1. Infusion Management and Auto Pump Programming
University Of Missouri
Marcia Stewart, RN
Sr. Clinical Strategist

2. Agenda Scope of Project Glossary of Terms iAware
Infusion Management -introduction
Auto Pump Programming- introduction
Benefits
Timeline – Target February
Process Issues
Demo Requests
Trip to Cerner / Kansas City
What I’m not covering: Pharmacy Workflow / Infusion Billing

3. iAware

4. iAware Overview – What is iAware?
“iAware” refers to a platform, not a solution
Term is more synonymous with “Millennium” than “FirstNet, Surginet, Scheduling”
Platform allows arrangement of “gadgets” or sets of gadgets (content sets) which may have distinct purposes and distinct sources of data
iAware is not part of Millennium
Some gadgets do get their data from Millennium database or leverage existing Millennium services
Code is not delivered in Millennium releases or packages
Distinct set of iAware packages with own naming convention, i.e. “iAware 4.4”

5. iAware Overview - Content
Currently two available content sets:
iAware for Critical Care
iAware Infusion Management
Content sets are licensed separately, so being licensed for one does not mean you are licensed for the other

6. iAware Overview – Two Modes of Operation
Dashboard mode:
Always on, displayed on wall as a dashboard
Operates under generic user context / user does not log in or log out
Intended to provide viewers with patient context while requiring little interaction / scrolling
Allows nurse unit filtering
No customization of perspectives or gadget layout
Personalized mode:
Supports the individual workflow and runs on user devices
Requires user to log in / out using his/her Millennium credentials
Enforces encounter-org security and patient-provider relationships
Allows individual users to customize layouts (add/remove/move/resize gadgets and create/customize perspectives)

7. iAware Overview – Dashboard Mode

8. iAware Overview – Personalized Mode

9. Infusion Management

10. Infusion Management What is Infusion Management
Review of Functionality
Key Design Decisions
Lessons Learned
Enhancements

11. iAware Platform – Cerner Solutions
Critical Care
Infusion Management
EPS Patient, Provider and Equipment Tracking
Physiologic Waveforms
APACHE
Critical Care Mobile
Staff Link
EPS Capacity Management

12. Requirements for CareAware Infusion Management
iAware Framework and CareAware Infusion Management
CareAware iBus
Smart Infusion pumps and associated drivers
Millennium code base of
Interactive View, I&O2G, eMAR, PharmNet

13. Infusion Management Goals
Centralized views to manage infusions
Increase nursing and pharmacy efficiencies
Removes the nurse as the integrator of devices and data
Pro-active volume status and alerting directly from device and MDBus
Near real-time Pharmacy awareness of infusion status
Evaluate effect of infusions on patients
Near real-time graphical display of infusion data directly from device
Correlate with near real-time graphical display of physiologic data
Comprehensive documentation
Document rate, dose rate, and volume in one step
Document associated infusion information in context with hemodynamic and vital sign documentation
Infusion Management Gadgets available in iAware Framework driven by CareAware and the iBus

14. Infusion Management Unit View Patient Infusion Status
Patient to Device Association
Documentation
Graphing
Pharmacy Infusion Status

15. Comprehensive View of Infusions

16. Correlate with Patient Specific Information

17. Infusion Documentation

18. Verified and Real Time Physiologic & Infusion Data

19. Infusion Graph Enhancements
UOP decimal precision
Display most recently documented result with same date/time
Added rSO2 concepts to Hemodynamics graph
Collapse zoom

20. Documentation Enhancements
Feasible limit checking during documentation
Ability to document a witness for infusion rates when required
Selecting an hourly column will select the infused volume results for the previous hour
Pharmacy dispense status in hover

21. Documentation – Hourly Column Selection

22. Documentation – Second Nurse Witness

23. Infusion Management Enhancements
Dispense status in hover
Unit view
Patient Infusion Status
Infusion Documentation

24. Lessons Learned
Strong client clinical leadership is a must to drive the project
Bedside clinician involvement early and often
Test based on clinician workflow – not feature/function
Drug library for infusion pumps when incorporating IV Auto-Programming – test, test, test
Technical resources for iBus and server management

25. Infusion Management Resources
Reference Pages
iAware Implementation Group – uCern
Demonstration Applications

26. Auto Pump Programming
September 11, 2018

27. What is Auto Pump Programming?
Sending Cerner medication charting window to Auto Program the pump

28. What are the Benefits of Auto Pump Programming
Time
40 steps down to 7?
20 steps down to 2?
Safety
Removes manual entry
Much more accurate
Guard rails

29. Prerequisites for Auto Pump Programming
iBus
Certified Smart Pump
Point of Care

30. Auto Pump Programming Workflow Scan the Patient

31. Auto Pump Programming Workflow Scan the Medication

32. Auto Pump Programming Workflow Complete Required Fields

33. Auto Pump Programming Workflow Click Program

34. Auto Pump Programming Workflow Scan the Pump

35. Auto Pump Programming Workflow Programmed – Waiting Confirmation

36. Auto Pump Programming Workflow Confirm Program – Start Pump
Pump does not automatically start… still needs clinician validation

37. Auto Pump Programming Workflow Real-Time Communication Back from Device
Automatic 5 Rights checking
Verifies IV pump settings
Programs IV pump from order detail
The device “knows” who/what is attached
Devices are integrated… not interfaced

38. Questions?