Requested CCMDB changes for the next version

see the Development Documentation Category for other development logs

Additions required

remove old backups

Clean up batch file to get rid of the old data where names were just ccmdb.mdb Ttenbergen 13:54, 9 February 2011 (CST)

Integrity rule for Move dates in TMP file

• Move date/time in TMP file should NOT be BEFORE admission date/time or AFTER discharge date/time.
• if coming from your own site ER department, the first move TO "item" MUST always be to same as Hospital Site_Location.
  • EXCEPTIONS:
    • HSC first move can be to H7N (contingency beds).
    • VIC first move can be- S2, N4, N4F (code purple contingency beds)
    • GRA first move can be - S2, E4 (contingency beds)
    • STB first move can be - A6S

• For patients who DO NOT come directly from site's OWN emergency department it would be good to have a boolean of YES or NO for:
  • parked in ER? if YES then move required
  • from contingency bed (exceptions) prior to actual ward admit, if YES, then moved required.
• otherwise, NO move required if from: ICU own site or other sites, OR's, RR's, HOME (ZZ), ambulatory care, XE, YE, ward from other sites, wards from own site.

protect serial numbers

• Can you make it more difficult to delete the serial number as this can be deleted/changed when you first open up the patient profile after you have entered data and wish to check the chart number in order to look up labs , xrays, etc. When a profile is first opened, it opens up on the serial number and can be deleted accidentally.--CMarks 13:44, 8 February 2011 (CST)

show only relevant locations

• Is it possible to eliminate all other hospitals, other than where you are physically working, from the drop-down list for only the locations pertinent to that specific hospital for your first move? ie:HSC_ER move to HSC_A4 with a location of A4. If this is not possible, could you bold the wards and/or enlarge HSC locations as the curser easily catches wards above and below the lines.--CMarks 13:58, 8 February 2011 (CST)
• Also the debug error is showing up more frequently than ever. Is there something that I/we are doing to cause this?--CMarks 14:01, 8 February 2011 (CST)

add another sorting for the MR list

Would be great to be able to sort medical records list by serial number, as well as alphabetically by last name. Thanks. (as per Debbie PN)

Post-Roll-out Cleanup for DB update

• Make sure that data mdb is no longer being rolled out in update batch file.
• update data file to default the labs flowsheet date to now(). Ttenbergen 13:56, 4 January 2011 (CST)

Bug Fixes

Apostrophes in TMPs

If an apostrophe is used in the comments for any of the tmp studies, the edit button to open the details viewer will fail. Don't use apostrophes in tmp comments until this is fixed. Ttenbergen 14:55, 14 February 2011 (CST)

Labs Scrolling

Scrolling in Labs Flowsheet is still a problem. Mousewheel will scroll down, but not back up in the form. Error can be overcome for now by scrolling up using the scroll bar rather than the mouse wheel. Ttenbergen 14:05, 19 January 2011 (CST)

debug error

"Could you figure out why "debug error" keeps showing up? It used to happen after working on the laptop for hours at a time; especially if we were not plugged into A/C. Now it seems to happen after having things running only for a little while. It also happens repeatedly throughout the day. Is this significant or should we continue to ignore it?" as per Con Marks Ttenbergen 10:14, 27 January 2011 (CST)

Functional Improvements

Apache secondary upper and lower limit verifying abnormal Apache values by collectors using Access

Apache limits - upper and lower - set secondary limits for some of the values for Apache or MOST - these are values that can be occur, but are not the norm. Julie to review database and advise what the values will be. Purpose, reduce checks and question to collectors--TOstryzniuk 18:48, 5 November 2010 (CDT)

Implement mean BP calculation tool on laptop

It would be beneficial to put in a mean BP helper (like the ABG helper) so that we could enter our systolic and diastolic BP's and it would automatically calculate the mean BP and perhaps even indicate the higher apache score and then we could pick the worst one. This would make apache scores more accurate.

Changes Under Discussion

These requested changes can not be processed until the questions about them have been answered. Wherever possible the discussion should conclude in the home article of the topic. If a topic has no home article, it can be listed here.

Full Apache Score

Add full apache score to the Viewer form

• That one would need thorough testing to make sure I got the score right, e.g. enter 10 patients and check if their apache scores in ccmdb are what you would have calculated. Any volunteers for the testing? If it won't be validated I'd rather not add this to confuse anyone. Ttenbergen 11:05, 9 June 2010 (CDT)
  • Marie Laporte offered to help with this. I will let her know once I have implemented this. Ttenbergen 16:01, 2 July 2010 (CDT)

• What would this "full apache score" be used for? Much of the diagnostic scoring seems to be documented only in the form of a macro which will be a mess to decipher and implement in Access. What is the benefit? Ttenbergen 10:48, 29 October 2010 (CDT)
• if this is implemented, Marie Laporte offered to help test this (2010-06-21) Ttenbergen 10:43, 27 January 2011 (CST)

Help to manage Serial numbers

If I understand right data collectors currently collect one or more locations from one or more pools of serial number pools. Details of the serial number system are located in Serial number. This has been flagged as one reason why people find paper printouts of the most recent patients sent useful.

Serial numbers have to be unique for a collection location, so if a ward like HSC_H4H is collected on by multiple collectors then a serial number must never be re-used. One way this is achieved is to assign blocks of numbers for each 100 possible serial numbers to a given collector.

A study number must be entered before any other data since access uses it to set the relationships for the data. To accomplish that, function new_pat_id() opens a window requesting the serial number pops up when "add new patient" is clicked on the patient list.

Added question to Serial_number#Special-Use_Serial_Numbers to find out if any serial numbers need to be "reserved".

Possible Solution

The program would provide a default serial number. For locations with only one serial pool, this would be a one-step, transparent process. Collectors with more than one serial number pools would get a dropdown list of possible pools; upon choosing one the program would default to serial (most recent+1). Collectors using only blocks of serial numbers would have to keep track if they are "leaving" their block (e.g. if you are using only 20-39 and the program defaults to 1140, you would have to realize that and change it to 1220).

To accomplish this, the _info table would store

• variable: serial_pools, value: comma-separated list of wards
• for each ward, a variable "Serial_pool" & <ward> (e.g. Serial_pool_HSC_H4H) with the most recent value used, updated automatically by the serial wizard

• Any thoughts about this? Do you think it would/wouldn't work or be helpful? Especially, do you think collectors would consistently "catch" the ends of blocks?
  • This may not work as planned as there are times when the data collector assigns a number to a patient file in her log book but is unable to use it immediately and must use numbers out of order (even though the numbers are assigned in the right order).--CMarks 08:39, 30 November 2010 (CST)

Facilitating diagnosis entries

As discussed at the Meeting Laura Kolesar is reviewing the names of the diagnoses we use to make it more likely that you get the right one when you start typing. Laura, any progress on this? Ttenbergen 19:24, 30 December 2010 (CST)

• • I have put the respiratory system changes on the regional server site for Tina and Trish to review before I proceed with similiar changes to the other systems. When you get a chance, take a look and see what you think. --LKolesar 14:08, 21 January 2011 (CST)

Extra "pathogens"

As part of an effort to reduce relying on paper notes during collection, Marie brought up the possibility to put "waiting for tests" and "review" as options into the pathogen dropdown and to conditional-format the field in orange if they are chosen. Of course, choosing them would also disable checking DX complete.

Some of you are entering Unknown Pathogen, and then re-check all patients with unknown pathogens before sending.

• Actually, I don't understand how this is better than just leaving the entry as "No Value" until you know what you will put there. This way you would get an error if you tried to set the dx to complete. Can someone explain to me how a different dropdown would improve upon this? I don't see how you use this in the field, so I might be missing something. Ttenbergen 19:43, 30 December 2010 (CST)

Also, some of you were addressing here how long they wait for a pathogen which is not immediately available; that is discussed in the article Pathogens. Here i am wondering if additional options would make collection easier.

change Final_checks to dropdown to allow for more options once we start to be able to send back data

• add s_FinalChecks, fix all spots that use FinalCheck (or make a function to check it)

Bugs that need replicating

In order to troubleshoot bugs in the program we need to know how they happen. There are a number of articles about known bugs we are trying to fix in the bugs category. Any further feedback on these bugs might be the piece of the puzzle that allows me to fix the bug.

Previous requests that were not addressed (with reasons)

Default location field to main collection location

There have been requests to default the location field to the main (or only) collection location. I could set this up, but defaulting these would increase the chances of the data just being left in there if a patient is an exception. Upon consultation with Trish it was decided not to risk an increase in errors to make this more convenient.

• "There are a number of site collecting on 2 or more units using the same laptop. We get ward location entry error when there is a default location set." ... "--TOstryzniuk 12:25, 20 October 2010 (CDT)"

PS: If I enable defaulting for anywhere then I would not be able to disable defaulting for other locations, so it was decided not to have defaulting. Ttenbergen 12:44, 12 January 2011 (CST)

Cancel for Settings

change the settings form to have a save and a cancel button...

No can do. There are is a sb-form in settings form that would not be cancelled, so having a cancel would be misleading.

Off-line copy of wiki for laptop

We found a way to do this, but it would add overhead work to the collectors' job and it would deter from using the wiki as a tool owned and updated by all, so Trish and Tina decided not to pursue this further. Ttenbergen 15:01, 16 April 2010 (CDT)

• look into possibility of automatically downloading WIKI guide to laptop each day that it is synch'd. (portable version of guideline)--TOstryzniuk 20:11, 4 April 2009 (CDT)

• As moved from Diagnosis Coding:

A suggestion has been put forth to Tina is to find a away to allow a downloaded copy of the WIKI guide on laptops, the collection tool we are moving to soon. I think this would be an excellent solution if she can do this. Collectors would then be able to search for info no matter where they are in the collection field and each time they synch there laptop, they would get updated WIKI items. That is the plan............but waiting to here from IT support.

It is challenge right now in that the guideline information is not easily and quickly accessible while you are doing your work in the unit or in medical records. Most collectors must run back to their office or find a free computer to log in and look up guide info.

Keep in mind, guide information changes regularily, so what you print out one day is outdated the next for a number of articles. TOstryzniuk 11:25, 29 April 2009 (CDT)

• April 2010 - Trish and Tina reviewed the apparent option to have a COPY of wiki on laptop. Problem if implemented:

1. if collectors will not have the most update the copy on laptop because changes and updates are happening daily on the MAIN copy here, and thus changes to instruction will get missed.
2. 2. Don't want multiple copies of instruction and information on multiple laptops that are not up to date.
3. Collector questions and contribution to the Wiki cannot be added to copy of Wiki on laptop. Questions and contribution must be made centrally not locally so that information is in ONE PLACE and the same for everyone.--TOstryzniuk 19:11, 20 April 2010 (CDT)

APACHE lab value limit change request

• Apache upper limit for creatinine is 2968, which is based on the highest APACHE that was ever in database. STB has one pt with a creat of 3000 and has requested to change upper limit. Laura K. --TOstryzniuk 12:12, 6 July 2010 (CDT)
  • Decided to leave limits be and have collectors enter limit values and email Pagasa with real values when extreme values are encountered. Contacted Pagasa to let us know if such emails become too frequent. Ttenbergen 08:53, 12 July 2010 (CDT)