iSite 3.5: Patient / Exam Management

1. iSite 3.5: Patient / Exam Management

2. Table of Contents • Objectives • Terminology • Patient Merges • Patient Record Maintenance • Exam Record Maintenance • Delete Patient • Delete Exam

3. Learning Objectives Understand the purpose and performance of: • Patient Merge • Patient Record Maintenance • Exam Record Maintenance • Patient Deletion • Exam Deletion

4. Terminology • PACS (Picture Archive and Communications System) • Information Systems designed to manage, store and distribute medical images and related information throughout the healthcare enterprise • HIS (Hospital Information System) • Information Systems designed to manage patient records, including patient registration, billing, and order entry • RIS (Radiology Information System) • Information Systems designed to manage exams (orders), including filling orders and scheduling

5. Terminology • MRN (Medical Record Number) • A unique patient identifier (also known as Patient ID) used for auditing of billing and scheduling for patients • Accession Number (ACCession Number) • A unique exam identifier (also known as an order number or requisition number) used for auditing of billing and scheduling of scheduled procedures • SUID (Study Instance Unique IDentifier) • A unique study identifier used for auditing of performed imaging service requests

6. Terminology • DICOM (Digital Imaging COmmunication in Medicine) • DICOM is the predominant communication standard between imaging equipment throughout the Healthcare Enterprise • HL7 (Health Level 7) • HL7 is the predominant messaging standard for exchanging key sets of administrative and clinical data in the healthcare enterprise

7. Introduction

8. WARNING: Hazard Area!  • The patient record merge functionality (Merge option) has been identified as a hazard area in iSite that could result in one of the following situations • Incorrect diagnosis • Delayed diagnosis • Delayed treatment • Philips strongly recommends that you visually verify the patient records you want to merge before performing the merge function

9. Patient Merges

10. Introduction • At times, a single person is entered into your institution's HIS/RIS with two different Medical Record Numbers (MRNs) • For example: "John Smith, MRN: 11111, M, DOB: 12/31/00..." and "John Smith, MRN: 12345, M, DOB: 12/31/00....“ • In reality, both of these entries belong to the same individual, but because of their differing MRNs, the system sees them as two unique individuals.

11. Introduction • Merge List • Automatically created by iSite • contains all likely candidates for a patient merge • iSite will identify patients who share demographic data but whose MRN is different and will recommend them for merging if they meet certain complex criteria • Recommendations for merge candidates are based on a highly-complex algorithm which weighs various similarities and discrepancies between two individual patient listings • Each recommendation should be carefully scrutinized before being accepted

12. Accessing the Merge List Step 1 Step 2 • In iSuite • Click ‘Patient/Exam’ • Click ‘Merge List’

13. Accessing the Merge List • Merge Candidates List will appear • A list of likely merge-candidate pairs is presented • Each listing contains the patients' Names, Social Security Numbers, Dates of Birth and Sex

14. WARNING: Hazard Area!  Completing a Patient Merge PATIENT MERGING SHOULD ONLY BE PERFORMED BY THOSE WHO ARE IMPLICITLY AWARE OF THE POSSIBLE REPERCUSSIONS OF ERROR AND WHO HAVE EXCELLENT KNOWLEDGE OF THIS PROCESS

15. Accessing the Merge List • Select a merge-pair • check the box next to the pair's listing • Select the continue button

16. Completing a Patient Merge Step 3 A detailed merge profile will be displayed • Check the boxes of the information that you wish to include in the newly merged patient profile • In this example, the MRN is taken from Patient 2, while the rest of the information is taken from Patient 1

17. Completing a Patient Merge Step 4 A detailed merge profile will be displayed • Click merge once you have indicated all the correct information

18. Completing a Patient Merge • If information is missing (i.e. one of the fields has not been checked for either patient listing), you will be presented with a notification message • If all the information is in place, you will be presented with a confirmation message

19. Patient Record Maintenance

20. Patient Record Maintenance • There may be instances when a patient or exam record is not listed in the system • RIS (Radiology Information System) is functioning but the patient has not been created • RIS is not functioning or the RIS integration is not functioning and iSite cannot access the patient information • Important Note: Always create the patient and exam in the RIS if possible • If the RIS is not functioning, the patient or exam may be created in iSite; however, patients and exams generated in iSite will not appear on your RIS

21. Patient Record Maintenance Step 2 Step 1 • Access the Enter/Edit Patient by clicking the ‘Patient/Exam’ button in the navigation area at left • Select ‘Enter/Edit Patient’

22. Patient Record Maintenance Step 3 Step 4 • Select the patient identifier to “Search By:” and enter the appropriate information in the string filter • Click on the search button to begin the search • Existing Patient Records may be edited

23. Patient Record Maintenance • If the patient you are searching for is not found, you may create a new patient by selecting the new button Step 5

24. Patient Record Maintenance • iSuite will prompt the user to enter required fields prior to saving the patient record

25. Patient Record Maintenance • iSuite will assign an internal unique identifier, although a MRN (Medical Record Number) may be designated for a patient

26. Exam Record Maintenance

27. Exam Record Maintenance • Select Enter/Edit Exam Step 1

28. Exam Record Maintenance • Enter the Accession Number and select the ‘ellipsis’ button to search for an accession number Step 2 • Existing Exam Records may be edited

29. Enter/Edit Exam • To create an exam select the ‘new’ button to have iSite assign an accession number Step 3 • Existing Exam Records may be edited

30. Enter/Edit Exam • Enter the necessary information and click ‘save’ Step 4

31. Enter/Edit Exam • If information is missing (i.e. one of the fields has not been checked for either Patient listing), you will be presented with a notification message • If all the information is in place, you will be presented with a confirmation message

32. Delete Patient

33. Delete Patient • This feature is used to remove patient records from the iSite database • All exam information for the patient in question will be • permanently lost • Use the delete patient feature to remove duplicate records, records that have been corrupted (provided the patient record does not contain information for another exam you wish to preserve)

34. Delete Patient • Select the Delete Patient button in the ‘Patient/Exam’ module Step 1

35. Delete Patient • Choose a search criteria from the pull down menu and then add information as necessary to retrieve the patient in question Step 2

36. Delete Patient • The Delete Patient information page will be displayed • Enter the reason for deleting the record and complete the ‘Authorized by:’ field • Click ‘Delete’ once you have thoroughly reviewed the record, making sure that it is fit for deletion

37. Delete Patient • A confirmation message will be displayed • WHEN YOU CLICK THE ‘OK’ BUTTON, THE RECORD WILL BE IMMEDIATELY AND IRREVERSIBLY DELETED

38. Delete Exam

39. Delete Exam • Used to delete a specific exam • Exams with the following status may be deleted: • C (Completed) • X (Canceled) • N (Non-reportable) • D (Dictated) • P (Preliminary) • F (Final) • A (Addendum) • R (Revised)

40. Delete Exam • When you delete an exam, iSite erases all record of the exam from the system • For example, if a diagnostic report is associated with the exam it is deleted when you delete the exam record • Delete an exam only in the rare instance that the exam should never have been scheduled • For example, if two separate patients have the same name, and an exam is performed on the correct patient but recorded under the wrong name, you would need to delete the exam from iSite and re-enter the information under the correct name

41. Delete Exam • To delete an exam record, click Delete Exam from the Patient/Exam area

42. Delete Exam • Enter search criteria to find the patient whose exam you wish to delete Step 2

43. Delete Exam • Identify the patient by clicking the radio button next to their name Step 3

44. Delete Exam • Click the ellipses (…) button to view a list of the patient's exams • Select an exam from the list Step 4

45. Delete Exam Step 5 • Click delete exam after you have carefully reviewed the exam

46. Delete Exam • iSite will display the following confirmation message • If you wish to proceed, click OK • AFTER SELECTING OK THE EXAM IS IMMEDIATELY AND IRREVERSIBLY DELETED

47. For assistance, please call customer support at 1-877-328-2808 or 1-877-328-2809