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ACADEMIC EHR

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QUICK GUIDE April 2011

The Academic EHR System

Quick Guide

Important Info to collect before you begin

Your School's Web Address (See appendix A) ________________________ Your School Name/Abbreviation ___________________________________ Your Medical Center/Facility (where to register & find your patients)___________________________ Your Class Name (to use as Nursing Unit)____________________________

Use this as a reference. It includes the information you'll need most often. It does not include system details. For more information, please visit the Help Page or access the Full AEHR User Guide. Live assistance is available from your course, faculty or program lead at your school, or from the CHI staff:

Center for Healthcare Innovation Contact Information Nancy Sivertson [email protected] ph 218-723-6180 Toni Pearson [email protected] ph 218-625-4933 Joseph Janchar [email protected] ph 218-625-4974 Main Office Number - 723-7030

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The Academic EHR System

Quick Guide

Chapter 1. Getting Started

Getting Started - The Academic EHR System Confidentiality Statement Instructions Each user of the Academic EHR is required to read and agree to a confidentiality agreement protecting the patient information in the system and the screen/program content of the system. This printed version is a courtesy copy of the agreement. To complete your agreement to these terms, follow these steps: navigate to the following website: http://www.css.edu/x7552.xml scroll down the screen, and click on the this listed item: ->Confidentiality Agreement review the agreement, then click on NEXT fill out all requested information click SUBMIT You can exit from the website when finished with these steps. Here is a printed copy of the confidentiality agreement for your review: Access to and Use of Proprietary and Personal (Patient) Information

As an employee/contracted agent/student with access to technical and training information as well as systems and software owned by Cerner Corporation and with access to personal (patient) information within the electronic applications known as The Academic EHR System, you will have access to what this agreement refers to as "Proprietary Confidential Information" and "Personal (Patient) Confidential Information. The purpose of this agreement is to help you understand your duty regarding this Proprietary and Personal (Patient) Confidential Information. Proprietary Confidential Information: Proprietary Confidential Information includes application access and information. You may learn of or have access to some or all of this Proprietary Confidential Information through a computer system or through your academic activities. Proprietary Confidential information is valuable and sensitive and is protected by law and by strict Cerner Corporation policies, as reflected in the Colleges contract with Cerner Corporation. The intent of these laws and policies is to assure that Proprietary Confidential Information will remain confidential - that is, that it will be used only as necessary for academic purposes. As an employee/contracted agent/student, you are required to conduct yourself in strict conformance to applicable laws and Cerner Corporation policies governing Proprietary Confidential Information. Personal (Patient) Confidential Information: Personal (Patient) Confidential Information includes patient identifiable demographic, historical and clinical information. You may learn of or have access to some or all of this Personal (Patient) Confidential Information through a computer system or through your academic activities. The intent of these rules and policies is to assure that Personal (Patient) Confidential Information will remain confidential - that is, that it will be used only as necessary for legitimate academic purposes. As an employee/contracted agent/student, you are required to conduct yourself in strict conformance to applicable laws and Academic EHR System policies governing Personal (Patient) Confidential Information. Your principal obligations in these two areas are explained below. You are required to read and to abide by these duties. The violation of any of these duties will subject you to discipline, which might include, but is not limited to, legal liability.

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The Academic EHR System

Quick Guide

Accordingly, as a condition of and in consideration of your access to The Academic EHR System, you promise that: You will use Proprietary and Personal (Patient) Confidential Information only as needed to perform your legitimate duties as an employee/contracted agent/student receiving information from The Academic EHR System and about Cerner Corporation. This means, among other things, that: A. You will only access Proprietary and Personal (Patient) Confidential Information for which you have a need to know in the context of your official role as an employee, contracted agent or student; you will not access the Personal (Patient) Confidential Information unless it is specifically assigned to you or created by you for a legitimate academic purpose. B. You will not in any way disclose, use, copy, distribute, sell, license, publish, reproduce or otherwise make available Proprietary Confidential Information except as properly authorized by Cerner Corporation. C. You will not misuse Proprietary or Personal (Patient) Confidential Information or carelessly handle such information so as to risk its release to any unauthorized individual. D. You will safeguard and will not disclose your access code or any other authorization you have that allows you to access Proprietary and Personal (Patient) Confidential Information. E. You accept responsibility for all activities undertaken using your access code and other authorization. F. You will report activities by any individual or entity that you suspect may compromise the confidentiality of Proprietary or Personal ( Patient) Confidential Information. Reports made in good faith about suspect activities will be held in confidence to the extent permitted by law, including the name of the individual reporting the activities. G. You understand that your obligations under this Agreement will continue after you conclude your coursework and your academic program. You understand that your privileges hereunder are subject to periodic review. H. You understand that you have no right or ownership interest in any Proprietary or Personal (Patient) Confidential Information referred to in this Agreement except as it is yours to access for your personal legitimate academic purposes. Your access code, other authorization, or access to these applications may be revoked at anytime. At all times, you will safeguard and retain the confidentiality of all Proprietary and Personal (Patient) Confidential Information. I. You will be responsible for your misuse or wrongful disclosure of Proprietary and/or Personal (Patient) Confidential Information and for your failure to safeguard your access code or other authorization access such information. You understand that your failure to comply with this Agreement may also result in your loss of access privileges, disciplinary action, and/or other legal liability.

__________________________________ Employee/Contracted Agent/Student Signature __________________________ Date

_________________________________________________________________ Printed Name

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The Academic EHR System

Quick Guide

Getting Started - Loading the Citrix Online Plug In The Citrix online plug in is a ,,middleware program necessary to run the Cerner application. It is a free download that you can find on the CernerWorks site for Windows users or from www.citrix.com under the download option for Mac users. The Citrix download should take less then a minute on a highspeed internet connection and will only need to be completed once. *PLEASE NOTE* This application works best with a high-speed internet connection. WINDOWS USERS: (MAC USER'S SEE BELOW)

1. Enter https://cernaes.cernerworks.com/XXX/auth/login.aspx where XXX is the

address.)

abbreviation for your school. (Please see appendix A for your school's CernerWorks web

2. On the CernerWorks screen, locate the Citrix link near the bottom of the right hand

window pane click on it to download Citrix.

Click to Install the Citrix XenApp Web Client v11.000

Citrix for windows will automatically download when you click on the Citrix link. Follow the on-screen prompts to complete the download..

MAC USERS: 1. *PLEASE NOTE* The Firefox browser is required for Cerner use on Macs, rather than

the Mac Safari browser. You can download it from this URL: http://www.mozilla.com/en-US/firefox/ie-yl.html

2. To download Citrix for Mac go to www.citrix.com and click on Downloads .

On the next web page, scroll down to find the Client Center box. On the 3rd page, under for Desktops heading, click on Mac OS X Next page Select the "Citrix Online plug-in for Mac ­ Web" 18.2 MB (click Download) Save to your desktop. Click the desktop icon for Citrix to start the installation

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The Academic EHR System

Quick Guide

Getting Started - Logging In

If you are logging in from a CSS Computer at the Main Campus click the Athens Icon on your desktop and skip to step 3. All other users begin with step 1. CSS On Campus URL: http://cerner.css.edu/css

*PLEASE NOTE* This application works best with a high-speed internet connection.

1. Enter https://cernaes.cernerworks.com/XXXX/auth/login.aspx where XXX is the abbreviation for your school. (Please see appendix A for your schools CernerWorks web address)

2.

Type in the User name: cernaes Type in the Password: [email protected] Username and password are case sensitive Click on the Log In button *TROUBLE SHOOTING TIPS* If you encounter an error that says:"The Citrix Server reported that the Credentials entered were incorrect" this means the username and password were entered incorrectly. Some common logon errors include; typing in the wrong case and entering your personal username and password instead of the username and password listed above. You may also encounter a Cerner user warning for unauthorized users. Simply close it and move on.

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The Academic EHR System

Quick Guide

3. a. Click on the PowerChart Icon to launch the

PowerChart AEHR Software b. Click on the Appbar icon to launch special applications such as Lab, or HIM.

4. a. When you come to the logon screen

type in your assigned personal User Name.

b. Your Password: will be the same as your username for your initial logon. This is for the first time ONLY. You will be prompted to change your password. c. If you forget your password. Please contact your schools representative and they will be able to reset your password for you. 5. The application should now open. The screen should look similar to this:

Scr een shot of the Organizer page

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The Academic EHR System

Quick Guide

Chapters 2. Patient Search

Search for a Patient and Open the Chart 1. Click on the binoculars icon or the drop down patient option (search option), to open the Person Search window.

2. Type "Demo" in the Last Name field to call up demo, fiftyone, and click on Search. You do not need to enter a full name, and a partial name entry will be helpful when you are unsure of the spelling. 3. Select the entry named Demo fiftyone in the list of patients on the right. 4. Select an episode of care on the lower half of the window. Yu may have more than one choice if the patient was seen more than one time. Click OK. 5. When opening a patients chart for the first time, you are usually asked to select a relationship with the patient. Highlight the option that fits your role, click OK.

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The Academic EHR System

Quick Guide

6. Patient chart home screen view: The default view is the Chart Summary View showing a quick view of what is in the chart. The next chapter will go through the Navigation menu at the left of this screen.

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The Academic EHR System

Quick Guide

Chapter 3. The Navigation Menu and Chart Tour Chart Summary

The Chart opens up to the Chart Summary. This screen combines several views to give the user a quick summary of the patients chart. Multiple charts can be opened at once; the names will appear next to one another on the name bar, each in a different color. To open an additional chart, click the Binoculars icon again and search for another patient. The new chart will open as the first one did when the search is completed. To switch from one chart to the other, simply click on the other name.

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The Academic EHR System

Quick Guide

Procedures & Diagnosis A listing of procedures undergone, and diagnoses for this patient. When opened, the blue + allow the user to add new entries. Right clicking on a selected procedure or diagnosis will provide options of actions to take. Double clicking the blue i symbol to the left of a diagnosis or procedure indicates that a Medline search is available.

Allergies Click on Allergies. A healthcare provider can view and/or add in allergies while interviewing the patient by clicking the blue +. The check marks next to the allergies indicate a drug interaction has been checked using a data base. This screen allows you to store favorite, or frequent allergies, and search through common allergies. Reactions and allergy detail are also put into the record on this screen.

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The Academic EHR System

Quick Guide

Medication Administration Record (MAR) The MAR is used to chart into the record directly after administration of the medication. Details of the medication can also be viewed. By right clicking you are able to view the possible actions you would like to perform. Once the medication is administered, the dose will show in the light blue bar under the date. You have the options to view categories of medications from this screen. Medications that are Grayed are no longer active ­ they may have been stopped or discontinued. Note: The default date range when the MAR opens is limited to Today. For older cases, you will need to change the blue timeframe bar located in the middle of the screen. Right click, select Change Search Criteria and type in the timeframe desired (usually from admit to discharge date).

Medication List This for is used to view the medications and update using the blue + each time a patient is seen in an ambulatory setting. Right clicking on the medication will give you action options to perform, such as modifying the medication list. The screen makes bold any orders that are on the list awaiting signature.

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The Academic EHR System Medication Profile

Quick Guide

This view lists the medications that the patient is on currently as well as in past, and allows medication reconciliation upon admission, transfer or discharge.

Result Review This view has three sub-tabs with are displayed in a flowsheet format: Key Results, Vital View and Lab; also a timeframe bar to limit the display to a specific period of time, such as the clinical range. You can graph results to see trends by selecting specific result fields, see. You can scroll horizontally across the timeframe of the visit, OR You can scroll vertically through the list of resulted items.

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The Academic EHR System Reports

Quick Guide

This screen shows written or scanned documents that have been attached to or typed into the patients record. Reports can be viewed, or modified. Folders of the forms will be shown and clicking on them until a pink icon appears will allow you to access the form directly from the chart. You can filter the forms by using he radio buttons below the folder list to help sort and find the form by category.

Orders This screen opens to a listing of all patient orders for this encounter and allows addition of new orders by using the blue +. Right clicking on each order will allow you to select the action you would like to take. Orders in the chart and those for signature are listed In bold to the left of the screen. The orders will populate to the MAR and the Task list automatically.

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The Academic EHR System Intake and Output

Quick Guide

This screen shows specific intake and output reports and will graph them for you; also allows entry in intake & output directly into the record. Input into the record is completed by following the icons from right to left, making a selection for each one. Intake and output categories are listed In folders under the icon and need to be clicked open to make a selection. Once going through the icons, you will be able to put measurements into the fields under the correct day and time.

. Task List This screen shows the ,,to do list for each patient, it includes pending patient care or activity tasks as well as medication administrations due.

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The Academic EHR System Form Browser

Quick Guide

This view shows all the forms completed on the patient. Double click on a line to view the form. To select the action you wish to perform, right click on the form. This screen allows you to filter the forms into categories to help find the form you want to view. To add forms, go to the Adhoc icon at the top of the chart, or use the drop down list under chart and select Adhoc charting. Ask the Center for Healthcare Innovation staff for a list of the available forms in the AEHR.

Patient Info This screen displays demographics, visit list, patient/provider relationship summary. You are able to view all people who have worked or viewed the chart from the PPR tab. This view can be used for a module on data privacy along with other similar topics In your curricula.

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The Academic EHR System

Quick Guide

Advanced Growth Chart This view shows the growth chart of the patient and allows data to be directly input into the graph.

Immunization Schedule Displays the current immunizations and can enter from directly into the chart. Select the Adhoc button and input new immunizations. Yellow fields will appear to show the required fields for input before you can sign the form.

Reference Browser This screen is used to browse to reference text on drugs, orders education. Enter the information to be referenced under the tabs.

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The Academic EHR System Problems & Diagnosis

Quick Guide

This screen shows a listing of problems and diagnosis on the patient. A blue to add new problems or diagnosis.

+ allows you

Interactive Chart This flowsheet allows you to enter multiple vital signs and assessment data directly into the chart. Select the category on the left right click on the desired input field and entering the result value. Click the green check mark to chart / sign your results.

For more detailed information on the activities in this chapter please see the User Guide or Procedure Manual located at the following web address: http://www.css.edu/x7552.xml

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The Center for Healthcare Innovation ~ The College of St.Scholastica ~ Powered by CERNER Copyright 2011 All rights reserved Updated 05/2011 NS 18

The Academic EHR System

Quick Guide

Chapter 4. Registering or Creating a New Patient

In Chapters 2 & 3 you learned how to find a patient and look up key pieces of information in his or her chart. In the remaining chapters you will learn how to create patients and manipulate data stored in the Academic Electronic Health Record (AEHR). The AEHR is a Cerner product and is the same Electronic Health Record software used in many Hospitals and Clinics around the country. This means HIPPA software standards such as audit tracking and the inability to permanently delete entries or records are found in the AEHR. Please be respectful when making entries and treat the patient information as you would a "real" patient in a Hospital or Clinical setting. In addition please do not access or alter a patient that has not been assigned to you or that you did not create. Registering a New Patient When creating your first patient in the EHR we suggest that you register yourself as a play patient or have students register themselves (use their own names) for an assignment.. 1. To Register a new patient, make sure all other patients charts are closed and that you are on the Organizer View (or patient list screen) of the application. Youll see something similar to this:

2.

Select Patient from the drop down menu at the top of the screen and click on Patient Management Conversation > Add/Modify Encounter.

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The Academic EHR System 3. The Patient Search window will open on your

screen. Type the patients name (Last, First) that you would like to add into the Name field and click Enter on your keyboard.

Quick Guide

4.

After you click Enter on your keyboard and the system searches for your patients name, the Add Person button will light up on the bottom of the screen.

Click on the Add Person button.

4.

On the bottom half of the screen under the Facility Name tab. Type a * into the search field and click Enter on your keyboard. This will give you a list of all Facility options available to you.

Locate your school system Medical Center in the list and double click to select. Click OK.

5. The AES Common registration window will open. If this is your first time using this screen right click anywhere on the screen and select Highlight Required Fields.

All required fields will now have a yellow background. These fields must be satisfied in order to register your patient.

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The Academic EHR System 6.

Quick Guide

The Name fields, MRN, Financial # and Facility fields will automatically populate. The remaining data fields can be filled out as you deem appropriate. The drop down boxes will give you options to choose from. Do not enter personal demographic data into the AEHR. See the table below for more information on the different fields.

Registration Fields Registration Date (Required) Current date: Enter a T to populate todays date. Historic date: You can enter a past date into this field. Future date: You are able to enter a future date but will not be able to see any information entered on that encounter until that date and time. Any information entered on a future encounter will not be viewable until that date. Enter N for now or type in a specific time of your choosing Enter birthdates as mm/dd/yyyy. Once the birthdate is entered the age field will automatically populate. If you would like your patient to be a certain age for example 56; simply type the age into the age field and the birthdate will automatically populate. This is a required field where you designate the encounter status. The status refers to the encounter being; active, cancelled, discharged, transferred, etc. This is a required field where you designate the encounter type. Here you can choose if the encounter is inpatient, outpatient or emergency, as well as other options. In the medical setting the building would correspond to a specific hospital or clinic location. In the Academic EHR the building typically corresponds to your discipline such as nursing, HIM or Physical Therapy. Populating this field can help you organize your students working in the AEHR through the use of patient lists. (see chapter XXXX for more information on patient lists) In the medical setting this would correspond to a specific nursing unit or department in the Academic EHR this field typically corresponds to your class list. Populating this field can help you organize your students working in the AEHR through the use of patient lists. (see chapter XXXX for more information on patient lists.)

Registration Time (Required) Birth Date Age Encounter Status (Required) Encounter Type (Required) Building

Nurse\ Ambulatory

7.

Once you have entered all of your patients information click OK.

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The Academic EHR System 8. When you open a patients chart for the first time, a patient relationship query box will open. Highlight the most applicable option and click OK and the patients Chart will open.

Quick Guide

Modifying your Patient's Registration You may wish to make changes to a patients registration. Maybe an incorrect date was entered or you would like to change the encounter type or status. You can easily do this right from the patients chart. 1. While you are in the patients chart, from the toolbar select Patient > Patient Management Conversations > Add/Modify encounter.

2.

Once the AES Common Registration window opens you can make your desired changes. Click OK to save your changes.

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The Academic EHR System Adding a New Encounter

Quick Guide

You may wish to give your patient more than one encounter. Maybe the patient you are creating was seen at the clinic or in the emergency room before they were admitted to the hospital. You can depict this scenario in the Academic EHR by entering multiple encounters. 1. 2. 3. Make sure all patients charts are closed and go to Patient > Patient Management Conversations > Add Modify Encounter. In the Person Search window type your patients name (last, first) When your patient appears highlight and click the Add Encounter button.

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The Academic EHR System

Quick Guide

Appendix A:

AHIMA College of St. Scholastica Lakeland Community College Cuyahoga Community College Estrella Mountain Community College MnSCU Schools St. Catherines University WTCS Schools University of Portland Southern Univ Louisiana At Shreveport https://cernaes.cernerworks.com/AHIMA/auth/login.aspx https://cernaes.cernerworks.com/CSS/auth/login.aspx https://cernaes.cernerworks.com/Lakeland/auth/login.aspx https://cernaes.cernerworks.com/TRIC/auth/login.aspx https://cernaes.cernerworks.com/EMCC/auth/login.aspx https://cernaes.cernerworks.com/MNSCU/auth/login.aspx https://cernaes.cernerworks.com/SCU/auth/login.aspx https://cernaes.cernerworks.com/WTCS/auth/login.aspx https://cernaes.cernerworks.com/UP/auth/login.aspx https://cernaes.cernerworks.com/SUSLA/auth/login.aspx

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The Academic EHR System

Quick Guide

Appendix B:

Troubleshooting or FAQs Issue While accessing the system, you get the error "ERROR: The Citrix Server reported that the Credentials entered were incorrect. You are unable to get into Powerchart using the password you have set for yourself. Solution This means that the passwords are not being put in properly. Make sure the caps lock is off and put in the username and passwords just as you see them in this packet. Be sure you are using the exact/correct URL including punctuation and capitalization. If you are still not getting in, email your School's primary EHR SubScription Service contactto reset your password and/or troubleshoot with you. Contact your EHR Primary Contact so that passwords can be reset. The newest computers with SpyWare virus scanning sometimes interferes with the loading of Citrix. Remove the SpyWare and try to load Citrix again. Users can access the full EHR Subscription System users guide online. This is located in the EHR Subscription Administrative Support page.

You have forgotten your password. Citrix does not seem to be loading correctly. Online User Guide

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The Academic EHR System

Quick Guide

Notes

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