Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular...
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Transcript of Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular...
![Page 1: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/1.jpg)
heartbase™
Surgical Op NotePresented by
Nick Gawrit
March 4, 2008
…the Premier Cardiovascular Information System for Improving Patient Healthcare
![Page 2: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/2.jpg)
heartbase™
The Goal! Written Tree Diagram
![Page 3: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/3.jpg)
heartbase™
Starting With…
• Data Model Design Features– Patient centric– Longitudinal– Integrated
• Retrospective data entry
• Enthusiastic Users
![Page 4: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/4.jpg)
heartbase™
Data Model
Design Features
• Patient centric
• Longitudinal
• Integrated
![Page 5: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/5.jpg)
heartbase™
DEMOGRAPHICS
HOSPITALIZATION
CLINICALPRESENTATION
DRUG USAGE
DRUG USAGE
CATH LAB VISIT(CATH)
OPEN HEART SURGERY
(SURG)
CLOSURE DEVICES(EQUIPA)
COMPLICATION/OUTCOMES
PCI(PROC)
DIAGNOSTIC CATH SEGMENT
ANALYSIS
GRAFT GRAFT COMPLICATION/OUTCOMES
SEGMENT
EQUIPMENT(EQUIPA)
heartbase Data Model™
![Page 6: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/6.jpg)
heartbase™
Goals of Op Note Reporting• Prepare an Open Heart Surgery Op Note• Interface with transcription• Collect data points for registries• Provide perfusionists with data they need• Reduce surgeon time needed for
preparing an Op Note• Sync Up database with Op Note• Improve Workflow
![Page 7: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/7.jpg)
heartbase™
Goals of Op Note Reporting
• Ease of Use
• Create Consistency
• Improve Data Accuracy
• Ensure Completeness
• Provide Data for Research
• Improve Patient Satisfaction
• Eliminate Data Redundancy
![Page 8: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/8.jpg)
heartbase™
Steps to create Op Note
• Receive the aid of a physician champion to design a report for CABG only cases
• Meet with the perfusionists to review design and get input into data entry
• Meet with transcription to review requirements and set up automatic transfer to transcription system.
• Meet with IS to insure proper implementation• Utilize heartbase data administrator and staff
to coordinate all activities
![Page 9: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/9.jpg)
heartbase™
Surgical Op Note Workflow
Perfusionist Real Time
Surgery Capture
Perfusionist Report System
Transcribing
STS Data Collection MD Dictation
Patient Coronary
Tree
Referring MD
Narrative Reporting
Perfusionist Reports
heartbase
Review
Optional
![Page 10: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/10.jpg)
heartbase™
Surgical Op Note Workflow
Transcribing Folder
Interface Queue Folder
Transcribing Button
heartbase
Interface scans for reports that need to be sent
Back Up Archive Copy
heartbase
![Page 11: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/11.jpg)
heartbase™
Programming Issues• Schema changes• Develop a Custom Data Entry Form• Interface hospital demographic and admission discharge data• Create custom paragraphs and CSV file in PQL.• Integrate SIR with Microsoft Word (macros)• Interact of hb generated op-note with hospital transcription
department(EHR)• Implement SIR in a wireless environment• Create a graphical representation of patient coronary tree• Interact with flash drives• Create a Patient pocket handout• Allow Surgeons to dictate of additional findings in the OR which in
turn become part of the EHR.• Prevent Op-notes from being completed unless key fields are
entered.
![Page 12: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/12.jpg)
heartbase™
Schema Changes
• Needed by:– Surgeon– Perfusionist– heartbase
• Performed with Modify Schema
![Page 13: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/13.jpg)
heartbase™
Custom Data Entry Form• Create a new data entry screen that
reflects the needs of the perfusionist, hb data collector, surgeon, and transcription.
![Page 14: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/14.jpg)
heartbase™
DEMO
HOSP
CLINPRES
DRUG USAGE
DRUG USAGE
CATH LAB VISIT(CATH)
OPEN HEART SURGERY
(SURG)
CLOSURE DEVICES(EQUIPA)
COMPLICATION/OUTCOMES
PCI(PROC)
CATHSEGGRAFT GRAFT COMPLICATION/
OUTCOMES
SEGMENT
EQUIPMENT(EQUIPA)
heartbase Data Model™ ADT Data Interchange
Brings in Demographic, Hospitalization and ICD9Information
![Page 15: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/15.jpg)
heartbase™
Custom PQL• Auto generate paragraphs from data entry
fields• Creation of a CSV file to be used with Mail
Merge later. – Be aware of SIR CSV Save File max limit
• Audit function• Graphical tree creation with narrative data,
including wallet sized output• Event Management• Triggers
![Page 16: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/16.jpg)
heartbase™
Risk Factor Paragraph Example
• MYINDr=9• IFTHEN(CRSMOKE=1 )myindr=myindr+1;compute ind(myindr)='current smoker';• elseif(smoke =1)myindr=myindr+1;compute ind(myindr)='history of smoking';• endif• if(FHXCAD=1)myindr=myindr+1;compute ind(myindr)='family history of coronary artery
disease'• if(DIAB=1)myindr=myindr+1;compute ind(myindr)='diabetes'• if(HYPCHOL=1)myindr=myindr+1;compute ind(myindr)='dyslipidemia'• if(HRENFL=1)myindr=myindr+1;compute ind(myindr)='renal failure'• if(HYPTN=1)myindr=myindr+1;compute ind(myindr)='hypertension'• if(HCVA=1)myindr=myindr+1;compute ind(myindr)='cerebrovascular accident'• if(INFEND=1)myindr=myindr+1;compute ind(myindr)='infectious endocarditis'• if(chrlungd GE 2)myindr=myindr+1;compute ind(myindr)='chronic lung disease'• if(IMMSUPRX=1)myindr=myindr+1;compute ind(myindr)='immunosuppressive treatment'• if(PVDIS=1)myindr=myindr+1;compute ind(myindr)='peripheral vascular disease'• if(PRCBVDIS=1)myindr=myindr+1;compute ind(myindr)='cerebrovascular disease'• ifthen(myindr=9)mysent=mysent+' Risk factors were not noted.'• else• mysent=mysent+' Risk factors include '• ifthen(myindr=10)• . mysent=mysent+''+ind(10)+'.'• elseif(myindr gt 10)• . for sdsd=10,myindr-1• . mysent=mysent+ind(sdsd)+', '• write ind(sdsd) mysent• . end for• . mysent=mysent+' and '+ind(myindr)+'.'• endif• endif
![Page 17: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/17.jpg)
heartbase™
CSV Save File• CSV SAVE FILE FILENAME='surgnarr.dat'/HEADER/• VARIABLES=• PDATE ('SURGDATE')• LNAME ('LNAME')• FNAME ('FNAME')• MINT ('MINT')• APROC(1) ('APROC1')• APROC(2) ('APROC2')• APROC(3) ('APROC3')• APROC(4) ('APROC4')• APROC(5) ('APROC5')• APROC(6) ('APROC6')• APROC(7) ('APROC7')• APROC(8) ('APROC8')• APROC(9) ('APROC9')• APROC(10) ('APROC10')• SSNUM ('SSNUM')• BILLNUM ('BILLNUM')• PATSSN ('PATSSN')• WBDATE ('WBDATE')• WADMDATE ('WADMDATE')• WCWTLB ('WCWTLB')• wchtfi ('WCHTFI')• PRONOUN ('PRONOUN')• MYSENT ('ind12')
![Page 18: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/18.jpg)
heartbase™
Audit Program• . IFTHEN(SEX =1)COMPUTE W9 ='1'• . ELSEIF(SEX =2)COMPUTE W9 ='2'• . ELSE COMPUTE W9 =''• . ENDIF• . IFTHEN(EXISTS(W9)=0 or w9='')• . valfield(9,2)=valfield(9,2)+1;WERR=1• . IFTHEN('<AUDITALL>' = 'Y' OR '<WW9>'='Y')• . WRITE (VALIDATE_STS_NAR.CSV)SSNUM MYC MYC MYC 'SEX'
MYC 'STS0150 GENDER' MYC 'DEMO' MYC• . WLUDEMO=WLUDEMO+'SEX ';WLUDEMOQ='Y'• . ENDIF• . ALINEA=TRIM(ALINEA)+'|'• . ELSE• . valfield(9,1)=valfield(9,1)+1• . ALINEA=TRIM(ALINEA)+TRIM(VALLAB(SEX))+'|'• . ENDIF
![Page 19: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/19.jpg)
heartbase™
Microsoft Word Integration
• Utilize Word to produce the narrative letter by utilizing Mail Merge and Macros
• Include header information for Softmed
![Page 20: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/20.jpg)
heartbase™
Transcription Electronic Health Record
• Automatically send the case to transcription when all required variables are entered
![Page 21: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/21.jpg)
heartbase™
Wireless
• Access heartbase via the hospital wireless network– Security– Accessing SIR Master and heartbase
application
![Page 22: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/22.jpg)
heartbase™
graphical patient coronary tree• Use database to
define grafts and then map these points graphically (thanks Tom!)
![Page 23: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/23.jpg)
heartbase™
Flash drives
• Distribute information on flash drive
![Page 24: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/24.jpg)
heartbase™
Patient pocket handout
![Page 25: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/25.jpg)
heartbase™
Surgeon Dictation
• Surgeon needs to enter additional findings in the OR
![Page 26: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/26.jpg)
heartbase™
Op-Note Completion Check
![Page 27: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/27.jpg)
heartbase™
Data CaptureRules we follow:
• Optimize Workflow
• Eliminate Data Redundancy
• Offer Flexible Alternatives
• Reduce FTE costs
• Comply with Rules
![Page 28: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/28.jpg)
heartbase™
Real Time Data Capture
Customized data collection screens can be tailored to the individual need
• Perfusionist
• Physician Specific
• Nurse/Tech
• In-Lab/In-OR
![Page 29: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/29.jpg)
heartbase™
DEMO
HOSP
CLINPRES
DRUG USAGE
DRUG USAGE
CATH LAB VISIT(CATH)
OPEN HEART SURGERY
(SURG)
CLOSURE DEVICES(EQUIPA)
COMPLICATION/OUTCOMES
PCI(PROC)
CATHSEGGRAFT GRAFT COMPLICATION/
OUTCOMES
SEGMENT
EQUIPMENT(EQUIPA)
heartbase Data Model™ Op Note
![Page 30: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/30.jpg)
heartbase™
Data Collection: Op Note
• Perfusionist• Procedure MD• Variables =
Sentences and Paragraphs
• Graft Definition = STS Data Harvest Fields
![Page 31: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/31.jpg)
heartbase™
Op Note Preparation
• Run the Report• See the Patient
Coronary tree• See the Narrative
Report• Send to Transcription• Add Dictation
![Page 32: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/32.jpg)
heartbase™
Op Note Reports Written Tree Diagram
![Page 33: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/33.jpg)
heartbase™
Benefits of Op Note System• Savings of 20-30 minutes of surgeon time per op
note• Validation of data in Op Note to data in database• Concurrent Data Collection• STS data completion• Perfusionist Report Preparation• Integration into hospital electronic medical
record • Transcription savings • Physician ability to dictate additional findings
![Page 34: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/34.jpg)
heartbase™
Benefits of Op Note System(cont)• Electronic Signature• Op Note speed up to referring MD by 1-2 days• Medical record interaction• Flash drive patient record• E-Mail to referring cardiologist• Optional customization of report for physicians• Coding Improvements for billing• MD bonus program
![Page 35: Heartbase™ Surgical Op Note Presented by Nick Gawrit March 4, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare.](https://reader030.fdocuments.in/reader030/viewer/2022032604/56649e655503460f94b60280/html5/thumbnails/35.jpg)
heartbase™
Demonstration