MPages at Lpch - Thus Far
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  • TRANSITION TO CHP slide: a bomb dropped… the ultimate unintended consequence

Transcript

  • 1. MPages Development Conference LPCH MPages Overview Seattle March 30, 2009
  • 2. Introduction
    • Chris Longhurst, MD, MS Medical Director of Clinical Informatics, LPCH Assistant Professor of Pediatrics, Stanford
    • Joshua Faulkenberry Senior Web Applications Engineer, LPCH
  • 3. Outline
    • Overview
      • Lucile Packard Children’s Hospital at Stanford
      • LPCH history with Cerner
    • MPages
      • Clinical challenges and solutions
      • Technical challenges and solutions
      • Future projects
  • 4. Lucile Packard (Women and) Children’s Hospital Overview
    • Opened in 1991
    • Major pediatric/obstetric hospital associated with Stanford University
    • Patient stats (2006)
      • 13k Discharges
      • 5400 Deliveries
      • 106k Clinic visits
      • 280 Active Beds
      • 40%+ critical care patients
    • Centers of Excellence (6)
    • Top 10 children’s hospital by US News & World Report in 2007
  • 5. LPCH Information & Knowledge System (LINKS) Overview
    • Cerner selected as LPCH partner for IT applications in 2002
    • LINKS phase 1 went live 9/2005 – “ Conversion ” from legacy system included 13 “nets”
    • LINKS phase 2 went live 11/2007 – “ Clinical Transformation ” = CPOE using PowerPlans and clinical documentation (using IView)
  • 6. LPCH Development History with Cerner
    • 2005
      • Co-developed PowerChart Outreach
    • 2008 - 2009
      • IView Dynamic labels development partner
      • PRISM development partner
      • MPages development partner (1 st remote hosted site)
  • 7. Clinical Challenges and Solutions
    • Data review
    • Accessing external clinical databases
    • Integrating clinical decision support tools
    • Pediatric risk of mortality adjustment
  • 8. IView Use By Role in 24 Hours
  • 9. “ Rounds” tab 1.0 (RTF Genview)
  • 10. Rounds tab 2.0 (MPage)
  • 11. Clinical Decision Support Tool Integration
  • 12.  
  • 13. Technical Challenges and Solutions
    • Where to store MPage resources
      • Worked with Cerner to identify a standard location for all Remote-Hosted clients (In progress)
    • Loading HTML files into a tab
      • Identified two methods to load HTML files directly into a tab on PowerChart as MPages
  • 14. Technical Challenges and Solutions
    • Discovering the mechanism for true AJAX in MPages
      • Reverse engineered Cerner's code, discovering how to implement a fully functional XMLCclRequest
    • Complete separation of client and server development
      • Developed the “CCL as a Service” (CCLS) architecture – allowing CCL engineers to focus on the Backend and Client-side engineers to focus on the “Frontend”
  • 15. Video demo Illustrating AJAX and realtime waveforms
  • 16. Future MPages Projects at LPCH
    • Continued GenView improvement
      • Plan to combine multiple current GenView tabs into single, customizable “Pt Summary” tab with user-selectable widgets – Dr. Dan Imler * (imlerdl@stanford.edu)
    • Continued external resource integration
      • Transplant database (OTTR) – Dr. Scott Sutherland (suthersm@stanford.edu)
      • Personal health record (Google Health) integration – Drs. Chris Longhurst / Dan Imler
    • Multi-patient dashboards
      • Med/surg – Drs. Chris Longhurst / Dan Imler
      • NICU – Dr. Jon Palma * (jpalma@lpch.org)
      • CVICU – Dr. Andy Shin * (drewshin@stanford.edu)
      • PICU – Dr. Natalie Pageler (npageler@lpch.org)
  • 17. CVICU Dashboard Mockup
  • 18. Google Health Mockup
  • 19. Google Health Mockup
  • 20. Acknowledgements
    • Mattice Harris Manager Web Services, LPCH
    • Ed Kopetsky Chief Information Officer, LPCH
  • 21. Questions
    • Chris Longhurst – clonghurst@lpch.org
    • Joshua Faulkenberry – jfaulkenberry@lpch.org