Zynx Client Services: Cerner Implementation
-
Upload
linda-welch -
Category
Documents
-
view
87 -
download
1
description
Transcript of Zynx Client Services: Cerner Implementation
![Page 1: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/1.jpg)
Zynx Client Services: Cerner Implementation
Jonathan ChoClient Manager
Zynx Health
![Page 2: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/2.jpg)
Agenda
• About Zynx
• Build Process
• Integration
• What’s coming in 2007
![Page 3: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/3.jpg)
The Zynx Knowledge Factory
Pull Knowledge
Push Knowledge
Reference Information
Order sets, plans of care,
alerts
MEDLINE
CochraneClient
AHRQ NQF
LeapfrogJCAHO
CMS
![Page 4: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/4.jpg)
Zynx is in more than 1,200 hospitals nationwide
Integratable
687 hospitals
20% of all admissions
Zynx Client Base
1,245 hospitals
41% of all admissions
Referential
558 hospitals
21% of all admissions
Through 1/07
![Page 5: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/5.jpg)
• ZynxOrder
• ZynxCare
• ZynxAmbulatory Care
• ZynxEvidence
• AuthorSpace/ ViewSpace
Zynx Suite of Tools
![Page 6: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/6.jpg)
Operational - Paper
• Paper Order Set
• HTML Order Set w/ On-Demand Printing
![Page 7: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/7.jpg)
Operational-CPOE
ZynxEvidence links at the point of care
![Page 8: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/8.jpg)
Process- Life Cycle
CPOE Build
Draft Initial Draft
Consensus
ReviewInitial
ReviewFinal
Life cycle of an
Order Set
![Page 9: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/9.jpg)
Draft- Initial
• Purpose
– To prepare the Zynx template order set for Draft-Consensus stage to help focus the clinicians on the main content issues.
• Activities
– Naming of order set
– Deletion of non-formulary medications
– Copy and paste of already vetted sections
– Edit of Section Names
– Merging of content from paper based order set in current use
– Time: 30-90 minutes
![Page 10: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/10.jpg)
Draft- Consensus
• Purpose
– To build consensus on the content of an order set by local clinicians.
• Activities
– Goal is to look at all major order set components around quality, evidence, formulary and sometimes catalog.
– The build session can be done through several different methods such as:
• Meeting room
• Web/Audio conference
• Retreats
– Time: ~ .5 to 3 hours per order set. • ** Zynx Professional Services can help lead a sample build session. (led by Zynx clinician)
![Page 11: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/11.jpg)
Degree of Content Richness
Lean• More useable in
Paper/Intranet Order Set
• Faster Development time
Rich• More useable in
CPOE Order Set
• Greater opportunity to change behavior and supplement knowledge
Zynx RecommendationStart Lean -> Go Rich
![Page 12: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/12.jpg)
Modular or Comprehensive
• Modular (Plug and Play)- creating order sets for distinct clinical events.
• [admit to venue] + [disease/procedure] + [comorbid]
• 3 separate order sets
• Comprehensive – Creating order sets that include admission orders with disease specific content.
• [CHF Admit to ICU]
• 1 order set
![Page 13: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/13.jpg)
Modular or Comprehensive
Comprehensive
• Harder to manage content
• Easier to use in CPOE (one order set to order)
Hybrid
• Comprehensive order sets for common DRG’s
• Modular approach for other conditions
• Needs CPOE Merge/Nesting functionality
Modular• Customized care plan
• General Modules have less evidence specificity
• Needs CPOE Merge/Nesting functionality
![Page 14: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/14.jpg)
DVT Prophylaxis- LevelsDVT Prophylaxis- Levels for Designing Order Sets/ Protocols
Dia
gn
os
is*
(Le
ve
l 1
)D
ivis
ion
* (L
ev
el
2)
De
pa
rtm
en
t (L
ev
el
3)
Ge
ne
ral
(Le
ve
l 4
)
DVT- All
Surgical Medical
Orthopedics OB-GYN CT SurgeryGeneral Surgery
THR TKRHip
fracture
Abdom Hysterectomy
Vag Hysterect
omyCABG HVR
Thoracotomy
Pulmonary GI
Colectomy
Appy CAP GI Bleed
* Listings are simply examples and are not meant to serve as a comprehensive list.
Mech. Ventil.
More specific evidence
Easier to Manage
![Page 15: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/15.jpg)
Review-Initial
• Purpose
– To build clinician adoption of order sets by adopting local feedback.
• Activities
– Forward order set draft to local clinicians for feedback.
– Provide mechanism for feedback
• AuthorSpace
• ViewSpace
• Paper
• Email (.doc/.pdf)
– Make appropriate changes according to feedback in draft version
– Time: ~ 1 – 4 weeks
![Page 16: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/16.jpg)
Review-Final
• Purpose
– To validate finished draft and prepare it for CPOE.
• Activities
– Final review of draft version (local/corporate)
– CPOE parameter review
– Inclusion/Exclusion in enterprise catalog of order sets
– Time: ~ 30 – 90 minutes
![Page 17: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/17.jpg)
CPOE Build
• Purpose
– To build a functional order set in CPOE
• Activities
– Export Zynx order set into CPOE system and map terms
– Catalog term management
– Resolve CPOE process issues arising from content
– Communicate system parameters back to clinician builders and update style guide
– Time: Variable
![Page 18: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/18.jpg)
Local Customization or Enterprise Standard
Acute MI #1Acute MI #1
Acute MI #2Acute MI #2
Acute MI #3Acute MI #3
Acute MI StandardAcute MI Standard
Acute MI #2aAcute MI #2a
Acute MI #2bAcute MI #2b
Acute MI #2cAcute MI #2c
Having an enterprise standard w/ process for updates
is best practice
![Page 19: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/19.jpg)
Case Study
• Some clients adopt a balanced approach where local customization is allowed, but with limits.
• One organization has admitted that it was a mistake to allow total freedom in local customization.
– No standardization.
– Hundreds of duplicates.
– Inability to measure
– Impossible to update and maintain content
![Page 20: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/20.jpg)
Integration into CPOE
• Main Question:
– What are the parameters that organizations should understand when building content for CPOE?
![Page 21: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/21.jpg)
Cerner DCP Tools
Cerner DCP Tools
Order set export process from Zynx into CernerOrder set export process from Zynx into Cerner
Cerner Knowledge Compiler
Cerner CPOE Environment
AMIOrder Set (XML)
Zynx AuthorSpace Environment
AMIPowerplan
![Page 22: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/22.jpg)
Configurable Workspaces – 1.6
• Configurable Workspace functionality
– Ability to upload client’s custom catalog to AuthorSpace with the order entry formats and codesets.
– Mirrors the order entry fields that are present in Cerner in AuthorSpace to strengthen integration.
• Data extract through CCL script
• Project Plan Completion for CW= ~ 2 weeks
![Page 23: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/23.jpg)
Building Order Sentences in Required Formats
• Paper Example:
CBC q am starting in am for 3 days
• Cerner OEF (Order Entry Format) Example:
Orderable: CBC
Details: T+1; 0600 q am x 3 days
![Page 24: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/24.jpg)
Need order details in the following order:
Fields: [Entry]
1. Start Date/Time: T+1; 0600
2. Frequency: q am
3. Duration: 3
4. Duration units: days
![Page 25: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/25.jpg)
Configured Workspace – CERNER OEF Example: “T+1; 0600 q am x 3 days”
![Page 26: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/26.jpg)
Coming in 2007
• AuthorSpace 1.6 (Released this summer)
– Redesign w/ enhancements
• Management tools around content development and maintenance
• Paper order set functionality
![Page 27: Zynx Client Services: Cerner Implementation](https://reader035.fdocuments.us/reader035/viewer/2022081501/5681351e550346895d9c7dc9/html5/thumbnails/27.jpg)
Questions? ([email protected])