Clarity - Beacon Flashcards
True/False: An encounter can belong to more than one episode?
True
When is an Oncology Episode created?
When the Oncologist applies a Treatment Plan to a patient an oncology episode is created behind the scenes.
Why is it necessary to use the EPISODE_LINK table to join EPISODES with their related encounters?
Because one encounter can be linked to many episodes and one episode may have many encounters attached to it.
In Oncology, a stage is what?
The numeric representation of the progression of a patient’s cancer. Most, but not all, types of cancer are staged.
Treatment Plans are stored in what master file?
TPL. Treatment plans are linked to the patient through an episode.
Oncology protocols (PRL) are the base for what?
A patient’s treatment plan. Protocols are not patient specific.
In addition to protocols the PRL master file also contains what records?
Smart Set / Order Set and Therapy plan records.
True/False: Treatment Plan Cycles represent a specific ‘course’ of treatment. Cycle lengths and the number of days are the same for every plan.
False. Cycles can vary in length and number of days.
You can manually associate patient encounters and Problems (diagnoses) to an episode in what activity?
Episodes of Care activity
Staging a cancer involves what?
Identifying the location, size and extent of metastasis of the tumor to determine the most appropriate treatment for the patient.
True/False: To stage a patient’s cancer a cancer diagnosis must be added to the Problem List?
True
‘T’, ‘N’, and ‘M’ stand for what when staging a cancer?
T = Primary Tumor size in mm N = How involved are the nearby lymph nodes M = Distant metastasis
What action starts the Treatment Day?
Releasing orders
True/False: A Treatment Day equals a Calendar Day
False. In the Inpatient setting a planned treatment day can span more than one calendar days. You ‘complete’ a day you are really completing the planned treatment.
What actions advance the plan?
Completing a Day
Cancelling
Deferring
Marking that treatment was given somewhere else
A treatment plan order (OTP) record is also known as…
an Order Template Record
A treatment plan order is a container for…
A single medication that will be administered,
or a single procedure that will be performed,
on a given day of treatment.
Describe the difference between an OTP record and an ORD record.
Order template records provide the treatment plan context from which an order is generated. Order template records are ‘place-holders’.
Orders can be deleted from the treatment plan at any of four levels. They are…
Individual Orders (allows propagation)
Order category (allows propagation)
Treatment day
Treatment Cycle
True/False: You can delete orders that are signed.
True. You cannot delete orders that have been released. Those must be discontinued.
True/False: Treatment days and Treatment cycles can exist on their own, without any orders.
True. It is best practice to delete the entire day or cycle if you are going to remove all the orders from it.
True/False: When you change an order and click Accept you are prompted to propagate your change to other instances of the same order.
True
What activity would you use to change a chemotherapy dose by a percentage?
Dose Modification. It can be a percentage of either the original dose or the current dose.
OTP Master File holds…
Patient Order Templates, each a container, holding a single medication that will be administered, or a single procedure that will be performed, on a given day of treatment.
LINE in the EPISODE_LINK table represents
patient encounters linked to the episode
LINE in the PAT_EPISODE table
patient episode (useful when the episode does not have encounters yet)
LINE in the EPI_PROBLEM_LIST table
each problem associated with the episode
What column(s) in the PROBLEM_LIST table can you use to determine if a diagnosis is chronic?
PROBLEM_LIST.CHRONIC_YN = Y CLASS_OF_PROBLEM_C = 2 //Chronic 1-Acute, 3-Minor, 5-Stage I, 8-End Stage
Which table/column combinations can you use to display the ICD codes associated with a patient’s problem list diagnosis?
CLARITY_EDG.CURRENT_ICD9_LIST
CLARITY_EDG.CURRENT_ICD10_LIST
True/False: Every row in STG_INFO will have a value in the STAGE_CONV_SRC_ID column?
False. Only stages that were created via conversion will have a value in this column.
True/False: If you have stage records in both the ‘old’ data structure (pre-Epic 2014 conversion) and the ‘new’ data structure (Epic 2014 +) you need to manually combine the two data sets together to report on all stages.
False. V_CANCER_STAGING table combines the two data sets for you.
Under what circumstances is STAGE_EPT_ENC_CSN in table STG_CONTACT_INFO null?
If the user edited the stage outside of an encounter context (i.e. in the Chart workspace).
True/False: CL_PRL_SS and CL_PRL_SS_OT contain patient-specific treatment information.
False. Protocol PRL records and their associated tables don’t contain any patient specific info.
Which table could you use to determine all plans associated with a patient’s episode?
HSB_TPL_LIST
List the four levels of the treatment plan structure starting from the least specific.
Cycle, Day, Order Category, Order
Why would you compare protocols to patient treatment plans?
To understand how clinicians are using and modifying them.
Name three things that are contained in a treatment plan.
The Goal for the treatment
Information needed for dosing
The provider managing the patient’s plan
When you change an order, Foundation is configured to match on what order details?
dose, route, and category
Explain the difference between TPL_TX_DAYS.TX_PLANNED_DT and TPL_TX_DAYS.TREATMENT_DATE.
Planned date is the date originally laid out, Treatment date is the date stored when a day’s status is changed.
How might you report on orders contained in TRG_BLOCK_INFO and TRG_DEL_BLOCK_INFO in one query?
Use UNION to combine the tables.
True/False: All orders deleted from a plan will be contained in TRG_DEL_BLOCK_INFO.
False. Only orders deleted individually will show up in this table. If a cycle or day is deleted in total, those orders will not be in this table.
Which tables do you need to get from the OTP_INFO table back to the PATIENT table?
PATIENT *TPL_HSB_EPT_LINK* TPL_INFO TPL_CYCLES TPL_TXDAYS TRG_BLOCK_INFO OTP_INFO
Which column do you use in OTP_INFO to get the ERX associated with the order template? To get to EAP?
OTP_INFO.MED_ID (ERX)
OTP_INFO.PROC_ID (EAP)
True/False: Medication order templates do not appear in the OTP_DOSE_CHANGE table unless the original dose is modified.
False. The initial instance is listed too.
The process of creating new child orders from a parent order is called…
Instantiating an order, also ‘dropping child orders into the system’
True/False: Any procedure order placed during a hospital encounter is considered a standing order.
True
True/False: All child orders are created when the parent inpatient procedure order is released.
False
True/False: Future and Standing Parent orders are never actually acted upon or resulted.
True
True/False: Only child orders will have results.
True
Results for procedure orders are generally populated in the system in one of three ways.
An incoming results interface
By Beaker
By using the Enter/Edit Results activity
Which table and column provides a link from order (ORD) record to treatment plan order template (OTP) record?
ORDER_PRFLST_TRK.ORDER_TEMPLATE_ID
How can you differentiate between a future, normal, parent, and child record in ORDER_PROC?
Future = FUTURE_OR_STANDING = F
Standing = FUTURE_OR_STANDING = S
Normal = FUTURE_OR_STANDING is null
INSTANTIATED_TIME is null
Child = FUTURE_OR_STANDING is null
INSTANTIATED_TIME is populated
Is it possible for a lab order to have more than one component? Is it possible for a component to have more than one result? Do you need a filter to get the most recent result?
Yes, some labs have many components.
Yes, components
No filter necessary, only the most recent result for each component is extracted.
What is the difference between ORDER_RESULTS.LAB_STATUS_C and RESULT_STATUS_C?
LAB_STATUS_C is for all the components in the test. RESULT_STATUS_C holds the result for each component.
Grandparent Orders are created how?
When an Outpatient Standing Order is released into an Inpatient/HOV setting.
Which is more granular PAT_LIFEDOSE or PAT_LIFEDOSE_HX?
PAT_LIFEDOSE_HX provides individual dosing history
True/False: If multiple administrations occur for the same order, there is an entry in PAT_LIFEDOSE_HX for each of the administrations.
True
What is the difference between TAKEN_TIME, SCHEDULED_TIME, and SAVED_TIME?
SCHEDULED_TIME the scheduled time on the MAR.
TAKEN_TIME the user specified time
SAVED_TIME the time they clicked ‘accept’
What is the purpose of the SEC_USER_ID field?
If dual signoff is required for the medication it holds the verifying User’s ID.
You are creating a report of medications administered on a particular day. How can you display which medication is being administered?
MAR_ADMIN_INFO.ORDER_MED_ID to ORDER_MED.ORDER_MED_ID.
Will the column ORDER_MED_ID always be populated with a chemotherapy order for rows of PAT_LIFEDOSE_HX?
No, externally administered chemotherapy will not contain a value in the ORDER_MED_ID column.
How would you determine a patient’s lifetime cumulative dosage of doxorubicin?
Check PAT_LIFEDOSE.SIMP_DOSE_AMT where the CHEMICAL_C is equal to your system’s configured chemical for ‘Doxorubicin’.
