TIU Templates

RPMS EHR CAC Review

2

Content Developed by:

Philip Taylor, BA, RN Clinical Consultant

Medsphere Systems Corporation

TIU Templates

Learning Objectives • Create TIU Templates to facilitate communication, promote quality patient

care and patient safety, and meet professional and legal standards . • Increase efficiency in documentation through implementation of well

designed TIU Templates with "point and click" elements. • Ensure completeness, accuracy and standardization of EHR documentation

by providing structured TIU Templates. • Demonstrate the process of importing RPMS data elements via TIU

Templates into progress notes to reduce "double entry" of data by end-users.

• Demonstrate use of TIU Template components (data objects and template fields) to add clinically pertinent information to electronic orders and consult requests to improve quality of documentation.

• Demonstrate the process for sharing TIU Templates between facilities and how to obtain prior-built note templates from IHS FTP site.

3 TIU Templates

TIU Templates

• TIU Templates provide a mechanism for structured input of text into RPMS-EHR.

• While the most common use for TIU Templates is to output text into Progress Notes, there are other uses available within RPMS-EHR.

4 TIU Templates

Who can Create and Edit Shared Templates?

• Only users in the user class of Clinical Coordinator can create Shared Templates.

5 TIU Templates

Template Creation

Access to Personal Templates is controlled by a Parameter: TIU PERSONAL TEMPLATE ACCESS Select PARAMETER DEFINITION NAME: TIU PERSONAL TEMPLATE ACCESS Personal Template Access TIU PERSONAL TEMPLATE ACCESS may be set for the following: 1 User USR [choose from NEW PERSON] 2 Location LOC [choose from HOSPITAL LOCATION] 3 Service SRV [choose from SERVICE/SECTION] 4 Division DIV [MEDSPHERE DEMO HOSPITAL] 5 System SYS [DEMO.MEDSPHERE.COM] Enter selection: 5 System DEMO.MEDSPHERE.COM ---- Setting TIU PERSONAL TEMPLATE ACCESS for System: DEMO.MEDSPHERE.COM ---- PERSONAL TEMPLATE ACCESS: ? READ ONLY allows use, but not creation of, personal templates. Select one of the following: 0 FULL ACCESS 1 READ ONLY 2 NO ACCESS

6 TIU Templates

Template Fields

• Who can create or modify template fields? • This is controlled by the parameter: TIU FIELD

EDITOR CLASSES. • TIU is pre-configured to allow the user class of

Clinical Coordinator to create new template fields. • Locally you may decide to add additional users

without giving them Clinical Coordinator and access to Shared Templates.

7 TIU Templates

Template Field Availability

• Regardless of who is allowed to create TIU Template fields, once created, the template fields are available to all users who are allowed to create templates.

8 TIU Templates

Template Field Types • Edit box fields • Combo box fields (Drop Down box fields) • Button fields • Check box fields • Radio button fields • Date fields • Number fields • Word processing fields • Hyperlink fields • Text fields

9 TIU Templates

Template Field Types

• Specific Examples of each of these field types are available in an accompanying resource PowerPoint presentation.

10 TIU Templates

Common Properties of Templates

TIU Templates 11

• Display Only • Only Show First Line • Indent Dialog Items • One Item Only • Hide Dialog Items • Required

Template Properties

Display Only: • Generally used for a text field that give the

template user directions or help. • Can also be used for templates and dialogs.

12 TIU Templates

Template Properties

Template Formatting: • Indenting, One Item Only, Only Show First

Line, and Hide Dialog Items are tools that can improve the appearance and usability of the input template.

13 TIU Templates

Template Properties

Required: • It is tempting to make fields required to force

users to enter necessary information, but use this sparingly because it can be very frustrating and may cause providers to abandon use of templates altogether!

14 TIU Templates

Standardization

• Use a standard approach when creating any new template fields.

• Use beginning text in fields so that related items group together in the list, making it easier to find them later when building the template.

15 TIU Templates

Standardization (cont.)

Example: • Site Abbreviation: CIH • Specific Template: ANTICOAG

• CIH ANTICOAG DX • CIH ANTICOAG INR HI RANGE • CIH ANTICOAG INR LO RANGE • CIH ANTICOAG TIME

• This will group like elements together and aid in template building and future maintenance.

16 TIU Templates

Appearance of TIU Templates

• It is possible to create TIU Templates that look good for text entry.

• It is possible to create TIU Templates that output good looking text.

• But it is not always possible to create a TIU Template that does both at the same time.

17 TIU Templates

Using Template Notes In the Template Editor

• To annotate a template to record why or when a change was made. • This can be particularly useful if more than one

CAC edits templates. • This can also be where EHR Committee approval

of the template is recorded.

18 TIU Templates

Using Template Notes

19 TIU Templates

Using the Copy Button

• Templates can be created in the My Templates folder and then copied to the Shared Templates folder when completed.

• But beware, this action is not truly copy, but more akin to creating a shortcut link.

• After copying, if either of these templates are edited both will be changed!

20 TIU Templates

Using the Copy Button

1. Click the destination folder (e.g., Shared Templates).

2. Click the template to copy. 3. Click Copy.

21 TIU Templates

Importing IHS Templates

• IHS uploads and stores TIU templates at its national FTP site.

• These templates are publicly accessible at: ftp://ftp.ihs.gov/pubs/EHR/Templates/TIU%20Note%20Templates/

• When returning to the IHS FTP site remember to click View > Refresh to update the browser’s cache.

22 TIU Templates

Importing IHS Templates

23 TIU Templates

Importing and Exporting

• If an exported .txml file is double clicked, the browser will attempt to open it because it is an XML type file.

• Only TIU within EHR can properly process a .txml file.

• Those who have created HTML will see similarities in raw exported TIU files.

24 TIU Templates

Raw TIU Template File

TIU Templates 25

<CPRS_TEMPLATE> <TEMPLATE NAME="PHN Consult"> <TYPE>G</TYPE> <STATUS>A</STATUS> <DIALOG>1</DIALOG> <BOILERPLATE_TEXT> <p>THIS PATIENT IS BEING

REFERRED TO PHN SERVICES FOR:</p> <p></p> <p>{FLD:PHN CONSULT}</p> <p></p> <p>{FLD:VA*W-P8LINES}</p> </BOILERPLATE_TEXT> </TEMPLATE> <TEMPLATE_FIELDS> <FIELD NAME="PHN CONSULT"> <TYPE>X</TYPE> <INACTIVE>0</INACTIVE> <LENGTH>0</LENGTH>

<DEFAULT_INDEX>0</DEFAULT_INDEX> <REQUIRED>0</REQUIRED>

<SEPARATE_LINES>0</SEPARATE_LINES>

<MAX_LENGTH>0</MAX_LENGTH> <INDENT>0</INDENT> <PAD>0</PAD> <MIN_VALUE>0</MIN_VALUE> <MAX_VALUE>0</MAX_VALUE> <INCREMENT>0</INCREMENT> <ITEMS> <p>Abnormal Pap</p> <p>Communicable Disease</p> <p>Gestational Diabetes</p> <p>Newborn</p> <p>Positive HCG</p> <p>Postpartal</p> <p>Other</p> </ITEMS>

Exported TIU Templates

When exported, TIU Templates are very small text files that can be sent as e-mail attachments.

26 TIU Templates

Other Uses for Templates

TIU Templates 27

Where can template fields be used in addition to progress notes? • Discharge summaries • Quick orders that have free text fields (e.g.,

comments) • Generic orders that have word processing

fields • Consult reasons for request (using template

editor) • Reminder dialogs

Questions and Discussion

TIU Templates 28