mpages at lpch - thus far
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MPages Development MPages Development ConferenceConference
LPCH MPages Overview
SeattleMarch 30, 2009
IntroductionIntroduction
Chris Longhurst, MD, MSMedical Director of Clinical Informatics, LPCHAssistant Professor of Pediatrics, Stanford
Joshua FaulkenberrySenior Web Applications Engineer, LPCH
OutlineOutline
OverviewLucile Packard Children’s Hospital at StanfordLPCH history with Cerner
MPagesClinical challenges and solutionsTechnical challenges and solutionsFuture projects
Lucile Packard (Women and) Children’s Hospital OverviewLucile Packard (Women and) Children’s Hospital Overview
Opened in 1991 Major pediatric/obstetric hospital associated with Stanford University Patient stats (2006)
13k Discharges 5400 Deliveries 106k Clinic visits 280 Active Beds 40%+ critical care patients
Centers of Excellence (6) Top 10 children’s hospital by US News & World Report in 2007
LPCH Information & Knowledge System (LINKS) LPCH Information & Knowledge System (LINKS) OverviewOverview
Cerner selected as LPCH partner for IT applications in 2002 LINKS phase 1 went live 9/2005 – “Conversion” from legacy system included 13 “nets” LINKS phase 2 went live 11/2007 – “Clinical Transformation” = CPOE using PowerPlans and clinical documentation (using IView)
LPCH Development History with CernerLPCH Development History with Cerner
2005Co-developed PowerChart Outreach
2008 - 2009IView Dynamic labels development partnerPRISM development partnerMPages development partner (1st remote hosted site)
Clinical Challenges and SolutionsClinical Challenges and Solutions
Data reviewAccessing external clinical databasesIntegrating clinical decision support toolsPediatric risk of mortality adjustment
IView Use By Role in 24 HoursIView Use By Role in 24 Hours
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““Rounds” tab 1.0 (RTF Genview)Rounds” tab 1.0 (RTF Genview)
Rounds tab 2.0 (MPage)Rounds tab 2.0 (MPage)
Clinical Decision Support Tool IntegrationClinical Decision Support Tool Integration
Technical Challenges and SolutionsTechnical Challenges and Solutions
Where to store MPage resourcesWorked with Cerner to identify a standard location for all Remote-Hosted clients (In progress)
Loading HTML files into a tabIdentified two methods to load HTML files directly into a tab on PowerChart as MPages
Technical Challenges and SolutionsTechnical Challenges and Solutions
Discovering the mechanism for true AJAX in MPages
Reverse engineered Cerner's code, discovering how to implement a fully functional XMLCclRequest
Complete separation of client and server development
Developed the “CCL as a Service” (CCLS) architecture – allowing CCL engineers to focus on the Backend and Client-side engineers to focus on the “Frontend”
Video demoVideo demo
Illustrating AJAX and realtime waveforms
Future MPages Projects at LPCHFuture MPages Projects at LPCH
Continued GenView improvementPlan to combine multiple current GenView tabs into single, customizable “Pt Summary” tab with user-selectable widgets – Dr. Dan Imler*
(imlerdl@stanford.edu)Continued external resource integration
Transplant database (OTTR) – Dr. Scott Sutherland (suthersm@stanford.edu)Personal health record (Google Health) integration – Drs. Chris Longhurst / Dan Imler
Multi-patient dashboardsMed/surg – Drs. Chris Longhurst / Dan ImlerNICU – Dr. Jon Palma* (jpalma@lpch.org)CVICU – Dr. Andy Shin* (drewshin@stanford.edu)PICU – Dr. Natalie Pageler (npageler@lpch.org)
CVICU Dashboard Mockup
Google Health Mockup
Google Health Mockup
AcknowledgementsAcknowledgements
Mattice HarrisManager Web Services, LPCH
Ed KopetskyChief Information Officer, LPCH
QuestionsQuestions
Chris Longhurst – clonghurst@lpch.orgJoshua Faulkenberry – jfaulkenberry@lpch.org
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