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Session #10. Using JLV for Research Chart Review

Database & Methods Cyberseminar Series. Session #10. Using JLV for Research Chart Review. The objectives of this cyberseminar are to:. Briefly introduce the Joint Legacy Viewer (JLV) as a chart review tool Describe data type considerations in conducting a chart review

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Session #10. Using JLV for Research Chart Review

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  1. Database & Methods Cyberseminar Series Session #10.Using JLV for Research Chart Review

  2. The objectives of this cyberseminar are to: • Briefly introduce the Joint Legacy Viewer (JLV) as a chart review tool • Describe data type considerations in conducting a chart review • Explain how specific functions in JLV facilitate record review • Describe a search strategy for accessing Community Health Records • Present examples of using JLV in the research context 07/2019

  3. What is your role in research and/or quality improvement? • Investigator, PI, Co-I • Data manager, analyst, or programmer • Project coordinator • Other – please describe via the Q&A function Poll #1: Your role as a data user 07/2019

  4. How many years of experience do you have working with VA data? • One year or less • More than 1, less than 3 years • At least 3, less than 7 years • At least 7, less than 10 years • 10 years or more Poll #2: Your experience with VA data 07/2019

  5. Do you regularly use JLV? Yes No I’ve never used it Poll Question #3 07/2019

  6. Session roadmap • JLV Intro • Data Considerations • JLV tools to facilitate chart review • Community Health Record searches • Examples 07/2019

  7. Web-based health information viewer • VA VistA/CPRS, VistA Imaging Display • DoD AHLTA (outpt), Essentris (inpt), MHS Genesis (DoD Cerner implementation), HAIMS (Health Artifact and Imaging Solution) • Community VHIE/VLER • Directly connected to VA and DoD data sources • Summary reports from Community VLER partners • Data is not separated into individual data types (parsing) • Uses local VistA or CAPRI authentication for access • Accesses data on demand in real time • Subject to data availability at the time of query – no cache The Joint Legacy Viewer 07/2019

  8. Jointly developed by VA and DoD through Congressionally Directed funds • support VA-DoD Interoperability • support care from point of injury to point of care anywhere in the federal system • Used throughout VA and DoD • Replacement for VistaWeb • Current data set is more complete • Software maintenance, development and support funded by VA and DoD The Joint Legacy Viewer 07/2019

  9. Session roadmap • JLV Intro • Data Considerations • JLV tools to facilitate chart review • Community Health Record searches • Examples 07/2019

  10. Host systems are queried in real time • Data snapshot • Systems must make data available to JLV • Monitoring systems are in place – connections ≠ data • System of Systems • JLV = TV • Community Data Sources • Health Summaries standardized for information sharing • Not parsed • Limited metadata Data Considerations 07/2019

  11. Local vs Other VistA vs DoD • Data sources dictate their location • Structured data • In VistA, AHLTA, Essentris • Unstructured data (scanned documents) • In VistA Imaging, HAIMS • pdf scanned with OCR • Community • Continuity of Care documents • Similar to CPRS remote data in the Reports tab VA-local Data Considerations 07/2019

  12. Session roadmap • JLV Intro • Data Considerations • JLV tools to facilitate chart review • Community Health Record searches • Examples 07/2019

  13. Expands Widget • Date Range • Filters • More columns = > Column Sorting More>> 07/2019

  14. Expanded Prog Notes Widget Y,M,D+Apply Filters Columns sort Free Text Filter 07/2019

  15. Filters Check or change date range first Filters contain drop lists – choose one of more items to apply the filter Filters can be used in succession Click on Remove All Filters to return to the full number of records returned in your selected date range 07/2019

  16. Text Filter Searches text strings displayed in the widget Search begins after 0.5s pause in keystrokes Can be used after other filters have been applied 07/2019

  17. Column Sort Column headers sort by alpha or time Useful for IMAGES *Column limiter - upper R of the widget to the R of the printer icon 07/2019

  18. pdf builder Add any data type EZ select up to 25 50 max/rpt Text Searchable Reports Report Builder Report Builder icon EZ select Add to Report 07/2019

  19. Window opens over L column Can be minimized or closed. Reports persist 72 hrs Current Report = holding area Report Builder 07/2019

  20. CHS&D widget Free Text Filter 07/2019

  21. Name hyperlinked to pdf Reports can be saved ‘Current Report’ list can be modified or deleted without affecting completed reports in the ‘Patient Reports’ tab Report Builder window can be minimized or closed Report Builder up close 07/2019

  22. Reports • Ctrl+F brings up the pdfFind tool. You can now search the entire document for text. • If you save this pdf to your secure network drive, you will be able to highlight, comment, etc. • Share with secure email 07/2019

  23. Session roadmap • JLV Intro • Data Considerations • JLV tools to facilitate chart review • Community Health Record searches • Examples 07/2019

  24. What is the source system? • CCDs vs CCDs + • VLER/VHIE partner? • Part of an outgoing consult? • Reference out of network consults in the Consults widget • Scanned documents in VI with dicey indexing • Does the facility assoc scanned docs to CPRS note? • Consults widget may help define a date range to search • Data in narrative text • Report Builder text searches Community Health Record Searches 07/2019

  25. Session roadmap • JLV Intro • Data Considerations • JLV tools to facilitate chart review • Community Health Record searches • Examples 07/2019

  26. 07/2019

  27. Select filter tool Enter ‘office visit’ JLV will auto filter Click on EZ select EPIC Notes 07/2019

  28. Select filter tool Enter ‘office visit’ JLV will auto filter Click on EZ select EPIC Notes 07/2019

  29. Next session:September 9th @ 1 pm Eastern Database & Methods Cyberseminar Series Advanced Comorbidity Measures Denise Hynes, PhD Research Health Scientist VA Medical Center Portland

  30. Additional Resources

  31. JLV Training Resources ADDIITIONAL TRAINING RESOURCES: JLV Speed Training – 5 Topics/5 Minutes JLV Speed Training – 5 Elusive Data Types JLV Introductory Training Videos and JLV Resources Want more info? Follow us at VA Pulse - JLV Network 07/2019

  32. VIReC Options for Specific Questions HelpDesk HSRData Listserv Individualized support • Community knowledge sharing • ~1,400 VA data users • Researchers, operations, data stewards, managers • Subscribe by visitinghttp://vaww.virec.research.va.gov/Support/HSRData-L.htm(VA Intranet) • virec@va.gov • (708) 202-2413

  33. Quick links for VA data resources • Quick Guide: Resources for Using VA Datahttp://vaww.virec.research.va.gov/Toolkit/QG-Resources-for-Using-VA-Data.pdf (VA Intranet) • VIReC: http://vaww.virec.research.va.gov/Index.htm (VA Intranet) • VIReC Cyberseminars:http://www.virec.research.va.gov/Resources/Cyberseminars.asp • VHA Data Portal: http://vaww.vhadataportal.med.va.gov/Home.aspx (VA Intranet) • VINCI: http://vaww.vinci.med.va.gov/vincicentral/ (VA Intranet) • Health Economics Resource Center (HERC): http://vaww.herc.research.va.gov (VA Intranet) • CDW: https://vaww.cdw.va.gov/Pages/CDWHome.aspx (VA Intranet) • Archived cyberseminar: What can the HSR&D Resource Centers do for you? http://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/video_archive.cfm?SessionID=101 07/2019

  34. Contact information Reese Omizo, MD Reese.Omizo@va.gov VA Pacific Islands Health Care System VA Information Resource CenterHines VA Hospitalvirec@va.gov708-202-2413

  35. Community Notes from EPIC EMRs in JLV

  36. Data sources Community Partners on EPIC HPH, Kaiser, Queen’s Healthcare Systems • Summary data sent to JLV in Community Health Summaries (CHS&D) widget • Document type ‘Office Visit Summary’ has the highest yield of progress notes • Other document types rarely contain notes • Document contents vary by health care system • Scanned notes/documents can be found in • JLV Documents widget • JLV Progress Notes widget (if scanning techs enter a note) *Also check VistA Imaging Display

  37. JLV Tips • Create a tabbed workspace optimized for community notes • Cross reference Consults, Orders, Progress Notes and Documents

  38. CHS&D Tips • Connection Error icon Tells you when a partner is unable to provide data. Try to refresh a few mins later.

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