Author: Dale Sahlberg - 1 -

ZEN GOLD PRINTING

The current method for generating documents in the INVISION, SIGNATURE and other OAS systems is based on profiles, Print Control and document conditional logic. It was nicely designed back in the “flower child” era and is endemic to SMS applications today.

- - - - - - - - - - - - Profiles - - - - - - - - - - - -- Forms -- PRPR1 PRPR6 PRTLO DOCUMENTS

Document Terminal linked Terminal linked Hard coded Groups to document to nurse station & terminal logic group document group

However, it remains a rudimentary text-based system (no graphics) and requires substantial OAS programming to implement. Furthermore, the document retention period is usually 3 to 7 days - dependent on storage limits.

Generating a bar code, adding different fonts or larger characters remains an esoteric PCL skill. In order to vary the size and font of the text, PCL commands are used.

¬&a00.0c16.0R Case / Pt #: <…………> Medical Record #: <………>¬(s3B

There are currently five major levels of PCL. The creation of these levels was driven by the combination of printer technology developments, changing user needs and application software improvements. The first versions of PCL (PCL 1 & 2) were used in HP impact and Inkjet printers in the early 1980s; the latest development is PJL. Each printer manufacturer has specific instructions of what their product will support – this in turn complicates document generation for a hospital.

Should a hospital buy only Dell, Lexmark, Xerox, Brother or HP laser printers – or a mix of these laser printers?

Author: Dale Sahlberg - 2 - A hospital facesheet or census document is usually “one size / font fits all” as in the following example:

The titles and the text tend to run together and become hard to read. Guar Last Name: EdenTo vary the text, PCL code is placed before a field in the document – this makes document building a challenge because it shifts the image. “Trial and error” is used to align fields.

Using PCL code:

CLARKESVILLE ADMISSION RECORD Admission Date: <../../..> Time: <..:..> ¬&a00.0c16.0R Case / Pt #: <…………> Medical Record #: <………>¬(s3B Service: <…> Nurse Station-Bed: <……>-<…..>

ZEN Gold Printing offers applications the ability to take printing to a higher level.

Author: Dale Sahlberg - 3 -

DATA FLOWCHART

ADMITTING DEPARTMENT: Pt Name: Dale Sahlberg Pt Number: 7654321

SERVER

Author: Dale Sahlberg - 4 -PROCESS DESCRIPTION:

In the diagram above, the ADMITTING DEPARTMENT has registered a patient.

1) Patient Name: Dale Sahlberg Pt Number: 7654321

2) A WORD facesheet prints and a barcode generates for an armband. Soft fonts create the bar codes.

3) The facesheet .DOC and a .CSV file are sent to a secure server for storage. The files

are named using the patient number. The files can be written to a ferromagnetic drive so facesheets (7654321.doc) can be revised or to a large server

optical drive jukebox that will store successive copies of the patient facesheet as it is revised. (7654321-Rev2.doc)

Author: Dale Sahlberg - 5 -

4) An email is sent to departments / staff notifying them of the patient admission.

5) The email has a link (in the subject section) to the drive where the CSV file and the

DOC facesheet are stored. Only staff with network permission can access that secure server.

6) Emails do not have any attachments / files – staff simply access that link to print their

own copy of the facesheet when they want to. By storing the facesheet in one location, data space is saved.

Author: Dale Sahlberg - 6 -

7) Departments can also use the file to extract data into Microsoft Access, Excel and other programs that read comma delimited files. Departments can merge

that data into their own version of labels, such as labels.

Extension: CSV

Comma-Separated Variables

Specific Notes

A comma-delimited file is a database format where each record is a single line and each field in the record is separated by a comma. Where necessary (if there is a space in it) the field will also be quoted. Ex: “1839 PINE STREET”,”Key Largo”,

The HOME HEALTH form (top portion shown below) could be automatically filled in by a CSV file and then handed to the patient to sign …

8) The doctor has elected to forward the email to his PDA / cell phone so he can get

messages on the road. The email is sent via a secured format that requires a key (password) to read.

Author: Dale Sahlberg - 7 -Now a facesheet can look like this on a color printer:

Author: Dale Sahlberg - 8 -

A) In the final patient registration case screen (form), create these faux fields with a length of 240 / free text to store data –

"\CASE" "\DATA" "\GUAR""\INSU" "\DGUAR" "\DINSU"

B) Add a GUI controller for the first "\CASE" field and combine all the "C" fields for Invision or "N" fields for Signature to appear in the first "\CASE" output parameter:

Example: will concatenate into "111507", after an EXE program is run. Perform the same concatenations for the other data segments: "\GUAR" "\INSU"For any empty fields (Patient Email), enter a space " ", so the order of the fields is kept; do not skip empty patient data fields.

C) Build a CSV file for all the headers to appear above the data fields in the "\CASE" "\GUAR" "\INSU" output parameters and name that file "Merge.csv". Next, select the network drive to store your "Merge.csv" file. (E:\ drive used for this example). This file will be a template that gets copied into a virtual drive later. (E:\Merge.csv V:\Merge.csv )

View of the first few header segments below:

D) Add a GUI controller for the "\DATA" field -

Create GUI controllers for the other data segments: "\DGUAR" "\DINSU"

E) Add an EXE controller for the "\DATA" field -

Create EXE controllers for the other data segments: "\DGUAR" "\DINSU"

Author: Dale Sahlberg - 9 -

F) Create a virtual drive on the local computer / PC to temporarily provide RAM for merging operations. (V:\ drive was used for this example) This “virtual drive” ensures no patient data actually resides on a hard disc (HIPAA); the RAM only holds data for a millisecond anyway. The virtual drives copy templates from the network drive (E:\ drive for this example) that serves as the master location for templates. Any changes to a facesheet are only done at one location (E:\ drive), which becomes immediately effective for all.

G) Design a document "Merge.doc" for a hospital facesheet (see facesheet on page 7), attach it to the data source "Merge.csv" (V:\ virtual drive) and define the merge fields based on the headers in "Merge.csv".

Example:

H) Define the bottom portion of the facesheet with barcode soft fonts.

Will look like the following after being merged …

Author: Dale Sahlberg - 10 -I) Select a secure network drive to store the document "Merge.doc" in. (E:\ drive used for this example). This file will be a template that gets copied into a virtual drive later. (E:\Merge.doc V:\Merge.doc)

J) Add an EXE controller for the WORD program to call up the "Merge.doc" .

Program name -'C:\Program Files\Microsoft Office\OFFICE11\WINWORD.EXE'

Parameter -'V:\Merge.doc'

K) Code an EXE program that appends a data line below a header line and call the program "Merge.exe". Select a secure network drive to place the "Merge.exe” in. (E:\ drive was used for this example)

The "Merge.exe" was programmed with but other programs could be used.

L) Continue programming the "Merge.exe" to copy the "Merge.csv" into the virtual drive so a merge can take place later with the DOC facesheet. (E:\Merge.csv V:\Merge.csv virtual drive)

When is pressed,1) the system will concatenate all "\CASE" "\GUAR" "\INSU" data into a long string 2) and pass the patient data to the "Merge.exe" program 3) that will combine the data fields into the "Merge.csv" 4) with the result that patient data will appear below the headers.

Author: Dale Sahlberg - 11 -M) Program the "Merge.exe" to copy the "Merge.doc" template and make a duplicate in the virtual drive (E:\Merge.doc V:\Merge.doc) so a merge can take place with the CSV data.

Now there are two files in the virtual drive.

At the completion of the registration process: The EXE controllers will send patient information to "Merge.exe" that Creates a data filled "V:\Merge.csv" and Activates the "V:\Merge.doc" facesheet Which gets merged with the patient data in "V:\Merge.csv" then Prints the facesheet.

PRINTING OPTIONS:

a) The program does all the work so the user never actually has to press a key or click any prompt to generate the facesheet and labels. The net effect is the same as a 3270 registration where the user presses ENTER and goes to the printer to get the facesheet and labels.

or …

b) Manually select the PRINT icon and allow the user to redirect to another printer or print to the default printer.

Author: Dale Sahlberg - 12 -

N) Program the "Merge.exe" to store the following after the facesheet has printed, then clear the RAM cache / virtual drive: (V:\Merge.csv E:\DATA\7654321.csv) (V:\Merge.doc E:\FACESHEETS\7654321.doc)

After printing, both will be resident in that network jukebox.

Next, the program runs that sends messages to designated users notifying them

of the patient admission.

Staff can then access the patient information:

Author: Dale Sahlberg - 13 -

ZEN GOLD PRINTING

1) Allows images, different fonts, barcodes and highlighting on a document2) Does not use OAS profiles or the Print Control application3) Creates a CSV database file as well as a DOC facesheet for each patient4) Reduces the chances of staff accidentally altering data on a patient case screen while

looking for information (HIPAA data integrity)5) Gives departments a way to perform a database analysis using the CSV files or import

data into their own forms (example: a HOME HEALTH form)6) Does not have limited storage constraints (3 to 7 days)7) HIPAA security can be enhanced by reducing the mass printing method previously

used resulting in patient facesheets laying around department printers to a selective print only when staff need a facesheet copy.

8) Takes printing to a higher OS (operating system) level.

Dale Sahlberg www.ecsahlberg.com/Help.html

dsahl@earthlink.net