User Guide

Overview

Purpose

Consult/Request Tracking package V. 3.0 improves the quality of patient care by:

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  Interfacing with CPRS to provide an efficient mechanism for clinicians to order consults and procedure requests.
  
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  Providing consulting services with the ability to update and track the progress of a consult/procedure request from the point of receipt through its final resolution.
  
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  Providing results reporting that includes doctor's notes and comments entered during the tracking process.
  

Relationship to Other Packages

The Consults package works with the following packages:

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  Computerized Patient Record System (CPRS)
  
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  Text Integration Utilities (TIU)
  

Relationship of Consults to CPRS

From CPRS Actions to Consults:

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  Ordering
  
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  Order checking
  
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  Order updates via HL7 messages
  
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  Inter-Facility Consults via HL7 messages
  
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  Tracking Consults activity
  
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  Resulting TIU and Consults
  
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  Notifications
  

From Consults actions to CPRS:

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  Consult status changes update the CPRS order
  
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  Forwarded and edit/resubmitted consults get a new service/correction order from CPRS
  
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  Sends alerts based on consult activity
  

Relationship of Consults to TIU

From TIU Actions to Consults:

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  Select a consult to associate with a note
  
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  One consult link per consult note
  
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  Sends TIU updates to consult package for:
  
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  New consult note entered
  

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  Consult note completed
  
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  New addendum completed
  
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  Disassociate a note
  
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  Extract notes for SF 513 and displays
  

From Consult Actions to TIU:

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  A consult may have multiple notes associated with it.
  
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  Lists the notes associated with a consult.
  
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  Uses TIU to act on a note.
  
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  Updates consult status and activity log from TIU updates.
  

Enhancements since Version 2.5

GMRC*3*73

This patch is part of the Computerized Patient Records System CPRSv30 project. This project will modify the Computerized Patient Record System, Text Integration Utilities, Consults, Health Summary, Problem List, Clinical Reminders, and Order Entry/Results Reporting to meet the requirements proposed by the Dept. of Health and Human Services

to adopt ICD-10 code set standards Clinic Orders.

On January 16, 2009, the Centers for Medicare & Medicaid Services (CMS) released a final rule for replacing the 30-year-old ICD-9-CM code set with International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) with dates of service, or date of discharge for inpatients, that occur on or after

October 1, 2015. The classification system consists of more than 68,000 codes, compared to approximately 13,000 ICD-9-CM codes. There are nearly 87,000 ICD-10-PCS codes, while ICD-9-CM has nearly 3,800 procedure codes. Both systems also expand the number of characters allotted from five and four respectively to seven alpha-numeric characters. This value does not include the decimal point, which follows the third character for the ICD-10-CM code set. There is no decimal point in the ICD-10-PCS code set. These code sets have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better understand complications, better design clinically robust algorithms, and better track the outcomes of care. ICD-10-CM also incorporates greater specificity and clinical detail to provide information for clinical decision-making and outcomes research.

This patch installs the necessary routine updates to make the GMRC package compliant with the mandate to use ICD-10 codes. The installation also contains one post-install routine that will populate the new PROVISIONAL DIAGNOSIS DATE (30.2) and PROVISIONAL DIAGNOSIS SYSTEM (30.3) fields for existing entries in the REQUEST/CONSULTATION (#123) file. The PROVISIONAL DIAGNOSIS DATE will be populated using the value pulled from FILE ENTRY DATE (.01) field. The PROVISIONAL DIAGNOSIS SYSTEM field will be populated with "ICD" to indicate these diagnoses are from the ICD-9-CM coding system. These fields are only populated for existing entries where the provisional diagnosis contains an ICD code. Consult records with a free-text diagnosis will not have these fields populated.
See page 76 for examples of new displays as a result of GMPL*2*73.

General Overview of Consults/Request Tracking

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  Consults can be accessed through Windows NT, Windows 95, or a later Microsoft Windows version with the CPRS GUI Interface or through the List Manager (LM) interface.
  
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  Consult ordering is managed by CPRS Order Entry from within the CPRS Order tab. This includes Quick Orders.
  
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  Consult resulting is based on TIU Consult Notes, Medicine package results, and provider comments.
  
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  Services must be defined within the ALL SERVICES hierarchy in order to access their consults and requests.
  
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  Tracking services are not orderable unless the user is an update user for the service or its parent service.
  
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  The ordering provider may edit and resubmit a consult after it has been canceled.
  

Alert Actions

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  Users can process consult service update actions from the alert.
  
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  The recipient of an alert for a cancelled request can edit and resubmit the request from the alert .
  

Reporting

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  The Standard Form 513 is based on a hard-coded consults routine instead of the OE/RR Print Formats. This facilitates results printing when the consult reaches final resolution.
  
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  A report with completion time statistics has been added.
  
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  A report with pending consults has been added.
  
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  Lists of consults can be viewed by order status, service, and/or date range.
  

Communications

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  HL7 messages and protocols are the communications medium between CPRS and Consults.
  

Setup

Consult services have a related entry in the CPRS Orderable Items file (#101.43).

Management of procedures and services must be done through Consult options.