1. Creating a Diabetic Health Summary Object and a Diabetic Health Summary Flowsheet Object Lori Moore, Pharm D. Acting SFSU CAC Acting ABQ Area CAC

2. Goals & Objectives Define an object Review the Different Methods Used to Create Objects Discuss the RPMS Keys and Menus Required to Create Objects Create Diabetic Health Summary Object Create Diabetic Health Summary Flowsheet Objects

3. Objects What is an object? –Line of code that points to specific RPMS data –Once the code is inserted into a note the data is retrieved from the RPMS file and automatically populates the text into the note –Objects are surrounded by straight brackets when they are inserted into a note template |BMI WITH CAPTION|

4. Objects Does EHR have objects available for me to use right after it is installed or do I have to create all of them? –Yes – EHR comes with standard objects ready for use Medication Allergies BMI Demographic Information Immunizations Problem List Visit Orders, CPT/POV codes, Patient Education, Procedures, etc.

5. Objects TIU Objects –Requires programming access –Appearance is different –Allows you to pull in data directly from the RPMS package (i.e. lab, pharmacy, etc.) VA Health Summaries Objects –Does not require programming access –Need to have the VAHS patch released in the Summer 2006 –Allows you to pull in data from the health summary (i.e. women’s health data, flowsheets, etc)

6. TIU Objects S X=$$SLAB^BTIUPCC(+$G(DFN),"CREATININE-SFIH") |LAST CREATININE-SFIH| Last CREATININE-SFIH 7.1 H JAN 18, 2007@12:04:49

7. TIU Objects S X=$$NLAB^BTIULO7(+$G(DFN),"CREATININE-SFIH",8) |LAST 8 CREATININE| Last 8 CREATININE-SFIH: 7.1 H JAN 18, 2007@12:04:49 6.7 H NOV 20, 2006@09:16:24 5.8 H OCT 23, 2006@09:06:39 6.1 H SEP 11, 2006@09:21:54 6.4 H AUG 07, 2006@09:54 5.8 H JUN 08, 2006@09:25 5.3 H MAY 10, 2006@14:57:34 5.7 H MAR 31, 2006@09:05

8. DIABETES PATIENT CARE SUMMARY Report Date: Jun 12, 2007 Patient Name: DEMO,DEMO HRN: 999990 Age: 107 Sex: M Date of DM Onset: Apr 04, 2006 (Problem List) Dob: Jan 01, 1900 DM Problem #: SFH18 **NOT ON DIABETES REGISTER** Primary Care Provider: Last Height: 67 inches May 30, 2007 Last Weight: 156 lbs May 30, 2007 BMI: 24.4 Tobacco Use: HTN Diagnosed: Yes ON ACE Inhibitor/ARB in past 6 months: No Aspirin Use (in past yr): No Last 3 BP: 120/90 May 30, 2007 120/88 May 16, 2007 120/80 Feb 08, 2006 In past 12 months: Diabetic Foot Exam: Yes May 16, 2007 (Diabetic Foot Exam, Complete) Diabetic Eye Exam: Yes May 16, 2007 (Diabetic Eye Exam) Dental Exam: No SMBG: No Evidence in the past year DM Education Provided (in past yr): Last Dietitian Visit: Immunizations: Flu vaccine since August 1st: No Dec 10, 2001 Pneumovax ever: Yes Dec 10, 2001 Aug 13, 2001 Td in past 10 yrs: Yes Aug 13, 2001 Last Documented PPD: 0 May 30, 2007 Last TB Status Health Factor: EKG: Laboratory Results (most recent): HbA1c: 5.0 Jun 12, 2007 Next most recent HbA1c: 5.5 Jun 12, 2007 Nephropathy Assessment Urine Protein: Microalbuminuria: Creatinine: 0.5 Jun 12, 2007 Estimated GFR: 109 Jun 12, 2007 Total Cholesterol: 100 Jun 12, 2007 LDL Cholesterol: HDL Cholesterol: Triglycerides: 800 Nov 01, 2005 DEMO,DEMO DOB: 1/1/1900 Chart #SFH 999990 VA HS Flowsheet Object

9. FLO - Flowsheet DIABETIC FLOWSHEET GLUC A1C CHOL LDL HDL PROT M-ALB CREAT TRIG ------------------------------------------------------------------------------------------ 01/12/2007 :155 : :n/r :130.2 :41 : : :0.8 :159 :203 H : : : : : : ------------------------------------------------------------------------------------------ 12/01/2006 :236 H :8.5 H : : : : : :0.7 : ------------------------------------------------------------------------------------------ 08/23/2006 :235 H :7.7 H : : : : : :0.7 : ------------------------------------------------------------------------------------------

10. VA Health Summary Menu/Keys VAHS Health Summary Overall Menu... [GMTS MANAGER] Select EHR SETUP MENU Option: VAHS Health Summary Overall Menu: 1 Health Summary Coordinator's Menu... 2 Health Summary Enhanced Menu... 3 Health Summary Menu... 4 Health Summary Maintenance Menu...

11. VA Health Summary Menu/Keys ************************************* ** IHS Health Summary ** ** Health Summary Maintenance Menu ** ************************************* Version 2.0 SANTA FE HOSPITAL IS Inquire About a Health Summary Type [APCHSINQ] HM Health Maintenance Reminders... [APCH MENU HEALTH MAINTENANCE] PP Print Health Maintenance Item Protocols [APCHSHMIP] LS List Health Summary Types [APCHSTINQ] LC List Health Summary Components [APCHSCINQ] LM List Measurement Panel Types [APCHSMINQ] LF List Health Summary Flowsheets [APCHSFSINQ] LI List Health Summary Flowsheet Items [APCHSFIINQ] MS Create/Modify Health Summary Type [APCHSTED] MM Create/Modify Measurement Panel [APCHSMED] **> Locked with APCHSMGR MF Create/Modify Flowsheet [APCHSFSED] MI Create/Modify Flowsheet Item [APCHSFIED] **> Locked with XUPROG DS Delete Health Summary Type [APCHSTDEL] **> Locked with APCHZMGR DM Delete Measurement Panel Definition [APCHSMDEL] **> Locked with APCHZMGR DF Delete Health Summary Flowsheet [APCHSFSDEL] **> Locked with APCHZMGR DI Delete Health Summary Flowsheet Item [APCHSFIDEL] **> Locked with APCHZMGR

12. Creating VA HS Objects 1 st step –VAHS Health Summary Overall Menu –Health Summary Maintenance Menu –Create/Modify Health Summary Type –Select Health Summary Type: __________ –Setup Occurrence Limit &/or a Time Limit 2 ND Step –TIU Menu for Medical Records –TIU Maintenance Menu –Document Definitions (Manager) –Create TIU/Health Summary Objects with the same name you created in the first step 3 rd Step –Test the object you created in EHR

13. Creating Flowsheet Object 1 st Step –VAHS - Health Summary Maintenance Menu –HSH - Health Summary Menu –MF Create/Modify Flowsheet 2 nd Step –VAHS - Health Summary Overall Menu –Health Summary Maintenance Menu (^HSM) –Create/Modify Health Summary Type –Select Health Summary Type: __________ –Setup Occurrence Limit &/or a Time Limit 3 rd Step –TIU - Menu for Medical Records –TIU - Maintenance Menu –Document Definitions (Manager) –Create TIU/Health Summary Objects with the same name you created in the first step 4 th Step –Test the object you created in EHR