CLN 251/252 Flashcards
What is Chronicles?
Epic’s database management system. Often referred to as the “database”.
All the data that users access in Hyperspace is stored in Chronicles.
It’s the master filing cabinet
What is Hyperspace?
Epic’s front-end user interface.
Where users complete their work.
It basically asks Chronicles for data or to edit existing or save new data.
What is hyperdrive?
The wedbased platform that launches Hyperspace. (Similar to Chrome, edge etc..)
What is Classic?
The original Hyperspace.
You can build or configure records or utilities here (or in text).
What is Text?
Is a text-based back-end interface with Chronicles data.
Used solely by administrators for creating, editing and analyzing records.
Text includes a number of applications such as:
*Clinical Administration (for various clinical apps)
*Chronicles (for importing, duplicating, hiding, searching for or otherwise managing records)
* Training Tools (which includes things like patient duplication)
Master files
Chronicles is organized in master files. Each master file stores all the data about one thing.
Ie:
* Info about patients is stored in the patients master file.
* Info about users is stored in the users master file.
Think of Chronicles as the filing cabinet
Master files is the cabinet drawer
Records
A record stores information about one specific entity in the master file.
Think of Chronicles as the filing cabinet
Master files is the cabinet drawer
Records are the file folder
Each Record has a unique ID number
Note: A master file’s record can network to one another record for efficient data storage and maintenance. (ie an employees record (Dr Small) (in the Employee master file) may link to the department’s record (pedatrics) where he /she works (with in the Departments master file)
A Contact
In Chronicles, date sensitive information about a record is stored within a “contact”.
A contact is a date specific snapshot of the data within a record allows for changes to the record to be effective on a specific date.
NOTE: not all data in a record is a contact (Date specific)
Think of a contact as the new or changed data at each encounter.
Think of Chronicles as the filing cabinet
Master files is the cabinet drawer
Records are the file folder
The contact (encounter) is the piece of paper for that new data.
Items and Values
individual pieces of data are stored as items and values.
An ITEM is like a question on a standardized form.
A VALUE is like the answer
Every record contains the same ITEMS, but the values in each record will likely be different.
Each record will contain lots of items, but very few records will have a value for every item (Ie; a patient may not have a home phone #, just a cell #, but there is a question for a home number in every record.)
Items have numbers associated with them as unique identifiers as well a name to help you understand the purpose of the item.
All of the information that you enter in Hyperspace is stored in ____________________ , Epic’s database management system.
Chronicles
A(n) __________________________is a date-specific snapshot of the data within a record.
Contact
Each ________________________ stores all of the data about one type of thing.
Master file
A(n) ________________________ is a discrete field within a record.
Item
Each _____________________________ stores information about one specific entity in the master file.
Record
A(n) _______________________ is the data that is stored in an item.
Value
A dynamic master file
One that grows and changes (Ie the patient master file)
Users (mostly) and builder can make changes.
Not every record will have a name…. dynamic records often do not.
Note: A master file’s record can network to one another for efficient data storage and maintenance. (ie an employees record (Dr Small) (in the Employee master file) may link to the department’s record (pedatrics) where he /she works (with in the Departments master file)
A static master file
One that can be changed or updated, but mostly stay the same.
(Ie User (Employee) master files).
Mostly builders make changes here.
Note: A master file’s record can network to one another for efficient data storage and maintenance. (ie an employees record (Dr Small) (in the Employee master file) may link to the department’s record (pedatrics) where he /she works (with in the Departments master file)
Record viewer
Record Viewer is a tool that allows you to take a read-only look at a record in Chronicles.
When looking at records behind the scenes, while all the same components are there (records, items, values, etc.), you might note that the naming of records and the data they contain are quite different.
Record Viewer can show every item programmed into a master file. Some master files have thousands of items, but very few records in a master file have a value specified for every item.
For efficiency, most users leave the Include Blanks check box cleared, so Record Viewer only shows items in a particular record that have a value. This can greatly reduce the amount of scrolling needed. To see all the items that exist within a master file, select the Include Blanks check box from the Item Filters on the right.
After making any change to a lookup in Record Viewer, remember to click View Record.
Report (LRP)
Is a master file
Provides information for the End User.
Often these reports provide the user with information that helps them stay informed about a patient. Reports are comprised of one or more print groups. Reports are used across Epic in a variety of clinical and non-clinical activities.
For example, reports are used to format In Basket messages, as printouts for prescriptions, for read-only sections in navigators, and many other places.
Each record in the Report (LRP) master file links to, or is networked to, one or more records in the Print Group (LPG) master file
Print Groups (LPG)
Is a Masterfile
Print group records are shared.
This means they can be reused across many different reports. For example, many different reports may all use the same print group to display patient demographics.
Steps for editing a report (5):
- Determine how a report needs to change: What information is missing? What information is not needed? (ie Pediatricians want a snapshot report to provide additional information compared to others in the department)
- Identify the report record (name and ID) you want to edit.
(i.e. Use session information report to show report and print group ID #’s) - Identify (or create) the print groups (Name and ID’s) that need to be added, edited or removed. (ie. what info (Print groups) do they want added)
- Edit the report by adding, modifying, or removing print groups as needed. (ie Duplicate the current report and add the necessary print groups to create the desired report for the peditricians)
- Confirm that the report is linked in the appropriate place so that it affects the desired users. Done by linking to a profile. (ie. linked to right heirarchy in profiles so it affects only the necessary users)
Clinical Administration (In text)
Is a tool for administrations/builders to modify content in Chronicles
This controls how hyperspace behaves for end users.
The first page in Clinical Administration shows a listing groups of related Master Files (ie: Medication, Allergies and immunizations are all together so are all the procedures etc..)
An Activity
A space in Hyperspace that allows you to perform a task or enter data
What are the six levels of the profile hierarchy?
The profile hierarchy allows administrators to make profile settings to best fit a users’ needs in the most efficient way possible. The profile hierarchy consists of profiles attached to six records, listed below in order of most specific to least specific (most general):
- User/User Template: For profile settings common to a specialized group of users.
- EpicCare Security Class: For profile settings common to people with the same job duties or scope of practice, like all ambulatory physicians or all pharmacy technicians.
- Login Department: For profile settings common to people who have different job duties but who work in the same department.
- Login Revenue Location: For profile settings common to everyone who works in a particular hospital or clinic, regardless of job duties.
- Login Service Area: For profile settings common to everyone who works in a particular billing entity, regardless of job duties.
- EMR System Definitions: For global profile settings that apply to every clinical user in your system unless overridden at a more specific level.
Profiles (LRP)
Is a Masterfile
Allow activities to adapt for various users, particularly users with different specialties.
They configure the options within activities.
One example is the SnapShot activity. While both an obstetrician and a cardiologist may have access to this activity, the obstetrician may want to see OB history reports, while the cardiologist may want to see an EKG results report. Profiles make this flexibility possible. (building modifying a report happens in reports, but is linked to profiles in the end)
The last step of building a new report is making it available to users. You do that by linking it to a profile.
When a user opens the activity that needs that report, the profile (LPR) tells the system what report to load. Then the report tells the system what print groups to display.
Profile records configure options within activities. The system looks to profiles to determine how the activity looks, behaves, and what options are available within that activity.
A profile is a profile is a profile…
Every profile record contains the same screens and items. The differences among profile records affecting a user are the values they contain and where on the hierarchy they are linked. Any profile record can be linked to any level of the profile hierarchy.
A compiled Profile
It represents the collection of profile settings that will impact a user.
You build from the most general profile up.
The system reads from the most specific down when determining what profiles a user needs.
Note: in Session Information you can veiw the profile compilation for each level of the profile heirarcy:
(user, Sec class, depat, rev location, service area, facility) which will form the compiled profile.
The rule of Specificity/ Building by exception
refers to the method of making general settings in the broadest levels of a hierarchy and overriding individual settings in more specific levels of the hierarchy. By making fewer setting changes and avoiding duplicate work across records, building by exception allows for efficient build that is easier to maintain over time.
What questions will help you identify the best level to deliver changes to profile settings:
What setting needs to change?
Which users need the change?
What do the users who need the change have in common?
What’s the most general hierarchy level that could deliver this change to the correct users?
Two goals should be considered whenever you are asked to change any shared record
Make the right changes for the users who need them.
Don’t make changes for users who don’t need them.
What are some possible settings that are configured in a profile record.
Reports: Incorporated into several activities across clinical applications
- Schedule reports
- Available reports in the Patient Lists, as well as the columns a user can select when creating a new My List
- Chart Review reports for each type of encounter and each type of order
- Synopsis Views
Orders-related settings:
- Orders preference lists
- Default order mode, such as verbal
- Whether the system tries to have the ordering and/or authorizing provider appear by default when you place an order
- Which order types require an associated diagnosis
- What validation extensions are checked when signing an order (to check for duplicates, make sure that an admitted patient has a hospital account, etc.)
Vitals: Units of measure used when displaying a patient’s height or weight
Signing a visit: What information must be charted before an encounter can be closed
Flowsheets: Default buttons and preference list items
Navigators: Which navigators you see when you log in to Hyperspace (these settings may be overridden by Workflow Engine rules)
Workflow Engine Rules:
A Workflow Engine rule is a set of conditions that will change a patient workspace based on certain conditions
Facility (EAF) Record
A facility record is not the same thing as System Definitions. While both can impact an organization, System Definitions impacts clinical settings, while facility records impact other organizational settings. A profile is linked to System Definitions (LSD), not the facility (EAF) record. You can’t link a profile to the facility (EAF) record.
The facility structure forms the backbone of your administrative build. Without it, you would be unable to determine where patients are being seen, where users are working, and what settings should apply. Designing and building your facility structure is one of the first tasks in an implementation.
Service Area
Service areas represent the accounts receivable and/or business entities of your organization. This level in the hierarchy exists for the purposes of Epic’s billing applications. If a patient could receive care from two places and still get a single bill, those two places would be part of the same service area.
Depending on the financial reporting needs of your organization, a service area might represent a geographical region, a previously independent organization that your organization has acquired, or simply your entire organization. The need for multiple service areas is determined by the billing or access management teams. Many customers have just one service area
Revenue Location (More commonly called Locations)
Represent entities that exist within each of your service areas.
Locations are typically physical buildings, freestanding clinics, and hospitals. Locations can also represent groups of departments.
Department (DEP)
The Department (DEP) master file contains records for the hospital units and departments. They belong to the revenue location you link them to, so you can NOT reuse these records across revenue locations even if the same kind of department exists at different revenue locations.
A department record exists for one of the following reasons:
It’s a place where patients receive care from healthcare providers. Patients are scheduled or admitted in such a department every time they have a clinical encounter.
Often users have the ability to choose a department when they log in to Hyperspace after entering an ID and password. The login department controls a variety of settings, such as which department is displayed for your schedule and which reports are available.
Preference Lists
These are the only ones that combine all the option at each hierarchy.