S & a day 1 app training

Maureen Russell MSn, RN-BC
PCCI- Connected Care Solutions
November 2013
IntelliSpace Perinatal
Surveillance & Archiving Training
Revision H

November 2013
Introduction

PCCI- Connected Care Solutions, Maureen Russell, November 2013 3
Application Training
• Objective: to provide new product introduction training for IntelliSpace
Perinatal revision H. Upon course completion, the student will be able to
demonstrate the new feature set and explain the clinical use models.
• Prerequisite: Student must have basic understanding of product
features and OB GYN clinical workflow
• Teaching model: Instructor led hands on product training sessions
using rev H VMware image via RDP.

PCCI- Connected Care Solutions, Maureen Russell, November 2013
Rev H Training Agenda
Day 1: Tuesday
• Introductions
• Product overview
• Obstetrical clinical environment
• Clinical documentation workflow
• User roles and permissions
• User interface
• Navigation
• Patient search
• Lab sessions

Day 2: Wednesday
• Patient profile
• Chalkboard
• Single trace
• Flowchart
• Notes browser
• Audit trail
• Printing
• Lab sessions

Day 3: Thursday
• System Manager configuration
• General overviews
• PC and default sets
• Maternal locations
• Alarm defaults
• Screen layouts and print maps
• Lab sessions

Resources – Product Documentation
1. Data Field Reference Guide
2. External Database Guide
3. Integration Guide
4. Installation and Service Guide
5. Instructions for Use
6. Site Prep and IT Guide
7. System Administration and Configuration Guide
8. Trainer Toolkit

Philips Learning Center
• https://theonlinelearningcenter.com

Philips Learning Center
IntelliSpace Perinatal eLearning Modules:
Module 1 - System Hardware
Module 2 - Configuration of General and Hospital tabs
Module 3 - Configuration of Users
Module 4 - Configuration of Maternal/Newborn Locations and Multi-bed
Overview
Module 5 - Configuration of Alarms
Module 6 – Configuring PCs
Coming soon:
Module 7 - Flowchart Fundamentals
Module 8 - Flowcharting Patient Assessments and Medications

Summary of Major Features rev H
• Introducing IntelliSpace Perinatal - Product rebranding
• Updated user interface
• Comprehensive Patient profile
• Improved navigation and clickable links
• User account deactivation/expiration
• Improved scalability and manageability
• Enhancements for IT, EMR interfacing/integration
• New service layer infrastructure
• New high availability
• New Excel Log and Word Reports
10

Revision H Main Take Aways!
Improved Care Team
Communication
- Patient Profile
- Patient-Centric Clinical Workflows
Perinatal
Excellence
- Maternal Statistical Reports
- Newborn Statistical Reports
Usability
- Updated User Interface
Streamline Navigation
-
Manageability
- Separation of Services
- System Console
- Virtualization
11

• A new name- the same
commitment
• IntelliSpace Perinatal joins the
family of Philips IntelliSpace
clinical informatics solutions
• Customer-facing literature name:
‘IntelliSpace Perinatal’.
• Parts of internal documentation
will have ‘ OB TraceVue’ name

New Product Logo and Splash Screen

Product Number and Option Structure
Product
Number
Description
866131 IntelliSpace Perinatal Advance system:
Surveillance, Archiving, HL7, OBTV link, attachment,
advanced charting (Forms) and reporting
866132 IntelliSpace Perinatal Advanced System, Integration Edition:
Surveillance, Archiving, HL7, OBTV link, attachment
866133 IntelliSpace Perinatal - Surveillance and Archiving System :
bundled with Server HW, pre-installed
866138 IntelliSpace Perinatal Optional Components

Surveillance & Archiving (S&A)
Data Storage
& Archive
Surveillance
and Alarming
Web
Access
ADT Interface
to HIS
Maternal
Flowchart
(intrapartum)
Newborn
Documentation
(flowchart & Forms)
Reports and
Statistics
Lab data
interface
Maternal
Documentation
(Forms & Gyn)
Data Export
(ORU
interface)
Surveillance &
Archiving System

Advanced System Integration Edition
Data Storage
& Archive
Surveillance
and Alarming
Newborn
Documentation
(flowchart & Forms)
Reports and
Statistics
Web
Access
ADT Interface
to HIS
Maternal
Flowchart
(during birth)
Maternal
Documentation
(Forms & Gyn)
Lab data
interface
Data Export
(ORU
interface)
Advanced System
Integration Edition

IntelliSpace Perinatal S&A; two possibilities
Standard S&A
 On rp5800 desktop PC
no RAID, single CPU, single power supply
H*W*D in mm: 100*340*380
Weight in kg: 8.9
 Max 10 concurrent web sessions
 Max 16 FM
 No document export
High-end S&A
 On DL380 G7 server
RAID-hot swap, dual CPU, dual power supply
H*W*D in mm: 86*445*700
Weight in kg: 27.27
 Max 16 concurrent web sessions
 Max 32 FM
 Event-triggered automatic document export
accompanied by HL7 MDM message (if
wanted) “DOX”

Improved Manageability and Scalability
• Increased scale
– Max users configured 3000
– Max users concurrent 250
– Max episodes, 4,000,000
• Improved remote management
– Convert most processes to Microsoft services
– MMC-style management module
– System management – ping, reboot, stop/start IntelliSpace
Perinatal
• More efficient administrator workflow
– Multi-admin access to configuration pages
– Ability to deactivate/expire user accounts
– Support for IPV4 and IPV6
18

Obstetrical Clinical Environment
• Fast paced clinic or high risk hospital setting
• Multiple caregivers- Midwives, Consultants, Physicians
• Fetal and maternal surveillance- critical for optimal patient outcome
• Archiving of trace data and documentation
• Pregnancy documentation: multiple visits during pregnancy
• Patient may have several pregnancies

Obstetrics
Terminology
0
Antepartum
40
Conception
Weeks of Gestation
Birth delivery
Intrapartum
( during delivery )
Postpartum
( after delivery)
20

When is Electronic Fetal Monitoring(EFM) Used
Antepartum Monitoring
• Used during the last of three trimesters, use of CTG is recommended
from week 25
• Non-invasive external monitoring of both mother and fetus
• The prime goal is to prevent fetal death
• Routine basis throughout pregnancy
• Special importance for high risk pregnancies
21

Avalon Fetal Monitor

When is Electronic Fetal Monitoring Used
Intrapartum Monitoring
• Used for fetal and uterine monitoring during the onset of labor and the
actual birthing process until delivery
• Both external and internal (invasive)
• Performed on all mothers upon admission to the labor ward
• Special importance during labor and delivery when there is a suspicion
of complications.
23

Avalon Fetal Monitor - Monitoring Twins and
Triplets

Antepartum – Before Birth

Intrapartum- During Labor

Postpartum- After Birth

Patient Data Storage

S&A
S&A Intrapartum documentation

Documentation Workflow-Maternal Newborn

What is an Episode?
• Each encounter is an ‘episode’
• A pregnancy can have multiple episodes
• A patient may have multiple pregnancies
• A patient may have multiple newborns within 1 pregnancy
• Each Newborn is linked to a Maternal record
• Automatic closure of pregnancy record or newborn documentation = 18
months from the last closed episode

Working with Episodes
Open
• Create patient
• Open episode
Chart
• Surveillance-fetal trace
• Flowchart/Forms documentation
Close
• Transfer patient Home
• Episode closed/archived

Working with Episodes
• Can configure data elements to be mandatory before allowing closure
• Can retrieve closed episodes for review and/or correction
• Can re-open a closed episode to continue documentation
• Can merge and un-merge patient records
• All episode corrections are listed in the audit trail
• Total number of simultaneously open episodes = 1100
• Total number of episodes = 400,000

Mother
Pregnancy 1 Pregnancy 2 Pregnancy 3
Baby 1 Baby 2
Episode 1 Episode 2 Episode 3
GYN
Patient Data Overview

User Roles and Permissions
• Philips User
• System Administrator
• System Manager (SM)
• Super User (SU)
• User

User, Roles and Permissions
Philips User
• responsible for initial setup,
including giving access to the
System Manager
• has full system permission
• the institution can change the
password for this user

System Administrator
• uses special Perinatal support
tools such as database repair
System Manager (SM)
• responsible for overall clinical
administration of system
• can grant System Manager,
Super User, and User
permissions to other users
• there must be at least one System
Manager per system

Super User (SU)
• responsible for day to day clinical
administration (adding new users)
• can change system defaults
(alarm, storage parameters)
• cannot grant permissions
• there must be at least one Super
User per shift.
User
• clinically trained nurse or
healthcare provider who uses the
system.
• may change her own overview
screen, password

November 2013
User Interface

IntelliSpace Perinatal Revision H
Why Main UI changes?
Harmonize with Philips: User Experience Identity (UEI)
40

IntelliSpace Perinatal Revision H
Why Main UI changes?
41
Harmonize with Microsoft: (MSCUI)
:

User Interface

Comparison of G to H

Improved User Experience
44

Multi-Bed Overview
•

System Toolbar
• Functions that relate to multiple patients and quick admit function
• Administrative functions

Patient Banner
“Patient in Focus”
• Key concept for Rev H
• Wherever you navigate in the application you can keep the patient in
focus
• Middle name initials now in banner

Patient in Focus
• Open drop down to show patient list
• Patient selected is highlighted
• Can ‘Clear patient selection’ to remove patient in focus
• Can filter to show only: all departmental patients(----) or ‘Own Patients’
48

Patient Panel
• Divided into 4 sections
1. Patient medical data
2. Current pregnancy status information
3. Current episode data
4. Alerts for LAB reminders and flagged data
Clickable link navigates to the page that contains the data
4

Patient Panel
• New in H.10: once the delivery date is documented the panel changes
from AP/IP to PP
• User can create Newborn from here
• User must manually change Flowchart to PP

Create Newborn

Patient Toolbar
• All functions are for the ‘Patient in Focus’
• Left side – clinical functions
• Right side – administrative functions

Patient Toolbar Icons – Clinical Functions

Patient Toolbar – Administrative Icons

November 2013
Navigation

New Navigation

Navigation
• ‘Patient in Focus’ stays in focus as you navigate unless you ‘Clear
patient selected’
• Patient-centric information/navigation is contained within the ‘Patient in
Focus’ view

Navigation Comparison
G
H

Patient in Focus
• Patient remains in focus, can choose to navigate to a different patient or
can clear patient in focus

Patient Panel
• User can hover over item to reveal a tooltip
• User can click on data and be linked to the source of documentation

Patient Panel Links to Record/Tab
Patient Panel Label Links to Record / tab
Born Admission/Demographics/Date of Birth
Patient identifier Admission/Demographics
Problems Prenatal or Admission/Problems
Allergies Prenatal or Admission /Allergies
G/P Prenatal or Admission /Pregnancy
GA Prenatal or Admission /Pregnancy
Membr. Flowchart/Vag.Exam/Membranes
A.Fluid Flowchart/Vag.Exam/A.Fluid
Dilation Flowchart/Vag.Exam/Dilation
Station Flowchart/Vag.Exam/Station
Position Flowchart/Vag.Exam/Position
Attending Provider Maternal Chalkboard
Admission date/time Admission/Admission

Patient Panel - Maternal Newborn Link

Patient Toolbar
• User can navigate to patient specific documentation or actions

Patient Search
• Able to navigate between maternal and newborn with 1 click
• An include newborns from the maternal search

Patient Search
ADT: Enhanced Patient Search
65
• Use Case: Find any patient in the system
Newborn
HIS pre-admit

Patient Administration
• New LAB icon
• Archive Search –
• Removed Super User permission for ‘Open for Correction’
• Rolodex filter supports non-SU view of open for corrections episodes
66

Patient Search Notification Buttons
• Background is highlighted when information requires action/viewing

Review Episodes and Retrieve Episodes

One View - Complete Patient Record
69

Quick retrieval of Archived Episodes
70
1. Click
icon
2. Select
episode for
review
3. Click select or double click episode

Able to View if Data Exists in Previous Episodes
71

Patient Administration Updates
• Added icon to show if prior episode has trace data
Trace
exists -
for
Revision
H episode
or later
?
Unknown
trace data
– would
show for
Revision
G and
earlier
<blank>
No trace
exists
72

Retrieved Episodes
ADT: Find any Patient in archived episodes
73

Closed Episodes- Archived Episode
• If an archived episode is being reviewed or open for correction, the
panel displays:
Period of time and length
Visit Number
Responsible physician at time of episode close
• By clicking ‘Hide Episode’ it is removed from screen and the user is
taken to the current data of the selected patient

Open for Correction
• “Close Episode” button is displayed
• Clicking the button opens a dialog to confirm closure
• If message is confirmed, episode is closed and the user is taken to the
current data of the selected patient

No Archiving
• Panel displays:
Start time of the episode + length as elapsed time
A button “Convert to Quick Admit”

Lab
• Create a patient
• Open pregnancy
• Document several episodes with data on the flowchart
• Close each episode
• Open Review episodes dialog
• Retrieve the last episode from archive for correction & continued
charting
• Retrieve a episode, open and change data, delete data-note what
happens prior to closing
•

Labs
• Create several users with different permissions
• Log in as System Manager, Super User, User- note
• Note where the source documentation exists
• Review Pt Search/Identify
• Review Chalkboard- click on Flags
• Clear patient selection in patient focus dropdown

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