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1Q95 Pages 1 & 2

Recently, INVISION Clinical Development has been very busy creating many new enhancements for the INVISION Pharmacy and Med/IV Charting products.

Micromedex will be offered to RCO clients in March 1995. Lee Stevens is coordinating the rollout through the Allied Products area. The well-respected drug information compendia and drug identification information will be accessed by RCO clients by stacking a TCL in an INVISION pathway. The Micromedex software/data is loaded at the Data Center (CD ROM technology will not be used). Information can be printed to any printer. INVISION will be able to pass patient name, weight, height and sex for dosage guide lines to the Micromedex product. At least one ICO INVISION Pharmacy client has loaded Micromedex on its mainframe. Micromedex’s Kinetidex and Rythmstrips will not be available through offering. In addition, SMS will also make available Bibliomed, an index into the National Library of Medicine. Access on INVISION is similar to the TCL access with Micromedex. Both products are considered add ons, with additional support fees associated with each product.

PRN IVs allow the clinician to enter titratable IV orders; i.e., IV orders with varying rates. The rate field is not required. The refill function creates and dispenses additional occurrences/bottles as needed. The initial order can be placed without an initial occurrence created, if desired. The nurse can charge on chart or charge on dispense. Note: This new feature, however, does not support change IV rate (9.94 SUP/94.4 SUT Customer Memo #715).

Install Model for pharmacy contains many new exciting pathway enhancements, some of which you have probably built on many of your installs and some to help the pharmacy department with its order entry steps:

• A new Med Browse feature in Alphabrowse allows the user to qualify on the generic or brand name together (before you had to specify either generic or brand to search), strength and/or dosage form. For example, you can now browse for "Tylenol 650mg Suppository."

• Orders As Written (a.k.a. "Concatenation") allows you to string together various order fields into a 60-character readable order description. Now you can tailor various order types (i.e., you can have different description formats based on whether you have a med, TPN, chemotherapy order, etc.) using all or part of the various order fields. For example, you can now identify your order as, "ACETAMINOPHEN 650MG PO TAB Q4HRS DAILY PRN X 4 D."

• Display Active Profile brings the pharmacy user to a display of active pharmacy orders as their first screen after selecting a patient. The screen footer contains many of the common branch-to functions, as well as a key-in field for the next patient.

• Multiple Mnemonics

• Drug Interaction Monographs show detail text information regarding the specific drug interaction. The detail references Hanstens Interactions or Drug Interaction Facts.

• Drug Monographs are now available (3.95 SUP/95.2 SUT). These monographs provide helpful drug information at a seventh grade reading level and can be used as a patient education tool for inpatient, outpatient or discharge meds. Two monograph formats are available. To take advantage of this new feature, the hospital must perform an NDDF update and Service

• Master Maintenance and include the look up monograph code in one of several available Common Segment user fields. Future downloads will include the code as part of the standard download.

• A model Drug Utilization Evaluation (DUE) report is now available. This Mark IV report allows the pharmacy to track the use of a given service. This report can be scheduled as often as every hour, if desired (3.95 SUP/95.2SUT).

• A modular pathway to branch to COR through pharmacy now exists.

MAR/IVAR From Automated Charting Enhancements:

• The MAR/IVAR From Automated Charting and the new Display Summary MAR/IVAR, formerly only available to customers who purchased Med/IV Charting, has recently been reinventoried and made available to all INVISION Pharmacy Clients. The offering is a free enhancement to those INVISION Pharmacy customers who have not purchased Med/IV Charting. These MARs add more flexibility and feature to the single and multiple patient reports. For example, both the med and IV pages print together for the given patient. The current multipatient MAR/IVAR prints all MARs first, followed by a second job producing all IVARs. The MAR/IVAR From Automated Charting also provides an option to move all orders with a Discontinue, Held or Stop D/T falling within the MAR window to their own section within the MAR (10.94 SUP/94.4 SUT).

• An enhancement to the MAR now optionally allows the user to print the date with the administration time, should the nurse administer/chart a dose after midnight that is scheduled to be administered before midnight (or visa versa). To take advantage of this feature (and you should), you need to value %OCADMDI=1. If the %field is valued to ‘1’ or unvalued (how model is delivered), the date will not print in the column.

• %OCMARFA=OCMARFFA is a new feature which will print an optional 30 character message (stored in %OCMARIM) with a stopped order, if the Stop D/T falls in the MAR window (much like the existing discontinued order line).

A new target/source multiple patient Charted/ Uncharted Orders Report replaces the old hard-coded Mark IV Uncharted Orders Report. This new report can be used as a worklist for nursing (if run prospectively) or as a quality assurance tool to track uncharted doses, if run retrospectively. The report can be run for single patients (CHPPOC05) or multiple patients (CHPPOC06) using the scheduling system. Advantages over the Mark IV report include adaptations using the OAS builder tools, scheduling options and the option to exclude PRN orders. Most clients would prefer to exclude PRN doses from an uncharted orders report. When charging on chart, uncharted doses not only mean inaccurate clinical/legal documentation, but potentially lost revenue for the hospital.

The Display Summary MAR/IVAR is an on-line version of the Summary MAR/IVAR document. Target/source screens allow for user flexibility when defining the display. An option in Display Orders allows the user to pick an order and branch to the display MAR summary.

A new Rounds Report using target/source documents is available to clients who have purchased Med/IV Orders or Orders 21.0. COR, LCR and/or Nursing applications do not have to be installed, but would maximize the benefit of the report features. The new report is designed to provide a synopsis of information from the patient’s medical record. The Rounds Report includes:

• COR information such as lab results, diagnostic results, nursing information, selected abnormal and/or critical results and LCR information

• Active order information

• Pharmacy orders

• Patient demographic information

• Options to schedule or demand print the report

• Print options by care provider, walking sequence order or across multiple nurse stations

• Name and title of person requesting the report

You will now be able to officially add an ingredient to a PCI or change an existing ingredient in a PCI (12.94 SUP/95.1SUT). See Customer Memo #766 dated November 18, 1994.

Med and IV Carts can now be processed in "background" using the %GHST command. Doing this can free up a "captive" CRT while the carts are processing. See Customer Memo #717 dated November 18, 1995 (12.94 SUP/95.1 SUT).

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