RX205 Willow Inpatient User Configuration - Chapter 1: Epic's Data Structure Flashcards
Hyperspace
Epic’s front-end user interface, accessed on the Hyperdrive client
end users log into Hyperspace to complete their workflows and do their jobs
admins and builders also log into Hyperspace to test and troubleshoot build
Hyperspace Web
web server that runs the web-based application, Hyperspace
when you launch the hyperspace icon, you are launching a specialized web browser called Hyperdrive –> the Hyperdrive client presents the Hyperspace Web application to users, like a commercially-available browser (eg. Chrome) presents a web site
Chronicles
the data management system (“the database”) that provides the underlying structure for all of Epic’s applications
users and admins access Chronicles via a number of paths, including Hyperspace, the Classic client, and Text
all the data that users access in Hyperspace lives in Chronicles
- when a user logs into Hyperspace and opens a patient chart, Hyperspace is requesting data from Chronicles
- when a user documents in a patient’s chart, they are saving data to Chronicles
Classic
the original Hyperspace client
as of the May 2022 release, all end-user facing activities are available in the new, web-based Hyperspace but many admin activities are only available in the Classic client (have yet to be migrated)
when migration is complete, the Classic client will be retired
Text
text-based back-end interface with Chronicles data, used solely by admins for creating, editing, and analyzing records
Text runs directly on a server that hosts Chronicles and you connect via a terminal emulator (eg. PuTTY in training, or Reflection)
there will always be some tools and editors that only exist in Text; will not be retired
includes multiple applications: Clinical Administration, Chronicles itself, Training Tools, etc
master file
aka INI
stores all the data about one type of thing
examples =
- patient data in the Patients master file
- clinician info in the Provider master file)
like a drawer in the Chronicles filing cabinet
INI
aka master file
stores all the data about one type of thing
examples =
- patient data in the Patients master file
- clinician info in the Provider master file)
like a drawer in the Chronicles filing cabinet
record
stores info about one individual or entity in the master file
examples =
- each patient has a record in the Patient master file
- each combination of drug/strength/form has a record in the Medication master file
like a folder in a drawer (master file) of the filing cabinet (Chronicles)
item
set of prompts or fields for storing information
examples =
- gender
- smoker
- MRN
like fields you fill in on each file folder (record)
value
every record in the same master file has the same set of items, but each record will have a different set of values
examples =
- male/female
- yes/no
- dates (string values)
what you write in the fields (items) on each file folder (record)
contact
set of values within a single record that relate to a particular event or significant change to that record
examples =
- patient record contacts can be visits, telephone encounters, admissions
- order record contacts mark when an order is signed, verified, dispensed, administered
like dated sheets of paper in the file folder (record)
record viewer
a utility for looking at the data stored in Chronicles for particular records
available in Classic to admins and others with proper security
path: Classic»_space; main toolbar»_space; Record Viewer
no-add items
values associated with a record and NOT a single contact
stored at the record level
over time items
values associated with a single contact
stored in a specific contact
Clinical Administration
a back-end application within Text to modify data in Chronicles
networked
when a value in Record Viewer is linked to another record
appears as a hyperlink
category list
every item in Chronicles has a data type, which determines what kind of data the item can store as a value
a category data type has values that will be selected from a list of possible options, called a category list
a category list is a list of potential values for a particular item; it is part of an item
shared category list
some items have a “category” data type but re-use the category list from another item (eg. yes/no, gender)
string data type
value is free text, any string of characters
release range
some category lists have release ranges, meaning Epic code expects those options to exist. you cannot edit the category options in that range.
you can see the release range for a category list in the Category List Maintenance activity
ALL CUSTOMER OWNED = no release range, can edit all options in the category list
ALL CATEGORIES = entire category list owned by Epic, you cannot edit, deactivate, or add choices to the list
FROM X TO Y = can’t edit options with IDs between X and Y but you CAN create and edit options outside that range
facility
the entire enterprise or “instance” of Epic, aka your
entire organization
this level was named a long time, before largescale
consolidation in the industry
broadest facility structure
service area
separate business entities within your
organization, or that you use your install of
Epic
used for grouping revenue and accounts
receivable
nested immediately under “facility” structure
location
a hospital or free‐standing clinic
there’s a separate Location (EAF) record for each
hospital and clinic in your organization
location records are where we attach:
- formulary
- main pharmacy for a hospital/clinic
- content that appears on the Facility List
nested immediately under “service area” structure
department/unit
places where patients receive care, and/or where users work
includes:
- nursing units in a hospital, where patients are admitted (“EMH 1 East” or “EMH 2 West” or technically “EMH Emergency”)
- outpatient departments, where patients make appointments, receive care, and go home (“EMC Family
Medicine,” or “EMH Allergy Clinic”)
- hospital outpatient departments, which can see both admitted patients and outpatients (“EMH CT Imaging” or “EMH Cardiac Cath Lab”)
- virtual departments, which never have patient encounters and exist only for users to pick as their login department (“EMH IP Pharmacy” or “EHS Internal
Medicine” or “EMH Admitting Department”)
department/unit records are where we attach the list of Pharmacy (PHR) records that serve patients in that unit
Willow users also log into a “virtual” department for their hospital’s pharmacy
nested immediately under “location” structure
room and bed
these records only exist in nursing units or some hospital outpatient departments
they represent the specific place where a patient gets admitted
appears on dispense labels, ADS load labels, and cart fill reports to help identify where the patient is
some hospitals will configure dispense logic (the list of pharmacies serving a patient) for specific sets of rooms in a unit
nested immediately under “department/unit” structure
how to distinguish between Hyperspace and Classic at a glance
log in screen
- says “Classic” or “Hyperspace”
color scheme once logged in
- “Classic” = black and gray
- “Hyperspace” = colorful
top left corner of window
- says “Classic” or “Hyperspace.”
how to use the Record Viewer
Path: Classic > main toolbar > Record Viewer
TO USE
- enter INI, record, and contact you want to view > View Record
- items sorted by item #
- can “Jump To” to jump to specific item
- can “Ctrl+F” to search for a text string
- can filter on the sidebar to show certain items
EACH ITEM SAYS NO-ADD or LISTS SPECIFIC CONTACT (OVER TIME)
- use filter to see each
CLICK ITEM NUMBER/NAME FOR DETAILS INCLUDING
- Data type: string, numeric, date, category, or networked
- For category items, you can also see the category list from here
- For networked items, you can see which INI the item is networked to
— If an item is networked, its value will display as a hyperlink; clicking that link will open that INI and record in Record Viewer
how to filter items in Record Viewer to see only “no add” values
no-add = value stored at the record level, NOT in a specific contact
- use filter in Record Viewer to see only these items
how to find values or items in Record Viewer
use Jump to enter item #
OR
Ctrl+F (+fn for mac) to search text
how to log in to text
click Text icon
wait for cow image, then choose environment
text window appears:
- initial pw - does not appear as you type > Enter
- user id - will appear as you type > Enter
- pw - does not appear as you type > Enter
Enter to skip copyright screen
then you see main screen of Text!
how to navigate menus in text
all navigation is done with the keyboard, mouse is not functional other than to resize the application window
to go forward, enter the number for the option you want and press Enter
to go backward, press Page Up or Page Down (or Enter without first entering an option)
typing “=” at a master file prompt will re‐open the last record you edited during this text session
how to navigate within records in text
move through fields L to R –> tab or enter
go back to previous field R to L –> shift + tab
go straight up/down to a field –> up/down arrows
move through values of multiple response field –> up/down arrows
get help on item (including list of values) –> shift + F5 (+Fn on mac)
move to next/previous screen –> page down/page up
exit record from any screen –> shift + F7 (+Fn on mac)
undo a change (but only if you haven’t left the field –> F3 (+Fn on mac)
how to move through fields L to R in text
tab or enter
how to go back to previous field R to L in text
shift + tab
how to go straight up/down to a field in text
up/down arrows
how to move through values of multiple response field in text
up/down arrows
how to get help on an item in text
shift + F5 (+Fn on mac)
includes a list of values!
click enter to leave help text
how to move to next/previous screen in text
page up/page down arrows
how to undo a change in text
F3 (+Fn on mac)
only works if you haven’t left that field yet
how to exit record from any screen in text
shift + F7 (+Fn on mac)
how to delete value or entire line of text in text
F1 (+Fn on mac)
how to erase everything from cursor to end of field in text
F2 (+Fn on mac)
good for partially deleting characters in free text fields
how to move cursor to far right position within current field
home + right arrow
how to move cursor to far left position within current field
home + left arrow
how to look up the INI and item number of an item in Hyperspace
ctrl+click in a field
a new window appears with the INI and item number in the top left of the windowe
how to expand space available for entering free text value in text
shift + F3 (+Fn on mac)
only works on some fields
how to look up the INI and item number of an item in Clinical Administration
home + F8
Displays information about the item the cursor is on,
such as the master file INI and item number.
how to edit values in a category list
how to identify the release range for a category list
you can see the release range for a category list in the Category List Maintenance activity
in Classic –> magnifying glass at top right –> search for Category List Maintenance
once in the activity, you can:
- add new choice
- edit choice
- deactivate choice (no longer appear to users or administrators as a choice to select, but existing values that use this choice are still valid)
explain the structure and relationship of the parts of Chronicles (master file, record, etc), providing examples of each
Chronicles = giant filing cabinet
Master Files (INIs) = drawers of the filing cabinet
- stores all the data about one type of thing (eg. patient data in the Patients master file and clinician info in the Provider master file)
Records = a folder in a drawer of the filing cabinet
- stores info about one individual or entity in the master file (eg. each patient has a record in the Patient master file and each combination of drug/strength/form has a record in the Medication master file)
Items = fields you fill in on each file folder
- set of prompts or fields for storing information (eg. gender, smoker)
Values = what you write in the fields on each file folder
- every record in the same master file has the same set of items, but each record will have a different set of values (eg. male/female, yes/no)
Contacts = dated sheets of paper in the file folder
- set of values within a single record that relate to a particular event or significant change to that record
- can vary among master files (eg. patient record contacts can be visits, telephone encounters, admissions while order record contacts mark when an order is signed, verified, dispensed, administered)
describe when you should log in to Hyperspace vs. Classic vs. Text
Classic client = build, configure records, use utilities
Hyperspace on the Hyperdrive client = test build/configuration by logging in as an appropriate test user because builds may behave differently in Classic vs. Hyperspace
describe the relationship between Hyperspace, Classic, Text, and Chronicles
what does a contact represent?
a meaningful version or event, not just a change
when are changes saved in Text?
once cursor moves away from item field or when record is closed (shift+F7)
can a category list be shared?
yes, multiple items can share a category list
for example, Yes/No is a category list that is frequently used
why should you be careful to not change the meaning of an existing option in a category list?
the changes will apply to all items that currently have that value, therefore data could be erroneous if the meaning has changed
describe the Epic facility structure
facility = entire organization
service area = separate business entities within organization, used for grouping revenue and accounts receivable
location = hospital or free-standing clinic
department/unit = where patients receive care and/or where users work
room/bed = only exist in nursing units and some hospital outpatient depts; represent a specific place where a patient gets admitted
facility > service area > location > department/unit > room > bed
how are different parts of the Epic facility structure connected and what does each level represent?
facility = entire organization (eg. UCSF)
service area = separate business entities within organization, used for grouping revenue and accounts receivable (eg. UCSF east vs west bay)
location = hospital or free-standing clinic (eg. PCMB, Parnassus)
department/unit = where patients receive care and/or where users work
- nursing units (eg. 14L, PCMB INF 3)
- outpatient depts (eg. MELANOMA CLINIC)
- hospital outpt depts which can see both inpt/outpts (eg. CT IMAGING)
- virtual departments (eg. PCMB SAT INF PCMB 3)
room/bed = only exist in nursing units and some hospital outpatient depts; represent a specific place where a patient gets admitted
- (eg. RM L3113A, chair 2)
who typically creates records in the facility structure?
administrators
why does Willow care about each type of record in the facility structure?
facility + service area
- you should know they exist
location
- where we attach:
- formulary
- main pharmacy for a hospital/clinic
- content that appears on the Facility List
department/unit
- where we attach list of Pharmacy (PHR) records that serve patients in that unit
- Willow users can also log into virtual department for their hospital’s pharmacy
room/bed
- appears on dispense labels, ADS load labels, and cart fill reports to help identify where the patient is
- some hospitals will configure dispense logic (list of pharmacies serving a patient) for specific sets of rooms in a unit
numeric data type
value must be a number
date data type
value must be a date
networked data type
value will link to a record, usually one in a different INI (Master File)
category data type
values will be selected from a list of possible options, called a “category list”
