So these are electronic clinical quality measures (eCQMs)? They are probably valuable for some of our clinical instructors. I am assuming that they would be part of the newer value based reimbursement by MACRA docs will be using instead of meaningful use stage 3. I’ll have to defer this to others and will bounce this off a HIM instructor today for feedback
These are created off of the 2016 PQRS Group Measures. We used these for the few folks that couldn’t get the idea that they could enter a list of patients that had a measure value easier than they could enter data for all measures patient-by-patient. They really are not that outdated in basic content. We have all the 243 registry/claim measure calculations/weighting/benchmarking for 2017 MIPS/MACRA QPP stuff, but we are trying to earn money off of those at the moment.
I bet you know more about MPP than I do but wonder if we might be able to borrow just one of these sheets for e.g. diabetes. Throughout all of the tutorials, I will probably focus on chronic disease, specifically diabetes. I would not want to do anything to interfere with your income from these forms
These forms are last-year’s cast-offs. These are all in a Librehealth repo (pull request branch only…no-one seems to be interested in doing reviews/merging there.)
Ok. I have created a go-by for an instructors and students user guide, organized around the menu features. This is just an outline so the steps and screen shots will have to be created by the student.
I’m now going to work on the exercises that hopefully will appeal to a broad audience of clinical and non-clinical students. At first blush, here are a few ideas about advanced functionality we could use to create more cognitive exercises. Please add to this list (aimed at graduate HI students primarily)
- Clinical Decision Rules (CDRs) a. Menu >> Administration >> Rules b. Current clinical decision rules are listed for the clinic c. Click on the first rule “Adult Weight Screening and Follow Up”. You can edit the reminder interval, edit the demographic filter, edit the clinical targets and actions d. Plans Configuration e. Click on first (Go button): Select the preventive care plan and you find 11 rules to generate reminders. Select the Diabetes Mellitus plan and you find 4 rules f. Add rule. Go to ePSS web site for ideas based on national recommendations
- Electronic clinical quality measures (eCQMs)
- Generating a HL7 message for a lab request
- Generating a C-CDA to send as a patient summary to a consultant
- Patient Portals
- Generating Clinic Reports
- Analytics?
Is there a way to change the default FROM date in the reports section to a time prior to December 31 2016? The lab work (NHANES Panel) has the default date of December 31 2016, so if students run a query with a date after that they will not get results.
I’ve updated NHANES to run as a site of ehr; this involves no change other and the old subdomain will continue to work.
You can now access it in two ways:
- http://nhanes.librehealth.io (The SSL certificate was revoked, don’t worry, it redirects to ehr.librehealth.io which uses a valid SSL certificate)
and preferably use:
This will work until I get around to moving EHR to rackspace, at which time the only way to access it will be the latter.
Old db dumps now can be accessed via: https://ehr.librehealth.io/downloads/nhanes/
and are in /opt/ehr/downloads/nhanes
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@yehster, I can see a few downloads on the link - https://ehr.librehealth.io/downloads/nhanes/ Which one is the final one that should be used for a new setup?
https://ehr.librehealth.io/downloads/nhanes/20170629.sql.gz
This is the most updated version at present. I’m working on some updates though. The main component being to split out the lab data in to multiple “panels” instead of having them all listed as a single group.
Can we please get an update regarding synthetic data? Does it look viable. What is the status? Thanks
@rhoyt Still in the midst of doing it. Its been hard to figure out a simple way to match the generated data with the lh-ehr schema. @yehster, can you please help?
Can you provide a sample of synthetic data so I can understand the sort of data you are trying to map?
I sent an email with the CSVs and ppt with the ERD in it
It appears that someone has used our demo https://ehr.librehealth.io/interface/login/login.php?site=nhanes
For a class, as it is full of “providers”. The facility is UWF Medical Clinic. I’ll contact the only person I know and ask. Two further issuses: 1. The calendar view shows blurring across the upper column where it lists providers 2. Activity log does not appear to work
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I don’t have a clean db dump of NHANES data…in the future – I’d run a nightly cronjob to reset it to a clean state
I did email the suspected culprit so let’s see what she says. As I understand it, I can make students inactive but I can’t delete them
I’m not sure what to do from here – once Tony and I and whoever else get the Docker images written – we’ll be able to take a db dump and load it and periodically reset it.
Dr Hoyt, I think @tony can access the database he has access to some tools, he should be able to remove the users and facilities. I am sorry you are having this issue. I would suggest changing the admin password and sending it to the folks who need it via private email. I don’t have access to tools or I would fix it for @tony.
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For everyone’s interest, this was one of the persistent and frequent challenges when we were hosting a dozen or so colleges’ eHealth training classes on OpenEMR demo sites circa 2011-2013. (This was part of an NSF project hosted by Bellevue College.) With a shared OpenEMR instance, one student or faculty could/would make changes that blindsided everyone other student and faculty member. Tried many tactics, none of which was an “awesome solution.” e.g., tried creating cloud instances for each separate college, instructor, and course, but then instructors objected to going into each instance to observe/grade students, and one student could still whack all of the other students’ work in that instance.
Eventually we were running as many as 30+ instances for a dozen classes simultaneously, but, again, instructors were overwhelmed and frustrated.
Also ran some trials with each student having his/her own personal instance. That was no better for the instructors, often worse, and the students could no longer see each others’ progress with simultaneous updates on various tasks. Imagine having 20 students in each of 4 courses, each with his/her own EMR instance to monitor and grade, let alone trying to coach the students…
Wound up needing daily backups of all instances, regardless, in case a student, say, changed all of the passwords, erased all of the docs, or deleted all of the ICD codes. Even with backups of all instances, deciding when an instructor authorized resetting a database took some effort to document the decision and prepare for the consequences of lost student work. Not sure that I have answers to these challenges, but hope mentioning them will be of use.
Another unexpected surprise for academic applications was that terms start on calendar dates all over the place (e.g., “Fall” may start as early as early August, or as late as October, and some terms are only 5 weeks, others 15 weeks!) Scheduling student passwords, database and code refreshes was “interesting.”
Yet another interesting learning was that instructors in Respiratory Therapy courses only wanted RT patients and cases, Physical Therapists only PT patients, Pediatric Nursing only wanted neonates and peds patients, Home Care Aides wanted chronic disease cases, Pharmacy Techs wanted dispensing and ePrescribing cases and tools, Rad Techs only PACS and radiology cases, Hospital Care nursing wanted hospital-based patient care examples, ED wanted emergency cases, and physician practice management wanted family medicine cases. The instructors had ZERO interest or tolerance in seeing other medical cases, no matter how interesting!
And that, my friends, was only a dozen or so colleges, AND they all clamored for Big Data and Data Analytics tools, but solely in their clinical specialty.
As the old saying goes, I were so busy killing alligators, at some points I kinda forgot that we came to drain the swamp. Turns out that few instructors had much interest in learning or teaching general electronic medical record keeping fundamentals, and more than a few had little or no interest in IT, IS, HI, etc.
As I said, I hope this information and experience is informative, and helps stimulate creative solutions for future training, because I STILL BELIEVE!
EBS
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