MPages at Lpch - Thus Far


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From the Mpages conference in Seattle help on March 30th 2009

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

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