.
Any patients who do not get checked-in for their appointments will have them automatically be marked as Missed after x number of days.
If a patient is unable to attend their scheduled appointment, the appointment can be canceled or rescheduled to a later date.
Queue (this is really PIH specific)
The Triage queue shows all patients currently waiting to be triaged and who are in triage at the Birthing Center. This queue is meant to support and organize patients to move efficiently from registration/check in into Triage.
Patients can be added to this list during the check-in process (see Check-In SOP) or by clicking the “Add patient to queue +” button. Patients should either be shown as “Waiting” or “In service.”
In service: Indicates the patient is currently in Triage.
Waiting: Indicates the patient is currently waiting to be Triaged.
The queue is organized by the amount of time a patient has been in the queue. Those who have been waiting the longest are at the top of the list.
Clicking the Triage button will open the Maternal Triage form and move the patient to the “In service” status. To move a patient back to the “Waiting” status the Undo and Transition buttons can be used.
To remove a patient from the queue, click on the Remove patient button. For details on the Maternal Triage see Maternal Triage SOP.