Cerner In A Nutshell

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Cerner In A Nutshell
Commonly used Applications
http://www.lhsc.on.ca/lab/lismanuals/lis_index.htm
Overview of Cerner Appbar
Use Cerner Appbar to quickly and easily open Cerner
Millennium applications. Cerner Appbar allows you to
have access to all Cerner Millennium applications
authorized to your position without having to log on to
each application you open.
Overview of Cerner Appbar
To Add Buttons to the Appbar
 Click on button
 Select customize
 Highlight app
 Sort
 Click OK
Cerner Speak
 Care Set
A set of commonly requested orders entered through a
single mnemonic in which individual orders can be
included, excluded, or designated as required. For
example, CS3 Careset contains the following Orderables
INRPTT,CBC,LYTE.
 Orderable
Something that can be ordered. In Cerner applications,
an orderable can be selected and used to create an
order. Different types of Orderables can be present in
the list, depending on the applications installed and
user security. For example LYTE.
Cerner Speak
Discrete Task Assay (DTA)
The subdivision of an orderable carried out by a department
or healthcare provider. For example, if the orderable is a
LYTE, the DTAs are Sodium, Potassium, Chloride, Bicarbonate
and Gap. The DTA's can be defined as an Alpha, Numeric,
Calculation, Text, Interpretation, Prompt and Free text.
Alpha
DTA's defined as an Alpha will have Nomenclature associated
with it. In ARE the result cell of a DTA defined as an Alpha will
appear with a drop-down box. Examples of Nomenclature
would be Negative or Positive. Nomenclature currently has a
60 character limitation. Click here.
Cerner Speak
Numeric
DTA's defined as Numeric are resulted with numeric
entries. A datamap can be defined to accept up to 8
digits to the right or left of the decimal point. Click here.
Calculation
DTA's defined as a Calculation, manipulate the values
from other Numeric or Calculation DTA's. When all the
dependent DTA's result cells have been populated, the
Calculation DTA will then populate. Click here.
Cerner Speak
Free text
DTA's defined as Text, have been restricted to Prompts.
There is a 15 character limitation with DTA's defined as
Text.
Prompt
DTA's defined as a Prompt, will appear in DOE (small
window) and in Power Chart (pick list) as a field to be
answered.
Cerner Speak
Text
DTA's defined as Text will appear in ARE as a word
processor. The result cell activated by either double
clicking or pressing space bar. Once activated, the result
cell can be populated by typing, retrieving a Template of
a combination of both.
Interpretation
A determination of a result value for one discrete task
assay (DTA) based on the result values of one or more
other DTAs. Click here.
Cerner Speak
Interpretive data
A standardized comment about the result that is
automatically appended to each result for the
procedure for which interpretive data has been defined.
Service Resource
A place where work is performed or routed. For
example, in the laboratory, the service resource could
be an instrument or bench, subsection.
Each subsection is a group of test sites.
Cerner Speak
Service Resource
A place where work is performed or routed. For
example, in the laboratory, the service resource could
be an instrument or bench, subsection.
Each subsection is a group of test sites.
Cerner Speak
Reference Range
Enables you to specify the low end and high end of the
normal reference range. Results outside this range have
an non-chartable L or H Flag posted with the result.
Critical Range
Enables you to specify the low and high end of the
critical reference range. Results outside this range have
a chartable C Flag posted . The result will appear in red
font in ARE, and will require a comment to be added
before it can be Verified. LHSC has aligned Critical
Ranges with our call ranges.
Cerner Speak
Feasible Range
Enables you to specify the low end of the feasible reference
range. Result values outside this range can not be Verified
without a comment. Results outside the Feasible Range will
post in ARE with a non-chartable F Flag.
Linear Range
Enables you to specify the low and high end of the Linear
Range. Result values outside this range appear with < or >.
Results outside the Linear Range will post in ARE with a nonchartable N Flag.
.
Cerner Speak
Performed
Results in Performed status are held results. When the
accession number is retrieved on subsequent
presentations, the result will appear with a red check
mark, making it available to be Verified. Results in
Performed status can be modified.
Verified
Results in Verified status are in a completed state. If the
DTA is chartable, once the result is Verified it becomes
available to both Paper Chart and Power Chart.
Cerner Speak
Corrected
Verified results can be modified through Correction
Mode of ARE. The history of the correction follows the
result.
Autoverified
Autoverified results have the same properties as
Verified results. The difference in the name indicates
they have passed Autoverification criteria, and have
automatically charted, with out the Technologist review
the results.
Overview of Department Order Entry
 Use Department Order Entry to place laboratory. You
also can add an order to a previous order, cancel an
order, or register a patient prior to entering orders.
Add On
Cancel
Overview of Department Order Entry
 Patients can be retrieved by;




Name
MRN
SSN
FN
Overview of Department Order Entry
 Use Department Order Entry to place laboratory. You
also can add an order to a previous order, cancel an
order, or register a patient prior to entering orders.
Patient Registration
Overview of Department Order Entry
A format can be specifically designed for departmental
use.
Prompts
Overview of Department Order Entry
A format can be specifically designed for departmental
use.
Prompts
Overview of Department Order Entry
 As you complete information in the form, the system
performs validity checks and prompts you to correct
errors or to supply additional required information.
When you submit the order, it passes through an
order submission process to ensure its accuracy and
appropriateness.
Overview of Department Order Entry
 Patient demographic information is displayed in the
Demographics box in the main window. The
demographics information displayed is for the
currently selected person and encounter.
Overview of Department Order Entry
 Use Department Order Entry to place laboratory. You also
can add an order to a previous order, cancel an order, or
register a patient prior to entering orders.
 Laboratory personnel use Department Order Entry to
enter orders in a format specifically designed for
departmental use. The system validates the order as you
enter it and defaults a defined order format. As you
complete information in the form, the system performs
validity checks and prompts you to correct errors or to
supply additional required information. When you submit
the order, it passes through an order submission process
to ensure its accuracy and appropriateness.
Overview of Pending Inquiry
 Use Pending Inquiry to view a list of pending
procedures that have not been completed for a
specific test site or subsection. You have the option
to view;
 only the ordered procedures that have been received
and logged in to the in-lab location
Overview of Pending Inquiry
 You can select the test site and, optionally, a specific
procedure to be viewed
 You also have some customization options for
Pending Inquiry, such as selecting which columns are
displayed and rearranging the column order.
Overview of Pending Inquiry
 You can select the test site and, optionally, a specific
procedure to be viewed
 You also have some customization options for
Pending Inquiry, such as selecting which columns are
displayed and rearranging the column order.
Pending Inquiry Tasks
 Select a retrieval option used to search for the
pending ordered procedures.
Pending Inquiry Tasks
Select the All Pending option if you want to retrieve all pending
orders for the selected test site and procedure.
Pending Inquiry Tasks
Select the Received Only option if you want to retrieve all pending orders for the
selected test site and procedure that have a specimen container currently logged in to
the in-lab location for the test site.
Pending Inquiry Tasks
Select the In-Lab Only option if you want to retrieve all pending orders for the selected
test site and procedure that have an in-lab status, regardless of the current location of
the specimen container.
Pending Inquiry Tasks
Select the Scheduled Only option if you want to retrieve orders that are currently
scheduled for a collection list. Note that scheduled orders are not included in any of
the other options.
Pending Inquiry Tasks
Transferring Ordered Procedures using Pending Inquiry
Select the line or lines of the ordered procedures to be transferred,
by highlighting the desired row(s).
Pending Inquiry Tasks
Transferring Ordered Procedures using Pending Inquiry
From the Task menu, select Transfer > All Orders > All Details
OR
Select Transfer > Selected Orders > All Details
Pending Inquiry Tasks
Transferring Ordered Procedures using Pending Inquiry
To open the Transfer dialog box. Enter the test site to which you want to
transfer the selected orders. Click OK to transfer the selected orders.
Overview of Specimen Log-In
 Use Specimen Log-In to document specimen
collection information, such as the collection time,
collection ID, collection method, and the location
where the specimen was received.
 The system can capture multiple locations for one
specimen, starting at the initial place of collection and
ending with a testing laboratory or storage location.
 Each log-in location is stored by the system along
with the date and time the specimen was logged in
and the person who received it. E.g. UH Core to VH
Core to VH Flow
Tasks of Specimen Log-In
 Various methods are available to identify the specimens to
be logged in. You can log in specimens using




location
transfer list
patient
accession number
 You must select one of these log-in options before you can
start the log-in process.
Overview of Transfer Specimens
Use Transfer Specimens to manage specimens requiring
transport from their current location to the testing
laboratory location.
Tasks Of Transfer Specimens
You can create a new list using List Build Mode or
Manual Build Mode.
Start by clicking on the New Button
A Build Transfer List Window will appear
Tasks Of Transfer Specimens
Select Mode either List or Manual
Select Locations From and To
Select Container Details, either All, Aliquots only, or
Specimen only
Click on the Retrieve Button
Tasks Of Transfer Specimens
Highlighting the tests in the From Available Window
will make them available for transfer to the desired
campus or To Selected Window using the Move Button .
Tasks Of Transfer Specimens
Once the samples are selected
click on the Save Button
Tasks Of Transfer Specimens
A Transfer List will be created
Clicking on the Transfer Button
virtually
send the Transfer List in motion to the desired
campus. You will be prompted “are you sure you
wish to transfer” and to select a “print option”
Tasks Of Transfer Specimens
Transfer List can be viewed; both Not transferred and
Transferred. From this window Transfer Lists can be modified,
printed, or deleted.
Overview Of Container Inquiry
Use Container Inquiry to view detailed information about
specimen containers based on the accession number assigned
to the collection. You also can view the orders included in each
container. The list includes containers that have aliquots
associated with them so you can view the orders included in
each aliquot.
Overview Of Container Inquiry
Use Container Inquiry to view detailed information about
Overview Of Order Result Viewer
Use Order Result Viewer to display information pertaining to the
ordered procedure and associated results. You can request this
information for a specified person or accession number. You also
can indicate the type of activity for which to view information,
such as Anatomic Pathology, Blood Bank, Case Integration,
General Laboratory, Helix, HLA, or Microbiology
Overview Of Order Result Viewer
To view order and result information for a person, you must enter the person's name
or medical record number. The system retrieves all orders for a specified date range.
To view the ordered procedures and results for a single accession number, enter the
accession number.
Overview Of Order Result Viewer
You also can indicate the type of activity for which to view information, such as
Anatomic Pathology, Blood Bank, Case Integration, General Laboratory, Helix, HLA, or
Microbiology
Overview Of Order Result Viewer
• Orders that have been added-on can be distinguished by
observing the Order Date.
• In the example below we see the .RETICM Orderable was
added to the CBCD Orderable 2 months later.
• Order Personnel ID, indicates the .RETICM was added by Rule
Overview Of Order Result Viewer
• There are two viewing modes in ORV; Order List Mode and
Flow Sheet Mode.
Overview Of Order Result Viewer
• Order List Mode, reveals all results entered in ARE. Both
Chartable results and Non-Chartable results
Overview Of Order Result Viewer
• Flow Sheet Mode, mimics Power Chart View and only reveals
those results that are Chartable.
Overview Of Accession Result Entry
Use Accession Result Entry to enter results for general laboratory
procedures.
You can select a specific ordered procedure and a test site to limit the
information displayed for the selected accession number.
Overview Of Accession Result Entry
Use Accession Result Entry to enter results for general laboratory
procedures.
You can select a specific ordered procedure and a test site to limit the
information displayed for the selected accession number.
Overview Of Accession Result Entry
The individual discrete assays included in the ordered procedure display with
columns for the result, result flags, result status, and previous results.
A check mark next to the result indicates that the result is selected when the
perform or verify action is applied.
Overview Of Accession Result Entry
Accession Result Entry has multiple result entry modes that allow the
application to be used in different ways. The modes include;
Accession
Differential
Instrument Queue
Worklist
Correction.
Overview Of Accession Result Entry
While entering results, you can right-click to access a context menu for
actions associated with the result, such as;
Adding a comment
Viewing previous results
Overview of Worklist Request
Worklist Request is used to create and print a worklist or worksheet using a
worklist name or template with predefined worklist parameters. If there is
not an existing worklist name that is appropriate for the needed worklist, you
can build an adhoc worklist, which identifies the parameters for the worklist.
Overview of Chart Request
Chart Request is Charting’s interactive tool for producing on-demand charts.
Rather than waiting for charts to be produced by distributions or triggered by
order or result activity, you can use Chart Request to generate a chart
immediately for any patient you identify using any chart format you specify.
This on-demand capability can be particularly useful when a chart is
misplaced, when a provider unexpectedly requests an additional copy, or
when a user is testing the database.
Overview of Label Reprint
Use Label Reprint to reprint labels to replace lost or damaged labels, or for
printing additional labels.
You can reprint labels for one or more accessions as needed; a label is printed
for each container associated with the accession. You can reprint labels for
collection lists and transfer lists, as well for one or more request IDs as
needed.
Overview of Instrument Queue Viewer
Instrument Queue Viewer also enables you to delete accession numbers from
the instrument queue. You can delete the entire instrument queue, all
accession numbers for a selected service resource, or selected accession
numbers for a selected service resource.
Overview of Workload Entry
Use Workload Entry to enter workload information manually and attach it to
the appropriate patient or institution. Workload Entry allows you to submit
manual workload entries directly into the Workload table. This allows your
organization to receive changes to the workload entry program without the
need to install a new server to accommodate the change.
Overview of Storage Tracking
Storage Tracking enables you to record the storage locations of specimen
containers and to find containers in storage. You also can record the discard
of stored containers as well as the discard of storage racks or storage trays.
Overview of Storage Tracking
You can find the location of a stored container by entering its accession
number and container ID, by searching for containers by patient name, or by
searching for checked out containers.
Other features of Storage Tracking include the check-out and check-in of
stored containers, and printing of reports showing the locations of stored
containers, checked out containers, or containers that should be discarded.
You also can modify the suggested discard date or update remaining
specimen volume information.
Overview of TAT Monitor
Turnaround Time (TAT) Monitor is an interactive monitor that alerts you if orders are
exceeding turnaround time parameters or if specimens are going to expire. It reviews all
Orderables items logged in to the lab for which turnaround time or specimen expiration
parameters have been defined, then indicates the status based on how long the
specimen has been logged in to the lab.
Autoverification
Autoverification is functionality that allows the system to
automatically verify results received from an interfaced
instrument.
The autoverification functionality is used to evaluate and
autoverify numeric, calculations, and alpha result type assays.
Autoverification
Each interfaced instrument result is evaluated based on assay
level parameters identified for each assay and instrument
combination. If the results meet the criteria defined, the results
are verified by the system. If the results do not meet the criteria,
the results remain in a performed status and a user must review
and verify the results using a General Lab result application.
Autoverification
The ability to evaluate QC results against the expected range and
the QC rule(s) provides ability to autoverify QC results. The QC
schedule provides the ability to validate that the QC has been
performed and is in control. If a QC result is determined to be out
of control, based on the QC rule evaluation, autoverification of
patient results stops immediately. The out of control situation
must be corrected and all QC results must be verified before the
system allows the user to restart autoverification.
Rules
• Discern Rules allows process to be automated. This most
commonly includes;
• adding on tests e.g. Ca Alb
• automatically resulting tests e.g. UIBC
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