rpms 101. david taylor mhs, rph, pa-c, rn national medical informatics consultant rpms ehr training...

RPMS 101RPMS 101

David Taylor MHS, RPh, PA-C, RNNational Medical Informatics Consultant

RPMS EHR Training and Deployment

Special Thanks to:

Chris Lamer, PharmD, BCPS, CDE

National Medical Informatics Consultant

Patient Education

INPUT OUTPUTSTORAGE

RPMS• Resource Patient Management System

• A set of integrated computer applications designed to

support the clinical and administrative functions of a

health care program.

What is RPMS?

RPMS

Files

Fileman

Labs

MedsVitals POVs

Pt Ed

Fileman

Kernal

Fileman

Labs

MedsVitals POVs

Pt Ed Labs

MedsVitals POVs

Pt Ed

Kernal

RPMS Inputs

Labs

MedsVitals POVs

Pt Ed

FilemanA1c Result

Diabetes Management System

Sample Input Tools

PCC Data Entry

Pharmacy Package

Laboratory Package

Radiology Package

DM Mgt System

Asthma Package

PCC

Labs

MedsVitals POVs

Pt Ed

Fileman

Bob’s visit 1/19/07

Mary’s visit 4/26/07

RPMS Outputs

Diabetes Audit

Labs

MedsVitals POVs

Pt Ed

Fileman

Sample Output Tools

Clinical Reporting System

Diabetes Audit

PCC Management Reports

Case Management Reports

QMAN

PGEN / VGEN

RPMS Jeopardy

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Inputs OutputsTips & Tricks

RPMS History

Getting Help

RPMS History 100

• RPMS runs on the MUMPS programming language.

• What does MUMPS stand for?

AI/AN Population by State 2000

Massachusetts General Hospital Utility Multi-Programming System

RPMS History 200

• Is MUMPS a dead computer language?

• Name at least 3 programs or companies that use the MUMPS computer language.

• PS- Everyone should get at least one!!

– Indian Health Service– Veterans Affairs – Department of Defense– Presbyterian University

Hospitals

• Reference labs– Quest – Dynacare

– Ameripath– Care Centric– Team health– Epic Systems Corporation– EMIS

• Banks

• Credit Unions

Health Information Systems

RPMS History 300

• Name at least 2 programs that use RPMS.

Over 250 programs around the world!

1. Indian Health Service

2. Community Health Network of West Virginia

3. Presbyterian Hospitals

4. Hawaii has entered an MOA with IHS

5. Eastern Europe

RPMS History 400Three part question:

1. Who is the current IHS RPMS program manager? (who is responsible for RPMS?)

2. Who is the current IHS Chief Information Officer? (who is responsible for all health information IT?)

3. Who is the current RPMS EHR Training and Deployment Lead?

Howard Hays, MD, MSPH

RPMS Program Manager, IHS

Theresa Cullen, MD, MS

Chief Information Officer, IHS

David Taylor, MHS, RPh, PA-C, RN

RPMS EHR Training & Deployment

RPMS History 500

DAILY

DOUBLE

Who developed (created) the MUMPS programming language?

Neil Pappalardo

Where did Neil develop MUMPS?

Dr. Octo Barnett’s animal lab

Inputs 100

• How do you document that your patient checks their home blood sugars?

– Note, this patient gets their supplies from another company.

Health Factor

Inputs 200 We often input groups of information into

RPMS and call them registries and taxonomies. What’s the difference between a template (aka registry) and a taxonomy?

• A registry is a list of people

• A taxonomy is a list of things (stuff) such as medication, labs, CPT codes.

Inputs 300 You talk with your patient who has type 2

diabetes about the importance of incorporating some type of exercise in their lives and the patient states that they are going to try to walk for 20 minutes three times a week.

What input data element do you use to document this?

Patient Education

DM-EX-G-CL-10min-GS-will walk 20min 3x/wk

Inputs 400

What input tool is this, and where does the information go?

Retinal ScreenIt goes electronically to PIMC where it is read and interpreted

Need to ensure it is entered into RPMS as an exam code

Inputs 500 As of July 2008 - how many sites have begun

using the Electronic Health Record?

166166

Outputs 100

How many areas run the diabetes audit?

Area 1

Area 2

Area 3

Area 4

Area 5

Area 6

Area 7

Area 8

Area 9

Area 10

Area 11

Area 12

All- Areas

All TwelveAll Twelve

Outputs 200

Name 3 RPMS Output Tools that let you manage and control groups (registries) of patients.

1) Diabetes management System2) Case Management System3) Asthma Register System4) Women’s Health5) HIV Management System6) iCARE

Outputs 300What is the difference between CRS and

GPRA?

CRS is the tool used to create outcome reports on many different measures.

GPRA is a group of outcome reports that goes to Congress. CRS is used to make this special report.

Appropriated Dollars

Activities

Consistent with Agency Goals

Customer benefits or outcomes

Return on Investment

Outputs 400

What six things need to be documented to get credit for the CRS measure called: Diabetes Comprehensive Care?

A1c checked

Blood pressure checked

LDL performed

nephropathy assessment (estimated GFR and qualitative protein)

Retinal eye exam

Diabetes foot exam

Outputs 500Name one output report that is specifically

designed for patients.

Patient centered care

Patient Wellness Handout

Logic used to provide information about results

Data extracted from RPMS

Reviewed with patient by clinician, nurse, educator, or pharmacist

Tips & Tricks 100

• I entered some information on a patient named Myirial Pilkiniskersinin using the diabetes management system, but I forgot to add one thing to her record.

• How can I choose her again in RPMS without typing in her name, chart number, or birthdate?

Press the space bar and hit the ENTER Press the space bar and hit the ENTER key.key.

When you do this, RPMS picks the last patient or item you were using

Tips & Tricks 200When performing a QMAN search, how can you

easily pick all of your diabetes diagnoses?

***** SEARCH CRITERIA *****

What is the subject of your search?// LIVING PATIENTS

Subject of search: PATIENTS ALIVE TODAY

Attribute of LIVING PATIENTS: DX

Enter DX: ??

Enter DX: [SURV 1 SURVEILLANCE DIABETES DM SURV - USED BY HLTH SUMM 2 SURVEILLANCE HYPERTENSION USED BY HLTH. SUM. SURV. 3 SURVEILLANCE OBESITY USED BY HLTH. SUM. SURV. 4 SURVEILLANCE PHYSICAL EXAM USED BY HLTH. SUM. SURV. 5 SURVEILLANCE PNEUMOCOCCAL RISK 6 SURVEILLANCE TUBERCULOSIS USED BY HLTH. SUM. SURV.CHOOSE 1-6:

Some diagnosis taxonomies are already created for you to use. Just type “[surv” and hit ENTER

Tips & Tricks 300

What character (key on the keyboard) is the same as using the ENTER key?

The colon (;) is like the enter key in The colon (;) is like the enter key in RPMSRPMS

Try it out…Try it out…Next time you log in, type your Next time you log in, type your username a colon, then your username a colon, then your verification codeverification code

C lamer;mypassword C lamer;mypassword

Tips & Tricks 400

How can you “jump” form one RPMS application to another?

How can I go from the health summary menu to the EHR menu quickly?

Use the

“Up-Hat” or “Carrot” or“Shift Six”

Select Health Systems Option: ^EHR

1 EHR Cover Sheet Reminder List [BEHORM EHR COVER SHEET LIST] 2 EHR Lookup Categories [BEHORM EHR LOOKUP CATEGORIES] 3 EHR Setup Menu [CIA EHR MENU] 4 EHR/PCC Coding Audit for One Patient [APCDCAF EHR AUDIT ONE PATIENT] 5 EHR/PCC Coding Audit for Visits in Date Range [APCDCAF AUDIT VISITS] 6 EHR/PCC Coding Audit Menu [APCDCAF EHR CODING AUDIT MENU] 7 Edit Parameters for Use in BH EHR [AMH M EHRBH PARAMETER EDIT]

Tips & Tricks 500

What is the best tool to use to get a printout of multiple items: name, chart number, gender, and age?

Try PGEN or VGEN

BH GENERAL RETRIEVAL Dec 16, 2007 22:04:34 Page: 1 of 1 BH GENERAL RETRIEVAL Dec 16, 2007 22:04:34 Page: 1 of 1 Patient Selection Menu Patient Selection MenuPatients can be selected based upon any of the following items. SelectPatients can be selected based upon any of the following items. Selectas many as you wish, in any order or combination. An (*) asterisk indicatesas many as you wish, in any order or combination. An (*) asterisk indicatesitems already selected. To bypass screens and select all Patients type Q.items already selected. To bypass screens and select all Patients type Q. 1) Sex 15) Patient Flag Field 29) Pts w/Problem (MHSS 1) Sex 15) Patient Flag Field 29) Pts w/Problem (MHSS 2) Patient Age 16) Case Open Date 30) Pts seen by a Provid 2) Patient Age 16) Case Open Date 30) Pts seen by a Provid 3) Patient DOB 17) Case Admit Date 31) Pts w/Education Done 3) Patient DOB 17) Case Admit Date 31) Pts w/Education Done 4) Patient DOD 18) Case Closed Date 32) Pts seen for an Acti 4) Patient DOD 18) Case Closed Date 32) Pts seen for an Acti 5) Living Patients 19) Case Disposition 33) Pts seen w/Type of C 5) Living Patients 19) Case Disposition 33) Pts seen w/Type of C 6) Chart Facility 20) Next Case Review Dat 34) Pts seen w/Axis IV L 6) Chart Facility 20) Next Case Review Dat 34) Pts seen w/Axis IV L 7) Community of Residen 21) Designated MH Prov 35) Pts w/Inpatient Disp 7) Community of Residen 21) Designated MH Prov 35) Pts w/Inpatient Disp 8) County of Residence 22) Designated SS Provid 36) Pts Last Health Fact 8) County of Residence 22) Designated SS Provid 36) Pts Last Health Fact 9) Tribe of Membership 23) Designated A/SA Prov 37) Pts w/ A/SA Componen 9) Tribe of Membership 23) Designated A/SA Prov 37) Pts w/ A/SA Componen 10) Eligibility Status 24) Designated Other Pro 38) Pts w/ Days in Res T 10) Eligibility Status 24) Designated Other Pro 38) Pts w/ Days in Res T 11) Class/Beneficiary 25) Personal History Ite 39) Pts w/ Days Aftercar 11) Class/Beneficiary 25) Personal History Ite 39) Pts w/ Days Aftercar 12) Medicare Eligibility 26) Pts seen at a Locati 40) Pts w/ A/SA Type of 12) Medicare Eligibility 26) Pts seen at a Locati 40) Pts w/ A/SA Type of 13) Medicaid Eligibility 27) Pts Seen in a Commun 13) Medicaid Eligibility 27) Pts Seen in a Commun 14) Priv Ins Eligibility 28) Pts w/Problem (DX) 14) Priv Ins Eligibility 28) Pts w/Problem (DX) Enter ?? for more actions Enter ?? for more actions S Select Item(s) + Next Screen Q Quit Item SelectionS Select Item(s) + Next Screen Q Quit Item SelectionR Remove Item(s) - Previous Screen E Exit ReportR Remove Item(s) - Previous Screen E Exit ReportSelect Action: S// Select Action: S//

BH GENERAL RETRIEVAL Dec 16, 2007 22:07:03 Page: 1 of 1 PRINT ITEM SELECTION MENUThe following data items can be printed. Choose the items in the order youwant them to appear on the printout. Keep in mind that you have an 80column screen available, or a printer with either 80 or 132 column width. 1) Patient Name 12) Class/Beneficiary 23) Case Closed Date 2) Sex 13) Medicare Eligibility 24) Case Disposition 3) Patient Age 14) Medicaid Eligibility 25) Next Case Review Dat 4) Patient DOB 15) Priv Ins Eligibility 26) Designated MH Prov 5) Patient SSN 16) Mailing Address-City 27) Designated SS Provid 6) Patient DOD 17) Home Phone 28) Designated A/SA Prov 7) Patient Chart # 18) Mother's Name 29) Designated Other Pro 8) Community of Residen 19) Patient Flag Field 30) Designated Other (2) 9) County of Residence 20) Patient Flag Narrati 31) Personal History Ite 10) Tribe of Membership 21) Case Open Date 32) Pts Last Health Fact 11) Eligibility Status 22) Case Admit Date

Enter ?? for more actions S Select Item(s) + Next Screen Q Quit Item SelectionR Remove Item(s) - Previous Screen E Exit ReportSelect Action: S//

BH GENERAL RETRIEVAL Dec 16, 2007 22:09:14 Page: 1 of 1

SORT ITEM SELECTION MENUThe Patients displayed can be SORTED by ONLY ONE of the following items.If you don't select a sort item, the report will be sorted by patient name. 1) Patient Name 7) County of Residence 13) Designated SS Provid 2) Sex 8) Tribe of Membership 14) Designated A/SA Prov 3) Patient DOB 9) Eligibility Status 15) Designated Other Pro 4) Patient DOD 10) Class/Beneficiary 16) Designated Other (2) 5) Patient Chart # 11) Patient Flag Field 6) Community of Residen 12) Designated MH Prov

Enter ?? for more actions S Select Item(s) + Next Screen Q Quit Item SelectionR Remove Item(s) - Previous Screen E Exit ReportSelect Action: S//

Getting Help 100You are getting an error every time you run

an RPMS report. Who do you contact for help?

Step 1: contact your local RPMS site manager

Step 2: contact your area RPMS site manager

Step 3: contact the IHS RPMS Help Desk

http://www.ihs.gov/GeneralWeb/HelpCenter/Helpdesk/index.cfm

Getting Help 200

We all love the EHR, but wouldn’t it be great if it….

What do you do when you have an idea for a new enhancement for RPMS or the EHR?

First, share your idea with the package manager, RPMS site manager, or Clinical Coordinator at your local site.

If they cannot help, or if they recommend it, you can post your request to the RPMS Feedback page.

http://www.ihs.gov/CIO/RPMS/index.cfm?module=feedback&option=add&newquery=1

Getting Help 300

I’m using the Diabetes Management System, but I’m not sure how to do something. Where do you go to find the manual?

The RPMS webpage makes all of the user and technical manuals available in PDF format. You will need to have Adobe Acrobat or another PDF reader to see them.

http://www.ihs.gov/Cio/RPMS/index.cfm?module=home&option=documents

Types of Manuals

• Install manual - used by the RPMS site manager to put the application on your RPMS system

• User manual - tells you how to use the application and what the application does.

• Technical manual - describes the fine details of how the application works in the system; generally for programmers

• Other documents - may contain additional information that can help you to use the application

rpms 101. david taylor mhs, rph, pa-c, rn national medical informatics consultant rpms ehr training...

Documents

rpms jeopardy slide

rpms files

neil pappalardo slide

eastern europe slide

daily double slide

current rpms ehr training

msph rpms program manager

octo barnetts animal