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MPages Development MPages Development Conference Conference LPCH MPages Overview Seattle March 30, 2009

MPages at Lpch - Thus Far

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From the Mpages conference in Seattle help on March 30th 2009

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Page 1: MPages at Lpch - Thus Far

MPages Development MPages Development ConferenceConference

LPCH MPages Overview

SeattleMarch 30, 2009

Page 2: MPages at Lpch - Thus Far

IntroductionIntroduction

Chris Longhurst, MD, MSMedical Director of Clinical Informatics, LPCHAssistant Professor of Pediatrics, Stanford

Joshua FaulkenberrySenior Web Applications Engineer, LPCH

Page 3: MPages at Lpch - Thus Far

OutlineOutline

OverviewLucile Packard Children’s Hospital at StanfordLPCH history with Cerner

MPagesClinical challenges and solutionsTechnical challenges and solutionsFuture projects

Page 4: MPages at Lpch - Thus Far

Lucile Packard (Women and) Children’s Hospital OverviewLucile Packard (Women and) Children’s Hospital Overview

Opened in 1991 Major pediatric/obstetric hospital associated with Stanford University Patient stats (2006)

13k Discharges 5400 Deliveries 106k Clinic visits 280 Active Beds 40%+ critical care patients

Centers of Excellence (6) Top 10 children’s hospital by US News & World Report in 2007

Page 5: MPages at Lpch - Thus Far

LPCH Information & Knowledge System (LINKS) LPCH Information & Knowledge System (LINKS) OverviewOverview

Cerner selected as LPCH partner for IT applications in 2002 LINKS phase 1 went live 9/2005 – “Conversion” from legacy system included 13 “nets” LINKS phase 2 went live 11/2007 – “Clinical Transformation” = CPOE using PowerPlans and clinical documentation (using IView)

Page 6: MPages at Lpch - Thus Far

LPCH Development History with CernerLPCH Development History with Cerner

2005Co-developed PowerChart Outreach

2008 - 2009IView Dynamic labels development partnerPRISM development partnerMPages development partner (1st remote hosted site)

Page 7: MPages at Lpch - Thus Far

Clinical Challenges and SolutionsClinical Challenges and Solutions

Data reviewAccessing external clinical databasesIntegrating clinical decision support toolsPediatric risk of mortality adjustment

Page 8: MPages at Lpch - Thus Far

IView Use By Role in 24 HoursIView Use By Role in 24 Hours

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Page 9: MPages at Lpch - Thus Far

““Rounds” tab 1.0 (RTF Genview)Rounds” tab 1.0 (RTF Genview)

Page 10: MPages at Lpch - Thus Far

Rounds tab 2.0 (MPage)Rounds tab 2.0 (MPage)

Page 11: MPages at Lpch - Thus Far

Clinical Decision Support Tool IntegrationClinical Decision Support Tool Integration

Page 12: MPages at Lpch - Thus Far
Page 13: MPages at Lpch - Thus Far

Technical Challenges and SolutionsTechnical Challenges and Solutions

Where to store MPage resourcesWorked with Cerner to identify a standard location for all Remote-Hosted clients (In progress)

Loading HTML files into a tabIdentified two methods to load HTML files directly into a tab on PowerChart as MPages

Page 14: MPages at Lpch - Thus Far

Technical Challenges and SolutionsTechnical Challenges and Solutions

Discovering the mechanism for true AJAX in MPages

Reverse engineered Cerner's code, discovering how to implement a fully functional XMLCclRequest

Complete separation of client and server development

Developed the “CCL as a Service” (CCLS) architecture – allowing CCL engineers to focus on the Backend and Client-side engineers to focus on the “Frontend”

Page 15: MPages at Lpch - Thus Far

Video demoVideo demo

Illustrating AJAX and realtime waveforms

Page 16: MPages at Lpch - Thus Far

Future MPages Projects at LPCHFuture MPages Projects at LPCH

Continued GenView improvementPlan to combine multiple current GenView tabs into single, customizable “Pt Summary” tab with user-selectable widgets – Dr. Dan Imler*

([email protected])Continued external resource integration

Transplant database (OTTR) – Dr. Scott Sutherland ([email protected])Personal health record (Google Health) integration – Drs. Chris Longhurst / Dan Imler

Multi-patient dashboardsMed/surg – Drs. Chris Longhurst / Dan ImlerNICU – Dr. Jon Palma* ([email protected])CVICU – Dr. Andy Shin* ([email protected])PICU – Dr. Natalie Pageler ([email protected])

Page 17: MPages at Lpch - Thus Far

CVICU Dashboard Mockup

Page 18: MPages at Lpch - Thus Far

Google Health Mockup

Page 19: MPages at Lpch - Thus Far

Google Health Mockup

Page 20: MPages at Lpch - Thus Far

AcknowledgementsAcknowledgements

Mattice HarrisManager Web Services, LPCH

Ed KopetskyChief Information Officer, LPCH

Page 21: MPages at Lpch - Thus Far

QuestionsQuestions

Chris Longhurst – [email protected] Faulkenberry – [email protected]