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System ReviewCORE ConceptsIlham Hobba
December 15, 2012
King Saud University Hospitals
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 2
What is Core?
The common processes or tasks that are shared multiple times across clinical domains, technical activities, or project tasks. It is those things that are required in order to get a Cerner Millennium™ application or applications installed.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 3
What is Core?
OrganizationsSecurityLocationsAlias PoolsCode SetsEvent Codes/Event Sets
Organizations
Core Services
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 5
Organizations in Millennium
Organization: Any business entity that is affiliated with the health system.
Organization Types• Organizations are classified into different Organization Types• Each type drives functionality within the Solutions
• Examples of Organization Types:• Client Facility• Employer Insurance Company• Hospital Physician Offices
Multiple Organization Types can be used to define an organization. • Example: Cerner Hospital can be a Facility, Client, Hospital, and Employer
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 6
Organizations
Facility
Organizations
ClientIns.
Company
EmployerHospital
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 7
Organization Types
Possible “Employment/Billing” Organizations:• Employers• Insurance companies• Clients (e.g. Industrial accounts)
Employer: An organization that may be given as a place of work or health plan sponsor
Insurance Company: An organization with one or many health plans associated underneath it.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 8
Organization Types
Client: An organization that is used to represent a specific patient population for patient numbering, billing or report distribution.
Organization is a Client if : • Charging processes occur (designation needed in
order to show is Charge Services tools)• The organization is used for client/industrial billing• Destination for Clinical Reporting
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 9
What are Core Organizations?
Possible “Patient Care” Organizations:• Hospital• Physician Office/Clinic• Home Health• Hospice• Facility
Physician Office/Clinic: Areas where health care services are given to patients who do not need to stay overnight. May include services usually provided in a Physician Office or Clinic.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 10
Core Organization Types
Facility • An organization at which patient care activity takes place.
Organization is a facility if:• Patient care takes place• Patient registration occurs• Identifiable patient population (Charting, Security)• ProFit billing entity (one tax id)
Facilities can contain:• One Pharmacy formulary• One Order Catalog• One Charge Description Master (CDM)
Security
Core Services
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 12
Security Design
Security Risks in Healthcare• Unauthorized disclosure of patient information• Unauthorized disclosure of sensitive information
• Substance abuse treatment, abortion, mental health, HIV/AIDS, genetics
• Unauthorized disclosure of intellectual property
Security is not…• An add-on to your solutions• Built after workflow is designed• Software that protects the configuration• Recommended to be set up at an user-level
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 13
SECURITY
Vital for Access Control in MillenniumWhat Solutions Can You Access?What Tasks Can You Perform?What Data Can You View?What Organizations Do You Have Access To?
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 14
Positions Defined
Role based access to Cerner Applications
Should be based on the role the user has within scope of Cerner Solutions • Not based on job title
Position determines authorization within Cerner
NOT the same as a job class or employee title
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 15
Position Collection
Positions will be collected on Core Systems Positions DCW• Start positions are outlined on the deliverable
This deliverable is assigned to the Core team to complete two weeks prior to Design Review• Solution teams will be required to assist the client in designing their
positions based on Start content• This is to be completed on weekly calls between System Review
and Design Review• Address position integration points between solutions as they arise
The completion of this deliverable will ensure the successful design of position based security at Design Review
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 16
Encounter/Organization Security
• Broad Level of Security• Limits what Patient visits (encounters) each User can
view, based on what organization the visit occurs at.• Users are “tied” to Organizations
• Users may view information from Patient visit, if the visit occurs at an Organization they are associated with
• Users can be associated to one or many Organizations• Will specific patient populations, such as behavioral
health, need to be secured?• If yes, each applicable location will be built as a
separate facility and therefore require its own organization.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 17
Encounter Organization Security
Information Available across all encounters/visits:Allergies Problems PowerNote Clincal NotesProceduresForm Browser (results) Histories (past medical, family, social) Immunizations Medication List (prescriptions and administrations)
Encounter/visit-specific information:PowerOrders Diagnoses Provider Relationships
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 18
Confidentiality Code Security
User associated to Facility
ANDUser assigned a Confid. Level
Patient encounter occurs at Facility
ANDEncounter assigned a Confid. Level
User has access to view patient encounter
User’s Confid. LevelMeets or exceeds
Encounter Confid. Level
If And
Then
And2 1
2 1>
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 19
Cerner Clinic Cerner Hospital C.H. Psych Unit
Encounter 1 Encounter 2 Encounter 3
Encounter/Organization Security
Dr. A Dr. CDr. B
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 20
Confidentiality Levels
Prerequisite - Encounter Organization Security
Compare user and patient encounter codes to determine access
Levels are client defined
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 21
Examples of Levels:
EncounterPsych 7
Security 5
Sensitive 3
Routine Clinical 1
7 Psych users
5 Partial Restricted/Regular Users
3 Clinical Staff
1 PMLocator Users(patient directory)User with a Confid. Level of 5 can view
any Encounters with a level 5, 3, or 1
Maximum of 4 levels recommended due to maintenance considerations
Users
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 22
Within ERM:
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 23
Without Cerner ERM
Confidentiality Codes can be sent from ADT (Registration System)
Sent in HL7 Message- PV2:22
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 24
After Encounter Org/Confid Level:
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 25
Positions Defined
Role based access to Cerner Applications
Should be based on the role the user has within scope of Cerner Solutions
Not based on job title
Position determines authorization within Cerner
NOT the same as a job class or employee title
Locations
Core Services
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 27
Locations
Generic term used to denote physical place in health care organization.
Area where Patient Care takes place.
Locations exist in the Location Hierarchy.
Any Organization that is a Facility can have locations tied to it.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 28
Location Hierarchy
Facility (type of organization)
Room
Buildings
Nurse Unit
Bed
Cerner Hospital
West Pavilion
2 South
202
A
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 29
Buildings
Buildings Defined• A physical structure on
hospital property• “Houses” registration
locations • Drives no product
functionality (security, billing, etc.)
Facility (type of organization)
Room
Buildings
Nurse Unit
Bed
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 30
Nurse/Ambulatory Unit, Rooms, and Beds
Core Units Defined• Nursing Unit • Ambulatory Unit
Facility (type of organization)
Room
Buildings
Nurse Unit
Bed
• Rooms and Beds• Represents physical
Rooms and Beds• Hierarchy format
allows for multiple Rooms and Beds with the same name
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 31
Facility
LOCATION HIERARCHY INPATIENT
BuildingNurse Unit
Room and Beds
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 32
Facility
LOCATION HIEARCHY DAY REHAB & OUTPATIENT
Building
Ambulatory Loc
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 33
Two Sides
Core Locations
FacilitiesBuildingsNurse unitsRoomsBeds
Service Resources
InstitutionsDepartmentsSectionsSubsectionsExam Rooms
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 34
What solutions use Core Locations?Registration
Scheduling
PowerChart
CareNet
INet
Charge Services
PharmNet
ProFile
ProFit
FirstNet
Clinical Reporting
PathNet AP
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 35
Encounter/Organization SecurityControls access to patient information by organization.
Confidentiality Level SecurityAdditional function available with Encounter Org Security that can be set per facility
What solutions use Core Locations?
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 36
Registration• Patients registered to Facilities• If an inter-facility transfer needs to occur, the alias pools for those two orgs must
be set up exactly the same• Registration can filter out patients by facility
• PMLocator (Cerner’s patient directory)• Auto-discharge can be set up differently per facility (and by patient type) - but not
per building, nurse unit, room, or bed• Certain code sets can be filtered by facility
• Patient Type• Medical Service• Accommodation Code• Discharge Disposition• Discharge Location
What solutions use Core Locations?
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 37
What solutions use Core Locations?
Registration
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 38
Person Search Window
Search by location or facility
Customize encounter results window with location hierarchy fields.
What solutions use Core Locations?
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 39
What solutions use Core Locations?
Scheduling• Patients will get scheduled to a “location”, this is typically an ambulatory location. • The location and the facility can be passed into registration if the conversation is
launched from the appointment.• Relevant to outpatient process only
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 40
What solutions use Core Locations?
PowerChart • Encounter Organization level security.
• An encounter that is hidden by the use of this type of security will not be accessible on the PowerChart Visit List tab or anywhere else in PowerChart/PowerChart Office.
• Encounters will also be hidden in the Patient Search for that organization
• Locations (nurse units/ambulatory) can be used to specifically lock down patient lists on individual computers
• Set up with a default location list• Location patient lists can also be used to help organize work
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 41
Organize Patients by Location
What solutions use Core Locations?
PowerChart
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 42
What solutions use Core Locations?
CareNet Orders• Locations used for routing and printing
• Orders requisitions• Consent forms• Reports• Printed charts
• Patient location and ordering location can be used to flex order entry formats.
• Orderables can be virtualized to specific facilities• Ordering is then controlled depending on whether patient is
registered at that facility.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 43
What solutions use Core Locations?Inet can flex views based on the patient’s location
• Patient on the left is located in the adult ICU• Patient on the right is located in the NICU
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 44
What solutions use Core Locations?
Charge Services• Any organization that will be used for charge purposes will need to be built
as an organization type of “Client”• Charges can be flexed based on a multitude of fields
• Patient location• Performing location• Facility
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 46
What solutions use Core Locations?
PharmNet• Formulary products can be flexed based on availability of products per
each facility.• If a formulary product is stocked on a floor and available via
Omnicell/Pyxis, the product can also be associated with a nurse unit/ambulatory location to indicate this.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 47
What solutions use Core Locations?
ProFile• HIM Chart Tracking has the ability to track a paper chart based on both
user-defined locations and locations defined in the hierarchy.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 48
What solutions use Core Locations?
ProFit• Revenue can be reported by:
• Patient location • Performing location
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 49
What solutions use Core Locations?
FirstNet• Any area where an emergency patient needs to be tracked (beds,
hallways, waiting room, etc) will need to built as a location within the emergency department
• Lab label printing can be routed to different printers in the ED based on location, if necessary
• Tracking List tabs can be organized based on location
Only displaying patients in Fast Track area
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 50
What solutions use Core Locations?
Clinical Reporting• Chart distributions and expedites can be routed by patient location, which
includes routing by facility, nurse unit, ambulatory location, or outpatient location.
• Keep in mind that if you are routing a distribution or expedite by patient location and you would like the ability to print charts to 2 locations within the ED, for instance, you would need to create 2 patient locations for the ED so that the chart can be printed to the respective device in that location.
• The location where the patient is registered to can also be printed in the chart header/footer. Again, this includes the facility, nurse unit, ambulatory location, and/or outpatient location.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 51
What solutions use Core Locations?
Anatomic Pathology (AP)• Uses the functions of Orders for all orders placed outside the pathology lab• AP uses the functions of Charge Services and Profit to charge based on
patient location• AP uses Registration and Patient search functions• Service resources are used to route internal orders to work lists and work
queues• Processing orders are added to work queues based upon routing• Worklists and Labels are printed based on routing• Reports are sent to review queues based on routing
• Calendars and Service Areas added to benches allow internal AP orders to be sent to the proper lab if there are multiple pathology labs working from the same database.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 55
What solutions use Core Locations?Registration
Scheduling
PowerChart
CareNet
INet
Charge Services
PharmNet
ProFile
ProFit
FirstNet
Clinical Reporting
PathNet AP
Alias Pools
Core Services
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 57
Alias Pools?
Sets of alphanumeric identifiersThese numbers are used as boundaries for checking for duplicate persons, encounters, orders, personnel, and organizations.
How are alias pools related to organizations?
Assigned at organization level
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 58
Alias Pools
Cerner HospitalCH MRN: 434-328
Cerner Clinic CC MRN: 223
PatientPete Smith
Pete checks into Cerner Hospital.
Hospital assigns Pete a MRN and a FIN
Hospital adds his SSN and
CMRN
CH MRN Pool
CH FIN Pool
SSN Pool
CMRN Pool
CC MRN Pool
CC FIN Pool
Pete visits Cerner Clinic.
Clinic assigns Pete a MRN and a FIN
Matches SSN and CMRN
Pete visits Cerner Clinic for a second
time.
Matches MRN
Adds FIN
434-328
CH3334
223
B890B2343
444-99-4421
34543CM
CH FIN: CH3334SSN: 444-99-4421CMRN: 34543CM
CC FIN: B890 CC FIN: B2343
SSN: 444-99-4421 CMRN: 34543CM
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 59
Types of Alias Pools
Person• SSN• MRN
Organization• Insurance company• Employer
Personnel• Organization Dr. #• UPIN• Provider Numbers
Encounter• FIN number• Visit number
Order• Placer order number
“Buckets” of numbersExamples of data elements that require alias
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 60
Alias Pools Association
Think of aliases in terms of the organization types rather than at the organization level.
Does every Organization need alias pools?• No, just certain types of Organizations need pools. • Define what pools will be needed for the different types
of Organizations• Occasionally, there will be an identifier that is unique to
one organization, but not apply to all others of the same type.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 61
Alias Pools Explained
Fin Number - If patients are being registered to the organization they will always have a FIN number pool. It will be system-assigned only if a client implements Cerner ERM. If it is system assigned you can identify a start number. The FIN number is an encounter alias.
MRN - If patients are being registered to the organization they will always have a MRN pool. This works the same way as FIN as far as the start number and system assign. MRN is a person level and an encounter level alias pool. Some applications will look to the encounter specific MRN where other situations you will want to utilize person level or all MRNs. Health Plan - This is required if importing health plans. It is associated to the facility. This pool is used to store Health Plan aliases.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 62
Alias Pools Explained cont…
Employer Code - This does not need to be associated to each Employer because this is one of the values that we know ahead of time what will be sent. The Employer Code alias pool should be tied to the main facilities.
Encounter Organization Alias - This will need to be associated to all facilities. This is required to correctly stamp the encounter table.
Insurance Code - This is the same as the Employer code. You need to have the pool built, but only need to tie to the main facilities.
SSN - This pool will be shared by all organizations that patients are registered too. Masking is typically used so the SSN displays with the proper format.
DOCDEA, DOCUPIN, External ID, and Organization Doctor - These are all personnel aliases that need to be tied to all facilities.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 63
Shared Alias Pools
Alias pools may be shared across organizations• Social security number• Community medical record number• Community doctor number
Code Sets including Code Values and Code Value Aliases
Core Services
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 65
Code Sets - Defined
What are code sets and what do they do?• Code Sets are groupings of like sets of reference data
• For example: Gender is a code set. Male, Female, Unknown are all possible reference data elements within the Gender code set.
• Code Sets also allow you to normalize information to be used across all solutions
• For example: By using code sets, the end user will see Female in both PowerChart and FirstNet, not Female in PowerChart and Woman in FirstNet
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 66
Code Sets
Two types of code sets• Standard
• Gender, state, marital status, Units of Measure
• Solution-specific• Laboratory Code Sets (Body Site, Organisms)
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 67
Code Sets - Interfaces
Code Sets are also used to map information via an Interface
Every data element coming into or out of Cerner from a foreign system must have an alias
Think of these standard values coming in and out as descriptors• Demographic descriptors – race, religion, gender• Order Information descriptors – collection priority, mode of
transportation, and report priority
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 68
Code Sets - Interfaces
Patient =John Smith
Gender Code SetInbound Values
Foreign ADT: “M”
Foreign ADT: “F”
Foreign Lab: “1”
Foreign Lab: “2”
M = Male1 = Male
F = Female2 = Female
gender display = Male
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Benefits of Code Sets
Allow for site customization of data elements• Cerner provides Start data elements for you to use
Provide for standardization or normalization of data display across all solutions• Common display values
Event Codes and Event Sets
Core Services
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What is a Flowsheet?
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What is a Clinical Event?
Often called a result• Result of a question• Result of a diagnostic test• Result of an assessment• Result of a consult
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What is an Event Code?
Event Code: • It is the reference data element against
which each clinical event is storedResultEvent Code
Reference Data Element
Activity Data Element
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More about Event Codes
Only ONE event code should ideally exist per concept. • It is not a good idea to purposely build more
than one event code that conceptually means the same thing.
• The GOAL and RECOMMENDATION is to strive for ONE event code for each result-able concept.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 75
Event Code Integrity
Once an event code is paired with a production result, the two must be an inseparable pair forever.
Therefore, event codes that have a result against them on production patients on the clinical event table should:• NOT be changed (meaning should not be changed)• BE viewable
ResultEvent Code
Reference Data Element
Activity Data Element
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Flowsheet – Event Codes
Event Code is the placeholder for result
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Viewing Event codes and results?
Event codes are how results are stored in the system.
For most solutions, however, we do NOT view event codes.
Thus, we introduce the Event Set.
Event Codes need to be paired with an Event Set for viewing.
Event CodeEvent Set
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What is an Event Set?
Event Set: • Event Sets are used to group/organize event
codes for viewing and printing (clinical reporting).
• The organization of event sets is hierarchical, thus called the event set hierarchy.
• No activity data is stored against an event set.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 79
Flowsheet – Event Sets
All rows here, BOTH dark and light blue bars, are event sets.
Event Sets are What You Can See
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More about Event Sets
Event Set Hierarchy: The event sets are organized in a hierarchical structure called the event set hierarchy (ESH).
Grouper Event Sets: Like event sets are grouped together into grouper event sets.
Primitive Event Set: At the lowest level of the hierarchy, there must be a connection to an event code in order for results viewing to occur. This lowest level event set is called the primitive event set.
Therefore, an event set within the ESH can be EITHER a grouper event set OR a primitive event set. It cannot be BOTH.
ESH
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Diagram of the Required Event Sets
All OCF Event Sets
All Specialty SectionsAll Result Sections
All Service Sections All Document Sections
Other Results Other Documents
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ESH Structure
Event Codes
Primitive Level
Child
All Service Sections
Laboratory
UrinalysisHematology
Parent
Parent
Child
Child
Parent
Parent
Child
GrouperEvent Sets
UA DipstickCBC
BilirubinUrine Dipstick
POCWBC RBC Hgb
WBC RBC HgbBilirubinUrine Dipstick POC
BloodUrine Dipstick POC
GlucoseUrine Dipstick POC
BloodUrine Dipstick
POC
GlucoseUrine Dipstick
POC
ParentChild
Parent
ChildAll Result Sections
All OCF Events
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Flowsheet – Grouper and Primitive Event SetsVital Signs would be considered a Grouper Event Set while Temperature Tympanic, Respiratory Rate etc. are Primitive Event Sets. Vital Signs is the Parent of these primitive event setsThe Event Code of Respiratory Rate is tied to the Event Set Respiratory Rate There are no Event Codes tied to Grouper Event Sets
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“All Results” Organization Analogy
Grouper Event Sets = Sections & Drawers
WBC, RBC & Hgb are filed into CBC. CBC goes to “Hematology” Divider in the “Laboratory” Drawer.
Event Codes = Paper
(Results of WBC, RBC, Hgb are written on different sheets of paper)
Primitive Event Sets = Files
All WBC, RBC & Hgb papers are filed into separate WBC, RBC, & Hbg files
All papers, files, dividers, and drawers are logically organized and sequenced in appropriate SIDE of the “All Results” cabinet.
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 85
“All Results” Organization Analogy
Event Codes
Primitive Level
All Service Sections
Laboratory
UrinalysisHematology
GrouperEvent Sets
UA DipstickCBC
BilirubinUrine Dipstick
POCWBC RBC Hgb
WBC RBC HgbBilirubinUrine
Dipstick POC
BloodUrine
Dipstick POC
GlucoseUrine
Dipstick POC
BloodUrine Dipstick
POC
GlucoseUrine Dipstick
POC
All Result Sections
All OCF Events
FILES
PAPER
SECTION
SECTIONS
DRAWER
FILE Cabinet
Side of the FILE Cabinet
© 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 86
Questions