Algorithms
Approved Afib and Migraine algorithms with a few mods. Need to discuss consistent way to use
outside calculators /links like CHAD, Framingham, warfarin, etc. Back pain covered, will use
popups for depth, keep current branch to help define when to do imaging tests, and what tx
works best .
<<Low Back PAin.vsd>> <<Backpain03.pdf>> <<12-19 Algo Adjustments.rtf>>
Summary screens/analytics (from Brian's notes)
1. DM Topic
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2.
Rob is currently working on rule changes to accommodate outside labs, changes
to prob/dx, missing microalbumin and BP events in MOCK, will have completed
today
Once these changes are completed and tested in MOCK will promote to PROD
Move to PROD by 1/7
If not moved to PROD by 1/7, will remove the DM3 – BP < 140/90 and DM6 –
Microalbumin measures or remove the interactive aspects (ie launching the
discern analytics application from the summary)
PQRI Topic
Custom PQRI Topic in MOCK by 1/5
Move to PROD by 1/16
3.
HF, CAD & HTN
Validated in MOCK, will move to PROD after DM topic updates and custom PQRI topic
Move to PROD by 1/23
4.
After this will work on the following sequence of conditions
HL
COPD
Asthma
Dep
OA
HA
Atrial Fib
Back Pain
5.
Other Issues Update
Working on a code package to be released mid January that will address the following issues:

Discern Analytics Crash
The application crashes when an incomplete action completes when the object is
no longer present. For example, a user selects an item on a filter list, drill to the
next report, filter completes but the user is on a new report that does not have
that filter list will result in a crash.
2.
Primary Care Physician Display - OMF_GET_PERSON_PRSNL
There is an error with the OMF_GET_PERSON_PRSNL function that returns the
person_id for the Primary Care Physician for the selected patient. When the
function qualifies the PCP physician on the person_prsnl_reltn table it does not
actually join that table to the code_value table, which results in the incorrect
display of the Primary Care Physician in the reports if there are other lifetime
relationships established for the patient.
3.
Topic Maintenance - PCA_MAINT_PERSON_TOPIC
There is an error with the maintenance script PCA_MAINT_PERSON_TOPIC in
how it is qualifying records for deletion. This retains patients within the topic that
no longer qualify. For example, MU decided to only qualify patients based on
active problems and not diagnoses, however any patient who previously qualified
based on a diagnosis only remains in the topic when they should be removed.
The longer term fix for this will be to include a maintenance feature in the Discern
Measure Builder, the interim fix for this will be to manually remove the previous
topic entries.
Condition Summary V3 collapsible sectional summary will go out around Jan 7 with current elements in Systems
based consolidated summaries (cardiovascular) . GFR to be included. Will also estimate BMI
without remeasured height if > age 21. IT to discuss use of height fields and forms. Will do
further study on newer elements (ie functional assessments). Will make date, location, and
service the more prominent colors in visits section. Planning to move to Health Maintenance
control, will move to new control after rollout.
Other adds - ECG, Stress tests, related surgical procedures to cardiovascular and other
summaries. B Blockers, Ace, Statins (if present). If allergic or Side effects to meds (ie ACE
cough), should list in allergies.
System summaries will have analytics from whatever problem is clicked (ie. HTN will show
Cardiovasc summary but HTN analytics).
<<MU System summaries.xls>>
Patient Summary - will add nml values for labs, add brand name if possible for meds, use lbs
instead of Kg, spellout TID, BID, etc in meds, remove analytics, FIN, and sparkline. Add visit
date and time. Potential use for handout/depart to patients at end of visit.
Will use H , L, instead of High/Low. Will give credit for any part of the foot exam done, and eye
apt at ophthal clinic. Will also accept home BP from direct charting flowsheet or powerform.
6x6 update
Will do Inpatient summary and ID, won't have resources to do more by May at this point.
Potential others afterwards and given budget - glucose mgmt, inpatient timeline/lines/tx hx,
patient list with required items (VTE prophy, DNR, etc), others from other sites doing inpt work.
Care Coordination
Good use to date, need to pursue further breakout of % satisfied by problem. Need ability to
filter by problem like an Excel sort. Could be heat map...
For the year, saw first prod use, should have prod use of analytics early in 09, several more
conditions live. Ambitious go live schedule distributed by Adele. Hot spot should be live
12/21...
Next meeting Jan 13 in KC.
Joe Boyce MD | Director, Physician Executive | Cerner Corporation | 816-2010204 | mobile 816-885-4069 | joe.boyce@cerner.com | www.cerner.com
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