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Health eTime User Guide Plus Step 1 and Step 2

1. This set of tables is used to represent the information related to the patient The data is originally derived from VistA The Patient can have multiple patient preferences and special needs based on standard special need types and patient preference types Biographic information about the patient is stored in the Person table that also links the person to a user of the system or a provider when necessary B 8 Health eTime Resources and Miscellaneous Entities 213 MedRed LLC and BT America a Facility a Address _ vistard 3 _ Name _ streett ShortName Street2 Siteld Street3 AddressId E City Phone State _ Hours E Zip E StationNumber DS5PrimaryStopCode ml DSSCreditStopCode a Abbreviation _ Faciltytd l Hours E Location _ Active Equipment This set of tables is used to represent the organizational structure of the VA including the Top Level Management Facility Site which has multiple Facilities Each Facility can have multiple Section Clinics and each Section Clinic can have a Service Type Finally lists of equipment and rooms are defined at the Site level B 9 Health eTime Reporting Health eTime persists most of its data to a relational database system using more than 50 tables to represent everything from patient data to scheduling policies and audit data
2. BENSON UGH cme ezam creso 200pm zou te meamea ALVAOU ALVA HEALTH e sosen acson Prove Pryia Therapy Raguar GREER ALANA case creso E eoon 3 PRIMARY CARE ALVA OUT VAHETA 6 MICHAEL HANSON Provar REGULAR NASH FRANCIS cms enans creou 30mm sonau 8 PRIMARY CARE ALVA OUTP AL VANEALT e Xeegymacnna MICHAEL HANSON Provo recua BANKS AUGIA coe ena creso E emou 6O PRMARYCARE ALVAOUTPATIENT AL VAYEALTS 5 Xeaymazting MICHAEL HANSON romos REGUAR Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort This is especially valuable in this report since the sorting allows the report more flexibility in terms of viewing information for each column 98 MedRed LLC and BT America A e Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first
3. Name C amp P PatientInstructions None AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR PatientInstructions None p CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 42 MedRed LLC and BT America Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE ServiceType None Type Provider VistaCliniclEN 3 Section Section Abbreviation PC Active True Appo
4. Room Listing Mental Health Examination Room 2 1 Select Primary Care Evaluation Room 3 a Select Primary Care Evaluation Room 4 1 Select Add Room 65 MedRed LLC and BT America a VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies Rooms Eb FACILITY Room D VETERANS AFFAIRS SCHEDULING PORTAL Appointments Administration About Home Facies Rooms Epit Enter the Name of the room and the floor then select Add To update a room click Select for that room edit and click Update Managing Equipment for a Facility From the VistA menu select Facilities then the link titled Equipment List and the following page displays with the list of Equipment 66 MedRed LLC and BT America a C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Faciimes EQUIPMENT FACILITY Equipment Listing Name Type X Ray X Ray Machine mn O fonsa ss Add Equipment To add equipment click the Add Equipment link To manage a piece of Equipment choose the Select link next to the Equipment name in the table Here you can update the Name and Type of the Equipment and click Update You are returned to the Equipment Listing table VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies Eourpme
5. 139 402 S13 330 4007 1534r TIBET 1199 13791 t299 TART A88 289 489 288 401 and VistaSiteID 557 263 265 MedRed LLC and BT America 7 D 8 Consults Summary and Overview This reporting suite fulfills the following requirement there is only one report in this suite B 7 3 The system shall provide reports for consults obtained outside of VHA Report 11 Consults Summary and Overview Detail Report Report Title Consults Summary and Overview Detail Report Report Purpose The purpose of this report is to enable a user to generate a report based on appointment requests marked as a consult and had a referral status that isn t recorded as originating from the VA to capture consult referrals marked as Walter Reed NMMC Portsmouth NNMC Brook AMC Other MTF Community Facility or Home To display a total count of consults for a specific time period Clinics Sites and Facilities entered by the user Reg 11 1 Enable the user to enter the following reporting parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to select one or more clinics e Facility Allow user to select one or more facility e Site Allow user to select one or more site Reg 11 2 For the From and To date use the most updated appointment date This can be either the date the appointment was initially scheduled or the rescheduled appointment date Req 11
6. 0 CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000004 Id 7 IsVeteran True MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring 21 MedRed LLC and BT America KeyValueOfstringstring Key 557 Value 4 ip KeyValueOfstringstring Key 555 Value 791 PatientType SC VETERAN Person Person Address Address City None Id 36 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1968 10 04 00 00 00 Email None Ethnicity None FirstName HUGH Id 403 LastName BENSON MaritalStatus None MiddleName None Phone 3105552233 SSN 300000006 Sex Male Preferences None PreferencesOther None Religion None SCPercent 100 ServiceConnected True SpecialNeeds None SpecialNeedsOther None step 5 create appointment for the patient on 23 july 2013 22 july 2013 is va holiday Scheduled checkpoint 1 appointment is scheduled on agreed upon date step 9 schedule appointments for the same patient and link two appointments Scheduled checkpoint 2 two appointments for the same patient step 10 patient pre appointment notification checkpoint 3 patient will receive pre appointment noticication letter step 11 schedule a group ap
7. 18 MedRed LLC and BT America checkpoint 3 section got deactivated step 12 step 12 reactivated a section checkpoint 4 section got re activated 3 2 Use Case 2 Test Script Execution User Master Scheduler Goals Establish and Manage Section Schedules Run_uc2 bat Data added modified in the Scheduling Application database e Appointment Types e Several Resources under a section o Provider o Room o Equipment e Scheduler policy e g slots definitions Data added modified in VistA e When a resource is added to a section the schedule for that resource is immediately provisioned This process also creates a provider clinic in VistA which will later be used to ensure that VistA has a record of every patient provider appointment Sample Log initializing vista and sql db plesae wait setp 1 adding appointment types to primary care sections checkpoint 1 appointment types are added to primary care section on AL VA REGIONAL MEDICAL CENTER appointment types are added to primary care section on AL VA OUTPATIENT CLINIC step 2 creating resource adding a provider creating resource adding a room to primary care creating resource adding an equiment to primary care step 3 adding scheudling policy to provider in primary care adding scheudling policy to equiment in primary care step 4 adding scheudling policy to provider in primary care checkpoint 2 scheudling policy is added to a provider in primary
8. Our application is built according to a coherent modular design that enables seamless operations with a Ul Our UI which will be improved upon through post contest user involvement enables an end to end scheduling process We demonstrate this by manually testing all the Step 1 Use Cases with the UI Reference Appendix B Application Design and Architecture for understanding of process flow and modular design Reference Appendix A Manual Execution of Use Cases 1 4 Security 1 4 1 The Scheduling Solution shall be able to support secure messaging Our application is designed to enable database level encryption and transport encryption for data uploads to the VistA environment transmitted notifications and transmitted reports We have implemented such encryption capability in the capability in the MedRed TBI Toolbox deployed as VA McGuire Medical Center Richmond 7 2 Evaluating Usability VA Requirements Instructions and Validating Outcomes 2 1 Understandability 2 1 1 The Scheduling Solution shall be self descriptive and explain itself through cues e g screen area and group titles indicating the purpose of the respective interface element on screen instructions diagrams explanations answers that are available on request no implicit assumptions about how users are expected to behave that would contradict users expectations and feedback is given on user actions system actions and the
9. Stop Code 323 MEDICAL PROCEDURE UNIT Section Service MEDICINE Abbreviations PC Location East Wing Rooms 10 and 11 6 Once the profile has been completed select Add at the bottom of the screen gt This action returns the user to Clinic Listing page The recently added clinic is listed in a table with the information presented as entered gt At this point the Clinic has been added to the Facility but has not yet been activated 7 To activate an added Clinic click the Select link to the right of the clinic to be activated gt The Clinic details are displayed as read only Activate button is available 8 Select the Activate button in the clinic details table gt Once the Active check box is selected the Activate button is relabeled as De Activate gt This page also contains an Edit option to allow clinic profiles to be modified as needed 176 MedRed LLC and BT America 4 A L fin A bhes ee E VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log out Scueputing PorTAL VistA Site CA VA HEALTH CARE SYSTEM UTC 08 00 Pacific Time US amp Canada VistA Appointments Administration About Help Home Facumes Cuns Derus Faciuty CA VA OUTPATIENT CLINIC Primary Care Clinic Id 27 Name Primary Care DSS Primary Stop Code 323 MEDICAL PROCEDURE UNIT Abbreviation PC Hours 0800 1500 Location East Wing Rooms 10 and 11 Activ
10. aaron From the toolbar in the upper left select VistA gt Facilities Click Select for the VA Regional Medical Center Click View Clinics to view the clinics associated with a facility Click the Select link for the Primary Care Clinic Click the Clinic Resources List link gt The associated clinic resources will be listed here Click Add Resource to view the resources details page gt Type Name Jane Smith Select Resource Type Provider Fulfilling Resource SMITH JANE e This is a list of providers populated from VistA Check Allow Overbooking Click Add Adding a Room or Equipment as a Resource to be scheduled for a particular Clinic Room Pre requisite User must have added Room to the Facility Room Listing above Fons From the toolbar in the upper left select VistA gt Facilities Click Select for the VA Regional Medical Center Click View Clinics to view the clinics associated with a facility Click the Select link for the Primary Care Clinic 182 5 6 7 MedRed LLC and BT America A Click the Clinic Resources List link Click Add Resource gt Type Name Conference Room Select Resource Type Room Fulfilling Resource Conference Room A Click Add gt The Room has now been added to the list of resources Equipment Pre requisite User must have added equipment to the Facility equipment list above 1 DARON From the toolbar in the upper left select VistA gt Facilities Click Select for the VA Regional Med
11. gt This action opens the Facility Profile Information page 4 To view the Clinics for the selected Facility click on the link for View Clinics 5 Click the Select link for the Primary Care Clinic to view Clinic Details 180 MedRed LLC and BT America 7 lt 6 Select Appointment Types List to view a table of previously created appointment types 7 Select Add Appointment Type to create new Appointment Type 1 gt The following page will allow the user to enter the Name Section Category Duration and DSS codes of the new appointment type gt Per the Contest Use Case Information enter Type Name Initial Category Regular Duration 30 minutes DSS Credit Code DSS Primary Stop Code 323 or 275 for Primary Care numbers populated from VistA 8 Click Add gt This will add the Appointment Type 1 to the VA Medical Center and return the user to the Appointment Types List 9 To add Appointment Type 2 to the VA Medical Center repeat items 1 8 but after selecting Add Appointment Type item 7 enter the following information gt Type Name Follow up Category Regular Duration 15 minutes DSS Credit Code DSS Primary Stop Code 323 or 275 for Primary Care numbers populated from VistA gt Following this procedure will add the Appointment Type 2 to the VA Medical Center and return the user to the Appointment Types List 10 To add Appointment Types 1 and 2 to the VA Outpatient Clinic as detailed in Table 2 of the Contest Use
12. Consequently each patient provider appointment in the scheduling application is matched with a corresponding VistA appointment Finally the entire lifecycle of the appointment check in check out is synchronized into VistA E 2 Documentation of Code APIs Health eTime includes a robust and comprehensive API arranged as a set of services to configure schedule policies and perform scheduling tasks This section lists a non exhaustive list of the signatures of these services AccountService Authentication User LogOn string username string password User Management Collection lt User gt GetUsers User GetUser int id User GetUserFromUsername string userName User AddUser User user User UpdateUser User user bool DeleteUser int id Role Management Collection lt Role gt GetAllRoles Role GetRole int id 274 MedRed LLC and BT America 7 Role AddRole Role role Role UpdateRole Role role bool DeleteRole int id Actions Management Collection lt Shared Model UserRoles Action gt GetAllActions Shared Model UserRoles Action GetAction int id Shared Model UserRoles Action AddAction Shared Model UserRoles Action action Shared Model UserRoles Action UpdateAction Shared Model UserRoles Action action bool DeleteAction int id AppointmentService Appointment Management Appointment Get int id Appointment Update Appointment appointment bool Delete int id Appointment Cre
13. DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR Patientinstructions None ip CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address 28 MedRed LLC and BT America Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 ld 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE ServiceType None Type Provider VistaCliniclEN 3 Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 29 MedRed LLC and BT America Nam
14. Ensure that VistA site on the upper right of the screen is CA Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource George Clark to view resource details Click Block List to view the table of blocked dated Click Add Block to view block details page gt Enter the following information Type Period Start 05 Dec 2013 09 00 Period End 05 Dec 2013 12 00 Reason Meeting 10 Click Add gt Conflicting Appointment information will appear to alert user of a scheduling appointment during the block period 11 Click Add Block gt Block is added Use Case 2 Step 9 Demonstrate the cancellation process for the appointments that were scheduled when the schedule was blocked to include reason for the cancellation Walkthrough Continue from step 8 above 12 Click Appointments gt Patient Appointments to view patient search gt This will take the user to the Current Appointments page for Hugh Benson 13 Click View Appointment Requests on the upper left 186 MedRed LLC and BT America 7 lt o gt Appointment requests are displayed cancellation is automatic 14 To reschedule the blocked cancelled appointment click Add Appointment for the Dec 5 2013 appointment gt
15. MEDICINE ServiceType None Type Provider VistaCliniclEN 3 th Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None p AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR 49 MedRed LLC and BT America PatientInstructions None CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None
16. Real time reports can be scheduled and ad hoc queries can be easily designed to report operational and management level information Current reporting formats to demonstrate capability are presented in Appendix D and the explanation of how to generate reports is presented in Section 4 Application User Manual 214 MedRed LLC and BT America 7 Technical Card Products MS SQL Server Reporting Services SSRS B 10 CalDav Server Health eTime integrates a full CalDav server to provide full access to schedules and calendars to authorized third party applications For example the CalDav server allows the synchronization of a CalDav compliant server with a smart phone calendaring application or a calendaring client such as Outlook or Firebird Technical Card Products Bedework B 11 MDWS Health eTime uses MDWS as a conduit to the data owned by VistA instances For example the Service Layer obtains Patient data Provider information and Appointment Category Types through the MDWS interfaces In some instances the MDWS functionality had to be patched or enhanced It is depicted on the architect diagram as MDWS In all instances changes to MDWS strictly follow the coding standards established by the VA Technical Card Source Code C Frameworks Net B 12 Health eTime Data Load Scripts The Scheduling Contest Health eTime submission includes a set of data load routines implemented in python that trigger the loading of v
17. e Fill note box in light grey to match legend e Italicize and bold the font Display as shown in Figure D5 Req 1 22 Create a table title the table Provider Utilization and Case Load Include the following columns for this table 229 MedRed LLC and BT America AN e Provider Show the provider name if the provider is included in the Provider Availability table Provider name should only be shown 1 time per day Date Show the date one time for each provider Utilization Rate Calculated field using the number of hours the provider is booked with appointments which were not cancelled or rescheduled divided by 7 5 hours This is not 8 hours since thirty minutes was removed for lunch hour Show this as a percent field Provider Availability T 22013 5 00 AM re miis _afa2033 23 00AM otis 1 00 PM ris aa20na oe isn ris aa20na 2 00 PM 11 00 AM 1 00 PM 2 3 2013 3 00 PM Note Blocks holiday s and holds are currently not shown in the above table Figure D5 230 Se Req 1 23 MedRed LLC and BT America Provider Utilization and Case Load 2 1 2013 a or ts 2 2 2013 87 Pr Thorns yoa 0 Pr Hills 2 3 2023 87 Provider Utilization Rate is the number of appointments the provider has per day divided by the total number of appointment slots the der has alloted for their scheduling pe Figure D6 Create a graph for the Provider Utilization and Case Load table and title the graph Prov
18. 25 Jun 2013 11 00 02 Jul 2013 11 00 12 00 EEE v 107 MedRed LLC and BT America q A Select Book Slot after you have chosen your Appointment Date and Time Here if your patient had another appointment on that day which is dependent on this appointment you could choose the Link the appointment If not select Confirm and Book Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years RESCHEDULE APPOINTMENT Appointment to reschedule 25 Jun 2013 10 00 60 minutes PRIMARY CARE REGULAR George Clark Step 3 of 4 Book Appointment CA VA OUTPATIENT CLINIC PRIMARY CARE George Clark GEORGE CLARK 02 Jul 2013 13 00 Link Appointment Not linked iy Notes Confirm and Book 108 MedRed LLC and BT America VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT AppoINTMENTS RESCHEDULE Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years RESCHEDULE APPOINTMENT A pre appointment queue item has been added A cancellation Queue item has been added Appointment to reschedule 25 Jun 2013 10 00 60 minutes PRIMARY CARE REGULAR George Clark Step 4 of 4 Communicate booking Appointment Time 02 Jul 2013 13 00 Length 60 minutes Appointment Type REGULAR Status Scheduled Provider George Clark View Patient Appointments View Provider Roster Hugh
19. Equipment and Appointment Types selected will display Existing Appointments display for that patient Select the Appointment Date and Time and choose Select Slot 104 MedRed LLC and BT America 7 VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT APPOINTMENTS ADD APPOINTMENT Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years ADD APPOINTMENT Step 2 of 4 Select Slot Facility CA VA OUTPATIENT CLINIC Clinic PRIMARY CARE Provider George Clark GEORGE CLARK Existing 02 Jul 2013 13 00 appointments 29 Aug 2013 13 00 12 Nov 2013 08 00 05 Dec 2013 08 00 05 Dec 2013 10 00 17 Dec 2013 09 00 Appointment date 17 Jun 2013 v Appointment Time 08 00 09 00 A 10 00 v 11 00 Y VETERANS AFFAIRS 29 SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT APPOINTMENTS ADD APPOINTMENT Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years ADD APPOINTMENT Step 3 of 4 Book Appointment CA VA OUTPATIENT CLINIC PRIMARY CARE George Clark GEORGE CLARK 17 Jun 2013 13 00 Service connected Link Appointment Not linked Notes Recurring Confirm and Book Here if your patient had another appointment on that day which is dependent on this appointment you could choose the Link the appointment You can also indicate if
20. ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE 55 MedRed LLC and BT America 7 Status Scheduled TelehealthLocation None Time 2013 05 28 15 00 00 Vistald 3130528 11 checkpoint 1 verified patinet s pending appointments Step 6 Display the patient no show unkept appointment history Step 7 Select the appointment slot Step 8 Reassign the patients appointment checkpoint 2 verified patient s reassigned appointment Step 9 Reschedule the associated appointments Step 10 Send the appointment notification checkpoint 3 verified new patient appointment notification letter 3 8 Use Case 8 Test Script Execution User Scheduler Goals Add Request to Waiting List and Schedule Patient from Waiting List Run_uc 8 bat Data added modify in the Scheduling Application database e Appointment Request used as the waiting list and transfer queue e Appointment Info especially appointment status e Notification Queue Data added modify
21. The current import mechanism uses MDWS for accessing the patient information and essentially any patient data can be displayed for verification and eligibility reasons Reference Appendix A 3 instructions for Use Case 3 Steps 3 and 4 registering and verifying patient information 135 MedRed LLC and BT America 7 lt References Section 3 Application User Manual Section X for instructions on searching selecting and displaying patient data 2 9 The system shall support user configuration preferences for data display and entry screens within security and standards constraints Our application UI is designed to enable secure entry and user control of displays from setting up scheduling for a site facility to scheduling data displays to reporting displays As explained in response to BN 1 4 1 our role based access via user identity and password then restricts what screens can be seen and what information can be changed by the user Reference Appendix A 1 instructions for Use Case 1 organizing a scheduling component Reference Appendix B Application Design and Architecture for explanation of UI and data structures Reference Section 4 Application User Manual for explanation of all UI functions 5 3 Evaluating BN 3 Manage Request VA Requirement Through the use of a calendar view the scheduler is able to view all providers services facilities and Veterans from a variety of calend
22. am going to reschedule one of Hugh s appointments Select Reschedule Appointment and the following displays 106 MedRed LLC and BT America Y VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help GONS PATIENT APPOINTMENTS RESCHEDULE Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years RESCHEDULE APPOINTMENT Appointment to reschedule 25 Jun 2013 10 00 60 minutes PRIMARY CARE REGULAR George Clark Step 1 of 4 Resources Preferred Time 02 Jul 2013 10 00 Days ahead to search Facility CA VA OUTPATIENT CLINIC Clinic PRIMARY CARE Provider George Clark GEORGE CLARK Room No room required Equipment No equipment required i lt x Eel cl x Ed Appointment Type REGULAR Search for slots eee From this page you can change any of the displayed appointment fields then select Search for slots All available time slots based on the resource scheduling policy display on the next page Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years RESCHEDULE APPOINTMENT Appointment to reschedule 25 Jun 2013 10 00 60 minutes PRIMARY CARE REGULAR Step 2 of 4 Select Slot CA VA OUTPATIENT CLINIC PRIMARY CARE George Clark GEORGE CLARK 12 Jun 2013 13 15 10 Jun 2013 12 00 29 Aug 2013 13 00 23 Jul 2013 09 00 12 Nov 2013 08 00 17 Dec 2013 09 00 05 Dec 2013 08 00 05 Dec 2013 10 00 25 Jun 2013 10 00
23. backup_uc2 bak etc Please note that there are a total of eight backup bak files 2 The VistA environment is reset to the initial state required for each test script by restoring a baseline copy of the Cache dat file These files are also found in the script directory for each of the VMs The file names indicate both the VistA instance and the use case to which they apply For example the Cache dat file named ca cache uc1 dat contains the VistA data for the California VistA instance use case 1 There are eight VistA Cache dat files corresponding to the eight use cases for each of the three VMs bringing the total number of cache dat files to 24 Test Scripts The following sub sections provide a high level description of individual test script execution In order to allow the VA to clearly understand our integration strategy we have also provided the following for each use case e A list of data items impacted along with an indication of whether such items are housed within the Health eTime or VistA application e Sample log runs for the scripts Note actual logs will vary slightly e Notes explaining decisions made during prototype application design and development Data modified in VistA as a result of its interactions with the Health eTime scheduling application can be accessed through VistA s Roll amp Scroll scheduling application and or through CPRS and checked for consistency Data modified in the Scheduling
24. especially appointment status e Appointment Request used to reschedule the appointment after cancellation e Notification Queue Data added modify in VistA e Corresponding clinic provider appointment status Notes e When the status of an appointment is changed within the scheduling application that status change is reflected in the corresponding appointment in VistA Sample Log initializing vista and sql db plesae wait setp 2 select an appointment to cancel Step 3 Appointment Cancellation Appointment Id 64 has been cancelled Step 4 Reason for Cancellation CancellationReason Id 27 Name APPOINTMENT NO LONGER REQUIRED Vistald 10 VistaSiteld 557 Who CLINIC checkpoint 1 verified appointment is cancelled with reason Step 5 Review the associated appointments 37 MedRed LLC and BT America 7 Step 6 Cancel Associated Appointment Associated Appointment Id 66 has been cancelled checkpoint 2 verified cancellation of associated appointment Step 7 High Priority Step 8 Add Patient to Rescheduling List Step 9 Cancellation Reschedule notification checkpoint 3 verified cancellation reschedule notification Step 10 Cancel Ind Group Appt for Patient ID 16 checkpoint 4 Individual Group Appointment Id 69 has been cancelled Step 11 Cancel Group Appt checkpoint 5 Group Appointment Id 68 has been cancelled 3 7 Use Case 7 Test Script Execution User Schedule
25. realignments and adding new modules The error messages and alerts will be reconfigured appropriately Reference Appendix B Application Design and Architecture for understanding of process flow and modular design 1 2 Accuracy 1 2 1 The Scheduling Solution shall display appointment time with appropriate time zones We use UTC times as the base time for all appointments and this then displayed at the local of VistA instances This enables integrated scheduling across VistA facilities Reference Appendix A Manual Execution of Use Cases for validation for time display across the appointment process 1 3 Interoperability 1 3 1 The Scheduling Solution shall support content transportation standards and implementation specifications set forth in 45 CFR 170 205 Our application is designed to be fully compliant with 40 CFR 170 205 Content exchange standards and implementation specifications for exchanging electronic health information MedRed LLC has fielded a HIPAA compliant VistA integrated system TBI Toolbox in the past and brings to Health eTime this understanding of transportation standards In an actual VistA deployment we will include transport encryption capability that we have deployed in the TBI 168 MedRed LLC and BT America Toolbox 1 3 2 The Scheduling Solution shall be capable of navigating seamlessly among related modules throughout the end to end scheduling process
26. system state Our application is operated by a web based User Interface that can be easily tailored to user display preferences All the functionality is accessed through dropdown menus that are based on stated titles and a simple functional hierarchy Specific tasks are executed in pop up blocks with clearly labeled fields for data entry Different calendar displays are used to support the scheduling process Usability is further supported by the development of a User Manual Reference Section 4 Application User Manual for an understanding of the usability of the application 2 1 2 The Scheduling Solution shall be usable across multiple operating systems browsers Designed as an enterprise system our application can operate across all VistA instances platforms The UI 169 MedRed LLC and BT America and platforms yd aa can be operated under standard browsers Internet Explorer Chrome FireFox but currently we recommend using Internet Explorer 9 0 Reference Appendix B Application Design and Architecture for understanding of architecture Reference Appendix C Application Refinement amp Enterprise Deployment for understanding of application s potential 7 3 Evaluating Maintainability VA Requirements Instructions and Validating Outcomes 3 1 Analyzability 3 1 1 The Scheduling Solution shall be capable of providing transaction logs error logs a
27. total Req 4 13 Create a graph for the Cancelled Appointment category Show all three of the Cancelled Appointment categories Reg 4 14 For the Cancelled Appointment Graph ensure all data labels are displayed like Figure D16 below 240 MedRed LLC and BT America j Cancelled Appointments 140 D O E Number of Cancelled 8 Appointments g 1 m Count of Unique Patients Who 6 Cancelled an Appointment E of Cancelled Appointments 4 2 oe Jan 13 Feb 13 Mar 13 of Cancelled Appointments is calculated by the total number of cancelled appointments total number of appointments created in report time period Figure D16 Reg 4 15 Create a Legend that displays as in Figure 3 1 e Outline legend e Ensure colors are consistent with report o Red Blue Green o Fill legend in light grey o Ensure font is easy to read and matches style of report Req 4 16 Create a note box under the Cancelled Appointment Graph e Outline note box e Fill note box in light grey to match legend e Italicize and bold the font e Display as shown in Figure D16 Req 4 17 Display data by month for time period selected for from and to date entered instead of by total Req 4 18 Display data by month for time period selected for from and to date instead of by total Reg 4 19 Ensure created report includes report parameters at the top of the report once report is run and looks as close to the report mock up as possible Req 4 20
28. 1 13 Patient Checked in Y N Record a Y if Patient has already checked in registered for appointment that day and N if the Patient has not checked in Req 1 14 Completed Appointment Y N Record a Y in the Patient has checked out and completed that appointment and N if the appointment is not completed Reg 1 15 Cancelled Appointment Y N Record a Y if the Patient has cancelled this appointment and a N if the appointment was not cancelled 227 MedRed LLC and BT America j om Reg 1 16 Create a table to summarize completed appointments Title Completed Appointments by Clinic Summarize the amount of completed appointments by Clinic Completed Appointments by Clinic PTRP a Figure D1 Req 1 17 Create a corresponding pie chart graph which graphs clinic by completed appointments Title the graph Completed Appointments by Clinic Completed Appointments by Clinic Figure D2 e Show graph as apie chart e Show data labels e Show legend with provider name which indicates what line they are on the graph Ensure each provider line is a different color in legend and in graph o Outline legend Ensure colors are consistent with report Fill legend in light grey Ensure font is easy to read and matches style of report see Figure D2 Reg 1 18 Create a table to summarize cancelled appointments Title Cancelled Appointments by Clinic Summarize the amount of cancelled appointments by Clinic Cancelled Appointmen
29. 11 6 Create a table under the Patient Work List Detail table and title it Consults Not Originating from VA Display the following columns e Consult Appointment Requests Display the Appointment Request type when it is equal to Consult only e Referral Source Show referral source for the consult exclude those have a referral source VA e Count of Requests Calculated field The total number of counts shown in the Patient Work List Detail table e Percentage of Requests Number of consults for each referral source divided by the total number of consults displayed as a percentage Display a Total column at the bottom of the table and total the count of requests and percentage of requests Percentage of requests should equal 100 Consults Not Originating from VA Brook AMC 1 Walter Reed NNMC 6 Note Consults which are marked with a referral source of VA are not included in Summary Figure D35 Req 11 7 Display the table as shown in Figure D35 Req 11 8 Include a Note at the bottom of the Consults Not Originating from VA table which says Note Consults which are marked with a referral source of VA are not included in Summary e Bold and place in Italics e Create a border around note e Fill in light grey e Display as shown in Figure D36 265 MedRed LLC and BT America ooo A Req 11 9 Display a pie chart next to the Consults Not Originating from VA table Display the data labels within the pie chart Only chart the r
30. 13 IsVeteran True MilitaryStatus Veteran NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring KeyValueOfstringstring Key 557 Value 6 Ip PatientType SC VETERAN Person Person Address Address City None Id 42 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1962 11 01 00 00 00 Email None Ethnicity None FirstName JUANA Id 409 LastName GREER MaritalStatus None MiddleName None Phone 3105552233 SSN 300000000 Sex Male Preferences None PreferencesOther None Religion None SCPercent 25 ServiceConnected True SpecialNeeds None SpecialNeedsOther None Step 3 Walkin Appt Step 4 Display and view provider schedule Appointment Activity ArrayOfAppointmentActivity AppointmentActivity AppointmentActivity ActivityReason None ActivityType Walkin Id 98 Time 2013 06 06 23 45 25 1 25 MedRed LLC and BT America AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None Caldavid None Chil
31. 2 ay CAVA CAVA 23 OUTPATIENT to ae era CVAOPC OUTPATIENT ECKERD SACRAMENTO CA Select CLINIC CLINIC AVENUE 916 555 0800 CVARMC BRADFORD SACRAMENTO Select XXXX 1600 pen Rooms List Equipment List Use Case 1 Step 6 Create a section clinic section within each MTF Walkthrough 1 Select VistA in the upper left 2 Select Facilities 3 For either the Outpatient or the Regional Medical Center click on the Select link right column gt This action opens the Facility Profile Information page 4 To view the Clinics for the selected Facility click on the link for View Clinics 175 MedRed LLC and BT America A 5 To add a Clinic click on the Add Clinic link and populate the Primary Care Section Profile gt The CA VA Outpatient Clinic profile below has been populated with the information provided in Table 8 Primary Care Section Profile California Outpatient Clinic in the VA Scheduling Contest Use Cases information gt The DSS Primary Stop Code information has been pre populated from VistA and may therefore vary slightly from the provided codes zA VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log out ScHEDULING PoRTAL VistA Site CA VA HEALTH CARE SYSTEM UTC 08 00 Pacific Time US amp Canada VistA Appointments Administration About Help Home Facumes Cums Eom Faciuty CA VA OUTPATIENT CLINIC BLockTest Clinic Name Primary Care Hours 0800 1500 DSS Primary r
32. 3 4 5 6 7 Reference Appendix B Application Design and Architecture Section B 4 for explanation of the data model 3 7 6 The system shall check availability and status of all resources including telecommunications system availability for a clinical video telehealth session Our application can define resource types which then have a scheduled and can then be used in the making of appointments Reference Appendix A 3 instructions for Use Case 3 Step 5D reserving resources for specific patient appointment Use Case 3 further demonstrates that telehealth resources are checked as a specific process in the application Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling for telehealth 142 3 8 Appointment Requests The system shall have the capability to manage appointment requests MedRed LLC and BT America 7 T Reference response for 3 8 1 to 3 8 3 below to validate that our application has the capability to manage appointment requests 3 8 1 The system shall have the ability to place Veterans on an appointment list which is accessible throughout the scheduling process Because our application is an enterprise solution as explained in the Application Design and Architecture veteran appointments are accessible throughout all locations Further Use Case 3 demonstrates that the application places appointment requests in a list structure that is satisfied in the sche
33. 7 2 Operational reports are generated by a facility VISN station or clinic to facilitate day to day operations These can range from printing daily appointment lists for a clinic to printing a listing of patients who missed appointments or who left without being seen Operational reports are also generated to track performance metrics access to care metrics utilization of staff workload measurement workload leveling and workload planning Operational data is contained in the centralized database to support all manner of reporting Sample report formats that show operational activities are presented in Appendix D New report formats can be easily developed in a similar manner Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 6 Capacity Workload and Utilization Report for examples of reports that show operational information 7 2 1 The system shall have the capability to generate and display a work list based on unfulfilled appointments at the operational level to capture the source of a request type of request and status of a request along a timeline Work list queue is automatically updated based on tasks that need to be completed by the scheduler Unfilled appointments at the operational level are tracked and constantly updated in our application database Work list reporting based on this data is done through the reporti
34. 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR Patientinstructions None I CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service 36 MedRed LLC and BT America A Id 26 Name MEDICINE Status Closed TelehealthLocation None Time 2013 05 21 19 00 00 Vistald 3130521 14 3 6 Use Case 6 Test Script Execution User Scheduler Goals Cancel Individual Appointment Run_uc 6 bat Data added modify in the Scheduling Application database e Appointment Info
35. Cancellation Reason Show the cancellation reason stored if the appointment was cancelled display as text Appointment Start Time convert military time to Hour Minute AM or PM Appointment End Time convert military time to Hour Minute AM or PM This is a calculated field based on the appointment start time and length of appointment Appointment Duration in minutes Length of appointment display as a number Clinic Format as text Name of the clinic the appointment is with Facility Format as text Name of the facility for the clinic the appointment is with Site Format as text Name of the site the appointment is with VISN Format as text Name of the VISN the site is located in Room Format as Text This could be a combination of letters and numbers this is the room number the patient s appointment will take place in Equipment Display as text this is the name of the piece of equipment if any will be used during appointment If there is no equipment allocated populate as None Provider Provider First Name Provider Last name Name of the clinician the appointment is with Provider Role Format as text this is the role of the clinician i e Physician Occupational Therapist Physiatrist etc Appointment Request Type Format as text and only show all 267 MedRed LLC and BT America 7 Req 12 4 If any fields in the table yield a null update to N A D 10 Congressional Performance Reports This reporting suite fulfil
36. Case 2 documentation repeat items 1 8 but after selecting Add Appointment Type item 7 enter the following information gt Appointment Type 1 Type Name C amp P Category Compensation amp Pension Duration 30 minutes DSS Credit Code 450 DSS Primary Stop Code 323 numbers populated from VistA gt Appointment Type 2 Type Name Regular Category Regular Duration 15 minutes DSS Credit Code 450 DSS Primary Stop Code 323 numbers populated from VistA gt Appointment Type 1 and 2 have been added as entered 181 MedRed LLC and BT America A lt gt 11 Repeat these steps for the Georgia and Alabama sites by changing the sites in the upper right of the page Use Case 2 Step 2 Configure resources for a section i e providers rooms equipment Walkthrough Rooms 1 2 3 4 Select VistA gt Facilities from the menu bar Click Rooms List to display the current list of rooms Click Add Room to display the Room Details page gt Type Name Conference Room A Floot East Hall 7 Click Add gt Conference Room A is now listed in the Room Listing Equipment 1 4 Select VistA gt Facilities link from the toolbar in the upper left to view all Facilities for a Site Click Equipment List to view a current list of equipment Click Add Equipment to view the equipment details page gt Type Name Oximeter Type Fingertip Click Add gt Oximeter is listed in the Equipment List Provider 1
37. Click Add Click View Slots Click Add Slots 179 MedRed LLC and BT America A gt Length of slot 30 minutes Start time 13 00 End time 16 00 Appointment type 24 Click Add Slots gt A Monday work day scheduling policy has now been added This procedure can be repeated for additional workdays and modified to accommodate different time slot lengths Use Case 1 Step 10 Repeat steps 6 9 for Georgia and California These sites will have different Providers Walkthrough 1 Follow the procedure in the previous Step 9 Use Case 1 The Site can be changed in the upper right corner of the screen Use Case 1 Step 11 Deactivate a section and schedules Walkthrough 1 Select VistA gt Facilities gt VA Regional Medical Center 2 Click View Clinics 3 Click the Select link for the Primary Care Clinic 4 Click the De Activate button to deactivate a section clinic Use Case 1 Step 12 Re activate a section and schedules Walkthrough 1 Select VistA gt Facilities gt VA Regional Medical Center Click View Clinics Click the Select link for the Primary Care Clinic Click the Activate button AON A 2 USE CASE 2 Establish and Manage Section Schedules Use Case 2 Step 1 Create section appointment types that map to existing appointment type categories and appointment type duration Walkthrough 1 Select VistA in the upper left 2 Select Facilities 3 For the VA Regional Medical Center click on the Select link right column
38. Click View Patient List gt All patients with upcoming appointments for provider are listed with appointment dates and times UseCase 5 Step 5 Display and view patient check in status performed by the provider 1 See steps 3 5 of Use Case 4 UseCase 5 Step 6 Check out patient appointment 1 Select Appointments gt Patient Check In from the menu bar gt Jodi Manning is already selected current appointments are listed 199 MedRed LLC and BT America o A gt If desired patient is not selected click Select Patient on the upper right search for patient and select the patient 2 Click Check In and then Appointment kept for the selected appointment UseCase 5 Step 7 Display other scheduled appointments and convey them to the patient 3 Select the link Patient Appointments VETERANS AFFAIRS OY SCHEDULING PORTAL VistA Appointments Administration Home PATIENT APPOINTMENTS CHECK IN gt Page includes upcoming appointments 4 Select the appointment text and right click to Print the appointments if desired A 6 USE CASE 6 Cancel Individual Appointment UseCase 6 Step 2 Select the appointment to cancel 1 Select Appointments gt Patient Appointments from the menu bar gt Search patient page loads 2 Type Ferguson in the search box and click Search gt List of patients named Ferguson are listed 3 Click WADE FERGUSON gt The patient demographics stored in VistA displays 4 Click Select Patient
39. Clinic Pp Reminder Postcard v2i 2oi3 _ PINS pS Reminder Postcard 1 22 2013 PINS pS Reminder Postcard 1 23 2013 PINS Pp 2 Reminder Postcard 1 21 2013 PTRP Pp Appointment Cancellation 1 21 2013 PINS Figure D10 Req 2 6 Create table and title it Total Generated Letters by Clinic for Time Period which displays the following headers as columns Number of Letters Count and display the total number of letters by type and clinic which were generated Letter Notification Type Display the letter notification type i e Reminder Postcard Appointment Cancellation Lab Reminder Clinic Display the name of the clinic which the patient has had an appointment with which instigated the letter or notification to be generated 234 MedRed LLC and BT America Display like mock up shown in Figure D11 Total Generated Letters by Clinic for Time Period p24 Reminder Postcard PINS 2 Reminder Postcard PTRP Pf Appointment Cancellation NS Figure D11 Req 2 7 Create a graph for the Total Generated Letters by Clinic for Time Period table and title the graph Generated Letters by Clinic e Graph Number of Letters by Letter Type for the Clinic Type e Show graph as a bar graph e Show data labels e Show legend with clinic name which indicates what bar they are on the graph Ensure each Clinic bar is a different color in legend and in graph e Outline legend e Ensure colors are consistent with report e Fill legend in light grey E
40. Clinics e Facilities Allow user to select one or more Facilities e Site Allow user to select one or more sites e VISN Allow user to one or more VISN Reg 9 2 For the From and To date use the most updated appointment date This can be either the date the appointment was initially scheduled or the rescheduled appointment date Req 9 3 Create a table and title it Patient Work List Detail include the following columns allow each of these columns to be able to be filtered by the user e Patient name Last Name First Name Middle Name e SSN last four digits Format as text e Appointment Date MM DD YYYY e Appointment Start Time Hour minute AM or PM e Appointment End Time Hour Minute AM or PM e Appointment Duration in minutes Minutes e Clinic Format as text e Facility Format as text e Site Format as text e VISN Format as text e Room Format as number e Equipment Format as text e Provider Provider First Name Provider Last Name e Provider Role Format as text MedRed LLC and BT America 7 lt e Most Updated Activity Type Format as text e Cancellation Reason Format as text Req 9 4 Include a note box at the bottom of the Patient Work List Detail table Have the note table read e Outline Box e Fill box solid in light grey e Bold and place in Italics Note Appointment date is the current date for the appointment this can be the original scheduled date or the rescheduled date The provider
41. Credit Code 442 Click Update gt Return to Appointment type table 191 MedRed LLC and BT America Z SS gt ID4shows Name New Research Patient and DSS Credit Code 442 9 By clicking Select next to an appointment type the user has the option to update the information or delete the appointment type gt Appointment Type can only be deleted if it s not in use Use Case 2 Step 18 Configure schedules for overbooking and assignment of overbooking privileges to users Walkthrough 1 Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for a provider Joseph Kirk to display resource details Click Edit Check AllowOverbooking and click Update gt This will return the user to the Resource details page with AllowOverbooking checked 9 Select Administration top blue toolbar gt Role Actions gt This page allows the Administrator to define Roles by Actions 10 In the Role drop down in the upper left select Scheduler 11 Select Role Action Overbook Appointments at the bottom of the list and click Save top right gt Scheduler now lists Overbook Appointments ONOarwWhND Use Case 2 Step 19 Assign a provider to multiple sections Prerequisites Each facility must include at least 2 clinics
42. Ensure report can be exported to Excel and displays in the same manner as presented in reporting tool without any additional user manipulation 241 MedRed LLC and BT America 7 Report 5 Patient Appointment Operational Details Report Title Patient Appointment Operational Details Report Purpose The purpose of this report is to show appointment related details for a patient within a user specified time period clinic site and facility This can be used by schedulers or anyone interested in an identified operational report with appointment detail for patients Req 5 1 Enable the user to enter in the following parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to single or select multiples e Site Allow user to single or select multiples e Facility Allow user to single or select multiples Req 5 2 For the From and To date use the appointment table where the date is the most updated appointment This can be either the scheduled appointment date or the rescheduled appointment date if populated Req 5 3 Only bring back data within from and to date clinic site and facility chosen by the user under the report parameters Req 5 4 Create a table which displays the following headers are columns e Patient name Last Name First Name Middle Name e SSN last four digits e Clinic e Provider e Appointment Created Date e Appointment Desired Date e Initial S
43. List of patients upcoming appointments display 202 MedRed LLC and BT America A lt gt Patients no show history for past 2 years is displayed in the upper left of the screen gt Individual appointments can found by selected the Status dropdown in the upper right as Scheduled and populating the From date UseCase 7 Step 2 Identify the appointment to reschedule Step 3 Review the associated appointments 1 Follow the walkthrough items 1 5 above in Step 1 of Use Case 6 to view patient s upcoming appointments gt All linked appointments appear in the columns to the right of a particular appointment gt The Status and From fields in the upper right can be used to filter appointments Patient ALICIA BANKS 500000003 Has had 0 no shows in the past 2 years Add Appointment Add Appointment Request p View Appointments Requests View App CURRENT APPOINTMENTS UseCase 7 Step 4 Search for available appointment slot 1 Follow the walkthrough items 1 5 above in Step 1 of Use Case 6 to view patient s upcoming appointments 2 Click Reschedule Appointment for a particular appointment Change appointment date as needed Set the days to search to the timeframe available 4 Select a reason for the rescheduling then click Search for slots gt First available slots display o UseCase 7 Step 7 Select the appointment slot 1 Follow the walkthrough items 1 5 above in Step 1 of
44. Oct 1970 Male 200 00 0008 JENNIE LAMB 01 Dec 1967 Female 200 00 0005 JODI MANNING 01 Aug 1969 Female 200 00 0007 FRANCIS MITCHELL 01 Oct 1965 Male 200 00 0003 LULA PENA 07 May 1960 Female 200 00 0009 LONNIE QUINN 01 Oct 1963 Female 200 00 0001 ALICIA RICE 03 Oct 1966 Female 200 00 0004 HORACE RODGERS 01 Nov 1964 Male 200 00 0002 HUGH STEVENS 04 Oct 1968 Male 200 00 0006 RAMIRO THOMAS 01 Nov 1962 Male 200 00 0000 Select the patient by clicking on their name Verify their demographic information and select the Select Patient button The patients current information for appointments displays VistA Appointments Administration About Help Home PATIENT APPOINTMENTS Patient HUGH BENSON 500000004 Select Patient Has had 2 no shows in the past 2 years Add Appointment Add Appointment Request Add TeleHealth Appointment View Appointments Requests View Appointment History CURRENT APPOINTMENTS Status Scheduled From 12 Jun 2013 Appointment Previ Followi mee Acti ppointmen revious ollowing Heats ions Change Provider 25 Jun 2013 10 00 for 60 minutes View in Provider At PRIMARY CARE Roster Status Scheduled n Appointment Type REGULAR 25 Jun 2013 2 Kahad George Clai 11 00 Appointment Normal Priority Cancel Appointment Change Provider 25 Jun 2013 11 00 for 60 minutes At Mental Health Group Regular View in Provider Status Scheduled Appointment Type Mental Health Group 25 Jun
45. Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource Lory Petri Click Scheduling Policy List gt The next page displays all of the existing scheduling policies for this resource 8 Click Add Scheduling Policy gt Scheduling policy details displays gt Enter the following Select Day of the week Monday Type Start Effect Date 04 Dec 2013 End Effect Date 15 Jan 2014 Priority 1 9 Once added a red notification will appear above the Scheduling Policy table stating Scheduling Policy Saved Once saved select Schedule at the top of the screen under the main toolbar a a Ot 2 E x VETERANS AFFAIRS Build 2 0 0 0 Logged in as fester2 log out ScHEDULING PORTAL VistA Site AL VA HEALTH CARE SYSTEM UTC 06 00 Central Time US amp Canada VistA Appointments Administration About Home Facnmes Cuntcs Demus Resources Derans Ex Faciuty AL VA REGIONAL MEDICAL CENTER Internat Meoicine Current Resource Dr SMITH Scheduling Policy Scheduling policy saved Day of the week Tuesday X Start Effect Date 04 Dec 2013 End Effect Date 15 Jan 2014 Priority 1 X View Slots 10 Repeat the previous 2 items for the rest of the week as required Use Case 2 Step 5 Hold the 4 January 2014 date and set it to automatic release scheduling on 3 January 2014 Walkthrough 1 Select VistA gt Facil
46. REGIONAL MEDICAL CENTER step 9 a resource is added to GA VA REGIONAL MEDICAL CENTER and schedule is added for one provider checkpoint 1 amp 2 step 1 check facility 1 matching site id matching facility name matching street address 1 step 1 check division 1 matching site id matching division name step 2 check facility 2 matching site id matching facility name matching street address 1 step 2 check division 2 matching site id matching division name step 2 check facility 3 matching site id matching facility name matching street address 1 step 2 check division 3 matching site id matching division name step 3 check service section found SERVICE SECTION MEDICINE found SERVICE SECTION SURGICAL found SERVICE SECTION PSYCHIATRIC found SERVICE SECTION ANCILLARY step 4 check appointment type found Appointment Type REGULAR found Appointment Type COMPENSATION amp PENSION found Appointment Type EMPLOYEE step 5 check holidays found holiday NATIONAL VA ORGANIZATION DAY 20 JULY 2012 found holiday NATIONAL VA ORGANIZATION DAY 22 JULY 2013 found holiday NATIONAL VA ORGANIZATION DAY 21 JULY 2014 found holiday VALENTINES DAY 13 FEB 2012 found holiday VALENTINES DAY 14 FEB 2013 found holiday VALENTINES DAY 14 FEB 2014 step 6 check section step 7 check pre appointment communication template step 8 check pre appintment communication letter for a section step 11 step 11 deactivated a section
47. Save C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Rows ROLES App ROLE Role Name Save Actions Actions are set within the Scheduling system This page displays the current available actions These are primarily menu options but the system could be set up to support the management of any action For example the ability to overbook appointments is an action which can be assigned to roles such as a Senior Scheduler within an application 120 MedRed LLC and BT America A Y VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Actions USERS Actions are fixed within the system and cannot be edited Description Access to mena menu About About aspx Access to menu Actions Administration Users Actions aspx menu 2i Access to menu 4 menu Menu item Administration Administration Access to menu 3 menu Menu item Appointments Appointments Access to menu 40 menu Clinic Patient ClinicSchedule aspx Schedule Access to menu 9 menu Administration FacilityList aspx Facilities Access to menu 12 menu Group Patient GroupAppointmentsList aspx Appointments Access to menu Help Help aspx menu 7 From the Administration page select Actions Note due to size of page only a portion of this page is shown in the screen shot Role Actions The Role Actions page displays a mapping of roles actions av
48. Start Time e Appointment End Time e Appointment Duration in minutes e Clinic e Provider e Patient Checked In Y N e Completed Appointment Y N e Cancelled Appointment Y N The above fields in Req 4 are listed and defined in Req 5 through Req 15 Reg 1 5 Patient Name column Concatenate the patient name together with last name first then first name and lastly middle name in this format last name first name middle name Reg 1 6 SSN last four digits column Display only the last four digits of the patient s social security number in column two Column will need to be formatted to return as text in the event that the first digit is a 0 Req 1 7 Appointment Date Most updated date of appointment This can be the date appointment was originally scheduled for however if appointment has been rescheduled place the rescheduled date here instead Req 1 8 Appointment Start Time Most updated begin time for the most update date of appointment Date of the appointment can be the date the appointment was originally scheduled for however if appointment has been rescheduled place the rescheduled date here instead Req 1 9 Appointment End Time Appointment Start Time found in Req 8 appointment duration time Reg 1 10 Appointment Duration in minutes Time in minutes that appointment will last for Req 1 11 Clinic Name of the clinic which appointment is located in Req 1 12 Provider Name of the provider patient has appointment with Reg
49. Use Case 6 to view patient s upcoming appointments 2 Click Reschedule Appointment for a particular appointment 3 Change appointment date as needed Set the days to search to the timeframe available 203 MedRed LLC and BT America 7 4 Select a reason for the rescheduling then click Search for slots 5 gt First available slots display Select the desired available slot and click Book Slot gt Book Appointment page opens UseCase 7 Step 8 Reassign the patient s appointment to the newly selected appointment and reserve the resources for the appointment 1 w Follow the walkthrough items 1 5 above in Step 1 of Use Case 6 to view patient s upcoming appointments Click Reschedule Appointment for a particular appointment Change appointment date as needed Set the days to search to the timeframe available Select a reason for the rescheduling then click Search for slots gt First available slots display Select the desired available slot and click Book Slot gt Book Appointment page opens Click Confirm and Book gt Resources are automatically updated UseCase 7 Step 9 Reschedule the associated appointments 1 Follow the walkthrough items 1 5 above in Step 1 of Use Case 6 to view patient s upcoming appointments Select Reschedule Appointment for the appointment linked to the appointment in Step 4 Change appointment date as needed Set the days to search to the timeframe available Select a reason for th
50. Vistald CommunicationTemplat E z aT Ta icationTemplate Recipient Facility_CommunicationTemplate_Rel Medium HiohiiiorkyReschedule 9 Facityid send Sectionid 8 CommunicationTemplateld f AppointmantTypatd N TelehealthLocation Subject Subject Message Body Recipient AppointmentId DateOffset AppointmentRequestId Medium Templateld AppointmentRequest Section_CommunicationTemplate_Rel KEG Addressid E Sectionta E Time Phone CommunicationTemplateld Ef DesiredDate Hours Creatinguserid StationNumber Patientia mj CausingAppointmentId _ ResuttingAppaintmentid RequestedSectionId RequestedResourceld RequestMethod Notes Status Priority Reason 221 MedRed LLC and BT America Z C Appendix C Our Recommendations Regarding Refinement and Enterprise Deployment Since many of the broad performance metrics presented in Step 2A Attachment C are relevant to an enterprise system in the production environment we wanted to provide this appendix to briefly outline our recommendations as to how in close consultation with end users Health eTime can be further developed into VA s 21 century enterprise wide scheduling solution The traceability matrix and supporting documentation in this volume are designed to communicate our approach to date in developing this open source application in response to the posted requirements As a rapid prototype however a major function of the Alpha version of the Health
51. Walkthrough 1 CA VistA site upper right 2 Select VistA gt Facilities from the menu bar 3 Click Select for the VA Regional Medical Center to view facility details 4 Click View Clinics gt Clinics for the VA Regional Medical Center are listed Click Select for the CA Dermatology Click Clinic Resource List to display resource table 7 Click Add Resource gt Add Resource page displays gt Type Name Jane Smith Service Type CA Dermatology Select Resource Type Provider Select Provider SMITH JANE ou 192 8 A 3 MedRed LLC and BT America 7 Sa Click Add gt Jane Smith has been added to the CA Dermatology clinic resource table USE CASE 3 Create a Patient Appointment UseCase3 Step 1 Receive an appointment request also demonstrate request through telephone e mail and internet form is available Walkthrough 1 Open browser using this link gt This action opens the Gmail sign in page Type schedulingcontest2593 gmail com for the sign in email and ch3dul1ng as the password Click Sign In gt Inbox is displayed Click email Appointment request gt Body of the email is need a follow up appointment with XXXX on July 3 would prefer afternoon if available Hugh Benson UseCase3 Step 2 Enter the desired future appointment date time Step 3 Enter register and select the patient to schedule Walkthrough 1 Click Appointments then Patient Appointments to open the patient search pag
52. a letter has been generated and sent Req 2 3 Only bring back data within from and to date clinic site and facility chosen by the user for the report Req 2 4 Create a table which displays the following headers as columns e Patient name Last Name First Name Middle Name e SSN last four digits Ensure that field is displayed in text in the event that the last four digits of the SSN are 0 s e Appointment Date Date the appointment was initially scheduled e Letter Notification Generated Display the date the letter or Notification was generated as MM DD YYYY e Letter Notification Type Show the letter or notification type that was generated e Clinic Name of clinic the appointment is scheduled for e Provider Name of provider the appointment is scheduled with Reg 2 5 Create table and title it Total Generated Letters By Date and Clinic which displays the following headers as columns e Number of Letters Count and display the total number of letters by type date and clinic which were generated e Letter Notification Type Display the letter notification type i e Reminder Postcard Appointment Cancellation Lab Reminder e Date Generated Display the date as MM DD YYYY that the letter or notification was generated e Clinic Display the name of the clinic which the patient has had an appointment with which instigated the letter or notification to be generated Display like mock up shown in Figure D10 Total Generated Letters By Date and
53. an appointment request for example if the date is unknown or there is no capacity at a particular clinic then an Appointment Request can be made In addition if Patient Appointments are cancelled due to a Block at a clinic then Appointment Requests will automatically be created which can then be later fulfilled Select Add Appointment Request from the patient appointments screen update all fields and select Add C VETERANS AFFAIRS 27 SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT APPOINTMENTS ADD REQUEST Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years App APPOINTMENT REQUEST Appointment Request Information 12 Jun 2013 22 32 CA VA OUTPATIENT CLINIC CA Family Practice Dr Johnson MICHAEL JOHNSON K k k J Unknown Service connected Notes 111 MedRed LLC and BT America A lt Group Appointments From the Appointments menu select Group Appointments Then select the This Week or Next Week button or if you know the group appointment availability you could enter a date to display the group appointments available The Group Appointments page is presented as a Calendar View A clinic and provider can also be selected to show the available group appointments that patient can be booked for These appointment slots are created when the Scheduling Policy for the resource includes sl
54. and time zones as all resources and patient schedules as anchored to UTC and accessible across all scheduling domains Workload data is captured in the individual resource schedules Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling a telehealth appointment Reference Section 4 Application User Manual Section 4 6 for explanation of telehealth appointments 7 2 The system shall have the ability to capture whether appointment is scheduled vs unscheduled to support travel reimbursement determination 3 Currently our application only treats walk in patients as unscheduled appoints Walk in appointments can be separated out for reimbursement determination If so desired we can designate other appointment types as unscheduled appointments or we can added a specific tracker with associated reimbursement rules for each appointment Reference Appendix A 5 Manage a Walk in Patient for explanation of such appointment are different than scheduled appointments 7 3 The system shall provide reports for consults obtained outside of VHA 5 Appointments made based on requests external to the VA are tracked as consults Ways to present this type of activity are explained in Appendix D and actual consult reports can be seen through the UI Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 8 Consults Summary and Overv
55. and in graph o Outline legend o Ensure colors are consistent with report o Fill legend in light grey o Ensure font is easy to read and matches style of report see Figure D9 below Clinic Utilization 90 80 v 70 g 60 5 o 50 E 40 E 30 x _ 22 19 10 i 0 0 2 1 2013 2 2 2013 2 3 2013 o _ a FFigure D9 Req 1 26 Ensure report displays like shown in Provider and Clinic Appointment and Utilization Mock Up Appointment and Clinic Dash Report 2 Notifications and Letters by Site and Facility Report Title Notifications and Letters by Site and Facility Report Purpose The purpose of this report is to show letters and notifications sent to a patient by date and type and to show summarizations of letters sent by Clinics by time periods clinic site and facility selected by the user This can be used by schedulers or anyone interested in a report to detail notifications and letters sent to patients as well as present overall summaries of letters sent by clinic by selected time period Reg 2 1 Enable the user to enter in the following parameters e From Date Allow user to select from a calendar e To Date Allow user to select from a calendar e Clinic Allow single and multiple selections e Site Allow single select e Facility Allow single select 233 MedRed LLC and BT America 7 u Req 2 2 For the From and To date use the letter notification table which shows if
56. be captured in reporting 9 3 11 The system shall have the capability to generate reports based on unfulfilled appointment request 5 Unfilled appointments among other metrics are tracked within each patients work lists and can be reported individually or at a summary level Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 9 Ad Hoc Operational Report for how reports can be tailored against specific operational metrics 9 4 1 The system shall have the capability to generate reports based on metrics and measures related to Workload management at the local Workload management is conducted at the clinic specific level and the stored data from management activities can be reported on using metrics traceable to the relational database Reference Section 4 Application User Manual Section 4 5 for 165 level 3 MedRed LLC and BT America 7 directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports for an example of how work load metrics can be presented 9 4 2 The system shall have the capability to generate reports based on metrics and measures related to patient information relevant to supporting the episode of care the continuity of care and missed opportunities of all patients 5 All activities associated with a patient are organized in
57. care step 5 create holds on provider in primary care 19 MedRed LLC and BT America checkpoint 3 there is a hold on the 4 jan 2014 there is a release of the on the 3 jan 2014 step 6 checkpoint 4 there is a hold on the 5 jan 2014 there is a release of the on the 5 jan 2014 step 7 creating a block on a provider in primary care checkpoint 5 there is a block for 9am 12pm on the 5 dec 2013 step 8 blocking a exiting scheduled patient appointment current appointment status Scheduled checkpoint 6 scheduled patient appintment is canceled due to a block appointment after block Cancelled step 9 creating communication queue for a canceled appointment checkpoint 7 there is a communcation queue due block on cancelation of appointment step 10 creating a group appointment current appointment status Scheduled current appointment status Scheduled checkpoint 8 there is a group appointment scheduled step 11 creating pre appointment patient instructions checkpoint 9 there is pre appointment patient instructions step 12 creating mutiple app types on the same day checkpoint 10 there is multple app types on the same day step 13 creating a block for multiple days with a reason checkpoint 11 there is a block for multiple days with a reason step 14 creating a block with reoccurring period checkpoint 12 there is a block with reoccurring period step 15 track appointment cancelation due to shcedules being blocked checkpoint 13 ther
58. co pay rules have been provide by VA 4 1 1 The scheduling system will display patient special needs and preferences when an appointment is requested and made Use Case 3 specifically demonstrates create display verify patient preferences and special needs as well as patient priorities to validate this capability Reference Appendix A 3 instructions for Use Case 3 Step 4 verifying patient information 4 1 2 The system should allow configuration to require approved authorizations prior to processing an appointment request 4 1 3 The system shall have the capability to create and manage various appointment types The verification process in Use Case 3 includes demographics insurance information and primary care provider designation If any of these parameters does not align with the appointment type requested the application could filter and deny authorization to appointment requests Reference Appendix A 3 instructions for Use Case 3 Step 4 verifying patient information Use Case 1 shows the establishment of appointment type categories and Use Case 2 shows the creation of appointment types across the Use Cases validate the capability create and manage appointment types Reference Appendix A 1 discussion for Use Case 1 Create standard 144 MedRed LLC and BT America 7 lt gt appointment type categories Reference Appendix A 2 instructions for Use Case 2 Step 1 Create sectio
59. function development The actual reports are based on data that is available through Health eTime and our designers and developers will work with the VA users to formulate the exact look and content of the reports during the development period after this contest D 1 Provider and Clinic Appointments Utilization Reports This reporting suite fulfills the following requirements B 9 1 System shall have the capability to generate reports containing scheduling data from both the solution application and legacy systems B 9 4 3 The system shall have the capability to generate reports based on metrics and measures related to appointments and clinics including availability and utilization case load cancellations check ins general random appointment information notifications and letters and audits by supervisors B 9 3 7 The system shall have the capability to generate reports based on metrics and measures related to Clinic Resources as defined by the business B 9 3 10 The system shall have the capability to generate reports based on Workload and Utilization Management metrics B 9 4 Allow ability to create Local Reports B 9 4 1 The system shall have the capability to generate reports based on metrics and measures related to Workload management at the local level B 9 3 4 The system shall have the capability to generate reports based on provider utilization and provider credentialing Note The providers licenses and credentials are not stored in t
60. gt List of patient s upcoming appointments displays 5 Click Cancel Appointment for a particular appointment gt Cancel Appointment page displays details for this appointment UseCase 6 Step 3 Cancel the individual appointment Step 4 Document the reason for the cancellation 1 Select Appointments gt Patient Appointments from the menu bar gt Search patient page loads 2 Type Ferguson in the search box and click Search gt List of patients named Ferguson are listed 3 Click WADE FERGUSON The patient demographics stored in VistA 5 Click Select Patient A 200 MedRed LLC and BT America 7 gt List of patient s upcoming appointments displays 6 Click Cancel Appointment for a particular appointment gt Cancel Appointment page displays details for this appointment 7 Select Cancelled by Cancelled by patient Reason Death in Family Reschedule Select Yes and click Cancel Appointment gt Confirm cancellation message displays 8 Click OK gt Cancellation message displays UseCase 6 Step 5 Review the associated appointments 1 Use the walkthrough in step 9 of Use Case 3 to create linked appointment 2 Follow the walkthrough for Step 2 of Use Case 6 to cancel ONE of the linked appointments 3 Click link to return to Patient appointments gt Remaining linked appointment still shows the relationship to the canceled appointment UseCase 6 Step 6 Cancel the associated appointments if appropriate 1 View Patient Appoin
61. he Facility of CA VA Outpatient Clinic View Report button on far right displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 6 10 2013 ee 6 z AL VA OUTPATIENT CLINIC AL mi Woah of2 b bi 100 z Sites AL VA HEALTH CARE SYSTEM C M Clinics fAudiology Mental Health Mental _____ Find net bby GB Capacity Workload and Utilization From Date To Date vISN Sites Facilities Clinics 6 10 2013 6 11 2013 6 AL VA HEALTH CARE SYSTEM CA VA HEALTH CARE SYSTEM GA VA HEALTH CARE SYSTEM AL VA OUTPATIENT CLINIC AL VA REGIONAL MEDICAL CENTER CA VA OUTPATIENT CLINIC CA VA REGIONAL MEDICAL CENTER GA VA OUTPATIENT CLINIC GA VA REGIONAL MEDICAL CENTER Audiology Mental Health Mental Health Mental Health Group Mental Health Group Regular Physical Therapy Regular Physical Therapy Regular PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE Patient Work List Detail BENSON HUGH 0006 6 10 2013 BURGESS BURGESS LONNIE 0001 6 10 2013 LONNIE 0o01 6 10 2013 2 00PM 3 00PM 60 PRIMARY CARE GAVAREGIONAL GAVA HEALTH 6 None None Lori Petri Provider CheckOut N A MEDICAL CENTER CARE SYSTEM 5 00PM 6 00 PM 60 Mental Health GAVA OUTPATIENT GAVA HEALTH 6 None None Joseph Kirk Provider Create N A CLINIC CARE SYSTEM 6 00PM 7 00 PM 60 PRIMARY C
62. holidays 1 3 2 The system shall allow flexible schedule options for urgent care and walk in appointments The scheduling application contains a menu item used specifically for walk in patients that takes the user to a screen used to record the request and appointment all at once Additionally other functionality supports the concept of urgent care For example appointment slots for resources have a particular limit on the number of patients allowed in the slot Nevertheless the application supports scenarios such as walk in appointments by overbooking the slot Note that the resource must be configured to allow overbooking Reference Appendix A 5 instructions for Use Case 5 Steps 1 to 5 flexibly scheduling walk in patients Reference Section 4 Application User Manual Section 4 6 for detailed instructions on how to record Walk in Appointments and how to configure a resource to accept overbooking 1 3 3 The system shall allow scheduling between facilities located in different time As our application is an enterprise solution not a local scheduler the application automatically makes time zone adjustments during communications and coordination across facilities 128 zones MedRed LLC and BT America 7 lt Data is stored in the Scheduling Application in UTC format Appointment start times are presented in the time of the clinic or provider for clarity and safety time zone suffixes ar
63. in the design of our reports Objective scheduling standards can be established based on such statistics and appropriate alerts can be established when the scheduling process moves beyond objective ranges Reference Appendix D 3 Summary by Activity Type with Patient Detail Reference Appendix D 6 Capacity Workload and Utilization Report 5 1 The system will when managing the appointment selection process shall have the capability to capture the desired date for the appointment 5 The verification of patient information along with collecting appointment preferences is a core functionality that is demonstrated in Use Case 3 Reference Section 4 Application User Manual Section 4 6 for explanation on capturing desired date in appointment requests Reference Appendix A 3 instructions for Use Case 3 Step 4 verifying patient information 5 2 The system shall allow for administrative closure of consults 1 Our application currently has a functional place holder for administrative actions We envision that specific VA schedule closure procedures will be added to this area in addition to removing either a patient or resource completely from the process Reference Section 4 Application User Manual Section 4 7 for discussion of administrative actions 5 3 The system shall have the ability to integrate unscheduled CPRS consults with the scheduling system 2 New patient records CPRS can be entered into V
64. int Roleld int ActionID int The following table contains examples of Roles and Actions This is for illustrative purposes only Additional analysis is required to define the actual roles and actions for any true production system The UI will reflect the particular roles actions and options available to an individual user based on their role Example Actions for Proof of Concept This is a limited set to demonstrate capability Administer Facilities VistA Menu Administer Clinic VistA Menu Administer Users Administration Menu Manage Appointments Appointments menu Patient Check in Part of appointments menu Override Slot Group Capacity Record Attendance Function within make appointment Part of appointments menu 217 MedRed LLC and BT America Example Roles Super User All User Administrator Administer Users Clinic Administrator Administer Clinic Administer Facilities Manage Appointments Scheduler Manage Appointments Clinic Receptionist Record Attendance Scheduler Manager Manage Appointments Override Slot Group Capacity Example roles Business Role System Access Description System Role VistA Site Administrator VistA Menu Can edit presented aspects of the VistA site with regard to facilities and clinics and schedules VistaSiteAdministr
65. of the software development process MedRed also performed comprehensive manual testing of the application prior to release A set of manual test scripts are included in Appendix A They provide application level detail for following the Step 1 Use Cases which have been validated by the automated scripts in Step 1 Appendix B Application Design and Architecture Overview To help evaluators better understand the Health eTime application we have also developed a brief Application Design and Architecture Overview document which is contained in Appendix B This overview document is referenced in Sections 5 6 and 7 Appendix C Our Recommendations Regarding Refinement and Enterprise Deployment Appendix C also contains information outlining how the Health eTime application can progress from a prototype to a class 1 enterprise solution in production and be effectively integrated at multiple VistA sites Appendix D Report Specifications Because a number of broad reporting requirements are listed in Attachments A and B we decided as part of our application development process to create detailed specification documents for all listed reports These reporting specification documents have been included in Appendix D of our submission package and a number have been operationalized in the prototype application Many assumptions were made in producing these specifications which may not precisely align with VA user preferences Going forward we would wel
66. pre appointment communication template created in step 7 Walkthrough Continued from previous step 1 Select VistA on the upper left of the Home page 2 Select Facilities 3 Click onthe Select link next to a particular Facility e g VA Regional Medical Center gt The Facility Details will be displayed 4 Select Template List at the bottom of the page gt The Template List includes all of the possible template types for a facility Next select Add Communication Template Click Select for the Pre appointment template gt This will prompt the Upload Communications page 7 Click extract template to prompt the Save As window Choose an appropriate location to save the file locally 8 Open the saved file with Notepad and edit the text as needed Replace Section Name here with Primary Care and Save as PreAppointmentPC txt 9 Click Select for Primary Care clinic to display the Clinic details 10 Select Template List at the bottom of the page 11 Click Communications Templates List 12 Click Add Communication Template to upload Communication Template page displays 13 Once the Template information has been entered see sample below click Upload to add the new template to the list of Clinic templates gt Sample Type Name PC Pre appointment Subject Before your visit Click Choose File and browse to the location of the file saved in step 7 Select Pre Appointment Medium Mail Recipient Patient 14 Click Upload Oo Use Case 1 Step 9 C
67. process VA Requirements 7 1 General Reporting Needs Instructions and Validating Outcomes Our application generates reports from the databases described in Section 4 Application User Manual The formats for these reports are developed through an assessment of VA requirements as presented in Appendix D Reporting Requirements Based on these formats which can be easily modified through user collaboration we then used the SQL Server Reporting Service SSRS functionality to generate the reports This functionality is accessed through the UI under the VistA Menu 7 1 1 Ad Hoc Reports The system shall have the capability to support user created ad hoc report generation without re programming and provide the capability to save the report definition for future use and to save the reports in various standard exportable formats Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function The Ad Hoc operational reporting formats will pull current data from the database These formats can be tailored to user needs Reference Appendix D 9 Ad Hoc Operational Report for explanation of how to Ad Hoc reports can be organized 7 1 2 The system shall have the capability to report on scheduling measures and metrics across the VHA at many levels including but not limited to National VISN Facility Station Clinic Commu nity Based Outpatient Clinic CBOC and sh
68. report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 4 Work List Summary Queue and Patient Detail 5 Work List Summary Queue and Patient Detail To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 26 2013 e Select Sites Any can be used e Select Facilities Any can be used e Select Clinics Any can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 89 MedRed LLC and BT America j Home gt Reporting gt Work List Summary Queue and Patient Detail From 6 9 2013 12 39 06 AM a To 6 26 2013 5 Sites GA VA HEALTH CARE SYSTEM z Facilities GA VA OUTPATIENT CLINIC z Clinics Audiology Mental Health PRIMA M ah oft Db bi 100 c Find Next bby Go B Work List Summary Queue and Patient Detail Report Parameters GA VA HEALTH CARE SYSTEM GA VA OUTPATIENT CLINIC Audiology Mental Health PRIMARY CARE Appointments with Action Required Patient Hame last name SSH last four digits Source of Request
69. slots until 15 00 iv Add 7 slots 77 MedRed LLC and BT America A Enter the Start Time Length Group Appointment Capacity Appointment Type and Add slots until fields The button will display the number of time slots you are about to add Select the button to update those time slots for your resource for that day The Group Appointment Capacity refers to how many patients that provider room or piece of equipment can be seen or utilized for a specific appointment time Continue this process until all your resources have a scheduling policy entered for the days and times they are available for appointments 4 5 Reports VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Sites Facilities AFFAIRS SCHEDULING PORTAL HOME Reports Welcome to the Veterans Affairs Scheduling Portal Please use the menu to perform the scheduling tasks you require To access reports from the Scheduling Application select VistA from the menu and select Reports You will be prompted to enter in a user name and password Connecting to 166 78 237 8 User name Password Domain DEV1T520 Remember my credentials Enter User Name VAContest Enter Password Scheduling101 78 MedRed LLC and BT America 7 lt Once you have entered this you will be re directed to our reporting formats on the VA Virtual Machine These formats are developed through an assessment of VA requireme
70. that appointment If there is a rescheduled date use this date as the most updated date Reg 14 3 Create a table title table Completed Appointments and display the following columns e Clinic Name of Clinic format as text e Facility Name of Facility format as text e Site Name of Site format as text e VISN Name of VISN format as text e Total Number of Appointments Count of Total Appointments scheduled e Number of Completed Appointments Count of Completed Appointments only show appointments where the activitytype field is not equal to cancel or no show e Percentage of Completed Appointments Count of completed appointments when activity type is not equal to cancel or no show divided by the total amount of scheduled appointments Show as a percent Req 14 4 Create a row under the table and call it Total Number of Completed Appointments Bold the title and sum the column Number of Completed Appointments Bold and sum the column Total Number of Appointments Display as shown in Figure D38 Congressional Report Percentage of Completed Appointments Richmond Hunter Holmes Mcguire 54 Richmond Hunter Holmes Mcguire 5 Total Number of Completed Appointments 30 Performance Measure for Congress Increase the percent of appointments completed within 14 days Note Percentage of Completed Appointments is a calculated field which takes the total number of appointments marked as complete divided by the total number of app
71. that are tied to Data on DSS stop codes connected with appointment activities resides in our database and is presented through the reporting function Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 5 DSS Stop Code Detail for example of how 162 the scheduling appointment Examples of existing reports include but are not limited to the following e DSS Outpatient Encounter and Workload 3 MedRed LLC and BT America metrics can be presented 9 3 4 The system shall have the capability to generate reports based on provider utilization and provider credentialing 3 Data on provider utilizing as a part of scheduling resides in our database and is presented through the reporting function We however are not given a provider credentialing source through VistA to validate against appointment types credential requirements Credentials validation reports can be easily generated as a part of the product system Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports for example of how metrics can be presented 9 3 5 The system shall have the capability to generate performance reports Performance measures include access measures clinical measures and scheduling measures 5 Perfo
72. the user under the report parameters Req 7 4 Create a table title the table Appointments with Action Required Display the following headers as columns and allow each field to be filterable in report e Patient name Last Name First Name Middle Name e SSN last four digits Format as text e Source of Request Format as text e Desired Appointment Date e Type of Request e Status Req 7 5 Patient Name column Concatenate the patient name together with last name first then first name and lastly middle name in this format last name first name middle name Req 7 6 SSN last four digits column Display only the last four digits of the patient s social security number in column two Column will need to be formatted to return as text in the event that the first digit is a 0 Reg 7 7 Source of Request Name of role of person who made request i e provider patient etc Reg 7 8 Desired Appointment Date Date the patient or provider supplied for the desired appointment date Display in format MM DD YYYY Req 7 9 Type of Request Display as text This is the type of request that was made only return those that are marked as standard or transfer Req 7 10 Status Display as text Only return data back that is pending Req 7 11 For the Appointments with Action Required table only return data where there is no appointment date and no rescheduled date and type of request standard or transfer and status pending That would make the appointment r
73. the relational database to support metrics based reporting A variety of reports can be generated from patient information and we have merely provided some examples are a demonstration of capability Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Appendix D 3 Summary by Activity Type with Patient Detail for an example of how a specific activity type can be reported 9 4 3 The system shall have the capability to generate reports based on metrics and measures related to appointments and clinics including availability and utilization case load cancellations check ins general random appointment information notifications and letters and audits by supervisors 5 Currently clinic utilization data is integrated from appointments and specific resource assignment activities This information can be presented in a variety of formats and we have provided some formats as a demonstration of capability Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports 9 4 4 The system shall have the capability to generate QA reports to ensure the proper disposition of incomplete appointment information Examples of current reports that rely upon this data and must be maintained include but are not limited to the following e E
74. the supplied VMs using the account password combination Contestant a link to the test directory should be visible on the user desktop The name of this directory is Step 1 Test Scripts The directory structure for that folder should appear as Step 1 Test Scripts logs lt Output file for each run is stored here scripts lt Python scripts run_uc1 bat run_uc2 bat run_uc3 bat run_uc4 bat run_uc5 bat run_uc6 bat run_uc7 bat run_uc8 bat 15 MedRed LLC and BT America 7 T run_post_step1_db_reset bat Set baseline 9 which includes demo data The folders listed above contain all the files required to run the eight automated scripts developed for Step 1 evaluation A description of the scripts and their method of operation follows Design of the Tests Scripts The overall test suite is composed of eight test scripts that correspond to each use case UC1 UC2 Each test script is designed to be run on its own repeatedly as many times as desired In order to accommodate this required functionality at the end of its run each script will reset the Health eTime data framework in the following manner 1 The scheduling application database is reset from a backup or snapshot to the initial state required for that script to run Snapshots may be located in the script directory and are named backup_uc1 bak
75. the test system has been loaded to support execution of these scripts in VistA site CA VA Health Care System The user will find the active site location displayed in the upper right corner of the application just below the Username field 173 MedRed LLC and BT America o A VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log SCHEDULING PORTAL gut AL VA HEALTH CARE SYSTEM Appointments Administration About Help H CA VA HEALTH CARE SYSTEM OME GA VA HEALTH CARE SYSTEM VETERANS AFFAIRS SCHEDULING PorTAL HOME Welcome to the Veterans Affairs Scheduling Portal Please use the menu to perform the scheduling tasks you require A 1 USE CASE 1 Establish Organize and Manage the Scheduling Component User System Administrator A note about our application architecture and design choices Our analysis of VistA architecture led our application design team to the conclusion that for the purposes of the contest a number of key scheduling variables should be configured using the legacy VistA UI and not directly through our scheduling application We made this decision for two primary reasons the first is that these application settings once implemented are fairly stable and not subject to change by scheduling personnel on a regular basis The second is that these settings are so fundamental to so many VistA backend systems that we felt it would be unwise to try to integrate their management into the user int
76. to 1 4 5 below Our scheduling application fully satisfies the requirements for maintaining and modifying user access 1 4 1 The system shall provide role based security for access control and provide improved remote access for Veterans to make and view appointments over the internet email and other mobile devices Our application has remote access control capability with security driven by user identity and assigned roles i e sys admin master scheduler scheduler For further validation our scheduling application includes an Open Source module based on the Open Standard CalDav which allows any authorized and authenticated CalDav compliant device to synchronize appointment information that the user is authorized to access The integration approach of this CalDav compliant module is described in the Application Design Architecture document For remote access users need to follow instructions on how to synchronize a CalDav compliant device with the CalDav server Reference Section 4 Application User Manual Section 4 3 for instructions on user password log on Reference Appendix B Application Design and Architecture Section B 10 for discussion of CalDav module Reference Appendix A 3 instructions for Use Case 3 Step 3 Selection patient to schedule 1 4 2 The system shall have the ability to create configure and maintain role based user staff and veteran access and authorization Our application i
77. to a given state data content in each of these two locations must be restored so that it mirrors that found in the desired state Data is added to system by one of two methods either data is populated by means of the automated test scripts or it is imported or restored from a pre recorded copy or snapshots of the application framework 1 Baseline 0 In its ground state the application framework contains almost no data with the exception of a few data elements used in reference tables 12 MedRed LLC and BT America 7 2 Importing data via the 8 automated test scripts Run UC1 Result Baseline 1 Run UC2 Result Baseline 2 Run UC3 Result Baseline 3 Run UC8 Result Baseline 8 We provide snapshots of the application data framework as it exists after each of the above scripts have been run These restoration points allow particular steps to be re run on demand 3 Baseline 9 We enriched Baseline 8 by manually adding data to the application framework in order to facilitate reporting and demonstration Data entered to create Baseline 9 has relevance to the demonstration of Users amp Roles UI Menus Communication Templates as well as general reporting and system capabilities 2 6 Data Used for Testing and Demonstrations To support demonstration of Health eTime in Step 2 additional dummy data has been entered by our development team to show capabilities such as report generation This data will remain
78. to include as much of these capabilities into the 8 Use Case demonstrations for Step 1 testing as possible This was done prior to the VA release of new Use Cases for demonstrating Step 2A However we believe that such traceability will still help Attachment A evaluators to validate the capability for each metric If so desired the Attachment A evaluators can execute the eight Step 1 Use Cases either by the automated scripts described in Section 3 or by manual operations of the Ul based on instructions scripts provided in Attachment A Manual Scripts for the 8 Use Cases to see capabilities relevant to Attachment A In the Traceability Matrices below specific Use Case Steps that demonstrate and validate the capabilities associated with each requirement are presented along with a brief explanation of why the demonstration satisfies the requirement The explanation may further reference Appendix B Application Design and Architecture to help the evaluators understand what is actually occurring in the application when a particular step has been reached in Use Case execution For those capabilities that are beyond the Use Case demonstrations we have referred the evaluators to additional UI functions and provided instructions on how to execute those functions in Section 4 of the Application User Manual 5 1 Evaluating BN 1 Manage National Medical Scheduling Setup VA Requirement The scheduling system shall provide the capability to configure and mana
79. user with the proper privileges can add appointment types and set fields such as appointment type category duration and stop codes Reference Section 4 Application User Manual Section 4 6 for instructions on how to make an appointment Reference Appendix A 1 discussion for Use Case 1 creating and updating standard appointment types Reference Appendix A 2 instructions for Use Case 2 Step 1 setting section appointment types based on appoint type categories and Step 12 designating time ranges for multiple appointment types 1 3 7 The system shall have the capability to search for available appointments using specific parameters and to display results for multiple These steps include a single view approach for seeing available resources against time spots and appointment openings The scheduler can search through this view to make appointments and demonstrate capability 129 resources ina single view i MedRed LLC and BT America How to validate Follow pages X of the User Manual for detailed Reference Section 4 Application User Manual Section 4 6 for instructions on how to select multiple resources and view their corresponding calendar on a single screen Reference Appendix A 3 instructions for Use Case 3 Step 5 and 5D setting patient appointments 1 4 User Access The system shall provide the ability to maintain and modify user access Reference instructions 1 4 1
80. 00 290 425 380 357 189 402 513 ocd 400 534 188 198 379 299 487 488 289 489 288 401 and VistaSitelD 557 Reg 13 6 Have report look like the mock up report Congressional Performance Reports Mock Up tab 1 titled Count of Mental Health Appts Req 13 7 Include the following note at the bottom of the Patient Mental Health Appointment Detail table and display like in Figure D37 Req 13 8 Allow each column in the table to be filtered on aera en eee Figure D37 Report 14 Congressional Report Percentage of Completed Appointments Report Title Congressional Report Percentage of Completed Appointments Report Purpose The purpose of this report is to allow a user to create a report for any time period Clinics Sites Facilities and VISNS they choose to display a count and percentage of completed appointments for to supply to Congress Reg 14 1 Enable the user to enter in the following parameters e From Date Allow user to select from a calendar 269 MedRed LLC and BT America a e To Date Allow user to select from a calendar e Clinic Allow single and multiple selections e Site Allow single and multiple selections e Facility Allow single and multiple selections e VISN Allow single and multiple selections Req 14 2 For the From and To date base this on the most updated appointment date use the initial appointment date unless there is a rescheduled date for
81. 09 00 Period End 11 Jun 2013 17 00 Reason Vacation Click Add gt Recurrence configuration opens Select Weekly and enter the following gt Interval 1 gt Period End 31 Aug 2013 Click Add gt Recurring block is added to the provider s schedule Use Case 2 Step 15 Track and manage the patients that were cancelled due to schedules being blocked Prerequisite appointments scheduled for George Clark on Fridays July 5 Hugh Benson July 12 Alice Rice 2 appts Each date has a different patient scheduled Block is added for dates of appointments Walkthrough 1 2 Ensure you re on the CA VistA site Click Appointments in the top blue toolbar the select Waiting Lists gt This action will open the Waiting List page with default values Select the VA Regional Medical Center Clinic Primary Care gt Waiting list is automatically updated Click Add Appointment for one of the patients in the report gt Fulfill Appointment Request page opens Request Information is at the top Set the fields to match the request Click Search for slots gt List of available slots in the time frame requested are listed 190 MedRed LLC and BT America A Select a date and time Click Select slot to view the Book Appointment page Select Urgency Not urgent Link Appointment Not linked gt Communicate booking screen displays with appointment details gt Communication template is used to send a pre appointment message C
82. 1 Id 533 Length 30 Time PT19H Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory ld 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity 1 Id 534 Length 30 33 MedRed LLC and BT America Time PT20H30M StartEffectDate 2013 01 04 00 00 00 i Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 ld 17 Name C amp P PatientInstructions None Ib AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR PatientInstructions None i CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 St
83. 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 10 2013 e Select Sites Any can be used Below AL VA Health Care System was used to show a smaller subset of data e Select Facilities Any can be used Below AL VA Outpatient Clinic was used to show a smaller subset of data e Select Clinics Any can be used Below all Sites for the above Facility was used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 6 10 2013 AL VA HEALTH CARE SYSTEM AL VA OUTPATIENT CLINIC Mental Health Physical Therapy Regular PRIMARY CARE Modified BANKS ALICIA 0004 Mental Health JOSEPH JACKSON 671072013 Checkout GREER JUANA 0000 Physical Therapy Regular JOSEPH JACKSON 6102013 NoShow 88 MedRed LLC and BT America A Patient Detail Patient Name last name first name middle name lt SSN last four digits Clinic Initial Rescheduled Appointment Date Activity Type Completed Appointment Y N Appointment Date 6 10 2013 Modified BENSON HUGH 0006 Mental Heatth JOSEPH JACKSON 6 17 2013 N BANKS ALICI
84. 12 2013 06 13 2013 83 Clinic Availability Note Blocks holiday s and holds are currently not shown in the above table d MedRed LLC and BT America Clinic Utilization Based on Appointments Clinic Utilization Rate is the number of appointments the Clinic has per day divided by the total number of appointment slots ipe Enie Vescea oostevo KEANE uch cc policy ie ae es E Minute Increments Mental Health 6 11 2013 13 00 Mental Health 06 11 2013 0 00 6 11 2013 13 30 06 12 2013 0 00 6 11 2013 14 00 06 13 2013 0 00 6 11 2013 14 30 Physical Therapy Regular 06 11 2013 2 50 6 11 2013 15 00 06 12 2013 2 86 6 11 2013 15 30 06 13 2013 14 29 6 11 2013 16 00 PRIMARY CARE 06 11 2013 11 48 6 11 2013 16 30 06 12 2013 0 00 6 11 2013 17 00 06 13 2013 0 00 6 11 2013 17 30 6 11 2013 18 00 6 11 2013 18 30 6 11 2013 19 00 6 11 2013 19 30 6 12 2013 13 00 6 12 2013 14 00 6 12 2013 15 00 Clinic Utilization Mental Health Physical Therapy Regular PRIMARY CARE Percentage of Time Utilized 06 12 2013 06 11 2013 06 13 2013 Please Note Due to the size of this report only sections of it are included in the snapshot The larger the time period you select the longer the report Step 6 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page From 6 11 2013 EE To Site GA VA HEALTH CARE SYSTEM V Fa
85. 13 6 7 2013 6 10 2013 N N Y LULA FRANKLIN 0009 Mental Health Group JANE SMITH 6 7 2013 6 7 2013 6 10 2013 Y N N HUGH BENSON 0006 Mental Health JOSEPH JACKSON 6 10 2013 6 10 2013 6 17 2013 6 10 2013 Y N N JUANAGREER 0000 Physical Therapy Reqular JOSEPH JACKSON 6 10 2013 6 10 2013 6 10 2013 N N Y Note Due to length of report snapshot shown above does not include the full information you will see when you run the report Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report 87 MedRed LLC and BT America A Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 3 Summary by Activity Type with Patient Detail 4 Summary by Activity Type with Patient Detail To generate a report Step
86. 2 2013 2 00 PM Clinic Utilization Rate is the number of appointments the clinic has per day divided by the total number of appointment slots the Clinic Resources have 6 12 2013 4 00 PM allocated for their scheduling policy Clinic Utilization Audiology Mental Health Mental Health Group Mental Health Group Regular Physical Therapy Regular PRIMARY CARE Percentage of Time Utilized 06 10 2013 06 11 2013 06 12 2013 94 MedRed LLC and BT America A Equipment Availability Equipment Utilization Rate agen R Mental Health Cat Scan 06 10 2013 0 00 Mental Health Cat Scan 06 10 2013 2 00 PM Mental Health Cat Scan 06 11 2013 0 00 Mental Health Cat Scan 06 11 2013 3 00 PM Mental Health Cat Scan 06 12 2013 0 00 Mental Health Cat Scan 06 12 2013 4 00 PM Mental Health Exercise Bike 06 10 2013 0 00 Mental Health Exercise Bike 06 10 2013 5 00 PM Mental Health Exercise Bike 06 12 2013 0 00 Mental Health Exercise Bike 06 12 2013 6 00 PM Mental Health X Ray 06 11 2013 0 00 Mental Health X Ray 06 11 2013 7 00 PM Mental Health Group Regular X Ray 06 10 2013 0 00 Mental Health Group Regular X Ray 06 11 2013 0 00 Mental Health Group Regular X Ray 06 12 2013 0 00 PRIMARY CARE CAT SCAN 06 10 2013 0 00 PRIMARY CARE CAT SCAN 06 11 2013 0 00 PRIMARY CARE CAT SCAN 06 12 2013 0 00 PRIMARY CARE X Ray 06 10 2013 0 00 PRIMARY CARE X Ray 06 11 2013 0 00 PRIMARY CARE X Ray 06 12 2013 0 00 Eq
87. 2013 Regular 10 00 No Joseph Kirk Reschedule Normal Priority Appointment Required after c an 103 MedRed LLC and BT America j You can Add Appointment Add Appointment Request and Add Telehealth Appointment from this screen by selecting that button on the top of the screen In addition the patients current and historical appointments display this includes all appointments across any Health eTime instance This patient has scheduled appointments created Making an Appointment To Make an Appointment for a patient select the Add Appointment button from the Patient Appointment Screen and complete all fields listed Equipment Providers Rooms Equipment and Appointment Types already created will be the only ones which display as options for you Once complete select Search for Slots VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT Appointments ADD APPOINTMENT Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years ADD APPOINTMENT Step 1 of 4 Resources Preferred Time 12 Jun 2013 22 20 Days ahead to search 7 Facility CA VA OUTPATIENT CLINIC iv Clinic PRIMARY CARE iv Provider George Clark GEORGE CLARK ik Room No room required y Equipment No equipment required bd Appointment Type REGULARS Search for slots Slots available based on the scheduling policy for the Provider Rooms
88. 236 S MedRed LLC and BT America i a Total Audits By Type 3 5 3 25 2 1 p K o Edit Patient View Patient Add Patient to Site Figure D13 Req 3 7 Ensure report displays like shown in Provider and Clinic Appointment and Utilization Mock Up Audits by User tab D 2 Operational and Wait Time Summary with Patient Detail Reports This reporting suite fulfills the following requirements B 9 2 The system will collect currently used wait time metrics including create date and desired date scheduled appointment date and completed appointment date B 9 3 The system shall have the capability to generate wait time metrics and measures based on clinic operational metrics B 9 3 5 The system shall have the capability to generate performance reports Performance measures include access measures clinical measures and scheduling measures Report 4 Wait Time and Operational Metric Scorecard Report Title Wait Time and Operational Scorecard Report Purpose The purpose of this report is to supply wait time and operational metrics for a designated time period These metrics can then be analyzed to help in the reduction of patient wait times managing patient missed appointments and appointment volume redistribution Reg 4 1 Enable the user to enter the following parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a cale
89. 276 MedRed LLC and BT America 7 Collection lt Service gt GetServices AppointmentT ypeCategory AddAppointmentT ypeCategory AppointmentT ypeCategory appTypeCalt Collection lt AppointmentT ypeCategory gt GetAppointmentT ypeCategories Holiday AddHoliday Holiday holiday Collection lt Holiday gt GetHolidays PatientService Patient Management Collection lt Patient gt Get Patient Get int id Patient Add Patient patient Patient Update Patient patient bool Delete int id Collection lt Patient gt Search string siteld string searchParam Patient Get string siteld string dfn Patient Appointments Collection lt Appointment gt GetAppointments string siteld string dfn DateTime rangeStart DateTime rangeEnq Collection lt Appointment gt GetAppointments int patientld DateTime rangeStart DateTime rangeEnd bool MakeAppointment int patientld Collection lt Resource gt resources DateTime appointmentTime ProviderService Provider Management Collection lt Provider gt Get Provider Get int id Provider Add Provider provider Provider Update Provider provider bool Delete int id ResourceService Resource Management Collection lt Resource gt GetAll int sectionld Resource Get int id Resource Add Resource resource Resource Update Resource resource 277 MedRed LLC and BT America 7 lt gt bool Delete int id Collection lt Appointment gt GetAppointments i
90. 2B Open Source Compatibility Evaluators U4 Appendix A Manual Operating Instructions for the Eight Published Use Cases Scenarios and Traceability to Requirements for Step 2A for Step 2A Attachment B VA Attachment C Non Specific Functional Requirements Requirements Evaluators Evaluators ry Appendix B Health eTime Application Design and Architecture Appendix C Figure 1 2 Appendix D Reporting Function Design e Section 5 for Attachment A requirements e Section 6 for Attachment B requirements 7 Our Recommendations Regarding Refinement And Enterprise Deployment Appendix E Open Source and Software Licensing Documentation Integration of Documentation 1 2 3 Locating Materials for Step 2 Evaluation in this Document Section 4 of the User Manual provides instructions on how to operate the application Details regarding the alignment of Health eTime application capabilities as they relate to Step 2 requirements are provided in MedRed LLC and BT America 7 T e Section 7 for Attachment C requirements e Section 8 for Step 2B Open Source requirements These various sections highlighted in blue in Figure 1 2 are organized as correlation matrices in order to further describe how to validate capabilities against requirements This correlation was requested as part of the submission materials As part
91. 3 Create a table and title it Patient Work List Detail include the following columns allow each of these columns to be able to be filtered by the user e Patient name Last Name First Name Middle Name e SSN last four digits Format as text only showing last four digits e Appointment Date MM DD YYYY Display the most recent date for appointment use the rescheduled date if populated if blank this is the initial appointment date e Clinic Format as text Name of the clinic the appointment is with e Facility Format as text Name of the facility for the clinic the appointment is with e Site Format as text Name of the site the appointment is with e Provider Provider First Name Provider Last name Name of the clinician the appointment is with e Appointment Request Type Format as text and only show those marked as consult e Referral Source Format as text Req 11 4 Include a note box at the bottom of the Patient Work List Detail table Have the note table read e Outline Box e Fill box solid in light grey e Bold and place in Italics 264 MedRed LLC and BT America Z e Note Appointment date is the current date for the appointment this can be the original scheduled date or the rescheduled date The provider is defined as the person the appointment is with i e the name of support staff or physician Figure D34 Req 11 5 Allow each field in the Patient Work List Detail Table to be filtered on Req
92. 6 10 2013 0 00 PROVIDER ONE 06 12 2013 0 00 PROVIDER TWO 06 12 2013 0 00 Provider Utilization Rate is the number of appointments the provider has per day divided by the total number of appointment slots the provider has alloted for thier scheduling policy GEORGE CLARK GEORGE SMITH JANE SMITH JOSEPH KIRK LORY PETRI MICHAEL HANSON MICHAEL JOHNSON PROVIDER ONE PROVIDER TWO 93 MedRed LLC and BT America Clinic Availability Clinic Utilization Based on Appointments Audiology 06 10 2013 0 00 Audiology 6 10 2013 1 00 PM Mental Health 06 10 2013 2 86 6 10 2013 2 00 PM Mental Health Group 06 10 2013 2 86 6 10 2013 3 00 PM Mental Health Group Regular 06 10 2013 12 90 6 10 2013 4 00 PM Physical Therapy Regular 06 10 2013 0 00 6 10 2013 5 00 PM PRIMARY CARE 06 10 2013 1 52 6 10 2013 6 00 PM Audiology 06 11 2013 0 00 6 10 2013 7 00 PM Mental Health 06 11 2013 2 78 6 11 2013 12 30 PM Mental Health Group 06 11 2013 0 00 6 11 2013 1 30 PM Mental Health Group Regular 06 11 2013 0 32 6 11 2013 2 30 PM Physical Therapy Regular 06 11 2013 0 00 6 11 2013 3 30 PM PRIMARY CARE 06 11 2013 0 19 6 11 2013 4 30 PM Audiology 06 12 2013 15 38 6 11 2013 5 30 PM Mental Health 06 12 2013 0 00 6 11 2013 6 30 PM Mental Health Group Regular 06 12 2013 1 68 6 12 2013 12 00 PM Physical Therapy Regular 06 12 2013 0 00 6 12 2013 4 00 PM PRIMARY CARE 06 12 2013 0 00 6 1
93. 6 12 2013 AL VA HEALTH CARE SYSTEM AL VA OUTPATIENT CLINIC Mental Health Physical Therapy Regular PRIMARY CARE Patient Name g SSN S Appointment Appointment Appointment Appointment Clinic Name amp Provider Provider Role amp Most Updated S Last Name First Name last four Date Start Time End Time Duration in minutes Middle Name digits HUGH BENSON 0006 6 10 2013 2 00 PM 3 00 PM 60 Mental Health AL VA HEALTH CARE Joseph Jackson Provider CommunicationSent Y SYSTEM ALICIA BANKS 0004 6710 2013 4 00PM 5 00PM 60 Mental Health AL VA HEALTH CARE Joseph Jackson Provider CheckOut N SYSTEM ALICIA BANKS 0004 6 10 2013 7 00 PM 8 00 PM 60 Mental Health AL VA HEALTH CARE Joseph Jackson Provider NoShow N SYSTEM Note Appointment date is the current date for the appointment this can be the original scheduled date or the rescheduled date The provider is defined as the person the appointment is with i e the name of support staff or physician Summary By Activity Type Appointments by Activity Type PSO ea Ee Appointments Appointments CommunicationSent 1 33 33 6 10 2013 CheckOut 1 33 33 6 10 2013 NoShow 1 33 33 6 10 2013 OSRE Total 3 100 00 ME NoShow Note Appointments which have been cancelled for the day are not shown in table or used to calculate rate please refer to the Patient Detail Table to see those appointments Step 4 Increase or decrease your viewing size of report if you wish to s
94. 8 3 8 Use Case 8 Test Script ExeGutionsscsic sich tersscidnatedeticasticantadiereseaessidedtereetadeatieess 56 3 9 Verbose OU Ou beset cca coscncosaeisaansnehescnuns tenes seh eaouneistetueula sass aecenenenesd eaauaedaneiiepiuxenuaeienenite 58 SEP 2 EVALUATION sac ieties aar aaea aa ear vats cers r EREE a a AaS Aa AE EA EEEE Erai 59 4 Health eTime Scheduling Application User Manual ssssseseeeesesesnerrnneessererrrrnnressrrrrrrrnn 60 4 1 Application Description csercicceicceresiseccssisrencrssaidensonsiencneiaientanetetenmscienenmecpmerreecinvaneraneets 60 42r OVES W rere ee acer n r eee ee ee ee ee 61 4 3 Getting Started and SIQl Onacdnen te inset Oe eek 61 44 VistA and VistA Site Selection nnsnnnneeneeoeeennreneeesoeeenrrnnrtstrrrrnrnnnrtserrnnnrnnrrssrrrnnn rnent 62 45 REPONS ceea a a e a a ee 78 4 6 Appointments ce cecestincescaesercronicencntvas esate tiereneraeiee deel an em tencteu muna secerewrenine 102 4 7 Administration cosuarotces cleat aantendun cierdconclectaas aaa cee clatter acaneieiaciaaeee 118 Wes POG ces cep tictegs eeaioeth as sie tec otis edi wince oat eee 122 49 Help ierctitecdiasetenene ra ceed cesuieeeneebeenergdaiwem acne tevars ata EE A NEER E ERE 122 5 Instructions and Traceability Matrix for Step 2A Attachment A Application Capability Alignment with Scheduling Centric Requirement ccceceeeeeeeeeeeeeeeeenneeeeeeeeeeeeneneneeeneneres 125 5 1 Evaluating BN 1 Manage National Medical Sc
95. A 0004 Mental Health JOSEPH JACKSON 6 10 2013 CheckOut Y GREER JUANA 0000 Physical Therapy Regular JOSEPH JACKSON 6 10 2013 NoShow N Summary of Missed Appointments by Cli Average Number of Missed Appointments by Clinic Clinic 3 Total No ShowiMissed Average Number of Appointments Missed n S 12 3 E Missed Appt Physical Therapy Regular 1 1 00 1 Average Number of Missed Appointments is a calculated value Number 0 6 of No Show Missed Appointments for time period for that clinic site and facility Total Appointments for time period clinic site and facility g 04 Appointments are the most recently updated date for an appointment this ippo can be initially created or the rescheduled date which has not been 0 cancelled Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the
96. A specific requirements The full list of currently audited events is stored in table dbo AuditFunction The full audit trail is available through the audit report The data can be filtered and sorted in multiple ways References Section 4 Application User Manual Section 4 1 and 4 5 for instructions on viewing Audit Trail reports 1 7 Templates The system shall have the capability to create modify change status and manage of templates which include notifications letters and scheduling events The system shall allow the templates to be shared and saved Reference instructions for 1 7 1 and 1 7 2 below to validate our application s capability to share and save templates Reference Appendix A 3 instructions for Use Case 3 Step 10 to validate that our templates includes notifications letters and scheduling events 1 7 1 The system shall allow the templates to be shared Templates that will support some form of text based token substitution text html xml can be uploaded and tied at a specific facility level and shared by sections which are configured under that specific facility When the template exists at the section clinic it naturally overrides the one at the higher level of the hierarchy This is validated through the use cases Reference Appendix A 1 instructions for Use Case 1 Step 7 amp 8 Create update one pre appointment communication template Reference Section 4 Application User Manu
97. ARE GAVAREGIONAL GAVA HEALTH 6 None None Lori Petri Provider Create N A MEDICAL CENTER CARE SYSTEM 92 Cancel CheckOut CommunicationSent Create Modified NoShow Mental Health Group Regular Mental Health Group Regular PRIMARY CARE Mental Health Group PRIMARY CARE Mental Health Mental Health Group Regular PRIMARY CARE Mental Health Group PRIMARY CARE Mental Health Group Regular Provider Availability Average Activity Type by Clinic 1 BR RP eB a BRR p MedRed LLC and BT America F Average Activity Type ee Cancel 1 CheckOut 5 CommunicationSent 2 Create 6 Modified 2 NoShow i GEORGE CLARK GEORGE CLARK GEORGE CLARK GEORGE CLARK GEORGE CLARK GEORGE CLARK GEORGE CLARK GEORGE CLARK 1 Percentage of Time Utilized 00 90 80 70 60 50 40 30 20 10 6 10 2013 6 10 2013 6 10 2013 6 10 2013 6 10 2013 6 10 2013 6 10 2013 6 10 2013 12 00 PM 1 00 PM 2 00 PM 3 00 PM 4 00 PM 5 00 PM 6 00 PM 7 00 PM Provider Utilization alala AT i T 06 11 2013 Count By Activity Type E Cancel E CheckOut EE Communication Sent E Create E Modified EE NoShow Provider Utilization and Case Load GEORGE CLARK 06 10 2013 9 09 GEORGE SMITH 06 10 2013 0 00 JANE SMITH 06 10 2013 1 69 JOSEPH KIRK 06 10 2013 8 47 LORY PETRI 06 10 2013 35 71 MICHAEL HANSON 06 10 2013 0 00 MICHAEL JOHNSON 06 10 2013 14 29 PROVIDER ONE 06 10 2013 0 00 PROVIDER TWO 0
98. ATIENT CLINIC CA VA REGIONAL MEDICAL CENTER GA VA OUTPATIENT CLINIC GA VA REGIONAL MEDICAL CENTER Audiology Mental Health Mental Health Mental Health Mental Health Group Mental Health Group Regular Physical Therapy Regular Physical Therapy Regular PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE ALICIA BANKS 0004 Mental Health 2 HUGH BENSON 0006 Mental Health Group Regular 1 JENNIE LAMB 0005 Mental Health Group Regular 1 Note Report is pulling appointments tagged as Mental Health via DSS Stop Codes Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report 99 MedRed LLC and BT America A e Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step in
99. Application Database can be manually accessed and validated through the Health eTime user interface 16 MedRed LLC and BT America i 3 1 Use Case 1 Test Script Execution User System Administrator Goals Establish Organize and Manage the Scheduling Component Run_uct bat Data added modified in VistA e Facility e Services e Holidays e Providers e Patients Data added modified in the Scheduling Application database e Section clinics e Pre appointment letters e The following are imported from VistA o Facility Services Holidays Providers Patients Appointment Type Categories O O O 0 0 Notes e Appointment Types Categories are not added to VistA because the VistA instances we received already contained those Sample Log 17 MedRed LLC and BT America Z step4 step 4 REGULAR appointment type is added step 4 COMPENSATION appointment type is added step 4 EMPLOYEE appointment type is added step5 step 5 National VA Organization Day holidays are added step 5 Valentines Day holidays are added step 5 imported facilities service section appointment type and holidays from VistA step 6 step 6 primary care clinic is added to GA VA REGIONAL MEDICAL CENTER step 6 primary care clinic is added to GA VA OUTPATIENT CLINIC step 7 step 7 pre appointment communication template is created step 8 step 8 pre appointment communication template is assigned to primary care section in GA VA
100. Appointment process includes selection of desired date and time gt Preferred Date is entered as July 8 2013 Days to search 30 Select Facility CA VA REGIONAL MEDICAL CENTER Clinic Physical Therapy Regular Provider Dr Kirk JOSEPH KIRK Room No room required Equipment No equipment required Appointment type Physical Therapy Regular 6 Click Search for slots gt Next available slot s start on July 17 7 Select an Appointment time on 7 23 13 for patient July 22 is a holiday created in Use Case 1 UseCase3 Step 5c Select the appointment slot 8 Select 11 AM on July 23 gt Select Slot button is activated UseCase3 Step 5d Assign the patient to the selected appointment record desired date and reserve resources 9 Click Select Slot gt Step 3 of Add Appointment displays 10 Click Confirm and Book Appointment gt Step 4 of Add Appointments displays 194 MedRed LLC and BT America 7 lt UseCase3 Step 9 Schedule another appointment for the same patient and demonstrate the linking of the two appointments Walkthrough 1 If the user is on step 4 of 4 of the Book Appointment process you may select Add another Appointment and skip to item 4 If not please proceed to item 2 2 Click Appointments then Patient Appointments to open the patient search page Click Add Appointment 4 Step 3 of 4 of the Book Appointment process allows the user to create another appointment and then link it to an existing appointment by utilizing t
101. CHAEL PRIMARY CARE HANSON MICHAEL 83828 zzzzz lt lt lt lt z 2 z z z lt Step 5 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 82 H MedRed LLC and BT America P J Provider Availability Provide Case Load Note Blocks holiday s and holds are currently not shown in the the number of appointments the appointment slots the pcre elton E Provider Available Hours for Appointments Supplied in Provider Utilization Rate Minute Increments GEORGE SMITH 6 11 2013 13 00 GEORGE SMITH 06 11 2013 0 00 6 11 2013 14 00 06 12 2013 0 00 6 11 2013 15 00 06 13 2013 0 00 6 11 2013 16 00 JANE STEWART 06 11 2013 0 00 6 11 2013 17 00 06 12 2013 0 00 6 11 2013 18 00 06 13 2013 0 00 6 11 2013 19 00 JOSEPH JACKSON 06 11 2013 1 33 6 12 2013 13 00 06 12 2013 2 38 6 12 2013 14 00 06 13 2013 2 38 6 12 2013 15 00 LORY RANDOLPH 06 13 2013 0 00 6 12 2013 16 00 MICHAEL HANSON 06 11 2013 42 86 6 12 2013 17 00 06 12 2013 0 00 6 12 2013 18 00 06 13 2013 0 00 6 12 2013 19 00 Completed Appointments by Clinic Cancelled Appointments by Clinic Ginic Name Appts Completed Clinic Name Appts Cancelled Physical Therapy Regular l Physical Therapy Regular 2 PRIMARY CARE 3 Chart Title Chart Title EE PRIMARY CARE E Physical Therapy Regular E Physical Therapy Regular Provider Utilization Percentage of Time Utilized 06 11 2013 06
102. COPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Caldavid None ChildAppointments None HighPriorityReschedule False Id 81 Length 15 Patient Patient Activelnsurance None CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000006 Id 13 IsVeteran False MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring KeyValueOfstringstring 39 MedRed LLC and BT America Key 557 Value 6 1 PatientType None Person Person Address Address City None Id 42 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1962 11 01 00 00 00 Email None Ethnicity None FirstName JUANA Id 409 LastName GREER MaritalStatus None MiddleName None Phone 3105552233 SSN 300000000 Sex Male Preferences None PreferencesOther None Religion None SCPercent 0 ServiceConnected False SpecialNeeds None SpecialNeedsOther None Resources ArrayOfResource Resource Resource AllowOverbooking False Blocks None CalendarID None FullfillingResourceld 4 Holds None Id 3 Name case1 step 9 test SchedulingPolicies ArrayOfSchedulingPolicy Scheduli
103. Canada 557 AL VA HEALTH CARE 334 272 UTC 06 00 Central Time US amp SYSTEM 4670 Canada Viewing Facilities From the Welcome page select the VistA tab and select Facilities The Facilities will display according to what Site you have selected in the top right toolbar under VistA Sites VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log out SCHEDULING PORTAL VistA Site CA VA HEALTH CARE SYSTEM UTC 08 00 Pacific Time US amp Canada VistA Appointments Administration About Help Home Facies Facility Listing Address 2 Name Phone Hours Abbreviation Address 1 City State ZIP Rooms List Equipment List This option shows the facilities that have been created For the purposes of this contest facilities have been set up by the automated test scripts This page allows the users to set up attributes for each facility which include e Facility Rooms which can be scheduled e Facility Equipment which can be scheduled 64 MedRed LLC and BT America A e Facility wide communication templates please refer to the section below on how communication templates can be further used Managing Rooms for a Facility From the VistA menu select Facilities then click the link titled Rooms List A list of rooms displays to add a room choose the Add Room link VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Home Facies Rooms FACILITY
104. Completed Appointments by Primary Stop Code and Clinic Have the note read and display like below in Figure D20 The primary stop code designates the main clinical group responsible for the care The secondary stop code can be used as a modifier to further define the primary work group Figure D20 D 6 Capacity Workload and Utilization Report This reporting suite fulfills the following requirements there is only one report in this suite B9 3 1 The system shall have the ability to capture and provide the data necessary to conduct capacity planning through complete visibility into supply provider equipment facility support staff and demand enrolled and or empaneled Veteran requests for appointments 3 B9 3 National Reports National reporting is generated by national program managers VISN management and by facility management to review performance trends analytics as well as access to care and payment issues National reports are populated by rolling up information from the various stations clinics and facilities across VHA B 9 3 5 The system shall have the capability to generate performance reports Performance measures include access measures clinical measures and scheduling measures B 4 The system shall have the capability to alert VA staff when appointments are scheduled about patient scheduling reliability show no show rate averaged over a period of time configured by the authorized end user 250 MedRed L
105. Desired Appointment 2 Type of Request Status first name middle name Date RAMIRO ROBERSON 0000 Administrator 6 17 2013 Transfer Pending Summary of Appointments with Action Required by Clinic Audiology 1 Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 5 DSS Stop Code Detail 6 DSS Stop Code Detail Report To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 12 2013 e Select Sites Any can be used Below AL VA Health Care System was used to show a sm
106. Fulfill Appointment opens and shows that the appointment was cancelled due to the block Appointment Request Information shows Notes Existing appointment was automatically cancelled due to following reason George Clark Block Use Case 2 Step 10 Create a group appointment slot on a schedule Walkthrough 1 ONOaArWN 10 11 12 13 14 Ensure that VistA site on the upper right of the screen is CA Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource George Clark Click Scheduling Policy List gt Table of policies displays Click Add Scheduling Policy gt Scheduling policy details displays gt Policy is listed in the Schedule table gt Enter the following Start Effect Date and Time use today s date End Effect Date and Time use same day and month use 2015 for the year Priority 1 Click Add Click Select for the Monday policy gt Edit Scheduled Policy includes a link for Slots Click View Slots Click Add Slot gt Type Time 0800 1200 Length 30 Group Appointment Capacity 10 Select Appointment type Select desired option Click Add gt Group appointment policy is added to the table Use Case 2 Step 11 Associate pre appointment patient instructions
107. Health eTime User Guide Plus Step 1 and Step 2 Instructions and Requirements Traceability Matrix For All Three VA Virtual Machines MedRed LLC and BT Americas submission to the Department of Veterans Affairs 21 Century Medical Scheduling America Competes Contest Challenge gov 2600 Virginia Ave NW Suite 709 Washington DC 20037 A MedRed LLC MedRed Point of Contact Krishna Dave kdave medred com BT E Tel 202 333 3506 ext 22 This manual includes information that shall not be disclosed outside the Department of Veterans Affairs and its designated contractors This manual shall not be duplicated used or disclosed in whole or in part for any purpose other than to evaluate the MedRed BT Americas scheduling contest submission and to support VA planning MedRed LLC and BT America 7 Table of Contents 1 Introduction and Overview c ccccceeeeeeeeeeeeeeeeeeeeeeeeeaaaaaaaaeeeeeeeeesaaaaaaaaeeeeeeeeeesnnsaaaaaeeeeees 4 1 1 About the Submission seessenesneeneeeeseernnrrrrerestrtttrrnntsssrttntrrntttssrtrntnnnnnnseretnnnnnn nenene 4 1 2 About Our OG USN AOD wretch arads daeusea ateedaieateali dt chet ie ereal aah teadedeataath dated 6 2 Installation Guide for the Contest Environment cccceeeee ee eeeeeeeeeeeeeeeeeeeeeeteeeeeeeeeeeteeel 9 2 1 Configuration of the Three VMs for Scheduling SUDMISSION ccceeeeeeeeeetteteeeeees 9 2 2 Preparation of the Assigned VistA inSta
108. I lt Ic Appointment Type C amp P Patient Location Search for slots Complete all fields including Patient Location then select Search for Slots 114 ea MedRed LLC and BT America A b Y VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT Appointments ADD APPOINTMENT Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years App TELEHEALTH APPOINTMENT Step 2 of 4 Select Slot Facility CA VA OUTPATIENT CLINIC Clinic PRIMARY CARE Provider Jane Smith JANE SMITH Existing 02 Jul 2013 13 00 appointments 29 Aug 2013 13 00 12 Nov 2013 08 00 05 Dec 2013 08 00 05 Dec 2013 10 00 17 Dec 2013 09 00 Appointment date 14 Jun 2013 iv Appointment Time 09 00 10 00 A 11 00 v 12 00 Select Slot Review the Existing Appointment times for your patient and then select your Appointment Date and Time based on the patient s availability and choose Select Slot The next two confirmation screens are identical to Add and Reschedule Appointment Once complete your TeleHealth Appointment is added to the Patients Appointments screen If the provider and patients are at different site switch to the other site and create a TeleHealth appointment at the second site Use the appointment time for the second appointment as it appears in the appointment list as the times are adjusted according to the site Patient Waiting List Pat
109. IA 0004 Physical Therapy JOSEPH JACKSON 6 10 2013 NoShow N 132 PHYSICAL THERAPY 456 MOVE PGM GROUP Regular BANKS ALICIA 0004 Physical Therapy JOSEPH JACKSON 6 13 2013 6 11 2013 Modified N 132 PHYSICAL THERAPY 456 MOVE PGM GROUP Regular GREER JUANA 000 PRIMARY CARE MICHAEL HANSON 6 10 2013 CheckOut Y 295 PRIMARY 507 CHART CONSULT CARE MEDICINE BENSON HUGH 0006 PRIMARY CARE MICHAEL HANSON 6 10 2013 NoShow N 295 PRIMARY 507 CHART CONSULT CARE MEDICINE NASH FRANCIS 0003 PRIMARY CARE MICHAEL HANSON 6 11 2013 CheckOut Y 295 PRIMARY 507 CHART CONSULT CARE MEDICINE BANKS ALICIA 0004 PRIMARY CARE MICHAEL HANSON 6 11 2013 CheckOut Y 295 PRIMARY 507 CHART CONSULT CARE MEDICINE BANKS ALICIA 0004 PRIMARY CARE MICHAEL HANSON 6111 2013 NoShow N 295 PRIMARY 507 CHART CONSULT CARE MEDICINE ode odes Mental Health 198 3 MENTAL HEALTH CLINIC Mental Health 180 3 PRE SURG EVAL BY NON MD GROUP Physical Therapy Regular 456 3 MOVE PGM GROUP Physical Therapy Regular 132 3 PHYSICAL THERAPY PRIMARY CARE 507 5 CHART CONSULT PRIMARY CARE 295 5 PRIMARY CARE MEDICINE The primary stop code designates the main clinical group responsible for the care The secondary stop code can be used as a modifier to further define the primary work group Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forwar
110. IENT CLINIC Clinic Listing Name ot asr Dii Abbreviation Hours Location Active 323 MEDICAL 0800 EAST WING ROOMS Mental Health 0800 West Wing Rooms EDE baited pein ese m eh ee sas CA Family 8 00 Add Clinic 69 MedRed LLC and BT America A Se To select a Clinic select the link titled Select next to the Clinic Location and the Clinic Details page displays You can select De Active to inactivate a Clinic or if it is not activated you could select Activate here Select Edit within the Clinic table to make changes to the Name DSS Primary Stop Code Abbreviation Hours and Location Once complete select the Update button You will be returned to the Clinic Listing screen VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facurmes Cunics Eom FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Clinic Name PRIMARY CARE Hours 0800 1500 DSS Primary Stop Code 323 MEDICAL PROCEDURE UNIT iv Section Service MEDICINE iv Abbreviations PC Location EAST WING ROOMS 10 AND 11 70 MedRed LLC and BT America 7 VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies Cunics Deras FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Clinic a aa fone iE De Activate Communications Templates List Clinic Resources List Appointment Types List Communications Temp
111. LC and BT America 7 T A 7 2 Operational reports are generated by a facility VISN station or clinic to facilitate day to day operations These can range from printing daily appointment lists for a clinic to printing a listing of patients who missed appointments or who left without being seen Operational reports are also generated to track performance metrics access to care metrics utilization of staff workload measurement workload leveling and workload planning Report 9 Capacity Workload and Utilization Report Report Title Capacity Workload and Utilization Report Report Purpose The purpose of this report is to enable a user to conduct capacity planning through complete visibility into supply availability for clinicians equipment and facilities based on a time period Clinics Sites Facilities and VISNS the user selects To enables national program managers VISN management and facility management to review performance and trends by allowing the user to roll up reports via time period Clinics Sites Facilities and VISNS To display the most recent patient activity related to the appointment to enable the user to see scheduling reliability just as no show rate and left without being seen based on parameters selected by the user Req 9 1 Enable the user to enter the following reporting parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to select one or more
112. MKFUT Make an appointment way way way into the future OK MKDAY Make an appontment on the same day OK MKCAN Make an appointment over a cancelled appointment Ran 1 Routine 5 Entry Tags Checked 15 tests with failures and encountered errors E 4 Licenses Stored in the VMs Health eTime is our primary open source scheduling application and its Apache 2 0 license is stored in the VM directories along with this main document The following is a list of supporting licenses stored in the VMs directories These components enable Health eTime operations in the test environment e Daypilot Lite 2010 Open Source e Log4Net Open Source e JQuery Open Source e NHibernate Open Source e Bedework CalDav Server Open Source e Apache HTTP Server Version 2 2 used to run Bedework Open Source e Webdev Net CalDav libraries e SQL Server Enterprise 2008 SQL Server Reporting Services The authorization letter also stored in the directory fully affirms that our installation is compliant with the licenses and that the VA can fully and freely test Health eTime in the VMs 279
113. MedRed LLC and BT America 7 T environment In the case of both these challenges we believe the VA would be well advised to avoid large scale waterfall development and deployment strategies in favor of OSEHRA brokered open source agile development iterative releases and staged deployments If this approach is correctly implemented we believe better alignment with current and future VA user specific requirements can be achieved in combination with lower cost lower risk incremental deployments 1 1 3 About the Team Because of the complementary capabilities of the partners our team was able to specify develop test deploy and document our prototype scheduling application on time and consistent with VA contest requirements Step 1 Use Case requirements Step 2A Attachment A B and C requirements and Step 2B Open Source metrics Team leader MedRed LLC is a small business and past winner of the VAi2 industry innovation competition MedRed has developed and supports the TBI Toolbox application now in production at the VA Hunter Holmes McGuire VA Medical Center a Polytrauma site located in Richmond Virginia MedRed s understanding of VistA integration VA user needs and the VA IT environment along with its relationships with the VistA hardhat and open source communities has been a driving force in our development dynamics BT brings to the effort the power and talent of an 80 000 person information communications and technolog
114. PORTAL VistA Appointments Administration About Help Home Facies Cunics Detrans Types Eb FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Appointment Type Name Category CLASS II DENTAL Duration minutes 15 minutes DSS Credit Stop Code DSS Primary Stop Cod 264 ACTIVE DUTY SEXUAL TRAUMA iv Enter the Name Category Duration DSS Credit Stop Code and DSS Primary Stop Code then select Add The Category and DSS Primary Stop Code fields are drop downs which are populated from up to date data pulled from Vista Repeat this process until you have added all Appointment Types for your Clinic 73 MedRed LLC and BT America A e Clinic Resources List From the Clinic Details page select the Clinic Resources link to update the resources for a Clinic Resources include providers equipment and rooms Providers are automatically uploaded from Vista However you will only be able to allocate rooms and equipment for the Clinic if they were created under the Facility screen discussed in the Managing Equipment for a Facility and Managing Rooms for a Facility section above Home Facimes Cunics Deras Resources FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Resource Listing Service Allow type Type Overbooking Primary Care Evaluation Room 4 Primary Care Evaluation Room 3 CAT SCAN Room Room Select CAT SCAN Equipment Select Joseph Kir
115. Release At 04 Jan 2014 8 00 gt On Hold just created time stamp is shown in UTC Click Add gt Hold is added and the is user is returned to the Hold Listing page for a resource Releasing the Hold 10 On the Hold Listing page select the hold you wish to release click Select 11 Set Auto Release At to current date and time or click Remove 5 January 2014 is released or Hold no longer appears in the Hold List Use Case 2 Step 7 Block 9 a m 12 noon on 5 December 2013 for a meeting Walkthrough 1 2 3 4 Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details 185 ONO MedRed LLC and BT America A Click the Clinic Resources List link to view previously created resources Click Select for the resource George Clark to view resource details Click Block List to view the table of blocked dated Click Add Block to view block details page gt Enter the following information Type Period Start 05 Dec 2013 09 00 Period End 05 Dec 2013 12 00 Reason Meeting Click Add gt Return to list of Blocks for George Clark Use Case 2 Step 8 Block a portion of a schedule or a schedule that has existing scheduled patient appointments Prerequisite George Clark has an appointment scheduled for December 5 2013 at 10 AM patient Hugh Benson Walkthrough 1 SON og sp hd
116. So In accordance with contest requirements we have provided detailed instructions to aid Step 1 and Step 2 evaluation 1 2 2 Locating Materials for Step 1 Evaluation in this Document Detailed instructions for executing Step 1 automated Python test scripts for the eight Use Cases are provided in Section 3 of this document shown in green in Figure 1 2 Section 3 also details test script outputs for each Use Case If the Step 1 evaluators wish to understand the manual operations of Health eTime they can refer to the Scheduling Application User Manual in Section 4 and the manual test scripts provided for the 8 Use Cases in Appendix A Section 2 Installation User Guide for Virtual Machine Documentation for Code APIs MUnit Test Report Health eTime User Guide Plus Step 1 and Step 2 Instructions and Requirements Traceability Matrix gt Section 3 Instructions and Instructions for N Running Step 1 Use Case Scenario Test Scripts VA STEP 1 Section 4 Health eTime EVALUATION Scheduling Application User anaal VA STEP 2 EVALUATION AA Section 5 D section 6 Section 7 Section 8 Instructions and Traceability Matrix for Step 2A Attachment A Application Capability Alignment with Scheduling Centric Requirements Traceability Matrix Instructions and Traceability Matrix Instructions and Traceability Matrix for Step
117. Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE Status Scheduled TelehealthLocation None Time 2013 05 28 16 15 00 Vistald 3130528 1115 Id 11 RelationType Followup 50 MedRed LLC and BT America Ip HighPriorityReschedule True Id 80 Length 15 Patient Patient Activelnsurance None CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000006 Id 13 IsVeteran False MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring KeyValueOfstringstring Key 557 Value 6 Ib PatientType None Person Person Address Address City None Id 42 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1962 11 01 00 00 00 Email None Ethnicity None FirstName JUANA Id 409 LastName GREER MaritalStatus None MiddleName None Phone 3105552233 SSN 300000000 Sex Male Preferences None PreferencesOther None Religion None SCPer
118. a N for any other status Reg 6 13 Display a table under the patient detail table that shows the following columns e Clinic Name of clinic Display as text e Total No Show Missed Appointments Total count of appointments with an activity type displayed in the patient detail table as no show missed appointments for the time period clinic site and facility Display as a number 244 MedRed LLC and BT America P A e Average Number of Missed Appointments This is a calculated field which takes the total number of no show missed appointments for the time period clinic site and facility divided by the total appointments for the time period clinic site and facility The appointment denominator is defined as the total count of appointments appointment the most updated date for an appointment which can be either the initially created date or the rescheduled date for a non cancelled appointment Display as a number with two significant figures after the decimal place Req 6 14 Display table as shown in figure D17 Average Number of Missed Appointments is a calculated value Number of No Show Missed Appointments for time period for that clinic site and location Total Appointments for time period clinic site and location Appointments are the most recently updated date for an appointment this can be initially created or the rescheduled date which has not been cancelled Figure D17 Req 6 15 Create two note boxes under the Summa
119. ailable by role You can assign specific Role Actions the User can complete here For example if a Scheduler is supplied permissions to overbook appointments To complete this function select the Role from the drop down you want to edit Then check or uncheck the action which the role can have access to complete then select Save 121 MedRed LLC and BT America a D VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Roes Actions USERS IN ROLES Role FrontDesk Y EE DEERE Role has Action M Access to menu About menu 6 Access to menu Actions menu 21 LJ Access to menu Administration menu 4 Access to menu Appointments menu 3 Access to menu Clinic Schedule menu 40 Access to menu Facilities menu 9 C access to menu Group Appointments menul12 Access to menu Help menu 7 iL Access to menu Patient Appointments menu 11 Access to menu Patient Check In menu 15 iL Access to menu Provider Roster menu 26 Access to menu Role Actions menu 22 4 8 About The About tab is located on the top toolbar in the application This page displays the deployment application version numbers and any specific messages that need to be published to the Scheduling user community VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help ABOUT CURRENT BUILD The
120. al Section 4 7 for detailed instructions on how to configure users and roles 1 7 2 The system shall allow the templates to be saved Templates that will support some form of text based token substitution text html xml can be saved uploaded and tied at a specific facility level and shared by sections which are configured 132 MedRed LLC and BT America 7 under that specific facility When the template exists at the section clinic it naturally overrides the one at the higher level of the hierarchy This is validated through the use cases Reference Appendix A 1 instructions for Use Case 1 Step 7 amp 8 Create update one pre appointment communication template Reference Section 4 Application User Manual Section 4 7 for detailed instructions on how to configure users and roles 1 8 The system shall allow for the configuration of notifications flags and alerts for scheduling process The use case actions as referenced below validate a configurable communication process for notifications flags and alerts The integrated notification functionality is explained in the application design Reference Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Use Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of co
121. al schedule impact and marginal the system as a result of cost in the future to show that our solution has maximum flexibility policies directives etc 5 and change management capability Reference Appendix B Application Design and Architecture for explanation total application design 158 3 The system shall provide the flexibility to accommodate new functional requirements based on business needs e g primary care home PACT based care appointments telehealth etc 5 MedRed LLC and BT America 7 lt Because our application is a tailored open source solution for the VA which has been demonstrated through only two months of agile development we are confident that we can easily add new functions based on business needs This can be done with minimal schedule impact and marginal cost in the future to show that our solution has maximum flexibility and change management capability For example we have established Home Health Care Clinic as a new point of care where additionsal functional requirements can be added Reference Appendix B Application Design and Architecture for explanation total application design 4 The system shall have the capability to alert VA staff when appointments are scheduled about patient scheduling reliability show no show rate averaged over a period of time configured by the authorized end user 3 Patient schedule satisfaction rate and resource utilization are captured
122. all have the capability to roll up data from the most granular level i e clinic or station level to the highest level for reporting purposes i e National level as defined by the business Our application s reporting function matches the enterprise scope of our scheduling solution As scheduling data from across the VA enterprise will be deployed on centralized databases through our application reports at all levels from national to clinics and from cross sections of the database can be generated As our database is a rational database a roll up of data for reporting can be achieved as demonstrated in the reporting formats in Appendix D The database relational model and precise fields can be redesigned to match VA needs in the production system 7 1 3 The system shall have the capability to establish and ensure the use of consistent metrics and measures across different areas of the VHA i e ensure that all business level facilities measure Our relational database embodies a centralized structured approach for managing and utilizing scheduling and scheduling activity data Our reporting functionality supports all manners of evaluations operational efficiency analysis and performance analysis based on the structured data This process enforces a consistency in metrics for all reporting across the enterprise 156 capture and report the same data in the same ways MedRed LLC and BT America
123. aller subset of data e Select Facilities Any can be used Below AL VA Outpatient Clinic was used to show a smaller subset of data e Select Clinics Any can be used Below all Sites for the above Facility was used 90 MedRed LLC and BT America j Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 Home gt Reporting gt DSS Stop Code Detail Home My Subscriptions Site Settings Help From 6 9 2013 a r 6 12 2013 E TREET Sites AL VA HEALTH CARE SYSTEM v Facilities AL VA OUTPATIENT CLINIC v Clinics Mental Health Physical Therapy i4 4 a d b bi 100 v Fndinext why e B DSS Stop Code Detail Z Most Recent Completed BENSON HUGH Mental Health JOSEPH JACKSON 6 17 2013 6 10 2013 Modified 198 MENTAL HEALTH CLINIC 180 PRE SURG EVAL BY GROUP NON MD BANKS ALICIA 0004 Mental Health JOSEPH JACKSON 6 10 2013 CheckOut Y 198 MENTAL HEALTH CLINIC 180 PRE SURG EVAL BY GROUP NON MD BANKS ALICIA 0004 Mental Health JOSEPH JACKSON 6 10 2013 NoShow N 198 MENTAL HEALTH CLINIC 180 PRE SURG EVAL BY GROUP NON MD GREER JUANA 0000 Physical Therapy JOSEPH JACKSON 6 10 2013 NoShow N 132 PHYSICAL THERAPY 456 MOVE PGM GROUP Regular BANKS ALIC
124. anning are listed UseCase 5 Step 2 Display verify demographics 198 MedRed LLC and BT America 7 1 Select Appointments gt Patient Check In from the menu bar gt Search patient page loads if not click Select Patient to start new search 2 Type Manning in the search box and click Search gt List of patients named Manning are listed 3 Click JODI MANNING gt Patient details display UseCase 5 Step 3 Process an unscheduled patient for a walk in 1 Select Appointments gt Walk In Appointment gt Patient Manning is already selected To process a different patient click Select Patient and return to Search for patient Step 1 of Add Appointment Date defaults to today 0 days ahead to search 2 Select Facility VA REGIONAL MEDICAL CENTER Clinic PRIMARY CARE Provider Lori Petri Appointment type Select Medication Refill Click Search for slots gt First available slots display 3 Select a slot and click Select slot gt Book Appointment screen displays 4 Click Confirm and Book gt Check in status can be viewed from Appointments gt Check In UseCase 5 Step 4 Display and view provider schedule and provider roster of patients used to confirm that the patient has been added to a provider s schedule 1 Select Appointments gt Provider Roster gt Provider Roster page displays 2 Select Provider LORY PETRI gt List of patients for the current week are displayed appointment for today is listed with status Checked In 3
125. application This process further captures patient notification attempts as a function of transmission and patient response Reference Appendix A 3 instructions for Use Case 3 Step 10 pre appointment notification Reference Appendix A 6 instructions for Use Case 6 Step 9 cancellation notification Reference Appendix A 7 instructions for Use Case 7 Step 10 rescheduled appointment notification 143 MedRed LLC and BT America DZA Reference Appendix A 8 instructions for Use Case 8 Step 2 waiting list notification Reference Section 4 Application User Manual Section 4 4 for explanation of notification function Reference Appendix B Application Design and Architecture Section B 15 for explanation of notification process 5 4 Evaluating BN 4 Manage Appointment VA Requirement Through the use of a calendar view the scheduler is able to view all providers services facilities and Veterans from a variety of calendar views such as daily weekly monthly with multiple providers services or facilities in view on a single screen VA Requirements Instructions and Validating Outcomes 4 1 The system shall have the ability to display co pay requirements The responses from 4 1 1 to 4 1 7 show that information associated with the determination of co pay requirements are being captured and managed in our application Thus co pay requirements based on such information can be displayed when
126. appointment was created in MM DD YYYY format Req 5 13 Rescheduled Appointment Date column Display the date the appointment was rescheduled for in MM DD YYYY format Req 5 14 Cancelled Appointment Y N column Display a Y if the appointment was cancelled and N if any other status Reg 5 15 Missed Appointment Y N column Display a Y if the patient has missed the appointment N if the appointment date has passed and marked as completed or any other status Req 5 16 Completed Appointment column Display a Y if the patient has an appointment status as completed or N if the appointment is any other status D 3 Summary by Activity Type with Patient Detail This reporting suite fulfills the following requirements there is only one report in this suite B 4 The system shall have the capability to alert VA staff when appointments are scheduled about patient scheduling reliability show no show rate averaged over a period of time configured by the authorized end user A 6 3 The system shall provide statistics for appointments such as no shows left without being seen etc B 9 4 2 The system shall have the capability to generate reports based on metrics and measures related to patient information relevant to supporting the episode of care the continuity of care and missed opportunities of all patients Report 6 Summary by Activity Type with Patient Detail Report Title Summary by Activity Type with Patient Detail Report Purpose The purpose o
127. ar views such as daily weekly monthly with multiple providers services or facilities in view on a single screen The scheduling system shall accommodate appointment requests from multiple inputs sources including Veterans and providers via different sources such as MyHeatheVet walk ins email and other communication modes This forms the basis of non solicited demand Solicited demand emerges in the form of unfulfilled appointments based on missed opportunities or requests outside the scheduling appointment horizon VA Requirements Instructions and Validating Outcomes 3 1 Variable Appointment Types and Lengths The system shall have the capability to allow variable appointment types and variable appointment lengths e g Compensation amp Pension C amp P Mental Health Clinic MHC Primary Care Clinic PCC New Follow up Pre op Post op Reference responses for 3 1 1 to 3 1 4 below to validate that the capability to allow variable appointment types and lengths fully exists 136 3 1 1 The scheduling system shall display any other scheduled or requested appointments for the patient when an appointment is requested MedRed LLC and BT America 7 lt Each patient s total scheduled appointments can be pulled up as it is inherently stored to support scheduling The patient appointments list includes relationships links between appointments Reference Appendix A 3 instructions for Use Case 3 S
128. arious data entities from VistA into the scheduling application database For example in the test environment provider information is imported from VistA to the Health eTime application using this approach B 13 Health eTime Presentation Layer The presentation layer of Health eTime provides the user with a browser based interface to perform all the required scheduling tasks required by Schedulers Patients and Providers 215 MedRed LLC and BT America 7 T The Ul utilises standard Microsoft C ASP Net controls and industry standard open source modules from the JQuery and DayPilot libraries This platform provides a consistent approach using renowned and well tested components allowing a more reliable development environment The underlying Microsoft Web Project uses Master Pages Web User Controls and Classes within specific web site folders in order to encapsulate common functionality Process messages are presented to the user as required during system operation with any issues such as exception messages stored on file which allows further offline investigation The Ul presents a traditional design with minimal colours and icons It deliberately relies on few colour tones and displays text for actions in order to convey information in a way that is pertinent consistent and less liable to misinterpretation Where business processes are long the UI splits the data entry process into more manageable and visually less confusing st
129. ate AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC 34 MedRed LLC and BT America Phone 334 272 XXXxX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE ServiceType None Type Provider VistaCliniclEN 3 Tp Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None p AppointmentType AppointmentTypeCategory 35 MedRed LLC and BT America AppointmentTypeCategory Id 30 Name REGULAR Vistald
130. ateAppointment Appointment appointment Appointment CreateWalkInAppointment Appointment appointment Appointment CheckInAppointment Appointment appointment Appointment CheckOutAppointment Appointment appointment string disposition Appointment NoShowAppointment Appointment appointment Appointment CancelAppointment Appointment appointment string cancelType string cancelReason string remarks Appointment CreateRecurringAppointments Appointment appointment Recur recur Resources and Appointments Collection lt Appointment gt GetForPatient int patientld DateTime start DateTime end Collection lt Appointment gt GetNoShowAppointmentsForPatient int patientld DateTime start DateTime end Collection lt Appointment gt GetForResource int resourceld DateTime start DateTime end AppointmentStatus status AppointmentStatus Unknown Collection lt Appointment gt GetAllForAppointmentT ype AppointmentType apptType DateTime start DateTime end AppointmentStatus status Collection lt Appointment gt GetAllRelatedAppointments Appointment appointment Communication Request Management CommunicationQueueltem AddToCommunicationQueue CommunicationQueueltem queueltem CommunicationQueueltem AddToCommunicationQueue CommunicationT emplate template Appointment appointment 275 MedRed LLC and BT America 7 lt CommunicationQueueltem AddToCommunicationQueue CommunicationTemplate template AppointmentRequest app
131. atient preferences to be addressed appropriately Business rules can be added to provide notification of appropriate parties Reference Appendix A 3 instructions for Use Case 3 Step 4 verify patient information Reference Section 4 Application User Manual Section 4 6 for explanation of gathering patient information 154 5 6 Evaluating BN 6 MedRed LLC and BT America A Manage Encounter of Care VA Requirement The system will have the capability to differentiate between encounter data and appointment data The encounter data is not tracked by the scheduler but by providers in the electronic health record VA Requirements Instructions and Validating Outcomes 6 1 The system shall have the capability to provide check in check out cancellation reasons and no show data As demonstrated in Use Case 6 cancellation reasons are specifically tracked Encounter data at check in or no show as shown in Use Case 4 can be tracked in a similar manner Reference Appendix A 6 instructions for Use Case 6 Steps 3 to 6 cancellation data and reason tracking Reference Appendix A 4 instructions for Use Case 4 Steps 3 to 6 patient check in status check out no shows 6 2 The system shall have the capability to provide facility wide visibility for a patient i e checked in or out in treatment room etc As demonstrated in Use Case 4 the patient s status from check in to check out can be tra
132. ation is automatically added to the communication queue UseCase 8 Step 3 On a daily basis schedulers must review the clinic grids for open capacity 1 Click Appointments gt Clinic Schedule from the menu bar gt Clinic Schedule search page includes Facility and Clinic 2 Select Facility CA VA REGIONAL MEDICAL CENTER Clinic Primary Care Date July 10 2013 gt Providers with slots configured for that day show Open and Booked slots UseCase 8 Step 4 Select a patient from the waiting list 50 100 Service Connected Veterans or those Veterans lt 50 but connected for the injury 1 Click Add Appointment gt Waiting Lists gt Patient Waiting List allows filtering for Facility Clinic and Priority 2 Click Add Appointment for the patient appointment with priority 1 gt Fulfill Appointment page opens UseCase 8 Step 5 Display verify the patient s demographics Contact the patient with the date of the opening 1 Click Select Patient and search for patient then click the Patient s name to see their details 205 MedRed LLC and BT America i j Build 2 0 0 0 Logged in as tester2 log out VistA Site AL VA HEALTH CARE SYSTEM UTC 06 00 Central Time US amp Canada Select Patient UseCase 8 Step 6 Make the appointment To schedule an appointment for a waitlisted patient 1 Appointments gt Waiting List 2 Select the appropriate Facility and Clinic to fil
133. ation will display and what site you are scheduling and viewing appointments for In this manual we will go over each of the sections VistA Appointments Administration About and Help and describe how to use all functionality available 4 4 VistA and VistA Site Selection This section of the application is for setting up and viewing facilities clinics rooms equipment providers resources slots and appointment type 62 MedRed LLC and BT America A gt Sj Selecting a Site The top right of the screen includes a Vista Site drop down Click on the site name to change your site You can change your site at any point while in the application This determines what information will display and what site you are scheduling and viewing appointments for Build 2 0 0 0 Logged in as tester2 log out AL VA HEALTH CARE SYSTEM GA VA HEALTH CARE SYSTEM Close Window Viewing Site Details From the home page select the VistA menu and select Sites A list of the Sites using Health eTime along with their phone number and time zone display 63 fa MedRed LLCand BT America AA VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Sites Help Facilities SEM source na Site Listing VistaSitelId Name Phone Time Zone CA VA HEALTH CARE 916 555 UTC 08 00 Pacific Time US amp SYSTEM 1212 Canada GA VA HEALTH CARE 404 321 UTC 05 00 Eastern Time US amp SYSTEM 6111
134. ational database and the CalDav server therefore enhancing re use and freeing the application developer from having to understand the subtleties of the interaction with the back end components The services currently in existence are listed in the table below Service Description Account Service Provides basic user management functionality such as managing users roles user in roles and logging Appointment Service Provides functionality to manage add retrieve delete and modify appointments Equipment Service Provides functionality to manage add retrieve delete and modify equipment Facility Service Provides functionality to manage entities referenced as services Import Service Imports data from VistA into the scheduling application database e g Providers Patients National System Service Fa ade for entities that are available and defined at the national level e g Appointment Type Categories Patient Service Provides access to patient information Provider Service Provides access to provider information Resource Service Manages resources which tie together entities such as 209 MedRed LLC and BT America 7 providers equipments and rooms with section and clinics for the purpose of scheduling them Room Service Provides access to room information Section Service Provides access to section information Site Service Provides access to site informatio
135. ations with VistA E 1 1 Our Integration Strategy Our integration strategy between the scheduling application and VistA allows the synchronization of data between the two applications in two different ways First we import reference data from VistA and treat that data as read only data within the scheduling application in order to ensure consistency between the scheduling application and VistA Second we continuously export data from the scheduling application to VistA to ensure that back end processes in VistA can continue to function even without any knowledge of the new scheduling application Note that for this proof of concept we currently do not continuously synchronize the data from VistA after the one time import of the reference data into the scheduling application VistA has an efficient way of detecting data changes using a data checksum that can be used to continuously synchronize any data between VistA and the scheduling application E 2 2 Integration Point Organization Data We assume that organization data is owned by VistA therefore we retrieve the following from VistA and treat it as referenced data e One Top Level Management System e Facilities linked to the Top Level Management System E 2 3 Integration Point General Reference Data We assume that the following data is owned by VistA and we therefore retrieve it from VistA and treat it as read only data within the scheduling applications Note that it is a fa
136. ator User Administrator Administration Menu Except for system administrator users and the system administrator role can add and edit users roles and actions in roles Actions are fixed UserAdministrator Schedule VistA Menu Can access the appointment ScheduleManager Manager limited override configurations i e change save Override Slot Group access Capacity Scheduler Appointments Can add cancel reschedule Scheduler Appointment menu and check in out Manager appointments Clinic Patient Check in Can view but not reschedule ClinicReceptionist Receptionist and check out or cancel appointments Can check in and check out appointments 218 MedRed LLC and BT America 7 T Actions Note In the contest environment limitations to a user s actions are implemented only through revealing or hiding a user s menu items manual URL redirect is possible this would not be the case in a production system Action name Used in role Notes ManageUsers UserAdministrator Show hide menu option ManageSltes VistaSiteAdministrator Show hide menu option ManageSchedule ScheduleManager Show hide menu option PerformClinicReception ClinicReceptionist Show hide menu option B 15 Notification Process Communication Templates Overview of templates There are 5 communication templates These will cover the notification of the transfer of a patien
137. ay 06 12 2013 0 00 PRIMARY CARE CAT SCAN 6 11 2013 6 00 PM Equipment Utilization Rate is the number of appointments the Equipment has per day divided by the total number of PRIMARY CARE CAT SCAN 6 11 2013 700 PM PO RS ES ES E E toe T Ea PRIMARY CARE CAT SCAN 6 11 2013 8 00 PM Physical Therapy Regular Exercise Bike 6 11 2013 3 00 PM ame Equipment Utilization Rate Physical Therapy Regular Exercise Bike 6 11 2013 4 00 PM Physical Therapy Regular Exercise Bike 6 11 2013 5 00 PM MME CAT SCAN 7 20 00 MB Exercise Bike Physical Therapy Regular Exercise Bike 6 11 2013 6 00PM z 204 EE X Ray Physical Therapy Regular Exercise Bike 6 11 2013 7 00PM Physical Therapy Regular Exercise Bike 6 11 2013 8 00 PM Physical Therapy Regular Exercise Bike 6 11 2013 9 00 PM 2 PRIMARY CARE CAT SCAN 6 12 2013 3 00 PM 10 8 33 PRIMARY CARE CAT SCAN 6 12 2013 4 00 PM g 5 26 PRIMARY CARE CAT SCAN 6 12 2013 5 00PM a PRIMARY CARE CAT SCAN 6 12 2013 6 00 PM 0 00 0 00 0 00 00 0 00 0 00 0 r r I eat 3 J p 5 g A gs J ee 23 6 22 3 oe Bes se ae gt 4 ae gt ae gt s amp Te 9 2s z 8 eo e H ee z5 2 2 7S F 2 6 amp a la L 06 10 2013 JL 06 11 2013 JL 06 12 2013 J Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer
138. ble Clinic Utilization Based on Appointments Include the following columns and note displayed in Figure D26 shown below for this table Clinic Show the clinic name if the clinic is included in the Clinic Availability table Clinic name should only be shown 1 time per day Date Show the date one time for each Clinic Utilization Rate Calculated field using the number of appointments the Clinic has per day that are not rescheduled or cancelled divided by the total number of appointments the Clinic has available in their scheduling policy 256 MedRed LLC and BT America 4 Clinic Utilization Based on Appointments Pns z n 34 Tre a y 22 PNS 2 2 2013 81 PTRP 2 2 2013 0 O ms zs2o s1 pree 2 3 2013 19 Clinic Utilization Rate is the number of appointments the Clinic has per day divided by the total number of appointment slots the Clinic Resources have Figure D26 Req 9 14 Create a graph for the Clinic Utilization Based on Appointments table and title the graph Clinic Utilization Show graph as a line graph Show data labels Show legend with provider name which indicates what line they are on the graph Ensure each Clinic line is a different color in legend and in graph o Outline legend o Ensure colors are consistent with report o Fill legend in light grey o Ensure font is easy to read and matches style of report see Figure D27 below 257 MedRed LLC and BT America i a Clinic U
139. c Time US amp Canada VistA Appointments Administration About Help HOME ROSTER PROVIDER ROSTER View Patient List Click an appointment to view in patient s appointment list Site Provider GEORGECLARK x Facility All Facilities x Clinic All clinics 6 11 2013 6 12 2013 6 13 2013 6 14 2013 6 15 2013 6 16 2013 Eo eee Done Internet Protected Mode On Clinic Schedule This option is a comprehensive view of the overall Schedule for a Clinic in a Calendar user interface control and these views can be changed to include other resources such as rooms or equipment 116 H MedRed LLC and BT America a From the Appointments menu select Clinic Schedule D VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home CLINIC SCHEDULE CLINIC SCHEDULE Facility CAVA OUTPATIENT CLINIC iv Clinic Mental Health Group Regular 12 Jun 2013 Provider Clinic Hours 0800 1500 George Clark Joseph Kirk Booked 117 4 OS 4 7 Administration This section allows for the management and security of users and roles typically this will be performed by a System or User Administrator la MedRed LLC and BT America For example users can be enabled or disabled and set to roles that can pe
140. cent 0 ServiceConnected False SpecialNeeds None SpecialNeedsOther None Resources ArrayOfResource Resource Resource 51 MedRed LLC and BT America AllowOverbooking False Blocks None CalendarID None FullfillingResourceld 4 Holds None Id 3 Name case1 step 9 test SchedulingPolicies ArrayOfSchedulingPolicy SchedulingPolicy SchedulingPolicy DayOfWeek 2 EndEffectDate 2014 01 15 00 00 00 Id 72 Priority 0 Slots ArrayOfSlot Slot Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None Capacity 4 Id 570 Length 15 Time PT16H 1 Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity 4 Id 571 Length 15 Time PT16H15M 52 MedRed LLC and BT America StartEffectDate 2013 01 04 00 00 00 y Section Section Abbreviation PC Activ
141. cheduled Appointment Date e Rescheduled Appointment Date e Cancelled Appointment Y N e Missed Appointment Y N e Completed Appointment Y N Req 5 5 Patient Name column Concatenate the patient name together with last name first then first name and lastly middle name in this format last name first name middle name Req 5 6 SSN last four digits column Display only the last four digits of the patient s social security number in column two Column will need to be formatted to return as text in the event that the first digit is a 0 Req 5 7 Appointment Created Date column Display the date the appointment was created Ensure all parameters selected by the user for Clinic Site and Facility and appointment was created The From and To dates are based on the most updated scheduled appointment for that patient Display date as MM DD YYYY Req 5 8 Clinic column Display the name of the clinic the patient has an appointment with 242 MedRed LLC and BT America 7 lt Req 5 9 Provider column Display the name of the provider that will be seeing the patient for that appointment as Provider First Name Provider Last Name format Req 5 10 Appointment Created Date column Display the date the appointment was scheduled as MM DD YYYY Req 5 11 Appointment Desired Date column Display the date the patient supplied as their desired appointment date in MM DD YYYY format Req 5 12 Initial Scheduled Appointment Date column Display the date the
142. cili Clinics Mental Health Group PRIMARY m ld 4 1 Jof2 gt gt i 100 v 84 MedRed LLC and BT America A Step 7 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 8 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing B XML file with report data CSV comma delimited PDF MHTML web archive Excel TIFF file Word Save Save as Do you want to open or save Appointment and Clinic Dashboard by Site and Clinic xts from 166 78 237 8 Open Save v Save and open 2 Audits by User by Site To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 11 2013 e Select a To date To return a smaller subset of data use date 6 13 2013 e Select a Site Any Site can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 85 MedRed LLC and BT America AS Ho
143. cility resources schedule and accounts The following Entity relationship diagram provides a high level view of the major entities in the model Technical Card Products Microsoft SQL Server 2008 Standard edition B 5 Health eTime Appointment Relations Appointment data is maintained in the following database relations i Appointment ef _ time _ Length _ Status E PatientId _ vistar _ Cadavid _ HighPriorityReschedule _ SectionId __ Appointment Typerd _ TeleheatthLocation AppointmentRelation EE Appointmentid m ChildAppointmentId E RelationType CommunicationTemplate _ Recipient DateOffset mj Medium CommunicationQueueItem EE _ Recipient iS Medium C SendBy senton _ Subject Body AppointmentId m AppointmentRequestId _ Templaterd AppointmentActivity __ Appointmentra _ Activitytype Ea ActivityReason Section_CommunicationTemplate_Rel P E SectionId 8 CommunicationTemplatetd The Appointments relation is as the center of the scheduling process Appointments can be linked to each other through the AppointmentRelation table All actions taken on an appointment are recorded in the AppointmentActivity table Appointments are also linked to CommunicationQueueltem which represent notifications sent out regarding the appoint
144. cked through this application via provider and admin log in to see and update appointment event details Reference Appendix A 4 instructions for Use Case 4 Steps 3 to 6 patient check in status check out no shows 6 3 The system shall provide statistics for appointments such as no shows left without being seen etc The end result of a patient encounter or no show can be collected and integrated across the patient base for a clinic or large group for statistical analysis and process optimization This is captured in our reporting design and functionality Reference Appendix A 4 instructions for Use Case 4 Steps 3 to 6 patient check in status check out no shows Reference Section 4 Application User Manual Section 4 5 and 4 6 for explanation of encounter tracking Reference Appendix D 3 Summary by Activity Type with Patient Detail 5 7 Evaluating BN 7 Reporting VA Requirement The system should have the capability to produce display and format reports and should be able to be saved in various formats such as PDF CSV etc Reports containing personally identifiable information that are required to be transmitted retrieved viewed or printed meet all VA Handbook 6500 requirements These reports represent the as is process It 155 MedRed LLC and BT America is expected that report requirements will be further defined with the business owners throughout the system development and acquisition
145. come SAEI RGG duling Portal Please use the menu to perform the scheduling tasks you require Walk in Appointment Provider Roster Tele Health Clinic Schedule Patient Appointments To make or manage an appointment for a patient select Patient Appointments from the Appointments tab The first section when making an appointment for a new patient is the patient search screen C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT SEARCH PLEASE SEARCH AND SELECT A PATIENT Enter starting letters of a surname a full SSN or leave blank then press enter or click search A variety of search criteria can be used and that option is automatically detected from what is entered into the patient search box This includes patient surname and SSN Enter your patient criteria you want to search by and select Search 102 MedRed LLC and BT America 4 u A list of patients will display Select your patient Upon selecting a patient further demographic details are displayed such as patient entitlement and service connected attributes for the Scheduler to confirm the identity of the patient For this data set you do not have to enter any information to bring back a patient leave that field blank and select Search This will return all patients for the site Click a name to verify the patient s details HUGH BENSON 04 Oct 1968 Male 300 00 0006 WADE FERGUSON 01
146. come the opportunity to validate or adjust the assumptions and adjust the specifications and reports to better satisfy VA user needs Appendix E Open Source and Software Licensing Documentation In accordance with contest requirements pertaining to Step 2B Open Source evaluation we have provided in Appendix E documentation concerning the applications Web Services Integration Layer and APIs Authorization letters for commercial and Apache 2 licenses accompanying the submission along with the Checksum for each VM are placed in the appropriate individual VM directories independent of this integrated document MedRed LLC and BT America a 2 Installation Guide for the Contest Environment This guide is developed in accordance with the contest submission checklist The following section describes how we have prepared and configured the three VMs assigned by the VA for this contest It is important to note that the Health eTime application is designed to run and be managed in production as an enterprise solution As such it does not need to be directly installed at each local VistA instance We believe this approach will minimize the support and maintenance issues connected with installing patching upgrading and maintaining the application across the enterprise It also allows the VA if it so chooses to later procure scheduling as a Software as a Service SaaS For the purpose of the contest however we have chosen to install and run the H
147. current build number is Build 2 0 0 0 VETERANS ASSOCIATION SCHEDULING CONTEST 2013 4 9 Help The application allows for unlimited Help Text which can be fully editable on line Help for each Menu Option The ability to edit this Online could be set by the role based access control 122 MedRed LLC and BT America a described above Information has already been added to each of the drop down menu options in the Help Text file VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Cancel Patient Appointment Change Password Clinic Details Password Change Success Patient Appointments Patient Check in 123 MedRed LLC and BT America y To view one of the topics select the Help tab then select a topic from the drop down you want more information about and a summary displays VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Rie HELP FOR PAGE ADD PATIENT APPOINTMENT Add Patient Appointment Save Select the Appointments tab then choose Patient Appointments If you do not have a patient selected select one and choose Add Appointment 124 7 MedRed LLC and BT America 5 Instructions and Traceability Matrix for Step 2A Attachment A Application Capability Alignment with Scheduling Centric Requirements To facilitate validation of our application s capabilities relative to Attachment A metrics we have endeavored
148. d LLC and BT America e Modified file 984 1 MASTER PATIENT INDEX added correct Station Number e Applied TASKMAN SET UP ROUTINES cleans up Taskman global for a new environment e Modified Taskman Startup delay file 14 7 e Edit taskman XWB LISTENER STARTER modified SPECIAL QUEUEING to STARTUP e Modified file ZSTU int file to Change VistA instance name 2 3 Installing amp Configuring SQL Server 2008 Enterprise Details about the installation and configuration of SQL Server 2008 are beyond the scope of this document More information can be found here http msdn microsoft com en us library bb500395 v sql 105 aspx 2 4 installing amp Configuring Bedework Details about the installation and configuration of Bedework are beyond the scope of this document More information can be found in Appendix B and at http www jasig org bedework 2 5 Configuration Recovery Instructions Methodology This section describes how to reset the Health eTime demonstration system to a specific state for testing and demonstration purposes In order to provide insight into the system s baseline and recovery states a brief overview of methods used to import test data is provided below The Health eTime application framework includes data that resides in 1 The RDBMS Server the application s transactional and reporting databases 2 And each individual VistA instance In order to accurately restore the Health eTime demonstration system
149. d or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy 91 MedRed LLC and BT America A e the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 6 Capacity Workload and Utilization Report 7 Capacity Workload and Utilization Report To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 10 2013 e Select a To date To return a smaller subset of data use date 6 12 2013 e Select VISN The only VISN for now is 6 and will default to 6 e Select Sites Any can be used Baseline data would be best to run report for CA VA Health Care System e Select Facilities Any can be used Baseline data would be best to run report for CA VA Outpatient Clinic e Select Clinics Any can be used Baseline data would be best to use both sites From VISN Facilities for t Step 2 Select Step 3 Report
150. dAppointments None HighPriorityReschedule False Id 51 Length 30 Patient Patient Activelnsurance None CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000006 Id 13 IsVeteran False MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring KeyValueOfstringstring Key 557 Value 6 p PatientType None Person Person Address Address City None Id 42 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1962 11 01 00 00 00 Email None Ethnicity None FirstName JUANA Id 409 LastName GREER MaritalStatus None MiddleName None 26 MedRed LLC and BT America Phone 3105552233 SSN 300000000 Sex Male Preferences None PreferencesOther None Religion None SCPercent 0 ServiceConnected False SpecialNeeds None SpecialNeedsOther None Resources ArrayOfResource Resource Resource AllowOverbooking False Blocks None CalendarID None FullfillingResourceld 4 Holds None Id 3 Name case1 step 9 test SchedulingPolicies ArrayOfSchedulingPolicy SchedulingPolicy SchedulingPolicy DayOfWeek 2 EndEffectDate 2014 01 15 00 00 00 Id 60 Priority 0 Slots ArrayOfSlot Slot Slo
151. data to generate these reports is available from the application Thus further development would create different data presentation formats based on additional VA feedback and needs VA Requirements Instructions and Validating Outcomes 1 The system shall have the Our application is designed for VistA integration and is able to pull and capability to provide for the push data into the VistA environment Thus we are able to pull enforcement and modification specific data and format standards from VistA as specified by the VA of national level data users The orchestration between VistA our rational database and standards including procedure CalDav server is done at the service layer Further because our and diagnosis codes as application is a tailored open source solution for the VA we can easily currently defined in VistA 3 create or adjust data format with our rational database to enforce VA standards Reference Appendix B Application Design and Architecture Section B 1 for explanation of VistA integration 2 Flexible Schedule Because our application is a tailored open source solution for the VA Component Organization which has been demonstrated through only two months of agile The solution shall have a development we are confident that we can make all appropriate mechanism to oversee and system changes to align with changes in statutes regulations and manage potential impacts to policies This can be done with minim
152. details Click View Clinics Click the Select link for the CA Dermatology Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource Dr OP Click Scheduling Policies List gt Table of policies displays 9 Click Add Scheduling Policy gt Scheduling policy details displays gt Policy is listed in the Schedule table gt Enter the following Day of the week Monday Start Effect Date use today s date End Effect Date use same day month use 2015 for the year Priority 1 ONOaARWON oa 188 10 11 12 13 15 16 MedRed LLC and BT America a Click Add Click Select for the Monday policy gt Edit Scheduled Policy includes a link for Slots Click View Slots Click Add Slot gt Type Time 0800 1200 Length 15 Group Appointment Capacity 1 Select Appointment type Consult Click Add Slots gt Type Time 1300 1600 Length 30 Capacity 1 Select Appointment type Follow Up Click Add gt New policy is added to the table Click Appointments gt Clinic Schedule to view Clinic Schedule page gt Select Facility VA Outpatient Clinic Clinic CA Dermatology Enter Tuesday July 2 2014 gt Calendar page displays with 15 minute slots in the morning and 30 minute slots in the afternoon Use Case 2 Step 13 Block or make unavailable multiple days of a schedule and include the reason for blocking Walkthrough 1 OONOa PP WN 10 Ens
153. dinate Associated and Occasions of VA Requirement The scheduling system shall provide schedulers the ability to coordinate medical services throughout the VA for other agencies with private practices and for various delivery modes and causes VA Requirements Instructions and Validating Outcomes 5 1 External Data Exchange The system shall have the capability to provide secure automated interfaces with external systems for data exchange Reference response for 5 1 1 to 5 1 3 below to validate that our application has the capability for external data changes 5 1 1 The system shall have the ability to allow inter facility scheduling including non VA facilities All medical facility schedules organized using our application can conduct integrated scheduling as demonstrated in Use Case 1 Even non VA facilities can set up a schedule and that schedule will be accessible from other facilities in the system This is the strength of our enterprise solution application when compared with locally deployed applications Reference Appendix A 1 instructions for Use Case 1 Create update two medical facilities 151 MedRed LLC and BT America Reference Section 4 Application User Manual for overall instructions on scheduling and schedule access 5 1 2 The system shall have the capability to link unscheduled CPRS consults to the scheduling system for viewing New patient records CPRS can b
154. duling process Our application implements this requirement through the use of a queue of requests that includes priority sorting For example when appointments are cancelled a request is generated in the request queue for rescheduling The user can similarly display the entries of the request queue to decide which request has the highest Reference Appendix A 3 instructions for Use Case 3 Step 1 receive appointment request and Step 2 enter desired appointment day time 3 8 2 The system shall have the ability to merge purge or distribute scheduled appointments from one resource to another when emergency scheduling changes occur Our application creates appointments by converging patient provider equipment and room schedules The appointments can be modified merge purge distribute by realigning any the schedules with the set appointment time or with a new appointment time For example the emergency loss of resource such as provider cancellation or failed equipment could automatically trigger a reschedule notification to schedulers and then to patients Reference Appendix A 3 instructions for Use Case 3 Step 5D reserving resources for specific patient appointment Reference Appendix A 7 instructions for Use Case 7 rescheduling appointments 3 8 3 The system shall have the ability to capture attempts to contact patient There is a flexible and expandable integrated notification process within our
155. e Communications Templates List Clinic Resources List Appointment Types List Use Case 1 Step 7 Create update one pre appointment communication template for the overall health care system that can be modified and utilized at the facility section level Walkthrough 1 Select VistA on the upper left of the Home page 2 Select Facilities 3 Click onthe Select link next to a particular Facility e g VA Regional Medical Center gt The Facility Details will be displayed 4 Select Template List at the bottom of the page gt The Template List includes all of the possible template types for a facility 5 Click Select for a previously created template 6 Click extract template to prompt the Save As window Choose an appropriate location to save the file locally 7 Open the saved file with Notepad and edit the text as needed for the new facility wide template you will be creating 8 Select Facilities link at the top of the screen 9 Select the same Facility as previously selected 10 Click Template List 11 Next select Add Communication Template 12 Enter Name Subject Template Type Medium and Recipient for the New Template 13 To upload the previously edited template click Choose File 177 MedRed LLC and BT America 7 Sa 14 This will open a new window prompting the user to selected the locally edited and saved file 15 Click Upload Use Case 1 Step 8 Create a pre appointment letter for a section based on the
156. e Service Id 26 Name MEDICINE Status CheckedIn TelehealthLocation None Time 2013 05 21 19 00 00 Vistald 3130521 14 checkpoint 1 verified patient walkin appointment Step 5 Display and view patient check in status Checkedin checkpoint 2 verified patient checkin status Step 6 Checkout patient appointment CheckedIn Step 7 Display other scheduled appointments Appointment Activity ArrayOfAppointmentActivity AppointmentActivity AppointmentActivity ActivityReason None ActivityType Walkin Id 98 Time 2013 06 06 23 45 25 Ih AppointmentActivity ActivityReason None ActivityType CheckOut Id 99 Time 2013 06 06 23 45 26 Th AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 31 MedRed LLC and BT America Name C amp P PatientInstructions None Caldavid None ChildAppointments None HighPriorityReschedule False Id 51 Length 30 Patient Patient Activelnsurance None CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000006 Id 13 IsVeteran False MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValu
157. e COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None b AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR Patientinstructions None Ih CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 30 MedRed LLC and BT America TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Servic
158. e gt If you were previously working on a particular patient click Select Patient on the upper right of the screen green toolbar Type Benson then click Search gt Search results include Hugh Benson Click Hugh Benson gt Patient details opens Click Select Patient gt Patients current appointments are listed Click Add Appointment gt Step 1 of Add Appointment includes selection of desired date and time Select the date July 3 13 00 Select Search for slots to Schedule the future appointment UseCase3 Step 4 Verify patient information Display verify demographics insurance primary care provider patient preferences and special requests Create display patient priority 193 MedRed LLC and BT America A Sa 1 Click Appointments then Patient Appointments to open the patient search page gt If you were previously working on a particular patient click Select Patient on the upper right of the screen green toolbar 2 Type Benson then click Search gt Search results include Hugh Benson 3 Click Hugh Benson gt Patient details opens UseCase3 Step 5 Make appointment using data from Table 1 and guidance from Back Story Scenario Table 2 1 CA VistA Site 2 Click Appointments gt Patient Appointments to open the patient search page 3 Search for desired patient e g Alicia Rice See Step 2 for help 4 Click Select Patient gt Patients current appointments are listed 5 Click Add Appointment gt Step 1 of Add
159. e True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 ld 17 Name C amp P Patientinstructions None Ib AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR PatientInstructions None Ib CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXxX ShortName AVAOPC Site 53 MedRed LLC and BT America Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaS
160. e If the below report is included in the sample reports following the report name you will see Available to View in bold and italics Reporting Suites with more than one report have a different name for the Suite Reporting Suites with only one report have the same name as their Suite except for the Clinic Operations Report For the Clinic Operations Report the specific report title aligns with the type of data the report is pulling The Reporting Suites group similar requirements together to create reports that fulfill more than one requirement whenever possible For detailed information about each report its logic and the requirements it meets please refer to Appendix D Suite 1 Provider and Clinic Appointments and Utilization Report 1 Appointment and Clinic Dashboard by Site and Facility Available to View 2 Notifications and Letters by Site and Facility 3 Audits by User by Site Available to View Suite 2 Operational Summary with Patient Detail Reports 4 Wait Time and Operational Metric Scorecard 5 Patient Appointment Operational Details Available to View 79 MedRed LLC and BT America 7 Suite 3 Summary by Activity Type with Patient Detail 6 Summary by Activity Type with Patient Detail Available to View Suite 4 Work List Summary Queue and Patient Detail 7 Work List Summary Queue and Patient Detail Suite 5 DSS Stop Code Detail 8 DSS Stop Code Detail Report Available to View Suite 6 Capacity Workload and U
161. e Applied sd_5p3_131000rc2 KID SDAM1 Fixed an extrinsic quit mismatch error fixed by the RGI T4 build SDMAPI2 Commented out code that isn t needed e Edit HL7 file Protocol VAFC ADT A04 SERVER This protocol fires off of the PIMS Registration option edit Event Driver removed Response Processing RTN 10 MedRed LLC and BT America 7 e Modified file 43 MAS Parameters added date to EARLIEST DATE FOR G amp L e Modified file 984 1 MASTER PATIENT INDEX added correct Station Number e Applied TASKMAN SET UP ROUTINES cleans up Taskman global for a new environment e Modified Taskman Startup delay File 14 7 e Edit taskman XWB LISTENER STARTER modified SPECIAL QUEUEING to STARTUP GA Instance e VistA dat file location C CACHESYS Megr VISTA e Instance Name VISTA e Refresh VistA short cut on Desktop to point to the proper location e Taskman Volume Set Box was not setup correctly e Change firewall in bound out bound ports i e 9200 e Applied Ray Group Scheduling Script SD_5 3_ 260003 RC4 KID e Applied zna Ray Group Scheduling Script SD_6_0_1_T7 KID Created by Chris Uhera e Applied XUA4A7_FIX_0 0 KID Fixes a problem with DIC 0 being undefined when using the updater e Applied sd_5p3_131000rc2 KID SDAM1 Fixed an extrinsic quit mismatch error fixed by the RGI T4 build SDMAPI2 Commented out code that isn t needed e Edit HL7 file Protocol VAFC ADT A04 SERVER This protoco
162. e Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of continued care Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 4 3 3 The system should have the capability to support automated coordination and consolidation e g onto one day of multiple appointments per patient Information to support the consolidation of appointments is displayed in the weekly views for a section or clinic This view shows vacancies for consolidation opportunities The view of all the appointments for a patient then shows how spread out the appointments have become and whether it makes sense for some appointments to be rescheduled for the same day Reference Section 4 Application User Manual Section 4 4 and 4 6 for explanation on how to access the calendar views 4 3 4 The system shall be capable of changing appointment types for an appointment or a request at any time within business constraints The appointment types are constrained by the resources that must be configured to satisfy them If the resources are available or if the resources are the same as the existing appointment type then the appointment type can be changed This can be done by allowing double booking setting the new appointment type and cancelling the old appointment and type Reference Appe
163. e Scheduling Application User Manual Version Alpha 4 1 Application Description The Health eTime Medical Scheduling Application Version Alpha has been developed as a rapid prototype in response to the America Competes Medical Scheduling Challenge Health eTime alpha s capabilities are consistent with the Medical Scheduling Challenge requirements It is broadly intended to facilitate the lifecycle management of individual and group patient appointments from booking canceling and rescheduling through to completion and the recording of appointment outcomes The Health eTime application is designed to augment and eventually replace functionality currently provided through the legacy VistA scheduling module but the application is oriented to and organically integrated with VistA as the system of record In order to maintain data integrity and facilitate VistA integration a number of basic data elements such as Patients and Providers are drawn from the local VistA instances and rendered as read only within the Health eTime application as described in Section 5 1 Health eTime also writes essential data such as patient appointment information back to VistA where it can be accessed by other modules such as CPRS or used for reporting purposes Several improvements to the current VA scheduling capability are included in this release The first is the ability was to extend scheduling capability across VA sites and time zones and cons
164. e entered into VistA and the associated information imported Once a new patient has been entered as demonstrated in Use Case 3 unscheduled patient same day needs can be addressed as walk in and long range needs can be addressed through the appointment process Reference Appendix A 3 instructions for Use Case 3 Step 3 entering new patient 5 1 3 The system shall have the capability to support coordinating multiple appointments e g provide information helpful in scheduling all appointments on one day multidisciplinary team appointments Multiple appointments are managed through link relationships as demonstrated in Use Case 3 The business rules for appointment linkage can be adjusted For example the linkage can constrain resources to those that match both linked points and the time period to be within 24 hours Reference Appendix A 3 instructions for Use Case 3 Step 9 setting multiple linked appointments 5 2 The system shall provide the ability to allow display of primary and associate providers designated by facilities Reference response for 5 2 1 to 5 2 4 below to validate that our application has the capability to coordinate display of providers across locations 5 2 1 Ability to schedule a patient and resource on both the VistA system where the health care resource is located and the VistA system where the Veteran is located This combination should be handled across VistA systems and time zones a
165. e generally always be presented Reference Section 4 Application User Manual Section 4 1 for a description of the application Reference Appendix A 1 discussion for Use Case 1 organize scheduling in locations at multiple time zones 1 3 4 The system shall have the capability to allow users to specify timing relationships between activities eg coordinate multiple activities in specified order Embedded in the linking process are business rules governing sequencing and the user setting of time relationships between appoints This validates capability and better user definable relationships can be added later for groupings of appointments other than based on a patient Reference Appendix A 3 instructions for Use Case 3 Step 9 scheduling multiple linked appointments 1 3 5 The system shall be configurable to display only available resources When making an appointment a user is only presented with appointment slots corresponding to selected resources that have some availability for the desired dates Reference Section 4 Application User Manual Section 4 6 for instructions on how to make an appointment Reference Appendix A 3 instructions for Use Case 3 Step 5D setting patient appointments with available resources 1 3 6 The system shall have the capability to allow users to define a standard set of appointment types with default appointment lengths After selecting a Section or Clinic a
166. e is a communcation queue due block on cancelation of appointment step 16 changing appointment types on a scheduled appointment checkpoint 14 appointment types are changed on a scheduled appointment step 17 adding modifying and deleting appointment types from a section checkpoint 15 appintment types got added modified and deleted from a section step 18 assigning overbooking privileges to a provider checkpoint 16 overbooking is assigned to a provider step 19 assigning a provider to multiple sections checkpoint 17 a provider is assigned to multiple sections 20 MedRed LLC and BT America 3 3 Use Case 3 Test Script Execution User Scheduler Goals Create a Patient Appointment Run_uc3 bat Data added modified in the Scheduling Application database e Appointment Request e Regular Appointment e Group Appointments Data added modified in VistA e Corresponding clinic provider appointment Notes e When an appointment is made within the scheduling application a corresponding appointment is created in VistA which ties together the corresponding Clinic Provider and Patient in VistA e For group appointments each VistA patient will have a corresponding VistA appointment with the corresponding Vista provider Sample Log initializing vista and sql db plesae wait setp 1 receive appointment request step 2 enter desired future appointment date step 3 register patient step 4 Patient Activelnsurance
167. e of our open source application being developed specifically for VA scheduling Reference Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Use Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of continued care 150 MedRed LLC and BT America E w Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 4 4 5 The system shall have the capability to provide configurable notification requests such as alerting staff when to contact patients about upcoming appointments The rules and recipients for notifications currently in the application can be changed based on staff alert needs This is the advantage of our open source application being developed specifically for VA scheduling Reference Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Use Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of continued care Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 5 5 Evaluating BN 5 Service Coor
168. e rescheduling then click Search for slots gt First available slots display Select the desired available slot and click Book Slot gt Book Appointment page opens If this appointment needs to be linked to the rescheduled appointment in step 7 and 8 of Use Case 7 select the appropriate item from the Link Appointment drop down Click Confirm and Book gt Resources are automatically updated UseCase 7 Step 10 Send the appointment notification to the patient 1 A 8 Notification is sent automatically USE CASE 8 Add Appointment Request to Waiting List and Schedule Patient from Waiting List UseCase 8 Step 1 Add a new patient request to Electronic Waiting List 204 MedRed LLC and BT America 7 1 Select Appointments gt Patient Appointments from the menu bar gt Search patient displays or click Select Patient and then search 2 Type Benson and click Search gt Search returns HUGH BENSON 3 Click Select Patient gt List includes HUGH BENSON 4 Click the name HUGH BENSON a The patient demographics stored in VistA display 5 Click Select Patient gt Patient Appointments are listed 6 Click Add Appointment Request gt Appointment request information page opens 7 Select Preferred Time July 25 2013 10 00 Facility CA VA REGIONAL MEDICAL CENTER Clinic CA Dermatology Provider Dr OP Reason Wait List and click Add UseCase 8 Step 2 Send a waiting list notification to the patient 1 Waiting List notific
169. e schedules in our application will be associated with survey data self reporting data and scheduler documentation Thus the schedule can be used to pull data sets from the sources identified in the requirements to generate reports for such metrics If given the stated external data sources from the VA we would have configured this reporting capability Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function 9 3 7 The system shall have the capability to generate reports based on metrics and measures related to Clinic Resources as defined by the business 4 The utilization of resources within clinics is tracked with our scheduling database and can easily be presented in a variety of report formats Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports for an example of reports with resource utilization 9 3 8 The system shall have the capability to generate on demand reports containing current data to be presented to Congress 5 Reports responding to recurring Congressional requirements can be pre formatted based on our reporting process More important our process allows for the development of new report formats within 24 to 48 hours in cases of ad hoc Congressional inquiries Reference Section 4 Application User Manual S
170. eOfstringstring KeyValueOfstringstring KeyValueOfstringstring Key 557 Value 6 Ib PatientType None Person Person Address Address City None Id 42 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1962 11 01 00 00 00 Email None Ethnicity None FirstName JUANA Id 409 LastName GREER MaritalStatus None MiddleName None Phone 3105552233 SSN 300000000 Sex Male Preferences None PreferencesOther None Religion None SCPercent 0 ServiceConnected False SpecialNeeds None SpecialNeedsOther None Resources 32 MedRed LLC and BT America ArrayOfResource Resource Resource AllowOverbooking False Blocks None CalendarID None FullfillingResourceld 4 Holds None Id 3 Name case1 step 9 test SchedulingPolicies ArrayOfSchedulingPolicy SchedulingPolicy SchedulingPolicy DayOfWeek 2 EndEffectDate 2014 01 15 00 00 00 Id 60 Priority 0 Slots ArrayOfSlot Slot Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity
171. eTime application is to allow VA users to provide concrete feedback based on a real working application As with any agile development project that feedback is essential to ensuring that Health eTime is fully tailored to VA business processes and needs As discussed in this document the current application as it stands has a number of beneficial features including 1 VistA integration 2 pan VA scheduling capability 3 configurable and expandable functionality and 4 flexible options in sustainment These core capabilities provide a basis for continued agile development after the contest ends Our first recommendation for moving this application forward to an enterprise solution is for MedRed and BT to form a lean integrated production team to refine Health eTime based on user interaction and feedback Our organizations have the full range of skills necessary to work with all user groups in refining the product so that it optimizes scheduling processes and user experience We are also fully able and ready to work with all applicable VA system acquisition organizations and processes to ensure a smooth acquisition lifecycle Figure C 1 provides a notional description of the phases that we see in reaching a full scale deployed VA scheduling solution Product Refinement The product refinement phase will show VA how truly flexible the Health eTime application is Needed functions can be added in weeks and user groups will be able to interact
172. ealth eTime application on the VMs inside the contest environment We made this decision predominantly to control for the connectivity issues that might emerge when an outside application server is connected to the contest environment The configuration and installation parameters outlined in this guide therefore are unique to the contest environment and do not represent the anticipated production state For an overview of the recommended configuration of the production system please see Appendix C 2 1 Configuration of the Three VMs for Scheduling Submission The VA provided three VMs for the contest Each of these VMs is running an instance of VistA configured to represent a specific site location from the production environment The three site locations are California Georgia and Alabama As mentioned above the Health eTime application and associated software are also running in the contest environment In addition to the Health eTime application the following software is part of the Health eTime framework and is being used for the contest e SQL Server Enterprise 2008 SQL Server Reporting Services e Microsoft Server pre installed on the VM e Bedework CalDav Server e Apache HTTP Server Version 2 2 used to run Bedework e Webdev Net Bedework libraries e Daypilot Lite 2010 e JQuery e Log4Net e NHibernate Because the contest environment does not include additional infrastructure i e database and application servers t
173. eate cancel and update Clinical Video Telehealth CVT appointment sets patient and provider as a single event to prevent creation of orphans including the following resources eCVT Rooms eCVT Equipment eTelepresenter Telehealth resources such as CVT Rooms and equipment are treated as other resource types that must be converged with the provider and patient schedules to create a telehealth appointment Patient and all resources including providers for the telehealth appointment are treated as a single event in our application Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling a telehealth appointment Reference Section 4 Application User Manual Section 4 6 for explanation of telehealth appointments 5 2 4 The system shall provide the ability to modify a CVT appointment pair patient and provider as needed to prevent creation of orphans or to correct errors CVT resources are anchored to the patient and provider at both ends of a single telehealth appointment If either end is broken then the CVT resource is freed for that time slot Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling a telehealth appointment Reference Section 4 Application User Manual Section 4 6 for explanation of telehealth appointments 5 3 Ancillary Services The system shall have the capability to accommodate different service types such as C amp P ancillary services and specia
174. ection 4 5 for directions on how to access reporting function 164 MedRed LLC and BT America 7 T Reference Appendix D 10 Congressional Performance Reports for example of Congressional Reports 9 3 9 The system shall have the capability to generate reports based on metrics and measures related to Mental Health appointments 5 Our data is matched to appointment types which include mental health appointments with associated stop codes Mental health metrics are also in our reports to Congress Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 7 Clinic Operational Report for example of reporting requirements associated with mental health Reference Appendix D 10 Congressional Performance Reports for example of Congressional Reports 9 3 10 The system shall have the capability to generate reports based on Workload and Utilization Management metrics 5 The density of appointments cancellations reassignments and unused appointment slots are all captured the tracking of appointment activities These metrics are all important to workload management and easily be reported at all level of operations Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports for examples of how workload can
175. ed Based on this linking the capability exists for the scheduler to cancel or adjust all associated appointments Reference Appendix A 3 instructions for Use Case 3 Step 9 making multiple linked appointments Reference Section 4 Application User Manual Section 4 6 for explanation of how to cancel all linked appointments 3 6 3 The system shall be capable of finding and displaying available appointment slots due to appointment cancellations additional resources etc based upon configuration parameters In the application there is a handshake between the process of canceling appointments which frees up timeslots and making appointments shows available timeslots Use Case 6 and Use Case 5 show that slots for cancelled appointments are freed up for schedulers to select as new appointments Reference Appendix A 6 instructions for Use Case 6 cancelling appointments Reference Appendix A 5 instructions for Use Case 3 Step 5 making appointments 3 6 4 The system shall have the capability to permit automatic rebooking of patients into comparable Use Case 7 steps show that appropriate filters business rules can be added or adjusted in the presentation of available appointments slots for rebooking but the final selection and rebooking must still be made a scheduler 140 appointment slots MedRed LLC and BT America 7 lt Reference Appendix A 7 instructions for Use Case 7 Steps 4 and 7
176. ed to handle VA specific requirements The full list of currently audited events is stored in table dbo AuditFunction This is validated through the full audit trail which is available in the audit reports The data can be filtered and sorted in multiple ways Reference Section 4 Application User Manual Section 4 5 for 126 MedRed LLC and BT America 7 lt instructions on viewing Audit Trail in reporting 1 2 3 The system shall have the capability to create modify and delete configurable business rules that are used in the scheduling process Our application is highly configurable as specified by the requirements in Use Case 1 and 2 such as Establishing and Managing Schedules Each step relies upon creating and modifying business rules such as setting standard appoint durations blocking off schedule portions and holding dates The ease in which such business rules can be modified in the process validates this capability Reference Section 4 Application User Manual Section 4 6 for discussions of business rules in the appointment process Reference Appendix A 2 instructions for Use Case 2 Steps 3 to 19 establishing and managing schedules 1 2 4 The system shall provide the capability to configure resources at the National VISN facility clinic and provider levels Different resources are configured at different levels of the organizational structure consisting of National VISN
177. ee more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 9 Ad Hoc Operational Report 9 Ad Hoc Operational Report To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 12 2013 MedRed LLC and BT America A e e Appointment Request Type This will default to all and display all values entered in the data you can select any you wish to include in report e Most Updated Activity Type This will default to all and display all values entered in the data you can select any you wish to include in report e VISN The only current VISN is 6 and the
178. eferral for Primary Care scheduler or supervisor to check on progress for the new location Scheduler selects patient for a view of appointments and status across sites UseCase 8 Step 4b Once capacity is available and the clinic is built transfer of patients to the new location is the next step Involve Primary Care Coordinator and or Administrative Officer User selects Reschedule for existing patient appointments at old location UseCase 8 Step 5b Patient is contacted negotiate an appointment date at the new location Clinic must be active and have resources configured before an appointment can be made 1 Contact would be manual phone call Would probably be editing current appointments 2 Click Appointments gt Waiting List from the menu bar gt Waiting list search screen opens 3 Select the Facility and Clinic gt Fulfill Appointment Request page opens Click Add Appointment 4 Select the Facility Clinic and resource and click Search for slots gt Dates and times available are presented 5 Select a date and time and click Select Slot gt Confirm Appointment step displays 6 Click Confirm and Book gt Confirmation message displays 207 MedRed LLC and BT America j on B Appendix B Health eTime Application Design and Architecture Health eTime is built with a modular architecture to allow the VA to change and or swap specific components without affecting the entire application The application can easily be sca
179. eferral source by the percentage of requests Title chart Percentage of Consults Not Originating from VA Req 11 10 For the chart Percentage of Consults Not Originating from VA display the legend and for legend e Create a border around legend e Fill in light grey e Display as shown in Figure D36 Percentage of Consults Not Originating From VA E Brook AMC m Home Other MTF E Walter Reed NNMC Figure D36 D 9 Ad Hoc Operational Report This reporting suite fulfills the following requirements there is only one report in this suite A 7 1 1 The system shall have the capability to support user created ad hoc report generation without re programming and provide the capability to save the report definition for future use and to save the reports in various standard exportable formats 9 3 11 The system shall have the capability to generate reports based on unfulfilled appointment request Report 12 Ad Hoc Operational Report Report Title Ad Hoc Operational Report Report Purpose The purpose of this report is to enable a user to generate a detailed work list report by various parameters allowing them to custom build their own report To allow users to create save and export their custom report to their computer To display a detailed patient work list so that a user can examine unfulfilled appointment requests 266 MedRed LLC and BT America 7 lt Req 12 1 Enable the user to enter the following repor
180. en and Search gt List of patients with BEN are listed with their upcoming appointments Click the name HUGH BENSON gt The patient demographics stored in VistA displays Click Select Patient gt Both appointments for CA VA Outpatient Clinic Primary Care on June 25 at 10 00 and Mental Health Group at 11 00 are listed listed with Status Scheduled UseCase 4 Step 2 Display verify patient demographics 1 See Step 3 above UseCase 4 Step 3 Check in the patient to section one Select Check In for the 10 00 appointment on July 3 Walkthrough 196 MedRed LLC and BT America A So Select Appointments gt Patient Check In from the menu bar gt Search patient page loads Type Ben in the search box and click Search If already in a patient record click Select Patient upper right green toolbar and then type Ben and Search gt List of patients with BEN are listed with their upcoming appointments Click the name HUGH BENSON gt The patient demographics stored in VistA displays Click Select Patient gt Both appointments are listed with Status Scheduled Select Check In for the appointment on June 25 at 10 00 gt Appointment status is changed to Checked in UseCase 4 Steps 4 and 5 Display and view patient check in status by section two Walkthrough 1 Select Appointments gt Patient Check In from the menu bar gt Search patient page loads loads If already in a patient record click Select Patient in the u
181. ent transfer or waiting list Recipient This will be either Patient or Provider and specifies the intended recipient Medium Specifies how the message will be sent either email mail or sms Processing Notifications When a notification is required the system identifies the template to be used from the type of notification needed and whether it is linked to a clinic or facility The system collects the additional data such as the medium and recipient Then the system replaces any user defined fields with the correct information and finally sends the notification Data Model The data model for Communication Templates is shown below The templates are stored in the Communication Template table They are associated with either a Facility through the Facility __Communication Template _Rel table or a Clinic through the Section_CommunicationTemplate_Rel table Notifications require a template appointment or appointment request and appointment resources Notifications are stored in the CommunicationltemQueue which has links to the CommunicationTemplate Appointment AppointmentRequest and Appointment_Resource_Rel tables which enable all the required notification data to be obtained 220 MedRed LLC and BT America Appointment_Resource_Rel aja AppointmentId Resourceld Appointment gf E Time E Length E Status E Patientid CommunicationQueueItem
182. ent demographics stored in VistA displays 16 Click Select Patient gt Current Appointments are listed with Status 17 Click No Show for a current appointment gt Appointment disposition is set as No Show UseCase 4 Step 7 Display other scheduled appointments and convey them to the patient 1 2 Click Patient Appointments gt Patient Appointment screen shows list of upcoming appointments and requests Select the text for appointments right click and select Print the list can be printed and handed to the patient UseCase 4 Step 8 Repeat steps 1 7 for a patient in a group appointment 1 A 5 Click Appointments gt Patient Check In gt Select Patient if needed gt Return to Patient Search Type Banks and click Search gt Search results include Jennie Lamb Click on the name JENNIE LAMB gt The patient demographics stored in VistA displays Click Select Patient gt Current Appointments are listed with Status Select Check In for the patient s group appointment continue as above Wade Ferguson and Jodi Manning can be used for the other 2 appointment dispositions USE CASE 5 Manage a Walk in Patient UseCase 5 Step 1 Enter patient information and select the patient to check in 1 Select Appointments gt Patient Check In from the menu bar gt Search patient page loads if not click Select Patient to start new search Type Manning in the search box and click Search gt List of patients named M
183. eps The system provides user authentication and allows users and business roles to be managed created updated deleted Users may be added to business roles for authorisation with each role defining actions which can be performed within the system These mainly relate to menu access visibility allowing the required test roles to be simulated Technical Card Source Code C Frameworks Net jQuery CSS DayPilot B 14 Health eTime Role based User Security Note The following simplified user model is incorporated in Health eTime Version Alpha to demonstrate capability for the scheduling contest It would not be used in a production system Each user is assigned roles relative to the sites and clinics they work for Each role is configured to perform a number of actions functions Data Model User table Already Exists Id int Personld int Username Nvarchar 50 Password Nvarchar 50 Salt Nvarchar 50 216 MedRed LLC and BT America Role table Roleld int RoleName nVarchar 50 Action Actionld int ActionName nVarchar 255 ActionDesc Nvarchar 255 Additional text to explain function ActionKey Nvarchar 255 Unique key used when checking for function in UI UserRole table UserRoleld int UserID int RolelD int SitelD int A Role must link to either a site Section ID int OR a clinic RoleAction table RoleActionID
184. eps 9 scheduling other linked appointments 4 3 Assign and Configure Time Slots The system shall provide the capacity to assign and configure time slots for appointments Reference response for 4 3 1 to 4 3 6 below to validate that our application has the capability to configure timeslots 4 3 1 The system shall have the capability to block time slots in user defined increments Use Case 2 validates the capability to block time slots on the schedule The procedures for blocking are explained in the Application User Manual 147 MedRed LLC and BT America 7 T Reference Appendix A 2 instructions for Use Case 2 Step 8 Block a portion of a schedule Reference Section 4 Application User Manual Section 4 4 and 4 6 for explanation on how to block time slots 4 3 2 The system shall have the capability to present alerts and reminders for a variety of reasons e g eligibility not verified means test or insurance information out of date Currently our application treats alerts and reminders as a part of the integrated notification process as demonstrated in Use Cases 6 7 and 8 When an alert or reminder is required a business rule for sending notification is established and a notification format is designed to meet user requirements Reference Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Us
185. equire action and need an appointment to be scheduled for a transfer to another site clinic facility or locally 247 MedRed LLC and BT America _ A Req 7 12 Below the Appointments with Action Required create a summary table and title it Summary of Appointments with Action Required by Clinic Display the following fields as columns in the table e Clinic Name of clinic display as text e Action Required Total Count of appointments with a desired appointment date no scheduled or rescheduled appointment date where the type of request standard or transfer and status pending Summary of Appointments with Action Required by Clinic PNS Figure D19 Req 7 13 Ensure report is displayed per mock up D 5 DSS Stop Code Detail This reporting suite fulfills the following requirement there is only one report in this suite B 9 3 3 The system shall have the capability to generate reports based on cost reporting metrics and measures i e DSS stop codes and other financial metrics and measures as defined by the business that are tied to the scheduling appointment Work List Summary Queue and Patient Detail Report 8 DSS Stop Code Detail Report Report Title DSS Stop Code Detail Report Report Purpose The purpose of this report is to supply the primary and secondary stop codes with descriptions and total overall counts of stop codes by a user specified time period clinics site and facility Additional financial cost reporting
186. erence Appendix D 6 Capacity Workload and Utilization Report for example of metrics can roll up to national level 9 3 1 The system shall have the ability to capture and provide the data necessary to conduct capacity planning through complete visibility into supply provider equipment facility support staff and demand enrolled and or empaneled Veteran requests for appointments 3 Data allowing complete visibility into supply to include providers equipment rooms resides in our database and is presented through the reporting function Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 6 Capacity Workload and Utilization Report for example of how metrics can be presented 9 3 2 The system shall have the capability to generate wait time metrics and measures based on clinic operational metrics 5 Data on wait time resides in our database and is presented through the reporting function Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 2 Operational and Wait Time Summary with Patient Detail Reports for example of how metrics can be presented 9 3 3 The system shall have the capability to generate reports based on cost reporting metrics and measures i e DSS stop codes and other financial metrics and measures as defined by the business
187. erface of a rapid prototype A list of these variables is top level management entities facilities standard services standard Appointment type categories standard national and VA specific holidays For this reason information regarding these variables in our application is drawn from VistA and presented as read only in Health eTime and instructions for configuring these variables which again is done using the legacy VistA terminal application is not detailed in this document Detailed instructions for use case 1 therefore start with step 6 174 f MedRed LLC and BT America a VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log out Y SCHEDULING PorTaL VistA Site CA VA HEALTH CARE SYSTEM UTC 08 00 Pacific Time US amp Canada VistA Appointments Administration About Help Sites EL Site Listing VistaSiteId Name Phone Time Zone CA VA HEALTH CARE 916 555 UTC 08 00 Pacific Time US amp SYSTEM 1212 Canada GA VA HEALTH CARE 404 321 UTC 05 00 Eastern Time US amp SYSTEM 6111 Canada 557 AL VA HEALTH CARE 334 272 UTC 06 00 Central Time US amp SYSTEM 4670 Canada VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log out SCHEDULING Porta VistA Site CA VA HEALTH CARE SYSTEM UTC 08 00 Pacific Time US amp Canada VistA Appointments Administration About Help Sites Facilities Reports Address Name Phone Hours Abbreviation Address 1 State ZIP
188. escheduled appointment date Req 10 3 Create a table and title it Patient Work List Detail include the following columns allow each of these columns to be able to be filtered by the user e Patient name Last Name First Name Middle Name e SSN last four digits Format as text only showing last four digits e Appointment Date MM DD YYYY Display the most recent date for appointment use the rescheduled date if populated if blank this is the initial appointment date e Appointment Start Time Hour minute AM or PM Convert military time to standard time this is stored in appointment table e Appointment End Time Hour Minute AM or PM Covert military time to standard time this is the appointment start time plus the length of appointment in appointment table e Appointment Duration in minutes Minutes Stored in appointment table as length e Clinic Format as text Name of the clinic the appointment is with e Facility Format as text Name of the facility for the clinic the appointment is with e Site Format as text Name of the site the appointment is with e Provider Provider First Name Provider Last name Name of the clinician the appointment is with e Most Updated Activity Type Format as text and show the most recent for this appointment e Cancelled Appointment Y N Format as Y N When Activity type Cancel then Y Req 10 4 Include a note box at the bottom of the Patient Work List Detail table Have the note table read e Outline Box e Fi
189. estriction type secondary Req 8 16 Secondary Stop Code Description The Name recorded in the Stop Code table when restriction type secondary Req 8 17 Create a table under the Patient Detail table title it Count of Completed Appointments by Primary Stop Code and Clinic This table s data is based on the patient detail table but summarized into counts Create the following columns 249 MedRed LLC and BT America 7 T Clinic Name of the Clinic Primary Stop Code The three digit number recorded in the Stop Code table under code when restriction type Primary Count of Primary Stop Codes Count of the three digit number recorded in the Stop Code table under code when restriction type Primary Primary Stop Code Description Description for the primary stop code Req 8 18 Create a table next to the Count of Completed Appointments by Primary Stop Code and Clinic and title it Count of Completed Appointments by Secondary Stop Code This table s data is based on the patient detail table but summarized into counts Create the following columns Clinic Name of the Clinic Secondary Stop Code The three digit number recorded in the StopCode table under code when restriction type Secondary Count of Secondary Stop Codes Count of the three digit number recorded in the Stop Code table under code when restriction type Secondary Secondary Stop Code Description Description for the primary stop code Req 8 19 Create a note box under the Count of
190. example report step by step instructions Suite 10 Congressional Performance Reports 10 Congressional Report Count of Completed Mental Health Appointments Per Patient To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 13 2013 e Select Sites Any can be used e Select Facilities Any can be used e Select Clinics Any can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 Home gt Reporting gt Count of Completed Mental Health Appointments Per Patient Home My Subscriptions Site Settings Help From 6 9 2013 5 31 37 PM B r 6 13 2013 E View Report Sites AL VA HEALTH CARE SYSTEM Facilities AL VA OUTPATIENT CLINIC AL Clinics Audiology Mental Health Ment id 4 i of1 b pi 100 v Find Next A B Congressional Report Count of Completed Mental Health Appointments Per Patient Report Parameters AL VA HEALTH CARE SYSTEM CA VA HEALTH CARE SYSTEM GA VA HEALTH CARE SYSTEM AL VA OUTPATIENT CLINIC AL VA REGIONAL MEDICAL CENTER CA VA OUTP
191. f the provider has an open hour available for scheduling Providers with less than a one hour block of availability should not be shown Note Vacation blocks are not accounted for at this time e Date Show the real date the provider is booked with an appointment this can either be the rescheduled date or appointment date in MM DD YYYY format e Available Time Slots for Appointments Only show the hours the provider does not have an appointment booked Only display based on possible appointment slots allocated in there scheduling policy 253 MedRed LLC and BT America 4 Req 9 9 Show a note box under the Provider Availability table e Outline note box e Fill note box in light grey to match legend e Italicize and bold the font e Have note display Note Blocks holiday s and holds are currently not shown in the above table Display as shown in Figure D23 Provider Availability w 4 2 1 201 8 00 AM 2 1 2013 11 00 AM 2 1 201 1 00 PM aja 2 00PM 4 Margaret Hills Margaret Hills Margaret Hills Margaret Hills Margaret Hills Margaret Hills Smith Thorns Smith Thorns 2 1 201 2 1 2013 2 1 2013 2 1 2013 2 1 2013 2 1 2013 2 1 2013 2 2 2013 2 3 2013 2 3 201 2 3 2013 2 3 201 w Smith Thorns Smith Thorns Smith Thorns Margaret Hills Smith Thorns Smith Thorns Smith Thorns Smith Thorns Smith Thorns 2 3 2013 Smith Thorns 2 3 201 Note Blocks holiday s and holds are currently not shown in t
192. f this report is to supply a patient detail and summary for appointments by activity type An activity type for an appointment is the disposition that was used by the scheduler when the appointment was updated This could be a no show missed appointment or left without being seen This supplies the scheduler the ability to pull these quickly in a report by the date of the appointment using the From and To date parameters of the report The scheduler can also select a specific Clinic Site and Facility These metrics can then be analyzed to help in managing patient missed appointments and to help analyze the volume of missed appointments for a time period and clinic Req 6 1 Enable the user to enter in the following parameters 243 MedRed LLC and BT America 7 e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to select a specific clinic have a drop down of available clinics populate e Site Allow user to select a specific site have a drop down of available sites populate e Facility Allow user to select a specific facility have a drop down of available facilities populate Req 6 2 For the From and To date use the appointment table where the date is the most updated appointment This can be either the scheduled appointment date or the rescheduled appointment date if populated Req 6 3 Only bring back data within from and to date clinic site and facility chosen by the user u
193. facility clinic and provider For example providers are defined at the level of a site while the specific resources representing these entities are created at the level of a clinic or section to logically group them for searches and privilege assignments This approach permits providing both a global configuration of resources and a local configuration of the resource at the section clinic level As an example the Allow Overbooking flag is available on the Add Resource screen when a resource of type Provider is created at the level of a section Reference Section 4 Scheduling User Manual Section 4 4 for instructions on selecting Sites Facilities and Clinics Reference Appendix A 1 instructions for Use Case 1 Step 6 configure for multiple facilities 1 2 5 The system shall provide synchronization with individual patient or provider Office Automation calendar for multiple types of end user devices including mobile applications irrespective of operating system Our scheduling application includes an Open Source module based on the Open Standard CalDav which allows any authorized and authenticated CalDav compliant device to synchronize appointment information that the user is authorized to access The integration approach of this CalDav compliant module is described in the Application Design and Architecture document The user merely needs to follow instructions on how to synchronize a CalDav co
194. formats created for the contest are not intended as the definitive production formats We can report any data in any format provided the data elements 223 MedRed LLC and BT America 7 lt are present in the master database or can be pulled from VistA Refining the current format would involve working with users to design the look and feel of the reports to support the objective process Expanded Automation Currently Health eTime s ability to carry out automated functions without a scheduler in the loop is limited because the feature was outside the scope of the contest Moving forward it is possible to clarify this requirement and incorporate additional application modules to improve automation and optimization Communications As with other components of the scheduling application the communication functionality must be fully integrated with the objective process of scheduling The flexibility and modularity of Health eTime enables the expansion of communication capability which need not be constrained by existing communication modalities Initial Deployment Phase In parallel with and following completion of refinement the necessary deployment preparations will be conducted These preparations will include Enterprise Architecture We will work with VA to detail hardware and software requirements prior to a staged deployment of the Health eTime application in the production environment Data Migration Plan A precise
195. g purposes E 2 5 Integration Point Stop Codes Stop Codes are required for reporting purposes and to reproduce appointments that are made from the scheduling application into VistA The list of valid Stop Codes is defined at the level of a site Sections Clinics are assigned stop codes when created When creating provider type resources in the scheduling application the section or clinic stop code is assigned to the provider resource When Appointment Types are created they are also assigned a stop code E 2 6 Integration Point Provider Data The list of VistA Providers is available and used when a provider resource is created in the scheduling application At that time creation of provider resource an equivalent clinic provider 273 MedRed LLC and BT America 7 lt entity is also created in VistA The information i e name for that clinic provider entry in VistA is derived from the section clinic and provider information Consequently the scheduling application may have multiple provider resources per section and clinic and each provider resource is matched by exactly one VistA clinic resource entry E 2 7 Integration Point Appointment Data Within the scheduling application a scheduler can commit a patient and several types of resources providers rooms and equipment into the same appointment When an appointment involves a provider the appointment is also saved in VistA using the patient and provider information
196. ge business rules and standards at a national level including establishing parameters for role based user access and security and supporting a process to monitor and evaluate results of audit reports VA Requirements Instructions and Validating Outcomes 1 1 The system shall have the Our integration strategy between the scheduling application and VistA capability to provide uses a two pronged approach integrated electronic access to and from other VistA 1 The application can import reference data from VistA and treating it applications as read only data within the scheduling application in order to ensure consistency between the scheduling application and VistA This is validated in the patient search function of the application which searches patients directly in VistA and pulls a local read only copy of the patient data once the patient is selected for scheduling 125 MedRed LLC and BT America 7 lt gt purposes Reference Appendix A 3 instructions for Use Case 3 Step 3 Select the Patient 2 The application can continuously export data from the scheduling application to VistA to ensure that back end processes in VistA will continue to function without any knowledge of the new scheduling application This is validated in the Create A Patient Appointment process which automated in Step 1 UC 3 records appointments in the local scheduling database but also adds these appointments
197. he above table Ww Ww Figure D23 Req 9 10 Create a table title the table Provider Utilization and Case Load Include the following columns for this table e Provider Show the provider name if the provider is included in the Provider Availability table Provider name should only be shown 1 time per day e Date Show the date one time for each provider 254 MedRed LLC and BT America 7 Utilization Rate Calculated field using the number of hours the provider is booked with appointments which were not cancelled or rescheduled This is the number of appointments the provider has per day divided by the total number of appointment slots the provider has allotted for their scheduling policy Z Provider Utilization and Case Load Margaret Hills 2 1 2013 27 Smith Thorns __2 1 2013 23 Smith Thorns ___2 2 2013 0 Provider Utilization Rate is the number of appointments the provider has per day divided by the total number of appointment slots the provider has alloted or their scheduling policy Figure D24 Req 9 11 Create a graph for the Provider Utilization and Case Load table and title the graph Provider Utilization Show graph as a line graph Show data labels Show legend with provider name which indicates what line they are on the graph Ensure each provider line is a different color in legend and in graph o Outline legend o Ensure colors are consistent with report o Fill legend in light grey o Ens
198. he Link Appointment drop down 5 Click Confirm and Book gt Communication booking page displays with new appointment details 6 Click the link to Patient Appointments gt Patients Current Appointments shows both appointments with the relationship shown w UseCase3 Step 10 Create schedule initiate patient pre appointment notification In our application the notification is sent automatically based on the template created in use case 1 UseCase 3 Step 11 Schedule a group of patients in a multiple appointment time slot e g group therapy Walkthrough 1 Create a group appointment type as details in Use Case 2 step 10 2 Select Appointments gt Group Appointments gt Group Appointment Calendar displays 3 Select the same Facility Clinic and Provider as used to create the appointment type 4 Select the scheduled group appointment on the calendar gt Appointment capacity is displayed Click Add Patients Add Patients shows list of all patients not already scheduled for the group appointment Select 3 additional patients to join the group appointment Select the appropriate Appointment Type gt Confirm that the appointment type matched that listed at the top of the page 9 Click Add Patients to Group gt Return to group appointment detail page i The number of available slots will now be reduced by 3 ONO Step 12 Schedule telehealth appointment where the patient locations is in one VistA instance California VM and the provider
199. he capability to generate reports based on metrics and measures related to Mental Health appointments Report 10 Mental Health Operational Report Report Title Clinic Operational Report Report Purpose The purpose of this report is to enable a user to generate a report based on one or multiple clinics of their choosing to see the most updated activity documented on an appointment i e no show checkin cancel etc To supply complete visibility on the number of appointments and their statuses based on a particular time period clinics site and facility selected Note Most mental health clinics end in the word Mental Health since this is not always the case the user has the ability to select which clinics make up their mental health report However this report can be used for any clinic or combinations of clinics Reg 10 1 Enable the user to enter the following reporting parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to select one or more clinics mental health clinics generally end with mental health but since this is not always the case the user can select whichever clinics they choose e Facility Allow user to select one facility 260 MedRed LLC and BT America 7 T e Site Allow user to select one site Req 10 2 For the From and To date use the most updated appointment date This can be either the date the appointment was initially scheduled or the r
200. he clinic does not have an appointment booked A booked appointment is either an appointment which has been scheduled or rescheduled for that date and time and that has not been cancelled Only show in 1 hour increments Req 1 24 Create a table title the table Clinic Utilization Based on Appointments Include the following columns for this table e Clinic Show the clinic name if the clinic is included in the Clinic Availability table Clinic name should only be shown 1 time per day e Date Show the date one time for each Clinic e Utilization Rate Calculated field using the number of hours the clinic is booked with appointments which were not cancelled or rescheduled divided by 8 hours This is 8 hours since 1 hour is not removed for lunch hour Show this as a percent field Clinic Utilization Based on Appointments pS zao 34 22 PPS o 81 a 7 PNS 2 3 2013 81 PTRP 2 3 2013 19 Clinic Utilization Rate is the number of appointments the Clinic has per day divided by the total number of appointment slots the Clinic Resources have alloted for their scheduling policy Figure D8 Req 1 25 Create a graph for the Clinic Utilization Based on Appointments table and title the graph Clinic Utilization e Show graph as a line graph e Show data labels 232 MedRed LLC and BT America pad e Show legend with provider name which indicates what line they are on the graph Ensure each Clinic line is a different color in legend
201. he highest priority and schedule that request based on the new availability Reference Appendix A 8 instructions for Use Case 8 add to waitlist and schedule from waitlist Reference Section 4 Application User Manual Section 4 6 for explanation of the waitlist function 139 3 6 Appointment Rescheduling The system shall identify appointments to be rescheduled and route them automatically to the reschedule status or pending list MedRed LLC and BT America 7 lt gt Reference responses for 3 6 1 to 3 6 5 to validate our capability for rescheduling appointments 3 6 1 The system shall have the capability to disposition rebooking of no shows Use Case 4 demonstrates how no shows are tracked and Use Case 7 shows how rebooking can be made based on operational procedures to include procedures for no shows The Application User Manual further explains how no shows are tracked in appointment execution Reference Appendix A 4 instructions for Use Case 4 Step 6 disposition of appointment to include no shows Reference Appendix A 7 instructions for Use Case 7 reschedule individual appointments Reference Section 4 Application User Manual Section 4 6 for explanation of appointment process 3 6 2 The system shall have the capability to link associated appointments so that if one is cancelled all linked appointments can be dispositioned together Use Case 3 validates that appointments can be link
202. he market we concluded that our submission should not consist of a poorly aligned proprietary Commercial off the Shelf COTS product forced to meet contest requirements Instead we settled on an underlying strategy of Open Source agile development and iterative releases based on close consultation with the requirements and the user group Details regarding our approach the resulting Health eTime scheduling application Version Alpha and its accompanying documentation are provided below 1 1 1 About the Health eTime Scheduling Application Version Alpha The Health eTime application Version Alpha has been developed to VA specifications as a rapid prototype and integrated with VistA through a web service layer based on the VA Medical Domain Web Services MDWS standard An overview of the application architecture is provided below in Figure 1 1 Our goal was to field a rapid prototype developed via agile methodologies All capabilities demonstrated are functional but as with any prototype much of the functionality can be refined and expanded The primary development goal was to demonstrate core functionality in the context of the contest requirements and constraints and provide insight into the critical baseline question of how Open Source VistA might be effectively modernized using open source agile methodologies and incremental releases The four core functional improvements included in Version Alpha developed for the contest inc
203. he scheduling database since they wouldn t tie to an appointment however we did complete the provider utilization piece of requirement B 9 3 5 The system shall have the capability to generate performance reports Performance measures include access measures clinical measures and scheduling measures Report 1 Appointment and Clinic Dashboard by Site and Facility Report Title Appointment and Clinic Dashboard by Site and Facility Report Purpose The purpose of this report is to show appointment related details for a patient provider and clinic within a user specified time period Clinic Site and Facility This can be used by schedulers or anyone interested in an identified report with detail for patients for a time period to better understand and manage provider and clinic utilization Req 1 1 Enable the user to enter in the following parameters e From Date Allow user to select from a calendar e To Date Allow user to select from a calendar 226 MedRed LLC and BT America 7 e Clinic Allow single and multiple selections e Site Allow single select e Facility Allow single select Req 1 2 For the From and To date use the appointment table where status created Req 1 3 Only bring back data within from and to date clinic site and facility chosen Req 1 4 Create a table which displays the following headers are columns e Patient name Last Name First Name Middle Name e SSN last four digits e Appointment Date e Appointment
204. heduling Setup eeeeeeeeees 125 5 2 Evaluating BN 2 Manage Veteran Information ccc cccceeeeeeeeeeeeeneeeeeeeeeeeeeeeaaees 133 5 3 Evaluating BN 3 Manage Request 2 c cess sacsnctdnestenedvessestdnarieladvesasdecetidetadtanesticesiees 136 5 4 Evaluating BN 4 Manage Appointment esssssssenrneeesseeenrrrnrrsserrrnrrrnnnrssererrrrnnnt 144 5 5 Evaluating BN 5 Coordinate Associated and Occasions of ServiCe 0 151 5 6 Evaluating BN 6 Manage Encounter of Care ceeeeeeeseeceeeeeeeeeeeeneeeeeeeeeeteneenaaees 155 5 7 Evaluating BN 7 Reporting icceciscscrcactecedecesnstinumeesnneten sanctus srerenenssainiaersieelenediaiwmacnens 155 6 Instructions and Traceability Matrix for Step 2A Attachment B VA Specific Requirements Evaluat iS eee E EE E EEEE REA ENE E EEE EER E E 157 7 Instructions and Traceability Matrix for Step 2A Attachment C Non Functional Requirements Evaluators esses verenetcncten ts tacreceteccnddesy cuca enendganbuasduc nixed aeieneseeiuenalecentnedtonsdeetces 168 7 1 Evaluating Functionality iecccsccrencsdeerencraratecunviacencrentanestieteccteeetentetas eamesnioecitietenecner 168 MedRed LLC and BT America 7 7 2 Evaluating Wor eee eee ieee eee eee ee eee ee ee eee 169 7 3 Evaluating Maintainability cc cccccceeeieeeecnneee terre eee eeeeneeeeeeeeeeeeeneceaeeeeeeeeeeneeenaaees 170 8 Instructions and Traceability Matrix for Step 2B Open S
205. ial needs linked to Patients Having said that we have actually not implemented the UI to these entities but this is a fairly trivial Reference Appendix A 3 instructions for Use Case 3 Step 4 verifying patient information 2 5 The system shall have the capability to receive notification of deceased patients and allow the authorized user to cancel future appointments ancillary services orders once notification has been received from an Cancellation process demonstrated in Use Case 6 can receive death notices through VistA when given a VistA data to pull from Once an official death notice matching patient identity in the scheduling data base has been confirmed all the patent s appointments can be cancelled through a process similar to Use Case 6 Reference Appendix A 6 instructions for Use Case 6 Step 2 selecting appointments to cancel 134 authoritative source MedRed LLC and BT America 2 6 The system shall have the capability to establish and update patient information enrollment status eligibility demographics preferences and special needs means test status provider assignments etc Our application has the capability to update any information in the scheduling application database The same is true with updating VistA We use the current MDWS interface or extend it We have already demonstrated that our application has both of these capabilities in previous steps requirements Howe
206. ical Center Click View Clinics to view the clinics associated with a facility Click the Select link for the Primary Care Clinic Click the Clinic Resources List link Click Add Resource gt Type Name Oximeter Select Resource Type Equipment Resource Oximeter Click Add gt The Oximeter has now been added to the list of resources Repeat as needed Use Case 2 Step 3 Create schedules for multiple resources that are assigned to one section Walkthrough 1 NO oP wh Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Select View Clinics at the bottom of the page Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for an existing resource Click Scheduling Policy List gt Policy list table includes policies for weekdays with time slots and capacities Click Add Policy gt Enter desired Policy information Day of the week Start Effect Date End Effect Date Priority Click Add gt Policy selected is added to the policy list for this resource Use Case 2 Step 4 Create a schedule for a provider from 4 December 2013 to 15 January 2014 183 a MedRed LLC and BT America o A Walkthrough 1 Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the
207. ide the capability to create modify manage delete and report on resources and groups The management of resources and groups are fully validated in the use cases The changes in resources and groups overtime are then captured in the reporting formats in Attachment B metrics The report functionality is further explained in the Application User Manual The provider resource can be changed using the dedicated function when viewing existing appointments Reference Appendix A 2 instructions for Use Case 2 Step 2 configuring resources Step 3 converging resources Steps 4 9 managing resources 131 MedRed LLC and BT America Reference Appendix A 6 instructions for Use Case 6 Step 6 cancelling and freeing up resources Reference Section 4 Application User Manual Section 4 5 for explanation of reporting functions 1 6 Audit Trails The system shall have the capability to display business and technical audit trails Reference instructions for 1 6 1 below Our scheduling application has the capability to display business and technical audit trails 1 6 1 The system shall provide the ability to record data to produce audit trails for items including user access activities modifications to schedules The scheduling application maintains a list of audited user activities that includes events such as login and logout events The delivered functionality can easily be augmented to handle additional V
208. ider Utilization e Show graph as a line graph e Show data labels e Show legend with provider name which indicates what line they are on the graph Ensure each provider line is a different color in legend and in graph e Outline legend o Ensure colors are consistent with report o Fill legend in light grey o Ensure font is easy to read and matches style of report see Figure D7 below Provider Utilization 100 z 90 87 g 80 87 5 70 60 r 50 amp 40 30 f emi 20 10 0 0 2 1 2013 2 2 2013 2 3 2013 Figure D7 Req 1 23 Create a table title the table Clinic Availability 231 MedRed LLC and BT America 7 lt Include the following columns for this table e Clinic Show the clinic name if the clinic is has an open hour available for scheduling An available hour is classified when an appointment has been scheduled or changed and rescheduled for a particular time Show hour as available if appointment was cancelled Clinics with less than a one hour block of availability should not be shown Clinics can be shown as available even if provider is on vacation or during a provider s lunch break Providers do not have to tie to the Clinic e Date Show the date the clinic is NOT booked with an appointment that is not cancelled which has been either scheduled or rescheduled for that date in MM DD YYYY format e Available Hours for Appointments Only show the hours t
209. ients who have outstanding Appointment Requests or are on a Wait List can be managed through these pages Priority patients are Service Connected 50 100 or lt 50 if the appointment is service connected From the Appointment menu select Waiting List You can search waiting lists by Facility Clinic and by highest priority as shown below 115 MedRed LLC and BT America J C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Warne List PATIENT WAITING LIST Facility CAVA OUTPATIENT CLINIC iv Clinic CA Family Practice Show highest priority only k No Outstanding Appointment Requests Provider Roster View This option provides a Calendar view of the Provider Roster for informational purposes This page allows you to see any appointment scheduled Tooltips provide appointment details including status e g Checked in You can get to the Provider Roster by selecting the Appointments menu and then Provider Roster or from the patients appointment screen selecting View in Provider Roster Provider Roster w http 166 78 237 187 SchedulingWeb Patient ProviderRoster aspx B 44 x P Search 8T intranet Qe iy Favorites Provider Roster a fit gt B Sl ae Pager Safetyy Tooky y Build 1 11 4908 21296 Logged in as test log out r4 2 ETERANS AFFAIRS VistA Site CA VA HEALTH CARE SYSTEM SCHEDULING PORTAL UTC 08 00 Pacifi
210. ies that require coordination with appointments e g ancillary services Activities can be treated as another type of appointment that is linked to a patient appointment through the process demonstrated in Use Case 3 If the activity is to occur with the appointment such as an ancillary test the activity can be treated as a resource For example a blood test could be a resource to be aligned with appointments and a CT Scan would be a linked appointment which the patient must separately go to Reference Appendix A 3 instructions for Use Case 3 Step 9 linking multiple appointments 5 3 4 The system shall have the capability to coordinate appointments with related ancillary services Ancillary services linked to an appointment will have its own schedule Thus they can be treated as resources and be coordinated as rooms and equipment are coordinated with an appointment In post contest development we will work with user groups to determine exact ancillary services that should be associated with each type of appointment Reference Appendix A 2 instructions for Use Case 2 Step 2 and Step 3 configuring and scheduling resources 5 4 The system shall have the capability to provide a patient preference field that informs clerks to special transportation concerns or other issues that limit availability e g specific days and times As demonstrated in Use Case 3 special patient needs can be tracked along with p
211. iew for an 160 MedRed LLC and BT America explanation of the consult reporting format 8 The system shall have the ability to disposition for travel reimbursement 3 Our application currently has a functional place holder for administrative actions We envision that specific VA travel reimbursement procedures will be added to this area and connected with the notification function Reference Section 4 Application User Manual Section 4 7 for discussion of administrative actions Reference Section 4 Application User Manual Section 4 4 for explanation of notification function Reference Appendix B Application Design and Architecture Section B 15 for explanation of notification process 9 1 The system shall have the capability to generate reports containing scheduling data from both the solution application and legacy systems 3 As demonstrated in the UI reporting function with formats explained appendix D our system can clearly report on scheduling activities within the system Because our system is fully integrated with VistA we can further pull data from the legacy system MSP for reporting but have not been given a data source in this contest to demonstrate this capability Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports for example of reporting on sched
212. ility to book or cancel recurring appointments e g recurring appointments to same resource all at once The capability to link appointments is the foundation for establishing recurring appoints and the scheduler can schedule a series of appointments by selecting Recur in the add appointment or add telehealth appointment function If the same timeslot is always open extending into future then setting recurring appoints is a very simple business rule that we have implemented In very busy schedules however automatically searching for openings at set intervals is a complex operation for the application Our application current does not have artificial intelligence that automatically searches for appointment openings at set intervals and will thus note schedule conflicts as pending appointments To canceling a series of appointments the scheduler should follow the displayed link relations and individually select the appointments to cancel Reference Section 4 Application User Manual Section 4 6 for 141 MedRed LLC and BT America explanation of recurring appointment capability Reference Appendix A 3 instructions for Use Case 3 Step 9 scheduling multiple linked appointments 3 7 3 The system shall have the capability to provide users the capability to view available appointments based on configuration parameters As shown in Use Case 3 the display of available open appointment slots can be filtered again
213. in VistA References Appendix A 3 instructions for Use Case 3 Step 5 Make Appointment 1 2 Maintain and Modify Scheduling Configuration The system shall provide the capability to establish and maintain national VISN VAMC clinic provider level configuration standards Configuration shall be enabled for facility level within business rules and parameters Reference instructions for 1 2 1 to 1 2 5 below Our application fully satisfies the requirements for maintaining and modifying scheduling configuration at designate levels of standards and enables facility level business rules and parameters 1 2 1 The system shall have the capability to provide on line help The Ul is designed to be an Online Portal thus enabling the capability for On line Help Every page of the User Interface has a context sensitive link to a help screen This is validated with the help link available on most screens The help content will be expanded in further development Reference Section 4 Scheduling User Manual Section 4 9 for instructions on how to use the Help Function in the UI menu 1 2 2 The system shall have the capability to maintain an audit trail of changes to resource configuration The scheduling already maintains a long list of audited events which includes resource related events such as Schedule Created Schedule Remove Schedule Activated etc The delivered functionality can easily be augment
214. in VistA e Corresponding clinic provider appointment status Notes e When the status of an appointment is changed within the scheduling application that status change is reflected in the corresponding appointment in VistA Sample Log initializing vista and sql db plesae wait setp 1 add a patient to waiting list step 2 sending waiting list notification to the patient checkpoint 1 56 MedRed LLC and BT America patient is listed on the waiting list and notification letter got created step 3 checking open resource for an appointment checkpoint 2 patient is listed on the waiting list step 4 select a patient from the waiting list where SC gt 50 step 5 display patient demographics and contact the patient Patient Activelnsurance 0 CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000004 Id 7 IsVeteran True MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring KeyValueOfstringstring Key 557 Value 4 1 KeyValueOfstringstring Key 555 Value 791 Ih PatientType SC VETERAN Person Person Address Address City None Id 36 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1968 10 04 00 00 00 Email None Ethnicity None Fi
215. in the above described data bases in preparation for the Step 2 demonstrations 13 MedRed LLC and BT America STEP 1 EVALUATION MedRed LLC and BT America pad 3 Instructions for Running Step 1 Use Case Scenario Test Scripts Consistent with contest requirements and guidelines provided in Instructions for the Use of the Test Environment we have developed and submitted automated Python test scripts that execute all the actions listed in the 8 Use Cases provided for Step 1 evaluation Below are instructions for executing these automated Test Scripts along with a brief explanation regarding how to interpret the expected system output We have also included some details regarding the manner in which the Test Scripts execute in order to facilitate clear comprehensive checkpoint validation Machine Setup The following components are required to run the scripts Note that these are pre configured for login Contestant Python 2 7 suds soap python client and pytz python time zone library Note on CTEST amp CMAKE We are currently not making use of either CTEST or CMAKE while following the VA s guidance on the subject which stipulated that We do not strictly require that CMake be used All submissions will be considered and need to work reliably even if not compliant with the CMake environment Our scripts are very easy to run and do not need anything else Directories After accessing any of
216. ing Function Design ccccceeeeeeeescececeeeeeeeeeeenenaaeeeeeeeeeeeeenenaaeaes 226 D 1 Provider and Clinic Appointments Utilization Reports ccceeeeeeeeeeeeeeeeeetneeeeeeees 226 D 2 Operational and Wait Time Summary with Patient Detail Reports ceee 237 D 3 Summary by Activity Type with Patient Detail 00nnnnnnneeeeeeneennnrrnnesserennrrnnnneserrrnee 243 D 4 Work List Summary Queue and Patient Detail nnnnnnnneeeeeseeennrrnnneeserennnrrnnreserrenne 246 D 5 DSS Stop Code Detail acdsee dep ite diy areciie Si distinse sy Od ease eee 248 D 6 Capacity Workload and Utilization Report cc eeeeeeeeeeee eee eeeeeneeeeeeeeeeeeeeesaeeeeeeees 250 D7 Clinic Operational EDOM iisiscccuccsnceieniasecuneistenueate sess ehatetuaniemaasedenemteiaenaeiearurentes 260 D 8 Consults Summary and OVErVieW c ccccceeeeeeeeeeeeneeeeeeeeeeeeeeeecaaeeeeeeeeeeneeeninneeeeeees 264 DY Ad Hoc Operational ROD OMl ceeccciccctccatecnscccnctadecstvetsacesetatecctonssicaveicsesetenasserenncdeenteneians 266 D 10 Congressional Performance Reports eeeceseccceceeeeeeeeeeeneeeeeeeeeetesensnaeaeeeeeees 268 E Appendix E Open Source and Software Licensing Documentation ceeeeeeees 272 E 1 Descriptive Documentation of the Integration Codes cccceeeeeceeeeeeeeeeeeenneeeeeeees 272 E 2 Documentation of Code APIS cscs scccscsazes sczcicedeserades inccteicizeeidenezeave
217. intmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None i AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR PatientInstructions None y CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC 43 MedRed LLC and BT America Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 Statio
218. irly simple exercise for our engineers to add user interfaces to manage add delete update these entities if needed 272 MedRed LLC and BT America 7 e Appointment Type Categories e Cancellation Reasons e List of Services Types currently not used e Stop Codes e Providers e Patients The VistA instances we received did not have providers that we could re use therefore we create them while running during Step 6 of UC 1 The VistA instances we received included Stop Codes Service Types Cancellation Reasons and Appointment Type Categories We are re using these The stop codes listed in the Contest materials differ from the auto populated codes imported from VistA Despite this discrepancy the flexible nature of our application ensures that such differences are easily a handled E 2 4 Integration Point Patient Data Patient information is owned by VistA The Search feature of the scheduling application always retrieves the list of patients from VistA When the user selects a specific patient the service layer determines whether the given patient has been imported locally in the scheduling database When that is not the case the service layer imports the patient data locally The patient information that is imported mainly includes demographic data Note that in order to have a richer testing environment we create a set of patient entries at the end of UC 1 in each VistA instance in order to have enough data for testin
219. is defined as the person the appointment is with i e the name of support staff or physician Figure D21 Req 9 5 Create a table and title it Average Activity Type by Clinic include the following columns e Activity Type Description Display the most recent activity type for the appointment e Count by Activity Type Count the number of appointments e Clinic Display the clinic name Display the table with information based on the selections the user makes for the parameters 252 as MedRed LLC and BT America C m on Z Req 9 6 Create a table next to the Average Activity Type by Clinic table and title it Overall Activity Type Count include the following columns e Activity Type Description Display the most recent activity type for the appointment e Count by Activity Type Count and display the total number of appointments Display the table with information based on the selections the user makes for the parameters Req 9 7 Create a pie graph for the Overall Activity Type Count table Call chart Count by Activity Type e Display the data labels within the pie chart slices e Show a legend o Outline the legend o Fill legend in light grey o Display on right Count by Activity Type E Cancel E CheckOut E NoShow E Unknown Figure D22 Req 9 8 Create a table for Provider showing provider availability Title the table Provider Availability Include the following columns for this table e Provider Show the provider name i
220. is not rescheduled or cancelled per day divided by the total number of time slots the equipment resource is allotted in their scheduling policy 258 P MedRed LLC and BT America 4 Equipment Utilization Rate PNS Exercise Bike 2 1 2013 13 PTRP__ Exercise Bike 2 1 2013 22 PNS catscan 2 1 2013 0 Pns Exercise Bike 2 2 2013 0 pTRP Exercise Bike 2 2 2013 0 pws catscan 2 2 2013 19 PNs ExerciseBike 2 3 2013 0 pTRP Exercise Bike 2 3 2013 0 ens catscan 2 3 2013 25 Equipment Utilization Rate is the number of appointments the Equipment is reserved per day divided by the total number of appointment slots the Equipment Resource has alloted for their scheduling poli Figure D28 Req 9 17 Create a bar chart which graphs the Equipment Utilization Rate table Display as shown in Figure D29 Include legend e Solid Outline e Fill with light grey Req 9 18 Ensure report displays like shown in Capacity Work Load and Utilization Mock Up 259 MedRed LLC and BT America E A Equipment Utilization Rate 30 25 25 2255 20 19 15 13 E Exercise Bike 10 E CatScan 5 0 0 0 0 0 0 2 1 2013 2 1 2012 2 1 2013 2 1 2012 2 1 2013 2 1 2012 PNS PTRP PNS PTRP PNS PTRP Figure D29 D 7 Clinic Operational Report This reporting suite fulfills the following requirement there is only one report in this suite 9 3 9 The system shall have t
221. istA and the associated information imported Once a new patient has been entered as demonstrated in Use Case 3 unscheduled patient same day needs can be addressed as walk in and long range needs can be addressed through the appointment process 159 MedRed LLC and BT America 7 T Reference Appendix A 3 instructions for Use Case 3 Step 3 entering new patient 6 The system shall associate each appointment type with the correct DSS stop code credit stop see http www1 va gov vhap ublications ViewPublication as p pub_ID 1788 5 DSS stop codes are associated with appointment types in our application This is explained in our Integration Code documentation and support the generation of DSS Stop Code reporting Reference Appendix E Open Source Documentation Section E 2 4 for explanation of stop codes Reference Appendix D 5 DSS Stop Code Detail for reporting format 7 1 Telehealth The scheduling system shall provide the capability for national Clinical Video Telehealth CVT scheduling which ensures resources at multiple ends of a telehealth visit are coordinated with the patient across different VistA systems and capture workload data 5 Telehealth resources such as CVT Rooms and equipment are treated as other resource types that must be converged with the provider and patient schedules to create a single telehealth appointment Our enterprise solution can schedule across multiple VistA instances
222. iteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE ServiceType None Type Provider VistaCliniclEN 3 Ip Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Ih AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR 54 MedRed LLC and BT America Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR Patientinstructions None 1 CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX
223. ities from the menu bar 2 Click Select for the VA Regional Medical Center to view facility details 184 ONO Pw MedRed LLC and BT America A Click View Clinics to view all clinics for a particular facility Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource Lory Petri to view resource details Click On Hold List to view a table of On Hold dates Click Add On Hold to display On hold details page gt Period Start 04 Jan 2014 08 00 Period End 04 Jan 2014 17 00 Auto Release At 03 Jan 2014 08 00 gt On Hold created time stamp is shown in UTC Click Add gt Hold is added and the is user is returned to the Hold Listing page for a resource Use Case 2 Step 6 Hold the 5 January 2014 date and manually release it for scheduling Walkthrough First create a Hold 1 o N D U e oP 9 Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource Lory Petri to view resource details Click On Hold List to view a table of On Hold dates Click Add On Hold to display On hold details page gt Type Period Start 05 Jan 2014 0708 00 Period End 05 Jan 2014 1817 00 Auto
224. k Provider Select Jane Smith Provider Select Room 323 X Ray Room Room Select X Ray Machine Equipment Select George Clark Provider Select Add Resource To edit a resource choose the Select link and choose Edit VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies Cunics Deras Resources Epi FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE CURRENT RESOURCE PRIMARY CARE EVALUATION ROOM 4 Resource Name Primary Care Evaluation Room 4 Resource Type Room Fulfilling Resource Primary Care Evaluation Room 4 Allow Overbooking Oo 74 MedRed LLC and BT America A You can choose to Allow Overbooking for the Resource Leaving the box unchecked means that the Resource can only have appointments made if they have a Scheduling Time Slot open for the time period This will be addressed in the next section Once you have made your changes select Update VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Factuimes Cumnics Deraus Resources Deras FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE CURRENT RESOURCE PRIMARY CARE EVALUATION ROOM 4 Resource Service Type Scheduling Policies List On Hold List Block List Once Scheduling Policies have been created then there are options which allow the scheduling user to subsequent
225. l fires off of the PIMS Registration option edit Event Driver removed Response Processing RTN e Modified file 43 MAS Parameters added date to EARLIEST DATE FOR G amp L e Modified file 984 1 MASTER PATIENT INDEX added correct Station Number e Applied TASKMAN SET UP ROUTINES cleans up Taskman global for a new environment e Modified Taskman Startup delay File 14 7 e Edit taskman XWB LISTENER STARTER modified SPECIAL QUEUEING to STARTUP e Modified file ZSTU int file to Change VistA instance name AL Instance e VistA dat file location C CACHESYS Megr VISTA e Instance Name VISTA e Refresh VistA short cut on Desktop to point to the proper location e Taskman Volume Set Box was not setup correctly e Change firewall in bound out bound ports i e 9200 e Applied Ray Group Scheduling Script SD_5 3_ 260003 RC4 KID e Applied 2 Ray Group Scheduling Script SD_6_0_1_T7 KID Created by Chris Uhera e Applied XUA4A7_FIX_0 0 KID Fixes a problem with DIC 0 being undefined when using the updater e Applied sd_5p3_131000rc2 KID SDAM1 Fixed an extrinsic quit mismatch error fixed by the RGI T4 build SDMAPI2 Commented out code that isn t needed e Edit HL7 file Protocol VAFC ADT A04 SERVER This protocol fires off of the PIMS Registration option edit Event Driver removed Response Processing RTN e Modified file 43 MAS Parameters added date to EARLIEST DATE FOR G amp L 11 i MedRe
226. late List for a Clinic Communication Templates are templates for letters that can be sent to a patient via email text message or mail based on the user s choosing These templates can be added for a Clinic by choosing the Communications Template Listing link from the Clinic Details page Please refer to Appendix B 15 for more detail on the communication notifications and templates The following fields can be added in a future release to the communication template Date Offset The possible values will be the number of days prior to 1 2 3 or after the 1 2 3 date of an appointment that the communication needs to be sent Select the link and the following displays 71 MedRed LLC and BT America 4 OA VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facures Cunics Derams Templates FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Template Listing Subject Medium Recipient Pre Appointment Pre Appointment patient Select Post Appointment Post Appointment patient Select Appt Cancellation Cancellation mail patient Select Transfer Transfer mail patient Select Add Communication Template Here you can edit a current template by choosing Select on the row of your template Once complete select Update to return back to the Template Listing page To add a new template select Add Communication Template and the following disp
227. lays VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facuimes Cumics Deraus Temprares UpLoan FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Upload Communications Template Name Subject Browse O Pre Appointment O Post Appointment O Cancellation O Transfer O Waiting List Medium E mail Recipient Patient Update the Name Subject Type of Template you are uploading Pre Appointment Post Appointment Cancellation Transfer or Waiting List Medium and Recipient Select Browse to locate the template you are uploading from your computer and select it Repeat this process until all templates for the Clinic have been uploaded Appointment Type List From the Clinic Details page click the Appointment Types List link 72 MedRed LLC and BT America z VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies Cunics Deras Types FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE Appointment Type Listing Name Duration DSS Primary Stop Code DSS Credit Stop Code 323 MEDICAL PROCEDURE UNIT 450 MOVE PROGRAM GRP ct elect poi ie Add Appointment Type All appointment types created for that Clinic will display to edit one choose the Select link To add an Appointment Type select the Add Appointment Type link D VETERANS AFFAIRS SCHEDULING
228. led up for enterprise wide deployment Health eTime also implements open standards whenever practical in order to enhance the VA s ability to foster interoperability I HTTP CalDAV 1 Presentation Layer WebDav Ea Calendar DB Server Service Layer Facility Nat Sys Provider ee Lr Figure B1 Health eTime Architecture MedRed LLC and BT America 7 T The Health eTime technical architecture stack currently includes the Net and Java platform The application can also run on a totally open source stack by converting the Net portion of the application to Open Source Mono applications Finally Health eTime integrates with VistA mainly through a set of VistA web services in order to reduce upgrade issues and re use functionality that can be leveraged The following sections describe the main component of the Health eTime depicted in Figure B1 Health eTime Architecture B 1 Health eTime Service Layer The Service Layer applies a service orientation design paradigm and organizes the various functions into a set of logically grouped services Services that are categorized into a particular layer share functionality Theoretically this helps to reduce the workload related to managing the service inventory since services belonging to the same group are only responsible for a subset of related activities in the application This layer orchestrates all the back end interactions between VistA the rel
229. lick Confirm and Book Use Case 2 Step 16 Change modify and update appointment types that are already on a schedule on the fly Prerequisite Appointment for Alicia Rice for August 13 2013 at 11 00 type Initial Walkthrough 1 N O 0 e oND oo Ensure that VistA site on the upper right of the screen is CA Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Select Appointment Types List to view a table of previously created appointment types Select Appointment type Initial gt Details of Initial appointment type display Type Initial Comp amp Pension for the Name Click Update gt Return to list of Appointment types gt New name is displayed Use Case 2 Step 17 Add modify and delete appointment types from a section Walkthrough 1 N oD Or amp o N CA VistA Site Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Select Appointment Types List to view a table of previously created appointment types Click Select for the New Patient appointment type gt New Patient appointment type details displays gt Enter the following information Type Name New Study Patient Select Category RESEARCH DSS
230. ll box solid in light grey e Bold and place in Italics Note Appointment date is the current date for the appointment this can be the original scheduled date or the rescheduled date The provider is defined as the person the appointment is with i e the name of support staff or physician Figure D30 Req 10 5 Allow each field in the Patient Work List Detail Table to be filtered on Reg 10 6 Create a table under the Patient Work List Detail table and title it Summary by Activity Type Display the following columns e Most Updated Activity Type Display the most updated activity as shown in the above Patient Work List Detail Table Do not show appointments where the activity type is populated with cancel MedRed LLC and BT America a e Number of Appointments Show the total count of appointments that are displayed in the above Patient Work List Table Do not show appointments where the activity type is populated with cancel e Percentage of Appointments Calculated field The total number of appointments by their activity type divided by the total number for all appointments for all activity types Appointments which are cancelled are excluded from both the numerator and denominator e Date Date of the appointment shown as MM DD YYY e Total Show a total for the number of appointments column Req 10 7 Display the table as shown in Figure D31 Summary By Activity Type INoshow a 5o 2 2 2013 Checkedo
231. ll have the capability to maintain a list of patients that can fill a cancelled appointment on short notice The waitlist process in Use Case 8 validates that patients from the electronic waitlist can fill openings identified by schedulers on a daily basis in short notice The Application User Manual explains how to use the waitlist functionality Reference Appendix A 8 instructions for Use Case 8 Step 5 displaying patient demographics and assigning waitlist patients Reference Section 4 Application User Manual Section 4 6 for explanation of the waitlist function 3 5 4 The system shall have the capability to provide users the ability to view available appointments beyond one year Our application does not limit how far beyond one year appointments can be made Thus the capability to view beyond one year exists However the scheduler must first establish resource schedules beyond one year to allow appointments to be made Reference Appendix A 1 instructions for Use Case 1 Step 9 creating a schedule for a provider 3 5 5 The system shall have the capability to maintain an electronic waiting list Our application implements this requirement through the use of a queue of requests that includes priority sorting For example when appointments are cancelled a request is generated in the request queue for rescheduling The user can similarly display the entries of the request queue to decide which request has t
232. location is in a different VistA instance Alabama 1 Select Appointments gt TeleHealth 195 14 MedRed LLC and BT America 7 T Search Benson to locate and select patient Hugh Benson On the Patient Demographics page click Select Patient This action takes the user to the Add TeleHealth Appointment page for a selected patient Select Facility CA REGIONAL MEDICAL CENTER Clinic CA Dermatology Provider Dr OP Appointment type Consult Patient Location Alabama Click Search for Slots Select the desired date and time and click Select Slot Click Confirm and Book Select the Site AL VA HEALTH CARE SYSTEM Select Appointments gt TeleHealth Select Preferred Time Use date of appointment created above Facility AL VA Outpatient Clinic Clinic Primary Care Provider Dr OP Appointment type TeleHealth Patient Location Alabama Select Search for Slots Select the appointment time to match the existing appointment time will be adjusted for the site click Select Slot Click Confirm and Book gt appointment is created at the second site A 4 USE CASE 4 Manage a Patient Appointment UseCase 4 Step 1 Enter patient information and select patient to check in Walkthrough 1 Select Appointments gt Patient Check In from the menu bar gt Search patient page loads Type Ben in the search box and click Search If already in a patient record click Select Patient upper right green toolbar and then type B
233. lowing VETERANS AFFAIRS Y SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies Cunics Deras Resources Deras Scuepute Eor FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE CURRENT RESOURCE PRIMARY CARE EVALUATION ROOM 4 Scheduling Policy Day of the week Monday Start Effect Date 12 Jun 2013 End Effect Date 12 Jun 2014 Priority 1 76 MedRed LLC and BT America a Choose the Day of the Week Start and End Effect Date and Priority then select Add C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facurmes Cunics Detaus Resources Derams Scuepute EDIT FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE CURRENT RESOURCE PRIMARY CARE EVALUATION ROOM 4 Scheduling Policy Scheduling policy saved Day of the week Sunday y Start Effect Date 12 Jun 2013 End Effect Date 12 Jun 2014 Priority 1 iy View Slots A note will display in red at the top of the screen indicating that the Scheduling policy saved Then select View Slots Another page will display select Add Slots From here Slot Edit page displays C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Fac mes Cunics Deras Resources Deras ScuHepure SLlors Epi Slot 08 00 60 minutes Group Appointment Capacity Appointment Type Mental Health Group Regular v Add
234. ls the following requirements and is comprised of two reports 9 3 8 The system shall have the capability to generate on demand reports containing current data to be presented to Congress The scheduling database doesn t contain information related to ROI or diagnoses after evaluating additional performance measures requested from the VA to Congress these requirements were found e Performance measure Increase the percentage of OEF OIF Veterans with a primary diagnosis of PTSD who received a minimum of 8 psychotherapy sessions within a week period e Performance measure Increase the percentage of appointments completed within 14 days Based on these requirements two and three the following reports were compiled Report 13 Congressional Report Count of Completed Mental Health Appointments Per Patient Report Title Congressional Report Count of Completed Mental Health Appointments by Patient Report Purpose The purpose of this report is to allow a user to create a report for any time period Clinics Site and Facility they choose to display a count of mental health appointments that have been completed for each patient Req 13 1 Enable the user to enter in the following parameters e From Date Allow user to select from a calendar e To Date Allow user to select from a calendar e Clinic Allow single and multiple selections e Facility Allow single and multiple selections e Site Allow single and multiple selections Reg 13 2 For
235. lty services Reference response for 5 3 1 to 5 3 4 below to validate that our application has the capability link different service types 5 3 1 The system shall have the capability to link ancillary tests to appointments if they are changed ancillary tests can be updated without canceling order and re ordering Ancillary tests can be scheduled along with appointments as additional resources The business rules for these resources would allow the appointment to be sustained even when tests are removed In post contest development we will work with user groups to determine exact ancillary tests that should be associated with each type of appointment Reference Appendix A 2 instructions for Use Case 2 Step 2 and Step 3 configuring and scheduling resources 153 5 3 2 The system shall have the capability to link ancillary tests to appointments MedRed LLC and BT America 7 kaa Ancillary tests can be scheduled along with appointments as additional resources The business rules for these resources would allow the appointment to be sustained even when tests are removed In post contest development we will work with user groups to determine exact ancillary tests that should be associated with each type of appointment Reference Appendix A 2 instructions for Use Case 2 Step 2 and Step 3 configuring and scheduling resources 5 3 3 The system shall provide the capability to establish links to activit
236. lude 1 Integration with VistA 2 Scheduling capability across VA sites 3 Improved resource management capability 4 MedRed LLC and BT America A E 4 A set of baseline functional capabilities consistent with VA contest requirements ks gt Both the application and the web service layer that provides integration are released to the Open Source Electronic Health Record Agent OSEHRA and its community for incremental refinement and continual support Po s HP RM ww we ww eee ee eee ee I HTTP CalDAW 1 Presentation Layer WebDav Service Layer Account Facility Nat Sys Provider esse sve Pe S f Se N Equipment j Import f rce VistA CA VistA AL VistA GA Figure 1 1 Health eTime Application Architecture 1 1 2 About Our Approach We see the contest as an opportunity to forward an operationalized concept of VistA as a Service Oriented Architecture The fact that the VA in structuring the contest provided a set of refactored MDWS APIs and a requirement that any integration components be open source led us to believe that this concept is in line with VA intent We see the two principal challenges to this approach as 1 how to ensure that the functionality of any new VistA modules enhances rather than disrupts enterprise workflow and productivity and 2 how to securely and effectively integrate new modules with the diverse patchwork of legacy components in the production 5
237. luding appointments kept providers cancellations and no show history While making an appointment and after having selected a patient the application will present the user with past patient appointment history including statistics such as no shows cancellations etc Reference Appendix A 3 to Appendix A 7 instructions for Use Cases 3 4 5 6 7 Use Case 7 also shows that all manner of past appointment information can easily be tracked based on our applications data model Reference Appendix A 7 instructions for Use Case 7 Step 6 displaying patient s no show history Reference Appendix B Application Design and Architecture Section B 4 Explanation of the data model 2 3 The system shall have the capability to display eligibility information necessary for appropriate scheduling We have designed and implemented our scheduling application to import most Patient s data from VistA making the assumption that VistA will remain the system owner of most patient s data The current import mechanism uses MDWS for accessing the patient information and essentially any patient data can be displayed for verification and eligibility reasons Reference Appendix A 3 instructions for Use Case 3 Step 4 verifying patient information 2 4 The system shall have the ability to notify inform schedulers of patient preferences Our application has the requisite data structures to maintain an unlimited list of Preferences and Spec
238. ly set block and holds on date ranges To add click either the On Hold List or Block List Link Choosing a Block means the resource whether than is a provider room or item of equipment is unavailable for that specific time period and any appointment affected are automatically cancelled and made available for rescheduling Setting a Hold means that the user cannot add new appointments using that resource during the time period when the hold is in effect 75 MedRed LLC and BT America A Se For every resource you will need to create a scheduling policy in order to make appointments for the resource Select Scheduling Policies List VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facumes Cumics Deras Resources Deras SCHEDULE FACILITY CA VA OUTPATIENT CLINIC PRIMARY CARE CURRENT RESOURCE PRIMARY CARE EVALUATION ROOM 4 Schedule Listing Start Date End Date Priority Add Scheduling Policy The policies that display for the resource are those that a previous user would have made In this instance this is part of the baseline data we created for you This displays that the resource is available Monday through Friday Monday through Friday are listed as days one through five Choose Select to edit a scheduling policy or to add another day to the resource s availability click Add Scheduling Policy Choosing Add Scheduling Policy displays the fol
239. m acquisition process Reference Section 3 Instructions for Running Step 1 Test Scripts for validating the capability for automated testing Reference Appendix C Application Refinement amp Enterprise Deployment for understanding of how the application will fit into a VA acquisition process 8 Instructions and Traceability Matrix for Step 2B Open Source Compatibility Evaluators The following responses and supporting references show that our solution is fully open source and compatible with VistA We have published the Health eTime Open Source codes as requested by the VA in each of the VMs C Users contestant OSEHRA Dashboards OSEHRA Automated Testing VA Requirements EELEE AEE KOITI tates 1 Open Source License amp Apache 2 0 Alignment Yes Open Source Apache 2 0 aligned license placed in each VM directory C Users contestant ContestantDocuments 2 Open Source codes for App and VistA integration Yes App and VistA integration codes are Open Source along with entire Health eTime application source code placed in VMs C Users contestant OSEHRA Dashboards OSEHRA Automated Testing 3 Descriptive Documentation for Integration Code Yes Reference Appendix E 1 4 Documentation of Code APIs and Install Instructions Yes Reference Appendix E 2 5 XINDEX SAC Checker a No new F failure messages were found b No new W warning messages were found 6 Headers
240. me My Subscriptions Site Settings Hel Home gt Reporting gt Audit Overview by Site Only From 6 10 2013 3 To 6 13 2013 2 View Report Site GA VA HEALTH CARE SYSTEM v id 4 2 offi gt Di 100 v Find Next WA O e B Audits by Site Report Parameters To 6 13 2013 Site GA VA HEALTH CARE SYSTEM Audits Patient Details Event Date Time gt Audit Function Patient Nam 6 10 2013 Appointment Created tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Created tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Checkin tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Updated tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Created tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Created tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Created tester2 Administrator ROBERSON RAMIRO 0000 6 10 2013 Appointment Created tester2 Administrator BENSON HUGH 0006 Total Audits by Type Appointment Checkin 1 Appointment Created 9 Appointment Updated 1 Block Created 25 Total Audits by Type Audit Count EN Audit Function Appointment Created Block Created Appointment Checkin Appointment Updated Note Due to length of report snapshots shown above do not reflect the full information you will see when you run the report Step 4 Increa
241. me appointments to be rescheduled for the same day Reference Section 4 Application User Manual Section 4 4 and 4 6 for explanation on how to access the calendar views 4 2 4 The system shall have the capability to create re schedule or cancel recurring appointments all at once with appropriate desired date The capability to link appointments is the foundation for establishing recurring appoints and the scheduler can schedule a series of appointments by selecting Recur in the add appointment or add telehealth appointment function If the same timeslot is always open extending into future then setting recurring appoints is a very simple business rule that we have implemented In very busy schedules however automatically searching for openings at set intervals is a complex operation for the application Our application current does 146 MedRed LLC and BT America 7 not have artificial intelligence that automatically searches for appointment openings at set intervals and will thus note schedule conflicts as pending appointments Reference Section 4 Application User Manual Section 4 6 for explanation of recurring appointment capability Reference Appendix A 3 instructions for Use Case 3 Steps 9 scheduling other linked appointments 4 2 5 The system shall have the capability to define individual schedules in terms of a single resource or as a pre defined set of multiple resources Use Case 3 sh
242. ment MedRed LLC and BT America p B 6 Health eTime Audit Relations The following relations maintain audit related information AuditFunction a 14 _ Description AuditData 8 Audtid _ EventDateTime _ site _ Username _ Statuso AuditObjectType _ Function e _9 10 _ contsinsero _ Description ObjectTypelD mf ObjectID Ef ObjectName AuditStatus _ Eventoata a 14 E Description All actions throughout the application can be tracked through the AuditData table All auditing entries have a type of audit AuditObjectType and are tied to a specific function of the system AuditFunction B 7 Health eTime Patient Relations These relations maintain most patient level information 212 MedRed LLC and BT America 7 PatientPreference af id _ Patientid _ PatientPreferencetypetd Person aj 14 FirstName PatientPreferenceType _ _ Middiename Provider SpecialNeed E Lastname 1d EE E name E ssn NPL _ Patientia pes _ Description _ DateofBirth Personid _ speciatNeedtyperd Pd E sex Phone Addressid Emai CaldavResourceld SpecialNeedType Id _ Personta Name caldavResourcetd _ speciaieedsother _ Preferencesother Description
243. ments for the time period selected Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions 101 MedRed LLC and BT America bad 4 6 Appointments This section of the application manages all patient appointments A pre requisite to making appointments is that clinics and resources with their scheduling policies have been set up as discussed above When first using this menu options the Scheduling User is presented with patient search page below VETERANS AFFAIRS SCHEDULING PORTAL Appointments Administration About Help Patient Appointments Group Appointments pane Checkin PULING PORTAL HOME Wel
244. metrics can be reported on once defined and supplied by the business These metrics provide stop code totals and line by line analysis by encounter to help in managing appointments not assigned codes Req 8 1 Enable the user to enter the following reporting parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to select one or more clinics e Site Allow user to select a specific Site have a drop down of available clinics populate e Facility Allow user to select a specific Facility have a drop down of available clinics populate Req 8 2 For the From and To date use the most updated appointment date This can be either the date the appointment was initially scheduled or the rescheduled appointment date 248 MedRed LLC and BT America 7 lt gt Req 8 3 Only bring back data within from and to date clinics site and facility chosen by the user under the report parameters Req 8 4 Create a table title the table Patient Detail Display the following headers as columns and allow each field to be filterable in report e Patient name Last Name First Name Middle Name e SSN last four digits Format as text e Clinic Format as text e Provider Provider First Name Provider Last Name e Initial Appointment Date MM DD YYYY e Rescheduled Appointment Date MM DD YYYY e Most Recent Activity Type Format as text e Completed Appointment Y N Y or N e Primary S
245. mmary Queue and Patient Detail Report Purpose The purpose of this report is to supply a patient detail and work list summary for appointments needing action required because an appointment needs to be made either locally or for a transfer Information is pulled for a user specified time based on the desired date 246 MedRed LLC and BT America 7 T of the appointment clinic site and facility A table displaying if action is required for an appointment at the top of the report and summary of appointments with action required by clinic is shown at the bottom of the report This supplies the scheduler the ability to quickly see and manage appointments which need to be rescheduled for a specific time frame Clinic Site and Facility These metrics can then be analyzed to help in managing unscheduled appointments and to help analyze workload Req 7 1 Enable the user to enter in the following parameters e From Date Allow user to pick from a calendar e To Date Allow user to pick from a calendar e Clinic Allow user to select a specific clinic have a drop down of available clinics populate e Site Allow user to select a specific site have a drop down of available clinics populate e Facility Allow user to select a specific facilities have a drop down of available clinics populate Req 7 2 For the From and To date use the appointment desired date Req 7 3 Only bring back data within from and to date clinic site and facility chosen by
246. mp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None 1 AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 15 Id 18 Name REGULAR Patientinstructions None p CommunicationTemplates None DSSCreditStopCode None DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Facility Facility Address Address City MONTGOMERY Id 16 State AL Street1 AL VA OUTPATIENT CLINIC Street2 23 ECKERD AVENUE Street3 None Zip 36109 CommunicationTemplates None Hours 0800 1600 Id 5 Name AL VA OUTPATIENT CLINIC Phone 334 272 XXXX ShortName AVAOPC Site Site Address Address City MONTGOMERY Id 15 State AL Street1 HEADQUARTERS AL HEALTH CARE SYSTEM Street2 None 48 MedRed LLC and BT America Street3 None Zip 36109 Id 3 Name AL VA HEALTH CARE SYSTEM Phone 334 272 4670 TimeZoneld Central Standard Time VISN 6 VistaSiteld 557 StationNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name
247. mplements a typical role based security which consists of users roles users in roles and actions related to roles This standard approach to security provides the basic capability required to restrict access to web pages actions and data elements Reference Section 4 Application User Manual Section 4 7 for instructions on how to configure users and roles 1 4 3 The system shall allow configuration and tailoring of user access roles at the national VISN facility clinic The standard role based security capability built into the application provides the functionality required to configure security privileges that are required by the VA 130 and provider levels based on business rules and policies MedRed LLC and BT America 7 lt Reference Section 4 Scheduling User Manual Section 4 7 for detailed instructions on how to configure users and roles 1 4 4 The system shall have the capability to enforce rules concerning what roles can overbook appointments for a service or resource The application already has the functionality required to manage overbooking and manage users in roles Therefore the basic capability to enforce rules concerning any function based on roles is already built into the application The capability to enforce rules and control overbooking is demonstrated in Use Case 2 Reference Section 4 Application User Manual Section 4 4 and 4 6 for detailed instructio
248. mpliant device with the CalDav server Reference Appendix B Application Design and Architecture Section B 10 for explanation of CalDav server in the design 127 MedRed LLC and BT America 7 T Reference Section 4 Application User Manual Section 4 6 1 3 Flexible Appointment Scheduling The scheduling system shall provide the capability to configure schedule parameters Reference instructions to 1 3 1 to 1 3 7 below Our scheduling application fully satisfies the requirements for flexible appointment scheduling through the configuration of parameters such as holidays immediate appointments time zones etc 1 3 1 The system shall allow configuration of scheduling to accommodate holidays Currently the standard list of holidays is pulled directly from VistA Other holidays can easily be added as shown in Use Case 1 Step 1 The holidays are used by the scheduling engine to prevent appointments to be made the day of the holiday Attempting to create an appointment with a desired date matching one of the holidays created in Use Case 1 e g National VA Organization Day 20 July 2012 22 July 2013 21 July 2014 will show a list of available appointment slots with no slots available on the given holiday Reference Section 4 Application User Manual Section 4 6 for detailed instructions on how to make appointments Reference Appendix A 1 discussion for Use Case 1 setting national and VA specific
249. n UI Service Miscellaneous utility functions for the presentation layer For additional details related to the service layer please see Appendix E 2 which provides a listing of the service layer public API Technical Card Source Code C Frameworks Net WebDav net Log4Net B 2 Health eTime Persistence Layer The Persistence Layer provides a complete abstraction of the database management system which makes it possible for the application to change the DBMS provider with no effect on the application itself As an example the Health eTime is currently deployed using the MS SQL Server but with fairly simple configuration changes we could redeploy the application using other commercial products such as Oracle or an open source one such as MySQL Technical Card Frameworks NHibernate B 3 Health eTime Integration Web Services A set of web services is available to integrate third party applications and modules in the overall process The web services are currently mainly used to expose functionality required by the data load scripts nevertheless additional API functionality can easily be exposed using this mechanism therefore making Health eTime easy to integrate with third party applications Technical Card Frameworks Net web services 210 MedRed LLC and BT America y B 4 Health eTime Scheduling Database Our scheduling database maintains all the scheduling data including patient provider clinic section fa
250. n appointment types 4 1 4 The system shall have the capability to manage scheduling process such as overbooking no shows cancels re schedules etc Different functions in the scheduling process are demonstrated throughout the Use Cases The following Use Case steps show that our application can manage the scheduling process Reference Appendix A 2 instructions for Use Case 2 Step 18 Assignment of overbooking privileges Reference Appendix A 6 instructions for Use Case 6 Canceling appointments Reference Appendix A 7 instructions for Use Case 7 Rescheduling appointments Reference Appendix A 7 instructions for Use Case 7 Step 6 Tracking no show history 4 1 5 The system shall support the ability to change or edit appointments as necessary A scheduler can directly start with the step of making appointments and place a new appointment with the correct information in the same time slot and then delete the existing incorrect appointment This is enabled through temporary overbooking privileges Reference Appendix A 3 instructions for Use Case 3 Step 5 Making appointment 4 1 6 The system shall have the capability to configure and enforce business rules at the clinical service level clinic level provider and appointment type level e g females in Obstetrics Gynecology clinic Many business rules exist in the application to converge resource schedules with appointment types and patient re
251. nCeS cceeeeeeeeneeeeeeeeeeeeeeeeeeeeeeeeeeeeeeenaaees 10 2 3 Installing amp Configuring SQL Server 2008 Enterprise cccceeceeeeeeeeeeeeeeeeeeeeenaaees 12 24 Installing amp Configuring Bedework cc iscccscssssecsasdcentsserascecteseneideareesscetncsnadueneeszveccenes 12 25 Configuration Recovery Instructions 2 ic i ccss ccccsncctssetissdccsensedseedeesascetnsedeeeteeeisaeeueedes 12 2 6 Data Used for Testing and Demonstrations ceeeeecececeeeeeeeeeeeeneeeeeeeeeeeeeeeeeenaaeaes 13 STEP T EVALUATION a ccatscraee neaeactbeas eaaa a e e AE see a Ee aaea i 14 3 Instructions for Running Step 1 Use Case Scenario Test Scripts 0 0 0 ceeeeeeeee eee eeeee 15 3 1 Use Case 1 Test Script ExeCution cceecceccccceeeeeeeeeeeeeeeeeeeeeeeeeeaaaaaaeeeeeeeeeeneenaaaaes 17 3 2 Use Case 2 Test Script EXeGWonccccicn passe etanain eda 19 3 3 Use Case 3 Test Script Ex Cutis ixvscccosccaccssencencsttecoresvanscncsstereresencemebieeeterumnanactieers 21 3 4 Use Case 4 Test Script Ex Cutan scissscciciscsiasscnnccstecwcnsasueetecatebencedcxeusedonur extutweavavensnare 23 3 5 Use Case 5 Test Script ExeCution cececcccccceeeeeeeeeeeneceeeeeeeeeeeeeseaaaeaeeeeeeeteneeenaaaaes 24 3 6 Use Case 6 Test Script Ex Cution ceeeeccccccceeeeeeeeeeeeeaeeeeeeeeeeeeeaaaaaaaeeeeeeeeeeneenaaaaes 37 3 7 Use Case 7 Test Script Exe Cution ccececcccccceeeeeeeeeeenaeeeeeeeeeeeeaaaaaaaeeeeeeeeeeeeesaaaees 3
252. nNumber 5570C Vistald 2959 Hours 0800 1500 Id 6 Location EAST WING ROOMS 10 AND 11 Name PRIMARY CARE Service Service Id 26 Name MEDICINE Status Scheduled TelehealthLocation None Time 2013 05 28 16 15 00 Vistald 3130528 1115 Step 4 Search for available appointment slot Step 5 Display the patient pending appointments Appointment Activity ArrayOfAppointmentActivity AppointmentActivity AppointmentActivity ActivityReason None ActivityType Create Id 149 Time 2013 06 07 00 23 01 AppointmentActivity 44 MedRed LLC and BT America ActivityReason None ActivityType Modified Id 151 Time 2013 06 07 00 23 03 ip AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Caldavid None ChildAppointments ArrayOfAppointmentRelation AppointmentRelation AppointmentRelation ChildAppointment Appointment Activity ArrayOfAppointmentActivity AppointmentActivity AppointmentActivity ActivityReason None ActivityType Create Id 150 Time 2013 06 07 00 23 02 i AppointmentType AppointmentType AppointmentTypeCateg
253. nada VistA Appointments Administration About Help Home PATIENT APPOINTMENTS CHECK IN Patient HUGH BENSON 500000004 Select Patient Has had 2 no shows in the past 2 years PATIENT APPOINTMENT CHECK IN CURRENT APPOINTMENTS From 12 Jun 2013 Date Time Status Linked to Checkin Check Out Mental Health re a Appointment Kept 60 minutes at Mental Heal j Py Change Provider 19 Jun 2013 08 00 Joseph Ja ckson Checkedin ete pees Normal Priority REGULAR Check In 60 minutes at PRIMARY CARE Patient No Show 02 Jul 2013 13 00 Scheduled 25 Jun 2013 10 00 George Clark Change Provider Normal Priority INITIAL Check In og 30 minutes at PRIMARY CARE Patient No Show 29 Aug 2013 13 00 Primary Care Evaluation Room 3 Scheduled a ae Normal PriorityTele Health Patent at GA VA OUTPATIENT CLINIC INITIAL Check In 2S 201s 08 0 eee oe PEARY CARE Scheduled Patient No Show Or Hanson Change Provider Normal Priority REGULAR Check In 05 Dec 2013 08 09 SU miniwtes at PRIMARY CARE Scheduled Patient No Sh Gasrye Saith Change Provider Normal Priority Walk in Appointment From the Appointments menu select Walk In Appointment The set up process for this is the same as Add Appointment described in the previous sections but the desired data is set to today Creating a Walk In appointment checks the patient in automatically VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Patien
254. nance at the local level The application is based on standard web based menus and controls and is designed to operate effectively through an application browser For the purposes of this pilot the recommended browser is Internet Explorer 8 or 9 It is recognized that schedulers are time constrained and with patients waiting on a phone or at a reception desk speed is an essential part of delivering a good customer service experience to the patient The user interface design was undertaken to ensure the application is easy to use and presents to the user only essential information and valid options such as only available slots when making an appointment and only valid Providers for a chosen clinic Within the system configuration menus breadcrumbs have been implemented to aid navigation At key parts of the application the user is asked to confirm the patient demographics to reduce any risk of invalid patient identification and the context of that patient is maintained through different menus Open source Calendar user controls are deployed within appropriate pages such as the Provider Roster or Clinic Views 4 2 Overview The Health eTime Step by Step User Guide provides users access to patient appointment scheduling as well as other functions based on their user access permission In this application portal you will be able to complete multiple tasks including but not limited to schedule patient group and telehealth appointments for patient
255. nce Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Use Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of continued care Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 4 4 3 The system shall have the capability to filter select appointment notifications based on user defined criteria The rules for notifications currently in the application can be changed based on user defined criteria This is the advantage of our open source application being developed specifically for VA scheduling Reference Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Use Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of continued care Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 4 4 4 The system shall have the capability to tailor appointment notifications to meet specific clinic needs The rules for notifications currently in the application can be changed based on specific clinic needs This is the advantag
256. nce that automatically searches for appointment openings at set intervals and will thus note schedule conflicts as pending appointments Reference Section 4 Application User Manual Section 4 6 for explanation of recurring appointment capability Reference Appendix A 3 instructions for Use Case 3 Steps 9 scheduling other linked appointments 3 1 4 The system shall provide the ability to verify patient information display eligibility and display a warning if there is an inconsistency between service requested and eligibility We have designed and implemented our scheduling application to import most Patient s data from VistA making the assumption that VistA will remain the system owner of most patient s data The current import mechanism uses MDWS for accessing the patient information and essentially any patient data can be displayed for verification and eligibility reasons 137 MedRed LLC and BT America AS Reference Appendix A 3 instructions for Use Case 3 Steps 3 and 4 registering and verifying patient information Inconsistency between the request and the eligibility can be identified through a simple business rule between Step 4 and Step 5 with associated alerts Reference Appendix A 3 instructions for Use Case 3 Steps 5 making an appointment based on patient request 3 2 Appointment Selection The system shall have the capability to manage the appointment selection proce
257. ncounter Activity Report e Encounter Action Required Report e Means Our reporting process has shown that it can create reporting formats rapidly in response to data sets For scheduling related data the reporting format will pull information from our relational database For data that reside in VistA such data can be pulled into our application for the purpose of reporting Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 4 Work List Summary Queue and Patient Detail 166 Test Eligibility Enrollment Report e Outpatient Encounter Workload Statistics e Performance Monitor Summary Report e Performance Monitor Detailed Report e Trend of Facility Uniques by 12 Month Date Ranges e Error Listing e Transmission History Report Full e Transmission History for Patient e Scheduling PCE Bad Pointer Count e Alpha List of Incomplete Encounters e Incomplete Encounter Error Report e Summary Report IEMM e Correct Incomplete Encounters e Provider Diagnosis Report e Visit Report by Transmitted OPT Encounter 5 MedRed LLC and BT America 4 9 4 5 The system shall have the capability to generate reports based on metrics and measures related to diagnostic and procedural information that ranks each by frequency and for a specific date range Examples of current reports that must be maintained include but are n
258. nd audit trails for pertinent scheduling transactions As shown in the design and architecture of the application all the transactions in the scheduling process are very transparent and captured for auditing error analysis and process refinement The auditing of specific activities is captured in the current design of reports Reference Appendix B 6 Audit Relations for understanding of audit trails Reference Appendix D 1 Provider and Clinics Appointment Utilization Report for an example of audit trail 3 2 Testability 3 2 1 The Scheduling Solution shall provide criteria to enable the measurement to test pieces of code or functionality or a provision added in software so that test plans and scripts can be executed systematically As shown in Step 1 Use Cases we have the ability to develop automated test scripts for the application against 8 use cases We further conducted manual end to end operational test of our application prior to every release Our development effort and post deployment support processes follow very rigorous testing procedures and 170 MedRed LLC and BT America pad result tracking for bug fixes These procedures are enabled through error documentation as a part of the application coding that aligns with the test plan taxonomy This will enable our application to successfully follow a full Test and Evaluation Master Plan TEMP in the syste
259. ndar e Clinic Allow user to single or select multiples e Site Allow user to single or select multiples e Facility Allow user to single or select multiples 237 MedRed LLC and BT America 7 lt Req 4 2 For the From and To date use the appointment table where the date is the most updated appointment This can be either the scheduled appointment date or the rescheduled appointment date if populated Req 4 3 Only bring back data within from and to date clinic site and facility chosen by the user under the report parameters Req 4 4 Create a table showing three categories in one column with the following headers Operational Metrics Missed Appointments Cancelled Appointments Average Wait Time Req 4 5 Create the following sections under each category Operational Metrics Scheduled Appointments Completed Appointments Missed Appointments header Number of Missed Appointments Count of Unique Patients Who Missed an Appointment of Missed Appointments Cancelled Appointments header Number of Cancelled Appointments Count of Unique Patients Who Cancelled an Appointment of Cancelled Appointments Average Wait Time header Average Time for a Patient to see a clinician Req 4 6 Next to the newly created column made from Req 4 and Req 5 create the corresponding headers as shown below e Value for Report Time Period is the header for Operational Metrics Missed Appointments and Cancelled Appointments Req 4 7 Pull the following field
260. nder the report parameters Req 6 4 Create a table title it Patient Detail which displays the following headers as columns Allow each field in the table to be filtered e Patient name Last Name First Name Middle Name e SSN last four digits Format as text e Clinic Format as text e Provider Provider First Name Provider Last Name e Initial Appointment Date format as MM DD YYYY e Rescheduled Appointment Date format as MM DD YYY e Activity Type Format as text e Completed Appointment Y N Reg 6 5 Patient Name column Concatenate the patient name together with last name first then first name and lastly middle name in this format last name first name middle name Req 6 6 SSN last four digits column Display only the last four digits of the patient s social security number in column two Column will need to be formatted to return as text in the event that the first digit is a 0 Req 6 7 Clinic Name of the clinic Reg 6 8 Provider Provider First Name Provider Last Name Req 6 9 Initial Appointment Date Date the appointment was initially created Req 6 10 Rescheduled Appointment Date Date the appointment was rescheduled to Req 6 11 Activity Type This is the appointment disposition note that was entered by the scheduler for the patient examples no show missed appointment left without being seen Show the most recent activity type for that appointment Reg 6 12 Completed Appointment Display a Y if the appointment was completed and
261. ndix A 2 instructions for Use Case 2 Step 2 Configure resources Reference Section 4 Application User Manual Section 4 7 for control of booking privileges 148 4 3 5 The system shall have the capability to configure the amount of time allowed between appointments for a patient with multiple appointments MedRed LLC and BT America 7 The linking relationship between multiple appointments as demonstrated in Use Case 3 can contain business rules to include time between appointments Reference Appendix A 3 instructions for Use Case 3 Step 9 Scheduling multiple linked appointments Reference Section 4 Application User Manual Section 4 6 for explanation of linking appointments 4 3 6 The system shall not permit booking appointments into invalid time slots based upon configured business rules The process of selecting appointment slots has business rules that prevent invalid appointments Resources cannot be assigned to multiple appointments with overlapping time slots unless double booking is allowed Double book can be used to change appointments manage the risk of no shows and allow providers to run between multiple patients in scheduling demanding scenarios Reference Appendix A 3 instructions for Use Case 3 Step 5c Select appointment slot 4 4 System Prompt Patient Notifications The system will provide the ability to establish and provide appointment notifications Reference respo
262. ng function Reference Section 4 Application User Manual Section 4 6 for directions on how to access reporting function Reference Appendix D 4 Work List Summary Queue and Patient Detail for how the report format is formulated 6 Instructions and Traceability Matrix for Step 2A Attachment B VA Specific Requirements Evaluators As many metrics in Attachment B involved reporting from the application we have adopted the design approach of fully identifying the reporting requirements and formats to enable our developers to build an integrated and flexible reporting capability that can expand to the number and types of reports ultimately needed by current and future VA users These requirements are presented in Appendix D with reporting formats placed into the following ten categories 157 MedRed LLC and BT America w Appendix D 1 Provider and Clinic Appointments Utilization Reports Appendix D 2 Operational and Wait Time Summary with Patient Detail Reports Appendix D 3 Summary by Activity Type with Patient Detail Appendix D 4 Work List Summary Queue and Patient Detail Appendix D 5 DSS Stop Code Detail Appendix D 6 Capacity Workload and Utilization Report Appendix D 7 Clinic Operational Report Appendix D 8 Consults Summary and Overview Appendix D 9 Ad Hoc Operational Report Appendix D 10 Congressional Performance Reports The reporting requirements process further validated that
263. ngPolicy SchedulingPolicy DayOfWeek 2 EndEffectDate 2014 01 15 00 00 00 Id 72 Priority 0 Slots ArrayOfSlot Slot Slot AppointmentType AppointmentType AppointmentTypeCategory 40 MedRed LLC and BT America AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity 4 Id 570 Length 15 Time PT16H b Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None Capacity 4 Id 571 Length 15 Time PT16H15M StartEffectDate 2013 01 04 00 00 00 i Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 41 MedRed LLC and BT America
264. ns on how to setup users in roles and how to configure a resource to accept overbooking Reference Appendix A 2 instructions for Use Case 2 Step 18 configuring for overbooking and assignment of overbooking privileges 1 4 5 The system shall have the capability to allow in certain circumstances Veterans to schedule appointments via remote access mechanisms such as phone internet email and other mobile devices Our scheduling application includes an Open Source module based on the Open Standard CalDav which allows any authorized and authenticated CalDav compliant device to synchronize appointment information that the user is authorized to access The integration approach of this CalDav compliant module is described in the Application Design Architecture document We currently implemented synchronization from the scheduling application to a CalDav compliant client device The capability for allowing the client device to send schedule updates to the scheduling back end server is also present and requires additional integration work Users need to follow instructions on how to synchronize a CalDav compliant device with the CalDav server Reference Appendix A 3 instructions for Use Case 3 Step 1 receiving appointment request by phone email and internet Reference Appendix B Application Design and Architecture Section B 10 for discussion of the CalDav module 1 5 Resources and Groups The system shall prov
265. nse for 4 4 1 to 4 4 5 below to validate that our application has the capability patient notifications 4 4 1 The system shall have the capability to generate a list of future appointment reminders Use Case 6 7 and 8 actions validate a configurable communication process for notifications flags and alerts This notification process can be connected with all future scheduled appointments via business rules Reference Appendix A 6 instructions for Use Case 6 Step 9 sending cancellation reschedule notifications Reference Appendix A 7 instructions for Use Case 7 Step 10 sending reschedule appointment notifications Reference Appendix A 8 instructions for Use Case 8 Step 2 sending notification of continued care Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 149 4 4 2 The system shall have the capability to produce appointment notifications in a variety of formats e g letter phone e mail text messaging pending appointment list or card Each option shall be capable of being enabled or disabled based upon patient preferences MedRed LLC and BT America 7 T Use Case 6 7 and 8 actions validate a configurable communication process for notifications flags and alerts via email This notification process can have tailored in later post contest refinement to address all VA preferred notification methods Refere
266. nsure font is easy to read and matches style of report see Figure D12 below Generated Letters by Clinic a 14 e 12 10 3 S 8 E PNS 6 mPTRP E Zz 4 2 c M 0 Reminder Postcard Appointment Cancellation Figure D12 Req 2 8 Ensure report displays like shown in Provider and Clinic Appointment and Utilization Mock Up Notifications and Letters Report 3 Audits by User by Site and Facility Report Title Audits by User by Site and Facility 235 MedRed LLC and BT America 7 T Report Purpose The purpose of this report is to present a patient detail of audits and their status as well as summarize total audits by type This can be used by supervisors or anyone interested in a report to detail patient chart audits as well as present overall summaries of audits by type in a user specified time period clinic site and facility Req 3 1 Enable the user to enter in their own report from and to date through reporting parameters e From Date Required e To Date Required e Clinic Allow single select e Site Allow single select e Facility Allow single select Req 3 2 For the From and To date use date the audit even took place Req 3 3 Only bring back data within from and to date clinic site and facility Req 3 4 Create a table which displays the following headers as columns e Event Date format MM DD YYY Displays the date which the user completed an audit function
267. nt EDIT FACILITY Equipment Name X Ray Type X Ray Machine 67 MedRed LLC and BT America a Managing a Facility From the VistA menu select Facilities then click Select for Facility you want to manage Here you can choose View Clinics to add or manage a clinic or Template List to add Communication Templates which apply to the entire Facility VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facnimes Deras Facility CA VA OUTPATIENT CLINIC ous foose mean foo SACRAMENTO CA VA OUTPATIENT CLINIC 2 EOKERD AVENE Ee Zi View Clinics Template List 68 MedRed LLC and BT America A e Managing Clinics This page enables the user to create clinics so that providers staff and or other essential resources such as rooms and equipment can then be assigned Policies can be set for scheduling for those resources Note that setting up Scheduling Application Clinics will create a corresponding clinic within the appropriate VistA systems Attributes of the clinic include Once you select View Clinics from a selected Facility a listing of that Facility s clinics display as shown below This listing displays the DSS Primary Stop Code Abbreviation Hours Location and Active status for that Clinic VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Facies CuInics FACILITY CA VA OUTPAT
268. nt resourceld DateTime rangeStart DateTime rangeEnd Dictionary lt DateTime List lt SlotInstance gt gt GetCapacity int resourceld DateTime rangeStart DateTime rangeEnd RoomService Resource Management Collection lt Room gt GetAll string siteld string facilityld Room Get string id bool Add Room room bool Update string id Room room SectionService Section Clinic Management Collection lt Section gt GetAll int facilityld Section Get int id Section Add Section section Section Update Section section bool Delete int id Communication Template in Section Clinic CommunicationTemplate AddOrUpdateCommunicationT emplate int sectionld CommunicationTemplate communicationT emplate bool DeleteCommunicationTemplate int sectionld CommunicationTemplate communicationTemplate AppointmentType AddOrUpdateAppointmentType int sectionld AppointmentT ype communicationTemplate bool DeleteAppointmentType int sectionld AppointmentT ype communicationTemplate SiteService Site Management Collection lt Site gt Get Site Get int id Site GetFromVistaSiteld string VistaSiteld Site Add Site site Site Update Site site bool Delete int id 278 MedRed LLC and BT America 7 E 3 MUnit Test Report GTM gt D KBANSDMU OK MKNOAV Make appointment on a clinic that has NO availability information OK MKHOL Schedule on a Holiday EVEN if the clinic doesn t allow it OK
269. ntinued care Reference Appendix B Application Design and Architecture Section B 15 for discussion on integrated notification process 5 2 Evaluating BN 2 Manage Veteran Information VA Requirement The system shall have the ability to access and manage update and maintain accurate Veteran information Veteran special needs and preferences shall be accessible and able to be updated in real time VA Requirements Instructions and Validating Outcomes 2 1 The system shall have the capability to provide alerts if patient information is missing out of date or requires verification e g eligibility means test demographics We have designed and implemented our scheduling application to import most Patient s data from VistA making the assumption that VistA will remain the system owner of most patient s data The current import mechanism uses MDWS for accessing the patient information and essentially any patient data can be displayed for verification and eligibility reasons Reference Appendix A 3 Instructions for Use Case 3 Step 4 verifying patient information 133 MedRed LLC and BT America lt References Section 3 Application User Manual Section X for instructions on searching selecting and displaying patient data 2 2 The system shall have the capability to maintain and present appointment information past and future within a specified date range e g inc
270. nts as presented in Appendix D Reporting Requirements Based on these formats which can be easily modified through user collaboration we then used the SQL Server Reporting Service SSRS functionality to generate the reports This functionality is accessed as follows A SQL Server Reporting Services amp Reporting earc e Gi New Folder New DataSource Bij Report Builder Folder Settings Upload File H Details view beg Ad Hoc Operational Report l g Appointment and Clinic Dashboard by Site and Clinic bea Audit Overview by Site Only bal Capacity Workload and Utilizetion bea Clinic Operational Report be Count of Completed Mental Health Appointments Per Patient LT DSS Stop Code Detail bea Patient Appointment Operational Details bea Percentage of Completed Appointments baal Summary by Activity Type with Patient Detail beg Work List summary Queue and Patient Detail From here you can select each report that you would like to generate view and export The reports included in this link are only a subset of our total reports Please note that if needed reports can be restricted based on user role and permissions Mock up reports detailed specifications and requirements were made to meet each of the requirements outlined in Appendix A and B to ensure all needs were met This information is stored in Appendix D of this manual Reporting Suites This section will list all reporting suites and reports they includ
271. o host the Health eTime application we have chosen to deploy components of the applications across the three VMs Figure 2 1 shows how the three VMs are configured This is for implementation of the prototype only and does not represent the MedRed LLC and BT America j recommended system configuration For an overview of the recommended configuration please see Appendix C i oor AANEEN FFE LLL Pore eet HN rg ia VM Alabama VM 111 222 333 444 111 222 333 444 Ar FF 111 222 333 444 VistA Instance VistA Instance VistA Instance Application Server IIS DBMS Server SQL Server SSRS CalDav Server Bedework Deployed Health eTime Enterprise Solution Figure 2 1 Scheduling System Deployment in the Contest Environment 2 2 Preparation of the Assigned VistA instances The three VistA instances that we received all required varying degrees of configuration modification and patching Details of the changes made to each individual VistA image are listed below CA Instance e VistA dat file location c CPM e Instance Name CPM e Refresh VistA short cut on Desktop to point to the proper location e Change firewall in bound out bound ports i e 9200 e Applied Ray Group Scheduling Script SD_5 3_260003_RC4 KID e Applied 2 Ray Group Scheduling Script SD_6_0_1_T7 KID Created by Chris Uhera e Applied XUA4A7_FIX_0 0 KID Fixes a problem with DIC 0 being undefined when using the updater
272. of appoint that links to primary appointments This would give such tests a check in process and allow dependent appointments to be cancelled rescheduled when they are missed The alerts can be set as a type of notification in the integrated notification process Reference Appendix A 3 instructions for Use Case 3 Steps 9 scheduling other linked appointments Reference Section 4 Application User Manual Section 4 4 for explanation of notification function Reference Appendix B Application Design and Architecture Section B 15 for explanation of notification process 4 2 2 The system shall have the capability to search for the available appointment across multiple resources The search function in our application is explained in the Application User Manual Reference Section 4 Application User Manual Section 4 5 for explanation of the search function in the application 4 2 3 The system shall have the capability to provide information to assist schedulers to consolidate appointments in one day when possible e g flag the fact that a patient is scheduled to show up X days of desired new appointment date Information to support the consolidation of appointments is displayed in the weekly views for a section or clinic This view shows vacancies for consolidation opportunities The view of all the appointments for a patient then shows how spread out the appointments have become and whether it makes sense for so
273. of modified M Routines have been updated Routine headers of all modified M routines have been updated using the given convention See 171 MedRed LLC and BT America 7 Section 2 2 for a list of modified M routines 7 VistA mods have MUnit tests MUNIT tests were created for all the routines that were modified 8 Did MUnit tests passed Yes Reference Appendix E 3 9 VistA mods have install methods into sd_5p3_131000rc2 KID Vista FOIA XUA4A7_FIX_0 0 KID 10 Does mods install cleanly Yes 172 SSS om A Appendix A Manual Operating Instructions for the Eight Published Use Cases Scenarios and Traceability to Requirements MedRed LLC and BT America j The following are manual scripts we used to test Health eTime against the eight Use Cases The steps in testing are further referenced in our Step 2 requirements traceability matrix to explain the capabilities of our application We Start by Logging into the Health eTime Application Prior to completing any of the Use Case steps detailed in this document you must log in to the application as an Administrator The log in information is as follows 1 Open browser to http 166 78 237 187 SchedulingWeb Account Login aspx 2 Enter Username tester Enter Password tester2 3 Select Log In VETERANS AFFAIRS ScHEDULING PORTAL Please log in Username tester1 Password Note Note Demonstration data in
274. ointmentRequest Collection lt CommunicationQueueltem gt GetAllRelatedCommunications Appointment appointment Collection lt CommunicationQueueltem gt GetAllRelatedCommunications AppointmentRequest appointmentRequest AppointmentRequest AddAppointmentRequest AppointmentRequest request AppointmentRequest UpdateAppointmentRequest AppointmentRequest request Collection lt AppointmentRequest gt GetAppointmentRequestsForPatient Patient patient Collection lt AppointmentRequest gt GetAllOpenAppointmentRequests Section section public enum AppointmentAction Create WalkIn CheckIn CheckOut NoShow Cancel Reschedule EquipmentService Equipment Management Collection lt Equipment gt GetAllForSite int siteld Collection lt Equipment gt Get Equipment Get int id Equipment Add Equipment equipment Equipment Update Equipment equipment bool Delete int id FacilityService Facility Management Collection lt Facility gt GetAll int siteld Facility Get int id Facility Add Facility facility Facility Update Facility facility bool Delete int id CommunicationTemplate AddOrUpdateCommunicationTemplate int facilityld CommunicationTemplate communicationTemplate bool DeleteCommunicationTemplate int facilityld CommunicationTemplate communicationTemplate ImportService Import Tasks bool CheckAndUpdate bool ImportSite string siteld NationalSystemService Service AddService Service service
275. ointments for the time period selected 270 MedRed LLC and BT America 7 Figure D38 Req 14 5 Create two notes under the Completed Appointment table and display as shown in Figure D39 above Performance Measure for Congress Increase the percent of appointments completed within 14 days e Make font bold and place in italics e Create a border around note e Fill in light blue Note Percentage of Completed Appointments is a calculated field which takes the total number of appointments marked as complete divided by the total number of appointments for the time period selected e Make font bold and place in italics e Create a border around note e Fill in light grey Reg 14 7 Have report look like the mock up report Congressional Performance Reports Mock Up tab 2 titled Completed Appointments MedRed LLC and BT America a E Appendix E Open Source and Software Licensing Documentation E 1 Descriptive Documentation of the Integration Codes The integration of third party applications with VistA can be a tricky process due to the complexity of VistA and the underlying processes Consequently we have opted for an integration strategy that showcases a comprehensive strategy The exact integration approach needs to be specified on the basis of the VA s strategic goals and requirements Therefore the chosen approach is just that an approach and the techniques used which valuably represent our ability to integrate our applic
276. olidate all scheduling activity into a single patient view The cornerstone of this capability is the applications use of Coordinated Universal Time UTC to broker an appointment management between the local VistA sites The application always presents appointment times in the user s local time zone PDT in California for example but system date times are held in UTC Coordinated Universal Time which the application translates to local time on demand Second Health eTime has a comprehensive data model that allows for the integrated scheduling and management of a variety of resources such as providers rooms and equipment Third the application framework permits role based access that can be linked in the future to the identity management and role definition within the VistA or MyHealthyVet systems Fourth as part of an extensive set of reporting capabilities the application creates an audit log of basic actions performed by users This includes actions such as creating or canceling appointments This functionality along with other reporting capabilities can be readily extended 60 MedRed LLC and BT America 7 T to provide a comprehensive overview of application and enterprise activity Finally Health eTime is a browser based application designed to be accessed from the tools menu of CPRS Aside from configuration changes to the local VistA CPRS instances it deployment requires no installation or ongoing upgrades and mainte
277. on e Audit Function Format as text Indicates what activity the user completed e User Format as text Indicates first and last name of user which completed the audit activity e User Role Format as text Indicates the role of the user that completed the audit activity i e provider admin or scheduler e Patient name Last Name First Name Middle Name Format as text Indicates the name of the patient if any if the audit function is tied to a patient e SSN last four digits Format as text Indicates the last four digits of the patient s social security number if the audit function is tied to a patient Ensure that field is displayed in text in the event that the last four digits of the SSN are 0 s Req 3 5 Create a table and title it Total Audits by Type which displays the following headers as columns Event Type Display the audit function that as completed Number of Audits Count and display the total number of audits by type this is a summarization of the Audits Patient Detail table All logic applied to the Audits Patient Detail table should apply to the summarization table Reg 3 6 Create a graph and title it Total Audits by Type which graphs the Total Audits by Type summary table e Ensure the legend displays the number of audits e Outline legend e Ensure colors are consistent with report e Fill legend in light grey e Ensure font is easy to read and matches style of report see Figure 13 below
278. or the From and To dates you can click on the calendar as shown above to help you to select your dates These parameters and options are based on data which has been entered Many of the reports also allow additional sorting functionality once your report displays To utilize this click on the downward or upward arrow next to the column header for the column that you would like to sort data for Your data will re display showing the newly sorted data This allows the user to flexibly decide how he she would like to view the data all the information presented in the table 81 MedRed LLC and BT America wi Appointment Overview Patient Hame SSH Appointment Appointment Appointment Last Name First Name last four Date Start Time End Time Middle Name digits RAMIREZ FRANCIS 0003 6 7 2013 15 00 16 00 LITTLE ALICIA 0004 6 21 2013 15 00 16 00 LITTLE ALICIA 0004 6 6 2013 17 45 18 45 Example Reports Available in Scheduling Application Suite 1 Provider and Clinic Appointments and Utilization Report 1 Appointment and Clinic Dashboard by Site and Facility To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 11 2013 e Select a To date To return a smaller subset of data use date 6 13 2013 e Select a Site Any Site can be used e Select a Facility Any Facility can be used e Select one or more Clinics You can le
279. ory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Caldavid None ChildAppointments None HighPriorityReschedule False Id 81 Length 15 Patient Patient Activelnsurance None 45 MedRed LLC and BT America CaldavResourceld None CurrentMeansStatus None EligibilityCode None HasInsurance False ICN 500000006 Id 13 IsVeteran False MilitaryStatus None NeedsMeansTest False Occupation None PatientSites ArrayOfKeyValueOfstringstring KeyValueOfstringstring KeyValueOfstringstring Key 557 Value 6 PatientType None Person Person Address Address City None Id 42 State None Street1 834 Ocean Vista Avenue Street2 SANTA MONICA CALIFORNIA 90401 Street3 None Zip None DateOfBirth 1962 11 01 00 00 00 Email None Ethnicity None FirstName JUANA Id 409 LastName GREER MaritalStatus None MiddleName None Phone 3105552233 SSN 300000000 Sex Male Preferences None PreferencesOther None Religion None SCPercent 0 ServiceConnected False SpecialNeeds None SpecialNeedsOther None Resources ArrayOfResource Resource Resource AllowOverbooking False Block
280. ot limited to the following e Outpatient Diagnosis Procedure Frequency Report e Management Report for Ambulatory Procedures 3 Diagnostic outcomes at appointments are treated as encounter data and currently not tracked with the scheduling database In a deployed environment the schedules in our application will be associated with diagnostic information and supporting services Thus the schedule can be used to pull data sets from VistA to generate reports for such metrics If given such external data set from the VA we would have configured this reporting capability Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function 167 MedRed LLC and BT America 7 Instructions and Traceability Matrix for Step 2A Attachment C Non Functional Requirements Evaluators 7 1 Evaluating Functionality VA Requirements Instructions and Validating Outcomes 1 1 The Scheduling Solution shall be capable of providing configurable error messages work flows and alerts Error messages and alerts are built into our application to support development and testing Development and testing is done both at the module level and the integrated system level of the application and end to end testing has shown that all errors have been resolved Because of our modular open source design the process follow and functionality of the application can be adjusted and expanded through modular
281. ots with capacity gt 1 Upon selecting a group appointment from the Calendar the remaining slots and patients are displayed for Scheduling Management Group Appointments Sa gt e http 166 78 237 187 SchedulingWeb Patient GroupAppointmentsList asp aA X P Search BT intranet pr Ve Favorites Group Appointments fh gt Bl E amp Pager Safetyy Tooky VETERANS AFFAIRS Build 1 11 4908 21296 ged in as test log out SCHEDULING PORTAL y tA Site CA VA HEALTH CARE SYSTEM 08 0C fic Time JS nad VistA Appointments Administration About Help HOME GROUP APPOINTMENTS Group APPOINTMENTS Facility CAVA REGIONAL MEDICAL CENTER x Clinic Physical Therapy Regular e Provid This Week 10 Jun 2013 E View Week 6 10 2013 ll 12 2013 er Jane Smith Bl wl N Internet Protected Mode On fay RS v Click Add Patients to select patients for the group appointment Patient Check in From the Appointments menu select Patient Check In This option allows the Scheduling or other user role such as a Front Desk to record the outcome of the appointment This includes whether the patient is recorded as no show or left without being seen 112 MedRed LLC and BT America AS VETERANS AFFAIRS Build 2 0 0 0 Logged in as tester2 log out SCHEDULING PORTAL VistA Site CA VA HEALTH CARE SYSTEM UTC 08 00 Pacific Time US amp Ca
282. ource Compatibility Evaluators 171 A Appendix A Manual Operating Instructions for the Eight Published Use Cases Scenarios and Traceability to ReQUINGINGINIG s 2c sisecenverseacstancidadveieedss eieeldevdinenidvasdebinedeneles aisubis detetieedyade 173 A 1 USE CASE 1 Establish Organize and Manage the Scheduling Componert 174 A 2 USE CASE 2 Establish and Manage Section Schedules cceeeeeeeeeeeeeee teen 180 A 3 USE CASE 3 Create a Patient Appointment cc cceeeeeee rere eee eeeenneeeeeeeeeeteeee 193 A 4 USE CASE 4 Manage a Patient Appointment eect e reer eeeeennneeeeeeeeeeteeee 196 A 5 USE CASE 5 Manage a Walk in Patient cccccceceeeeesssecceeeeeeeeeesneneeeeeeeeeeeeeeeees 198 A 6 USE CASE 6 Cancel Individual Appointment eceeeeeeeeeeeeeeeeeeenneeeeeeeeeeteeee 200 A 7 USE CASE 7 Reschedule Individual Appointment ccceeereeeeeeeetneeeeeeeeeeteee 202 A 8 USE CASE 8 Add Appointment Request to Waiting List and Schedule Patient from Waiting ISL cccnsactensac onctecsanadeensisemtmrstenetreeaascemnstevesmieranevsetteretedetacerdiesonsiaiateraraietarcmiebenererenea 204 B Appendix B Health eTime Application Design and Architecture c cccceeeeeteeeeetees 208 B 1 Health eTime Service Layer sc iccciitrctsstieeinaeslvccpiiea weeds tediieeee ees 209 B 2 Health eTime Persistence Layer ccccceeeeseseceeeeeeeeeeeeeeeeaeaeeeeeeeeeene
283. ows that our application permits scheduling when all the required resources converge for a desired appointment time However since resources each have their own calendar the alignment of individual schedules against a specific resource or multiple resources schedule can be easily presented as overlaps The UI functionality for such display will have to be refined based on user needs Reference Appendix A 3 instructions for Use Case 3 Step 5D setting patient appointments with available resources 4 2 6 The system shall have the capability to create groups of resources for scheduling a single event e g room equipment and ancillary staff Use Case 3 shows that our application permits scheduling when all the required resources converge for a desired appointment time This convergence can be regarded as a grouping process Reference Appendix A 3 instructions for Use Case 3 Step 5D setting patient appointments with available resources 4 2 7 The system shall have the capability to cancel restore resources and all linked appointments over multiple days not just one day at a time Once links between appointments are established as validated by the Use Case 3 the cancelling of a series of appointments will free up the resources In linked appointments one appointment cannot be cancelled without an application query regarding the disposition of other appointments Reference Appendix A 3 instructions for Use Case 3 St
284. plan will be formulated for how data residing in the current locally deployed Medical Scheduling Package MSP systems can be migrated into Health eTime Translation functions will be developed as required based on database cross mapping A data error check process will be further formulated to ensure that no errors have occurred as a part of data migration Transition Plan The transition process will be designed based on VA s schedule and location priorities At each location MSP will remain operational as Health eTime schedules are audited against MSP schedules When system accuracy and reliability has been verified MSP can be retired Testing Master Plan This plan coordinates all testing activities from developmental testing to operational testing in support of Certification and Accreditation and decision to field capability As a part of testing the application s integration with actual VistA instances readiness to connect to the network interoperability with other VistA applications and end to end performance will be validated Product Support As an open source product Health eTime s business model is to provide VA with unsurpassed product support capability over the full lifecycle of the product This includes 24 7 user support as needed updates periodic upgrades new functional components 224 MedRed LLC and BT America expanded deployment and installation support and process improvement support based on the applica
285. pointment in multiple time slot current appointment status Scheduled current appointment status Scheduled current appointment status Scheduled current appointment status Scheduled checkpoint 4 22 MedRed LLC and BT America A group appointment is made in a multiple appointment time slot step 12 schedule telehealth appointment Scheduled checkpoint 5 telehealth appointment is created 3 4 Use Case 4 Test Script Execution User Clinic Coordinator Goals Manage a Patient Appointment Run_uc4 bat Data added modified in the Scheduling Application database e Appointment Request info particularly status information e Appointment particularly status information checked in checked out e Notification Queue Data added modified in VistA e When the status of an appointment is changed within the scheduling application that status change is reflected in the corresponding appointment in VistA Sample Log initializing vista and sql db plesae wait setp 1 enter patient info step 2 verify deographics current appointment status Scheduled current appointment status Scheduled step 3 checkin appointment to section one step 4 display patient checkin status CheckedIn checkpoint 1 verified patinet checkin status step 5 display patient checkin status on section two Checkedin checkpoint 2 verified patinet checkin status on section two step 6 check out the appointments step 7 display othe
286. pointments will be cancelled Regular and Group appointments for the patient are listed Click Cancel Appointment for a scheduled group appointment gt Select Cancelled by Cancelled by patient Reason Death in Family Reschedule Select Yes and click Cancel Appointment gt Confirm cancellation message displays Click OK gt Cancellation message displays UseCase 6 Step 11 Cancel group appointments 6 7 8 9 Click Appointments gt Group Appointments gt Group Appointment Calendar displays Select Facility CA VA REGIONAL MEDICAL CENTER Clinic Physical Therapy Regular Provider Jane Smith Date June 21 gt Group appointments for that week are displayed Select the 11 00 slot Click Cancel all appointments gt Cancellation reason page opens 10 Select Reschedule No Reason for cancellation Weather Click Cancel all A 7 Appointments gt Appointments cancelled message displays USE CASE 7 Reschedule Individual Appointment UseCase 7 Step 1 Search for an existing individual appointment Step 5 Display the patient s pending appointments Step 6 Display the patient s no show unkept appointment history 1 Select Appointments gt Patient Appointments from the menu bar gt Search patient page loads Type MANNING in the search box and click Search gt List of patients named MANNING are listed Click JODI MANNING gt The patient demographics stored in VistA display Click Select Patient gt
287. pper right green toolbar Type Ben in the search box and click Search Click the name HUGH BENSON gt The patient demographics stored in VistA displays Click Select Patient gt The 11 00 appointments is listed with Status Scheduled Select Check In for the appointment on June 25 at 11 00 gt appointment is listed with Status Checked in UseCase 4 Step 6 Disposition check out the appointment i e kept no show or left without being seen 6 From Patient Check In page click Appointment Kept for 10 00 and 11 00 appointments checked in above Click Appointments gt Patient Check In gt Return to Patient Search Type Fer and click Search If already in a patient record click Select Patient first upper right green toolbar gt Search results include Wade Ferguson Click on the name WADE FERGUSON gt The patient demographics stored in VistA displays Click Select Patient gt Current Appointments are listed with Status Click Check In if there are no appointments already checked in gt Appointment status is changed to Checked in Click Left without being seen for the checked in appointment 197 MedRed LLC and BT America A gt Appointment disposition is set as Left without being seen 13 Click Appointments gt Patient Check In gt Select Patient gt Return to Patient Search 14 Type Lamb and click Search gt Search results include Jennie Lamb 15 Select JENNIE LAMB gt The pati
288. ppointments p30 Scheduled Appointments Completed Appointments P30 Number of Missed Appointments Count of Unique Patients Who Missed an Appointment Pl of Missed Appointments E Number of Cancelled Appointments Count of Unique Patients Who Cancelled an Appointment of Cancelled Appointmen Figure D14 Req 4 8 Create a graph for the Missed Appointment category Show all three of the missed appointment metrics in a bar graph Req 4 9 For the Missed Appointment graph ensure all data labels are displayed like below 239 MedRed LLC and BT America j Missed Appointments E Number of Missed Appointments E Count of Unique Patients Who Missed an Appointment E of Missed Appointments Jan 13 Feb 13 Mar 13 of Missed Appointments is calculated by the total number of missed appointments total number of appointments created in report time period Figure D15 Reg 4 10 Create a Legend that displays as in Figure D15 e Outline legend e Ensure colors are consistent with report o Red Blue Green o Fill legend in light grey o Ensure font is easy to read and matches style of report Req 4 11 Create a note box under the Missed Appointment Graph e Outline note box e Fill note box in light grey to match legend e Italicize and bold the font e Display as shown in Figure D15 Req 4 12 Display data by month for time period selected for from and to date instead of by
289. quest For example resource availability patient eligibility appointment type requirements and clinic level association with appointment types are governed by business rules in order to make appoints possible Female patients only for Ob Gyn is simply another filter in allowing for appointments that we can apply the application Reference Appendix A 1 instructions for Use Case 1 Step 9 Creating provider schedule in section and region Reference Appendix A 3 instructions for Use Case 3 Step 5 Making appointment 4 1 7 The system shall provide the ability for providers to request appointments The provider can initiate an appointment request for a patient or act as the scheduler in Step 3 to make the appointment If so desired we can grant providers role based access to schedule a select group of 145 MedRed LLC and BT America 7 lt gt patients under their care Reference Appendix A 3 instructions for Use Case 3 Step 1 Receive appointment request 4 2 Linking The system shall have the ability to automatically link relevant appointments resources Reference response for 4 2 1 to 4 2 7 below to validate that our application has the capability to automatically link appointments resources 4 2 1 The system shall have the capability to provide alerts when ancillary tests specialty consults have been scheduled missed Ancillary tests and specialty consults can be set as another type
290. r Goals Reschedule Individual Appointment Run_uc bat Data added modify in the Scheduling Application database e Appointment Info especially appointment status e Appointment Request used to reschedule the appointment e Notification Queue Data added modify in VistA e Corresponding clinic provider appointment status Notes e When the status of an appointment is changed within the scheduling application that status change is echoed to the corresponding appointment in VistA e When an appointment is cancelled within the scheduling application the existing corresponding appointment is also deleted in VistA which ties together the corresponding Clinic Provider and Patient in VistA Sample Log 38 MedRed LLC and BT America initializing vista and sql db plesae wait Step 1 Search existing individual appointment Step 2 Identify the appointment to reschedule An appointment is Scheduled for GREER JUANA On 2013 05 28 16 00 00 Step 3 Review the associated appointments ArrayOfAppointment Appointment Appointment Activity ArrayOfAppointmentActivity AppointmentActivity AppointmentActivity ActivityReason None ActivityType Create Id 150 Time 2013 06 07 01 23 02 000709 p AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOS
291. r appointments for the patient checkpoint 3 verified patient appointment status step 8 23 MedRed LLC and BT America repeat step 1 7 for group appointment current appointment status Scheduled current appointment status Scheduled current appointment status Scheduled current appointment status Scheduled checkpoint 4 verified checkout status on group appointment 3 5 Use Case 5 Test Script Execution User Clinic Coordinator Goals Manage a Walk in Patient Run_uc5 bat Data added modified in the Scheduling Application database e Appointment Request e Regular Appointment Data added modified in VistA e Corresponding clinic provider appointment Notes e When an appointment is made within the scheduling application a corresponding appointment is created in VistA which ties together the corresponding Clinic Provider and Patient in VistA Sample Log initializing vista and sql db plesae wait setp 1 Select Patient ArrayOfPatientSearchResult PatientSearchResult PatientSearchResult DateOfBirth 1962 11 01 00 00 00 FirstName JUANA LastName GREER MiddleName None SSN 300000000 Sex Male VistaDFN 6 VistaSiteld 557 b Step 2 Display Demographics Patient Activelnsurance 0 CaldavResourceld None CurrentMeansStatus None EligibilityCode None 24 MedRed LLC and BT America HasInsurance False ICN 500000006 Id
292. r report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 Home gt Reporting gt Patient Appointment Operational Details Home My Subscriptions Site Settings Help From 6 9 2013 5 07 13 PM ote 6 10 2013 5 07 13 PM a EEE Sites AL VA HEALTH CARE SYSTEM Facilities AL VA OUTPATIENT CLINIC AL m Clinics Audiology Mental Health Ment v bi 100 v Findint A O amp B id 4 1 jib Patient Appointment Operational Details From Date 6 9 2013 5 07 13 PM To Date 6 10 2013 5 07 13 PM Sites AL VA HEALTH CARE SYSTEM CA VA HEALTH CARE SYSTEM GA VA HEALTH CARE SYSTEM Facilities AL VA OUTPATIENT CLINICAL VA REGIONAL MEDICAL CENTER CA VA OUTPATIENT CLINIC CA VA REGIONAL MEDICAL CENTER GA VA OUTPATIENT CLINICGA VA REGIONAL MEDICAL CENTER Glinics Audiology Mental Health Mental Health Mental Health Mental Health Group Mental Health Group Regular Physica Therapy Regular Physical Therapy Regular PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE PRIMARY CARE Operational Metrics Patient Detail RAMIRO ROBERSON 0000 PRIMARY CARE LORY PETRI 6 1 2013 6 7 2013 6 10 2013 N N Y WADE STEWART 0008 PRIMARY CARE LORY PETRI 6 7 2013 6 7 2013 6 10 2013 N N N HUGH BENSON 0006 PRIMARY CARE JOSEPH KIRK 6 10 2013 6 10 2013 6 10 2013 N N N HUGH BENSON 0006 PRIMARY CARE LORY PETRI 6 1 20
293. rapy Regular PRIMARY CARE 100 MedRed LLC and BT America j TTotai Number of Appointments Number of Completed Appointments Percentage of Completed Appointments Audiology GA VA OUTPATIENT CLINIC GA VA HEALTH CARE SYSTEM 6 1 o 0 Mental Hesith AL VA OUTPATIENT CLINIC AL VA HEALTH CARE SYSTEM 6 2 1 33 Mental Hesith AL VA REGIONAL MEDICAL CENTER AL VA HEALTH CARE SYSTEM 6 2 o o Mental Hesith GA VA OUTPATIENT CLINIC GA VA HEALTH CARE SYSTEM 6 2 o o Mental Health Group GA VA REGIONAL MEDICAL CENTER GA VA HEALTH CARE SYSTEM 6 2 o o Mental Health Group Regular CA VA OUTPATIENT CLINIC CA VA HEALTH CARE SYSTEM 6 7 3 43 Physical Therapy Regular AL VA OUTPATIENT CLINIC AL VA HEALTH CARE SYSTEM 6 4 1 25 Physical Therspy Regular CA VA REGIONAL MEDICAL CENTER CA VA HEALTH CARE SYSTEM 6 1 o o PRIMARY CARE AL VA OUTPATIENT CLINIC AL VA HEALTH CARE SYSTEM 6 5 3 60 PRIMARY CARE AL VA REGIONAL MEDICAL CENTER AL VA HEALTH CARE SYSTEM a 2 o 0 PRIMARY CARE CA VA OUTPATIENT CLINIC CA VA HEALTH CARE SYSTEM 6 5 1 20 PRIMARY CARE CA VA REGIONAL MEDICAL CENTER CA VA HEALTH CARE SYSTEM 6 2 1 50 PRIMARY CARE GA VA OUTPATIENT CLINIC GA VA HEALTH CARE SYSTEM 6 2 o 0o PRIMARY CARE GA VA REGIONAL MEDICAL CENTER GA VA HEALTH CARE SYSTEM 6 8 3 28 Total Number of Completed Appointments 468 13 Note Percentage of Completed Appointments is a calculated field which takes the total number of appointments marked as complete divided by the total number of appoint
294. reate a schedule for a provider in the Primary Care Section of the Regional Medical Center Walkthrough 1 Select VistA on the upper left of the Home page 2 Select Facilities 178 o N Sot 10 11 12 13 14 15 16 17 21 22 23 MedRed LLC and BT America a lt Click on the Select link next to a particular Facility e g VA Regional Medical Center gt The Facility Details will be displayed Click View Clinics Click the Select link for the Primary Care Clinic Click the Clinic Resources List link Click Add Resource Enter the following information gt Type Name Jane Smith Select Resource Type Provider Fulfulling Resource SMITH JANE Check Allow Overbooking Click Add Click Resources top of the screen under blue toolbar Click Select for Jane Smith Click Scheduling Policies List Click Add Scheduling Policy gt Select Day of the week Monday Start Effect Date use today End Effect Date and Time use same day month and time use 2015 for the year Priority 1 Click Add Click View Slots Click Add Slots gt Length 15 minutes Start time 08 00 End time 12 00 Appointment type Regular PTSD Click Add 16 Slots 18 19 20 Return to the clinic resources page and select Jane Smith Click Scheduling Policies List Click Add Scheduling Policy gt Select Day of the week Monday Start Effect Date use today End Effect Date and Time use same day month and time use 2015 for the year Priority 1
295. report will default to show that e Select Sites Any can be used e Select Facilities Any can be used e Select Clinics Any can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 Home gt Reporting gt Ad Hoc Operational Report Home My Subscriptions Site Settings Help a From 6 9 2013 5 21 58 PM ote 6 12 2013 5 21 58 PM a View Report Appointment Request Type Mental Health Consult Regular v Most Updated Activity Type Cancel Checkin Checkout v VISN 6 Sites AL VA HEALTH CARE SYSTEM m Facilities AL VA OUTPATIENT CLINIC AL m Clinics Mental Health Physical Therap id 4 f1 of1 b bi 100 v Find Next A O B Ad Hoc Operation Report Report Parameters 6 9 2013 6 12 2013 Eerie aase rt a Mental Health Consult Regular Mental Health Group Regular Mental Health Group Regular Individual Mental Health Regular PC Regular Physical Therapy Regular Primary Care Regular Regular Regular Primary Care Regular D LEAN Cancel Checkin CheckOut VISN 6 Sites AL VA HEALTH CARE SYSTEM Facilities AL VA OUTPATIENT CLINIC AL VA REGIONAL MEDICAL CENTER Mental Health Physical Therapy Regular PRIMARY CARE
296. rform specific function A flexible standard pattern for User Administration is provider and this could also be linked to other user authorization policies as required Example users are provided with the baseline data set Managing a User Select the Administration menu then select User This page is for the management of users Note that some users cannot be managed through this option A list of users displays and shows you your current user role at the top of the table as well as a comprehensive user list Here you can change the user s password view roles and delete a user D VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments About Help Home USERS Users Roles USERS Users in Roles Actions Role Actions Add User AAninict ators User Name Manage User M 9952FRN A Change Password admin View Roles Delete User J m alan Change Password FrontDesk View Roles Delete User a hugh Change Password Jannette View Roles Delete User To change a user s password select the Change Password link to the right of the User Name Enter a new password and select Save 118 _MedRed LLC and BT America A VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Users USERS CHANGE PASSWORD New Password User Roles Once users and roles are set up the management of users in roles is performed in this page For example the u
297. rmance level information exists through the scheduling process and is stored in our database Reports are generated base on types of performance metrics with examples shown in the following references Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 1 Provider and Clinic Appointments Utilization Reports Reference Appendix D 2 Operational and Wait Time Summary with Patient Detail Reports Reference Appendix D 6 Capacity Workload and Utilization Report 163 9 3 6 The system shall have the capability to generate patient complaint tracking and status metrics and measures reports Examples of existing reports which work now and must continue to work include but are not limited to the following types of reports e Survey of Healthcare Experiences of Patients SHEP Inpatient and Outpatient Survey Reports e Patient Advocate Profiles e Number of Complaint Issues by Type of Care Patient Advocate Tracking System PATS e Summary of Responses to Patient Complaint Data in Outpatient SHEP OQP e Compliments Complaints as of Total PATS Report e All Complaint Issue Trending PATS e Complaint Clinical Appeal Data PATS 3 MedRed LLC and BT America 7 lt Patient complaints based on appointment experience are treated as encounter data and currently not tracked with the scheduling database In a deployed environment th
298. rstName HUGH Id 403 LastName BENSON MaritalStatus None MiddleName None Phone 3105552233 SSN 300000006 Sex Male Preferences None PreferencesOther None Religion None SCPercent 100 ServiceConnected True 57 MedRed LLC and BT America SpecialNeeds None SpecialNeedsOther None step 6 make the appointment Scheduled step 7 remove patient from the EWL checkpoint 3 verified the patient is removed from EWL step 8 send the appointment notification to the patient checkpoint 4 verified the existence of the appointment notification for the patient step 1 add patient request to the transfer list step 2 sending transfer request notification to the patient step 3 checking transfer request for the new location step 4 transfer the patient to new location step 5 create an appointment on new location Scheduled step 6 send the appointment notification to the patient on new location 3 9 Verbose Output The scripts can be run with verbose output which outputs a great deal of information mainly for debugging purposes The volume of data output may be difficult to understand for non developers who are unfamiliar with the scripts We will offer assistance with Verbose Output analysis if requested lt script_name gt bat verbose i e run_uc1 bat verbose 58 MedRed LLC and BT America STEP 2 EVALUATION MedRed LLC and BT America a 4 Health eTim
299. ry of Missed Appointments by Clinic e Outline note boxes e Fill note boxes in light grey to match legend e Italicize and bold the font e Display as shown in Figure 3 3 Req 6 16 Graph the Average Number of Missed Appointments by Clinic Display as depicted in Figure D18 245 MedRed LLC and BT America A Average Number of Missed Appointments by Clinic 0 60 0 50 0 50 0 40 0 30 E Average Number of Missed Appointments 0 20 0 10 0 00 PNS PTRP Figure D18 Req 6 17 Create a Legend that displays as in D19 e Outline legend e Ensure colors are consistent with report e Blue e Fill legend in light grey e Ensure font is easy to read and matches style of report Reg 6 18 Ensure report is displayed per mock up D 4 Work List Summary Queue and Patient Detail This reporting suite fulfills the following requirements there is only one report in this suite A 7 2 1 The system shall have the capability to generate and display a work list based on unfulfilled appointments at the operational level to capture the source of a request type of request and status of a request along a timeline Work list queue is automatically updated based on tasks that need to be completed by the scheduler B 9 4 4 The system shall have the capability to generate QA reports to ensure the proper disposition of incomplete appointment information Report 7 Work List Summary Queue and Patient Detail Report Title Work List Su
300. s None CalendarID None FullfillingResourceld 4 Holds None Id 3 Name case1 step 9 test SchedulingPolicies 46 MedRed LLC and BT America ArrayOfSchedulingPolicy SchedulingPolicy SchedulingPolicy DayOfWeek 2 EndEffectDate 2014 01 15 00 00 00 Id 72 Priority 0 Slots ArrayOfSlot Slot Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity 4 Id 570 Length 15 Time PT16H i Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity 4 Id 571 Length 15 Time PT16H15M i StartEffectDate 2013 01 04 00 00 00 Ip Section Section Abbreviation PC Active True AppointmentTypes 47 MedRed LLC and BT America ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION a
301. s Most data was entered for the timeframe of 5 31 2013 to 6 27 2013 However some reports are designed for smaller timeframes for example if you want to see appointments just for that day You will 80 MedRed LLC and BT America A only see information in the report based on data entered in the application based on the time frame and other parameters selected Once you have entered your parameters select the View Report button on the upper right The report generates and appears in the bottom pane Your report will display your parameter selections on the top of your generated report From 67572013 E To 67672013 a View Report Site GA VA HEALTH CARE SYSTEM gt Facility GA VA REGIONAL MEDICAL CENTER gt Clinics Dermatology Mental Health Priv ft oft b bi os Find next the O GO Appointment and Clinic Dashboard by Site and Facility 5 2013 6 6 2013 GA VA HEALTH CARE SYSTEM GA VA REGIONAL MEDICAL CENTER Dermatology Mental Health Primary Cate Tai Chi Class You can adjust how large or small you see it on the screen using the zoom feature in the toolbar To export and save it on your computer select the diskette icon options for export are displayed when selected E Specifications about all reports are included in each of the Report Specification documents which can be found in the appendix There each of the reports details and requirements it meets are outlined F
302. s along with scheduling for rooms equipment and providers You also have access to create run and export reports through the reporting section of the application 4 3 Getting Started and Sign on For the submission we have provided a set of users who have access to all actions within the application Access can be restricted based on the defined role for each logged on user To log in open a new Internet Explorer web browser and paste the following URL http 166 78 237 187 SchedulingWeb It is preferred that you use Internet Explorer to use the application Use the following sign in information to log in Username tester2 61 Pd MedRed LLC and BT America wS Password tester2 VETERANS AFFAIRS bg SCHEDULING PORTAL Please log in Username tester2 Password When you successfully log into the home web page the application presents the tabs that are available based on your permissions Currently the application is set up for the log in role of Administrator The below page displays VETERANS AFFAIRS Build 2 0 0 0 ogged in as tester2 log out SCHEDULING PORTAL Shoe CAVA HEALTH CARE SYSTEM VistA Appointments Administration About Help Hon VETERANS AFFAIRS SCHEDULING PORTAL HOME Welcome to the Veterans Affairs Scheduling Portal Please use the menu to perform the scheduling tasks you require The top right of the screen includes a Vista Site drop down The site selected determines what inform
303. s appointment is now rescheduled and the application alerts you that due to this a pre appointment massage and a cancellation message have been scheduled as well as a cancellation To return to Hugh s appointments select View Patient Appointments VETERANS AFFAIRS Saag ard cee gon peer Vista Site SCHEDULING PORTAL UTC 08 00 Pacific Time US amp Canada VistA Appointments Administration About Help Home PATIENT APPOINTMENTS Patient HUGH BENSON 500000004 Select Patient Has had 2 no shows in the past 2 years Add Appointment Add Appointment Request Add TeleHealth Appointment View Appointments Requests lj View Appointment History CURRENT APPOINTMENTS Status Scheduled From 12 Jun 2013 Appointment Previous Following Tele Health Actions Change Provider 02 Jul 2013 13 00 for 60 minutes At PRIMARY CARE View in Provider Roster Status Scheduled No Appointment Type REGULAR a Reschedule Appointment Gea 25 Jun 2013 10 00 Normal Priority Cancel Appointment Change Provider 23 Jul 2013 09 00 for 30 minutes At PRIMARY CARE View in Provider Roster Status Scheduled No Aopo inten roe AN aes once Reschedule Appointment Normal Priority Cancel Appointment 109 MedRed LLC and BT America a The new date displays under the Appointment column and the previously scheduled appointment appears under column labeled Following To Cancel an Appointment select Cancel Appoin
304. s appropriate as a synchronized event The telehealth appointment process demonstrates scheduling a patient in one VistA location with resources at a different location and time zone This is enabled through our enterprise solution that synchronizes all appointments as all instances against Coordinated Universal Time UTC Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling a telehealth appointment Reference Section 4 Application User Manual Section 4 6 for explanation of telehealth appointments 5 2 2 The system shall provide the capability to capture and to select locations of patient and healthcare resources including non VA facilities e g Veteran home DoD The schedule of the patient can be for any location time zone That schedule will be aligned with providers and resources at the treatment location either as a telehealth or physical appointment Non VA facilities can use our application by creating its own entity down to the section clinic level We have established Home Health Care Clinic through the UI to demonstrate making appointment at a non VA 152 academic affiliate contract provider etc MedRed LLC and BT America facility Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling a telehealth appointment Reference Appendix A 3 instructions for Use Case 3 Step 5 making appointments 5 2 3 The system shall provide the ability to cr
305. s shown in figure D13 above using the following calculations Scheduled Appointments Number of appointments that are currently scheduled and there is no cancellation date for that appointment and data is within all reporting parameters selected Completed Appointments Number of appointments that are currently marked as completed and all data is within all reporting parameters selected Number of Missed Appointments When the appointment status missed and data is within all reporting parameters selected Count of Unique Patients Who Missed an Appointment The number of distinct patients that had an appointment status missed and all data is within all reporting parameters selected of Missed Appointments When appointment status missed total number of appointments and all data is within all reporting parameters selected on report 238 MedRed LLC and BT America E Number of Cancelled Appointments Count of appointments where appointment status cancelled and data is within all reporting parameters selected Count of Unique Patients Who Cancelled an Appointment Count of distinct patients with appointments where appointment status cancelled and data is within all reporting parameters selected of Cancelled Appointments Calculate percent of cancelled appointments appointment status cancelled total number of appointments created during from and to date entered on report and all selected parameters Scheduled Appointments O O Completed A
306. se or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report Step 6 The column headers in this report allows additional sorting after the report has been run To complete this select the upward or downward arrow on the column header you wish to sort 86 MedRed LLC and BT America AS e Step 7 To export and save it on your computer select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 2 Operational Summary with Patient Detail Reports 3 Patient Appointment Operational Details To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 10 2013 e Select Sites Any Sites can be used e Select Facilities Any can be used e Select Clinics Any can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine you
307. searching for and selecting appointment slots for reschedule rebook 3 6 5 The system shall have the capability to merge purge or distribute scheduled appointments from one resource to another Our application creates appointments by converging patient provider equipment and room schedules The application allows changing the provider of an appointment by selecting the dedicated function when viewing existing appointments Reference Appendix A 3 instructions for Use Case 3 Step 5D reserving resources for specific patient appointment 3 7 Optimize Resource Utilization The system shall incorporate mechanisms that support optimization of resources Reference response for 3 7 1 to 3 7 6 below to validate that our application has the capability to optimization of resources 3 7 1 The system shall have the capability to capture the coded reason for cancellations no shows e g death of patient lack of transportation snow day Use Case 6 validates our application s capability to capture reasons for cancellations This is done through a comment block in the cancellation process VA specific reason codes can be added to this documentation process Reference Appendix A 6 instructions for Use Case 6 Step 4 document the reasons for the cancellation Reference Section 4 Application User Manual Section 4 6 for explanation of cancellation and documentation 3 7 2 The system shall have the capab
308. select the diskette icon options for export are displayed when selected To export to excel select excel then save to desktop Copy the report and then save to your computer to the location of your choosing Pictures displaying steps are shown in the first example report step by step instructions Suite 7 Clinic Operational Report 8 Mental Health Operational Report To generate a report Step 1 Select the parameters for your report e Select a From date To return a smaller subset of data use date 6 09 2013 e Select a To date To return a smaller subset of data use date 6 12 2013 e Select Sites Any can be used e Select Facilities Any can be used e Select Clinics Any can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 96 MedRed LLC and BT America E Se Home gt Reporting gt Clinic Operational Report Home My Subscriptions Site Settings Help From 6 9 2013 te 6 12 2013 3 Sites AL VA HEALTH CARE SYSTEM Vv Facilities AL VA OUTPATIENT CLINIC v Clinics Mental Health Physical Therapy mi View Report iq 4 1 offi b gt bl 100 v Find Net A O B Mental Health Operational Report Report Parameters
309. sername abrown could be assigned as a Scheduler There are a couple ways to get to the View User Roles section select Administration then Users and select the User in Roles link or by directly selecting User In Roles from the Administration tab On this page you can filter from the Roles drop down to show which user is assigned to each role A checked box indicates the user is assigned to that role and all associated permissions for that role You can also change the user s role here by checking or unchecking the box D VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home Users In Roes USERS IN ROLES Roles FrontDesk Vv ERE TREE admin FrontDesk Jannette Mary NoOverbook Roles Roles can be created which have a configurable set of Role Actions for example a Front Desk user has a limited set of options including Check in menu option From the Administration tab select Roles 119 E MedRed LLC and BT America A G e Y VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home ROI ROLES Add Role Administrator i Role Name Manage Role M Administrator View users in role FrontDesk Delete role Users in role NoOverbook Delete role View users in role Scheduler Delete role Select Add Role located about the Role table then select
310. ss Use Case 3 steps validate the management of the appointment selection process Reference Appendix A 3 instructions for Use Case 3 Step 5 making appointments 3 3 Providers Per Schedule The system shall have the capability to coordinate appointment scheduling based on resource availability Use Case 3 steps show the identification of resource availability based on convergence of providers rooms and equipment Then it demonstrates the committing of those resources to the appointment Reference Appendix A 3 instructions for Use Case 3 Step 2 enter desired future appointment date time and Step 5D selecting appointment and reserving resources 3 4 Access Restrictions for Scheduling Appointments The system shall have the capability to filter available appointments based on patient preferences appointment availability geographic considerations facility date range resource type and other special needs Patient preferences and special needs are captured and can be used as filters for selecting appointments in Use Case 3 The filters in the application can be adjusted to match VA s objective process for scheduling Reference Appendix A 3 instructions for Use Case 3 Step 4 identifying patient preferences and special needs Reference Appendix A 3 instructions for Use Case 3 Step 5C and 5D selecting and setting appointments based on filters 3 5 Waiting Lists The system shall provide
311. ssnaaaeeeeeees 210 B 3 Health eTime Integration Web Services 0 eeeeececccceeeeeeeeeeeeeaeeeeeeeeeeeeeessnaaaeeeeeees 210 B 4 Health eTime Scheduling Database cccccececcceeeeeeeeeeeeeeeeeeeaeeeeeeeeeeeeeesseneeeeeees 211 B 5 Health eTime Appointment Relations ccccccccceeceeeeeeeeeeeeeecneeeeeeeeeeeeeeeneeeeeeeees 211 B 6 Health eTime Audit Relations ccccccceeeeeeeeeseeeceeeeeeeeeeesnsnaaeaeeeeeeeeeseeenaaaeeeeeees 212 B 7 Health eTime Patient Relations cccccccceeeeeesesecceeeeeeeeeeenenaeaeeeeeeeteseesnsaaaeeeeeees 212 B 8 Health eTime Resources and Miscellaneous Entities ccceeeeeeeeeeeeeeeesenteeeeeeees 213 B 9 Health Time Reporting cceccecesscecccceeeeeeeeeeseneaeaeeeeeeeeesegaaaaeaeeeeeeeeeeessnaaaeeeeeees 214 B 10 CalDav Server eee eee eee ee er ee nener eenne 215 B11 I tare eres ceee ec ernn E eE E atten 215 B 12 Health eTime Data Load Scripts sinccesscasisncccsiacvsiactsncieecncvandvadenontetenusnesbiencdeanswentes 215 B 13 Health eTime Presentation Layer 0 0 ceceeeeecsceceeeeeeeeeeeeeeeaeeeeeeeeeeeesensaaeeeeeeees 215 B 14 Health eTime Role based User Security c ccccceeeeeeeeee eeceeeeeeeeeeeesesssaeeeeeeees 216 B 15 Notification Process Communication Templates ccceeeeeeeeeeeeeeeeseneeeeeeees 219 C Appendix C Our Recommendations Regarding Refinement and Enterprise Deployment 222 D Appendix D Report
312. st configuration parameters based on business rules Reference Appendix A 3 instructions for Use Case 3 Step 5D reserving resources for specific patient appointment 3 7 4 The system shall have the capability to receive notification of expired deceased patients from authoritative source and take appropriate action such as cancel future appointments ancillary services orders etc Because our application is integrated with VistA the cancellation process shown in Use Case 6 can receive expiration or death notices through VistA Once an official notice matching patient identity in the scheduling data base has been confirmed all the patent s appointments can be cancelled through processed similar to Use Case 6 Reference Appendix A 6 instructions for Use Case 6 Step 2 selecting appointments to cancel 3 7 5 The system shall have the capability to detect and notify users if patients have similar appointments service provider scheduled close together e g possible duplicate or both can be seen at one time Use Case 3 shows that appointment information for all manner of scheduling events is maintained in an integrated manner to enable presentation on total patient or resources activities across time Filters or searches can be conducted on patient provider equipment and room schedules based on business rules to identify redundant appointments Reference Appendix A 3 to Appendix A 7 instructions for Use Cases
313. structions 11 Congressional Report Percentage of Completed Appointments To generate a report Step 1 Select the parameters for your report Select a From date To return a smaller subset of data use date 6 09 2013 Select a To date To return a smaller subset of data use date 6 13 2013 Select VISN The only VISN currently available is 6 and the report will default to this Select Sites Any can be used Select Facilities Any can be used Select Clinics Any can be used Step 2 Select View Report button on far right Step 3 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 Home gt Reporting gt Percentage of Completed Appointments From 6 9 2013 5 29 42 PM To 6 12 2013 5 29 42 PM a VISN 6 Mi Sites AL VA HEALTH CARE SYSTEM M Facilities AL VA OUTPATIENT CLINIC AL s Clinics Audiology Mental Health Ment Id 4 fa fi gt bl E Find Next WA B Congressional Report Cc AL VA HEALTH CARE SYSTEM CA VA HEALTH CARE SYSTEM GA VA HEALTH CARE SYSTEM AL VA OUTPATIENT CLINIC AL VA REGIONAL MEDICAL CENTER CA VA OUTPATIENT CLINIC CA VA REGIONAL MEDICAL CENTER GA VA OUTPATIENT CLINIC GA VA REGIONAL MEDICAL CENTER Audiology Ments Health Mental Health Group Mental Health Group Regular Physical The
314. t AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P Patientinstructions None Capacity 1 Id 533 Length 30 Time PT19H b Slot AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION 27 MedRed LLC and BT America Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None Capacity 1 Id 534 Length 30 Time PT20H30M p StartEffectDate 2013 01 04 00 00 00 Section Section Abbreviation PC Active True AppointmentTypes ArrayOfAppointmentType AppointmentType AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 25 Name COMPENSATION amp PENSION Vistald 1 VistaSiteld 557 DSSCreditStopCode 450 BRONCHOSCOPY DSSPrimaryStopCode 323 TELEPHONE NEUROLOGY Duration 30 Id 17 Name C amp P PatientInstructions None AppointmentType AppointmentTypeCategory AppointmentTypeCategory Id 30 Name REGULAR Vistald 9 VistaSiteld 557
315. t assignment to a waiting list offer of an appointment attendance of an appointment and cancellation of an appointment Templates have been created as text files This Mechanism can be extended to cover complex documents such as Microsoft Word documents The templates allow for pre defined fields The notification process scans the selected template for these fields and exchanges them with the appropriate value The pre defined fields are Field Code Definition PATIENT NAME Name of patient PATIENT ADDRESS Address of patient PATIENT ID NO Patient number DATE Today s date FACILITY NAME Name of facility FACILITY ADDRESS Address of facility CLINICIAN NAME Name of clinician CLINIC NAME Name of clinic DATE OF APPOINTMENT Date of the appointment TIME OF APPOINTMENT _ Time of the appointment Adding Communication Templates Templates are added to the system using the Template Upload screen This screen exists for both Clinics and Facilities When a notification is generated the system looks for a Clinic based 219 MedRed LLC and BT America 7 lt communication template and if none exists it then looks for a Facility based template When a template is added the following fields are required Name This contains the name of the template Subject This contains the default subject line of the notification Template Type This indicates whether the template is a cancellation pre appointment post appointm
316. t Appointments ADD APPOINTMENT Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years App WALK IN APPOINTMENT Step 1 of 4 Resources Preferred Time 12 Jun 2013 22 43 Days ahead to search Facility CA VA OUTPATIENT CLINIC Clinic Mental Health Group Regular George Clark GEORGE CLARK No room required No equipment required C amp P Search for slots 113 MedRed LLC and BT America j Telehealth Appointment This functionality is for capturing specific appointments where the patient will not arrive at the provider location and where special communication resource types may be required Through the Add Appointment page the scheduler can also record the Telehealth appointment patient s location with appropriate time adjustments based on provider and patient UTC times From the Appointments menu select Add TeleHealth Appointment C VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT Appointments ADD APPOINTMENT Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years App TELEHEALTH APPOINTMENT Step 1 of 4 Resources Preferred Time 42 Jun 2013 22 48 Days ahead to search Facility CA VA OUTPATIENT CLINIC Clinic Mental Health Group Regular Provider George Clark GEORGE CLARK Room No room required Equipment No equipment required I lt
317. t the report default to selecting all Clinics Or you could limit your report to one Clinic Please note that there is only a small set of pre entered sample data for each Clinic Step 2 Select View Report button on far right Step 4 Report displays as shown below Examine your report and determine if you need a larger or smaller time frame or if you wish to change any of your parameters If so begin again at Step 1 Home gt Reporting gt Appointment and Clinic Dashboard by Site and Clinic Home My Subscriptions Site Settings Help From 6 11 2013 3 o 6713 2013 a View Report Site AL VA HEALTH CARE SYSTEM _v Facility AL VA OUTPATIENT CLINIC v Clinics Mental Health Physical Therapy i4 4 1 of1 b bi 100 v Find Next WA O A B AL VA HEALTH CARE SYSTEM AL VA OUTPATIENT CLINIC Mental Health Physical Therapy Regular PRIMARY CARE S Appointment 2 Appointment Appointment S Appointment S Completed Canceled Date Start Time End Time Duration in minutes Appointment Appointment BANKS ALICIA 6 11 2013 14 00 15 00 Physical Therapy Regular JACKSON JOSEPH BENSON HUGH 0006 67122013 1400 15 00 Physical Therapy Regular JACKSON JOSEPH NASH FRANCIS 0003 67112013 15 00 16 00 PRIMARY CARE HANSON MICHAEL BANKS ALICIA 0004 6 11 2013 17 00 18 00 BANKS ALICIA 0004 6 11 2013 19 00 20 00 PRIMARY CARE HANSON MI
318. teacees oxaaneusnaaedeciennsade 274 E 3 MUnit Test ROU ooo eas cet nna pa cccrts ander nee nenasdge reese meal g locate seared erteenebareas 279 E 4 Licenses Stored in the VMS 00 ceeeeececenee cece eeeeeeneceeeeeeeeeeeeaaaaaaaeeeeeeeeeeeessaaaeeeeeees 279 MedRed LLC and BT America 7 1 introduction and Overview 1 1 About the Submission The Health eTime submission for the Department of Veterans Affairs 21 Century Medical Scheduling America Competes Contest is the product of a collaboration between MedRed LLC and BT Americas Our approach reflects the combined experience and judgment of the partners in the areas of application development VistA integration and health information technology deployment In designing our approach and the application we were mindful of three overarching challenges that help to define the contest First as the contest materials make clear the Department of Veterans Affairs VA has a comprehensive expansive continuously evolving set of needs and requirements Second the VA operates and maintains enterprise systems of unparalleled scale Third inherent in the Open Source focus of the contest is an unstated concern regarding software license costs and vendor in Our team has extensive experience with these issues and we architected our plan and the application with that experience in mind After first examining a multitude of commercial and custom scheduling products currently available in t
319. tep 2 Evaluation Metrics VA Virtual Machines Health eTime Health eTime Team Team Creates Configures Automated Virtual Test Scripts Machines Health eTime Team Deve User Manu Instructions Requireme Traceability and Supporting Health eTime Team Develops Application Documents A UI ays4 Contest Evaluation Phase VA Step 1 Use Case Testers VA Step 2 Scheduling Evaluators Health eTime Demonstration Scenarios App Integration lops with VistA al Integrated Scheduling Across Sites Communities Tailorable and Expandable Functionality e Flexible Options in Sustainment nts Health eTime Product Refinement Phase VA User Community Schedulers Master Schedulers System Admin Providers Patients Facility Administrators User DrivenUl Design Process Based Business Rules Expanded Automation Communicagxions 1 Health eTime Project Office Requirements Analysts UI Designers Scheduling SMEs System Architects Apps Developers Network amp Ops Security Specialist Health eTime Capability Deployment Phase Transition from MSP C amp A and Ops Approval 7 Incremental Enterprise Implementation Enterprise Architecture Encryption amp Access Control Data Migration Plan EE Transition Plan Testing Master Plan Product Support Plan Figure C 1 Notional Steps Toward Deployment to VistA Locations Reporting Formats The report
320. tep 5 making appointments Reference Section 4 Application User Manual Section 4 6 for explanation for displaying patient specific schedules 3 1 2 The system shall have the capability to allow users to schedule an appointment for a specific user defined length of time based on role based access rules The use case steps of setting up multiple appointments with time ranges and making appointments highlight the role difference between master scheduler who can set time slots and appointment types for facility schedules and the schedulers who are making appointments for patients to the set time slots Reference Appendix A 2 instructions for Use Case 2 Step 12 setup multiple appointments with time ranges Reference Appendix A 3 instructions for Use Case 3 Step 5 making appointments 3 1 3 The system shall have the capability to establish recurring appointments The capability to link appointments is the foundation for establishing recurring appoints and the scheduler can schedule a series of appointments by selecting Recur in the add appointment or add telehealth appointment function If the same timeslot is always open extending into future then setting recurring appoints is a very simple business rule that we have implemented In very busy schedules however automatically searching for openings at set intervals is a complex operation for the application Our application current does not have artificial intellige
321. ter waiting list results 3 For the selection waitlisted patient click Add Appointment 4 Enter the appropriate appointment information and follow the create new appointment procedure outlined earlier UseCase 8 Step 8 As a reminder send the appointment notification to the patient if time allows For example If the opening is the next day there would be enough time for the letter to go out 1 The notification for the appointment creation is automatically sent to a queue UseCase 8 Step 1b Add patient request to transfer list 1 Select Appointments gt Patient Appointments from the menu bar gt Search Patient displays 2 Type Lamb and click Search gt Search returns JENNIE LAMB 3 Click Select Patient gt The patient demographics stored in VistA display 4 Click the name JENNIE LAMB gt Patient details display 5 Click Add Appointment Request gt Appointment request information displays 6 Select the Facility CA VA OUTPATIENT CLINIC Clinic CA Family Practice Reason Transfer then click Add gt Appointment request added notification is shown UseCase 8 Step 2b Notify patient that he she will continue to receive care until the new location is available 1 Notification using the Transfer Communication Template is created automatically 206 MedRed LLC and BT America a lt gt When developing the communication template users can specify means of communication such as SMS or email UseCase 8 Step 3b If r
322. the appointment is Service connected Then select Confirm and Book Your appointment is now made and any communication templates for a Pre Appointment added for that Clinic will automatically generate Additional information about automatic notifications for the patient are described in more detail in Appendix B 15 105 MedRed LLC and BT America 7 lt gt Note that a provider is allocated at the time of making that appointment However the Provider can be reallocated at different points during the life cycle such during Check in with the Change provider Option Recurring Appointments After selecting add a regular or telehealth appointment if you select the Recur checkbox and select the same recur criteria as the recurring block page Frequency Interval and End date then it will do the following Create the selected request and appointments for every date time matching the recur criteria If the same resources are available it will create a new appointment and a completed request for that date If the same resources are NOT available it will create a pending appointment request for that date All the appointments that are created are linked together with a Recurrence relationship Cancelling or Rescheduling an Appointment You can choose to Cancel Reschedule View in Provider Rooster and Change the Provider for any of his appointments which display by selecting the link in the appointment list For this example
323. the From and To date base this on the most updated appointment date use the initial appointment date unless there is a rescheduled date for that appointment If there is a rescheduled date use this date as the most updated date Req 13 3 Only bring back data within from and to date Clinics Site and Facility chosen Reg 13 4 Create a table title it Patient Mental Health Appointment Detail which displays the following headers as columns e Patient name Last Name First Name Middle Name e SSN last four digits e Clinic e Number of Completed Mental Health Appointments Reg 13 5 For the Number of Completed Mental Health Appointments count the number of appointments which do not have an activitytype of Cancel or No Show and have one of the following DSS Stop Code Descriptions DSS Stop Codes can change for every site all DSS 268 MedRed LLC and BT America a Stop Codes need to be specified by site in code Below is a listing of Mental Health codes to include for each site Note There are currently only three sites with data select from dbo StopCode where code in 198 379 299 487 488 489 288 401 400 5324 513 330 189 402 380 357 290 425 200 and VistaSiteld 557 OR code in 188 198 369 278 481 482 266 315 265 396 395 527 506 309 397 375 338 267 420 200 and VistaSiteld 555 OR code in 2
324. the capability to process various lists Reference responses for 3 5 1 to 3 5 5 below to validate that our application fully satisfy the capability for waiting lists 3 5 1 The system shall have the capability to provide a waiting list that appears when making or canceling appointments Our application implements this requirement through the use of a queue of requests that includes priority sorting For example when appointments are cancelled a request is generated in the request queue for rescheduling The user can similarly display the entries of the request queue to decide which request has the highest priority and schedule that request based on the new availability Reference Appendix A 8 instructions for Use Case 8 Step 1 add 138 MedRed LLC and BT America 7 lt gt patient to electronic wait list Reference Section 4 Application User Manual Section 4 6 for instructions on how to use the waitlist function 3 5 2 The system shall apply configurable business rules to the management of a long term appointment request list Business rules are applied throughout the scheduling process and demonstrated across the use cases One business rule that can be adjusted configured is the selecting of patients based on service connected disability levels Reference Appendix A 8 instructions for Use Case 8 Step 4 selecting patient from 50 100 service connected veterans 3 5 3 The system sha
325. tilization 90 80 70 50 30 Clinic Time Utilized 20 10 2 1 2013 2 2 2013 2 3 2013 Figure D27 Reg 9 15 Create a table for Equipment showing equipment availability Title the table Equipment Availability Include the following columns for this table e Clinic Show each open hour available for scheduling Equipment with less than a one hour block of availability should not be shown Do not display Equipment not available for that clinic e Equipment Show the name of the equipment e Date Show the real date the provider is booked with an appointment this can either be the rescheduled date or appointment date in MM DD YYYY format e Available Time Slots for Appointments Only show the hours the equipment does not have an appointment and based on the available time slots allocated in the Equipment s scheduling policy Formatted as Hour Minute and AM or PM Req 9 16 Create a table title the table Equipment Utilization Rate Include the following columns and note displayed in Figure D28 shown below for this table e Clinic Show the clinic name if the clinic is included in the Equipment Availability table Clinic name should only be shown 1 time per day e Equipment Shown the name of the available equipment e Date Show the date one time for each Clinic and piece of equipment e Utilization Rate Calculated field using the number appointments the equipment is reserved for an appointment that
326. tilization Report 9 Capacity Workload and Utilization Report Available to View Suite 7 Clinic Operational Report 10 Mental Health Operational Report Available to View Suite 8 Consults Summary and Overview 11 Consults Summary and Overview Detail Report Suite 9 Ad Hoc Operational Report 12 Ad Hoc Operational Report Available to View Suite 10 Congressional Performance Reports 13 Congressional Report Count of Completed Mental Health Appointments Per Patient Available to View 14 Congressional Report Percentage of Completed Appointments Available to View Generating Reports After selecting the link from the reporting tab and choosing a report you will be presented with parameters at the top of the report Based on the report s purpose the parameters supplied will vary This is addressed for each report further below You will have the opportunity to select different drop downs which you would like your data presented in Some of the reports supply you the option to select more than one option from the drop down For example the below report Appointment and Clinic Dashboard by Site and Facility allows you to choose a From and To date Site and Facility For the From and To dates you can click on the calendar to help you to select your dates Note We have created some data for you to run reports for each Site You can also enter data that you would like to see You can expand or shrink the time frame for report
327. ting parameters From Date Allow user to pick from a calendar tie this to the date of the initial appointment or if there is a rescheduled date use the rescheduled date To Date Allow user to pick from a calendar tie this to the date of the initial appointment or if there is a rescheduled date use the rescheduled date Appointment Request Type Allow the user to single or select multiples format as text Most Updated Activity Type Display the most updated activity type for that appointment Allow the user to single or select multiples format as text Clinic Allow user to select one or more clinics Facility Allow user to select one or more facility Site Allow user to select one or more site VISN Allow the user to select one or more VISN Req 12 2 For the From and To date use the most updated appointment date This can be either the date the appointment was initially scheduled or the rescheduled appointment date Req 12 3 Create a table and title it Patient Work List Detail include the following columns allow each of these columns to be able to be filtered by the user Patient name Last Name First Name Middle Name SSN last four digits Format as text only showing last four digits Initial Appointment Date MM DD YYYY Date the initial appointment was made Rescheduled Appointment Date MM DD YYYY Date the appointment was rescheduled Most Updated Activity Type Show the most recent activity type that is stored display as text
328. tion Our intent is to have Health eTime achieve the highest quality rating by OSEHRA Scalability Configuration of the Production System The VA schedules more than 70 million visits a year therefore future scalability of the system was a major requirement when defining the system architecture for Health eTime The following diagram represents a notional view of such supported secured scalable and enterprise ready architecture The main point here is that all the components of Health eTime RDBMS Application Server CalDav Server and Reporting Server can live in a clustered environment with redundancies that scale horizontally and vertically as required Third party Applications amp Systems uoz pasnyun Cluster of Load Balancers and Proxy Servers 12 o 3 7 g c a a N Cc 3 oC Cluster of Application Servers Web Application amp CalDav Servers auoz pasni Cluster of Database Servers auoz pap s y Figure C 2 Notional Configuration of Product System This brief summary of Health eTime s future potential is meant to illustrate our focus on building Health eTime into a scalable enterprise class application that fully meets the VA s requirements for their next generation scheduling solution 225 MedRed LLC and BT America 7 lt gt D Appendix D Reporting Function Design The following reporting requirements and presentation formats have been identified by our team to drive the reporting
329. tment D VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT Appointments CANCEL Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years CANCEL APPOINTMENT Appointment Information Clinic PRIMARY CARE Desired date 23 Jul 2013 09 00 Appointment length 30 Appointment Type Tele Health No Cancelled by Cancelled by patient y Reason for cancellation No reason Short notice cancellation 40 day s until appointment Reschedule No y Request Time 12 Jun 2013 22 01 Cancel Appointment Provide the Reason for Cancellation from the drop down Cancelled by and indicate the Patients Requested Time You could also choose to Reschedule the appointment here by select Yes Then choose the Cancel Appointment button If you choose Yes to the Reschedule Appointment field an Appointment Request will automatically by created for the Request Time indicated 110 MedRed LLC and BT America A Y VETERANS AFFAIRS SCHEDULING PORTAL VistA Appointments Administration About Help Home PATIENT APPOINTMENTS CANCEL Patient HUGH BENSON 500000004 Has had 2 no shows in the past 2 years CANCEL APPOINTMENT Appointment at PRIMARY CARE on 23 Jul 2013 09 00 is cancelled APPOINTMENT CANCELLED Appointment was rescheduled with a new Appointment Request View Patient Appointments Add Appointment Request If the patient wishes to make
330. tments and select the remaining associated appointment to be cancelled 2 Click Cancel Appointment gt Cancel Appointment page displays details for this appointment 3 Select Cancelled by Reason Reschedule and click Cancel Appointment gt Confirm cancelation message displays 4 Click OK gt Cancellation message displays UseCase 6 Step 7 View the Reschedule Notification for high risk patients if necessary 1 Appointments gt Patient Appointments gt Search Patient or Select Patient and Search 2 Click Select Patient gt This screen on the upper left of the screen shows the number of no shows in the past 2 years There is no special notification for high risk patients UseCase 6 Step 8 Add patient to the reschedule list if necessary 1 Patient is added to the reschedule list if Reschedule is selected during Cancellation process detailed in step 3 of Use Case 6 UseCase 6 Step 9 Send the Cancellation Reschedule notification to the patient 1 Notification is sent automatically when cancellation rescheduling takes place 201 MedRed LLC and BT America 7 UseCase 6 Step 10 Cancel individual group member appointment for group appointments Pre requisite Create a group appointment 1 If user is already reviewing the desired patient select Appointments gt Patient Appointments Otherwise click Search Patient or Select Patient and Search e g Francis Mitchell gt Search and select patient for whom ap
331. top Code Format as number 3 digits e Primary Stop Code Description Format as text e Secondary Stop Code Format as number 3 digits e Secondary Stop Code Description Format as text Req 8 5 Patient Name column Concatenate the patient name together with last name first then first name and lastly middle name in this format last name first name middle name Req 8 6 SSN last four digits column Display only the last four digits of the patient s social security number in column two Column will need to be formatted to return as text in the event that the first digit is a 0 Req 8 7 Clinic Name of clinic the patient appointment is located at Req 8 8 Provider Name of provider patients appointment is scheduled with Req 8 9 Initial Appointment Date Date the appointment was initially scheduled for Req 8 10 Rescheduled Appointment Date Date the appointment was rescheduled for if there are no values replace with N A Req 8 11 Most Recent Activity Type The most recently updated activity type recorded Req 8 12 Completed Appointment Y N Supply a Y if the appointment was completed and a N if any other status Req 8 13 Primary Stop Code The three digit number recorded in the Stop Code table under code when restriction type primary Req 8 14 Primary Stop Code Description The Name recorded in the Stop Code table when restriction type primary Req 8 15 Secondary Stop Code The three digit number recorded in the Stop Code table under code when r
332. ts by Clinic Oo Oo Q PTRP po Figure D3 228 MedRed LLC and BT America E E Req 1 19 Create a corresponding pie chart graph which graphs clinic by cancelled appointments Title the graph Cancelled Appointments by Clinic e Show graph as a pie chart e Show data labels e Show legend with provider name which indicates what line they are on the graph Ensure each provider line is a different color in legend and in graph o Outline legend o Ensure colors are consistent with report o Fill legend in light grey o Ensure font is easy to read and matches style of report see Figure D4 Cancelled Le Appointments by Clinic m PNS E PTRP Figure D4 Req 1 20 Create a table for Provider showing provider availability Title the table Provider Availability Include the following columns for this table e Provider Show the provider name if the provider has an open hour available for scheduling Do not show the provider as available if the provider is on vacation May need to add vacation as a field to store Providers with less than a one hour block of availability should not be shown e Date Show the date the provider is booked with an appointment in MM DD YYYY format e Available Hours for Appointments Supplied in 1 hour Increments Only show the hours the provider does not have an appointment Only show in one hour increments Req 1 21 Show a note box under the Provider Availability table e Outline note box
333. uipment Utilization Rate is the number of appointments the Equipment has per day divided by the total number of appointment slots the Equipment Resource has alloted for thier scheduling policy Note This report will display more information than run screen shots have been shortened to fit on the screen Once you run the report scroll to see entire report using the right vertical toolbar Step 4 Increase or decrease your viewing size of report if you wish to see more on your screen The default is 100 Step 5 You may be required to go to additional pages to view full report To complete this select the forward or back arrow if the report shows more than one page A picture of this is shown in the first report 95 MedRed LLC and BT America A Equipment Availability Equipment Utilization Rate Physical Therapy Regular Exercise Bike 6 10 2013 3 00PM Mental Health Group Regular X Ray 06 10 2013 0 00 Physical Therapy Regular Exercise Bike 6 10 2013 4 00PM Mental Health Group Regular X Ray 06 11 2013 0 00 Physical Therapy Regular Exercise Bike 6 10 2013 amp 00PM Mental Health Group Regular X Ray 06 12 2013 000 Physical Therapy Regular Exercise Bike 6 10 2013 9 00PM Physical Therapy Regular Exercise Bike 06 10 2013 20 00 PRIMARY CARE CAT SCAN 6 11 2013 3 00PM PRIMARY CARE X Ray 06 10 2013 8 33 PRIMARY CARE CAT SCAN 6 11 2013 4 00PM PRIMARY CARE X Ray 06 11 2013 0 00 PRIMARY CARE CAT SCAN 6 11 2013 5 00PM PRIMARY CARE X R
334. uling data 9 2 The system will collect currently used wait time metrics including create date and desired date scheduled appointment date and completed appointment date 5 Please refer to Appendix D for an explanation of how these metrics can be presented and the User Manual on how to execute this reporting function Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 2 Operational and Wait Time Summary with Patient Detail Reports for example of how metrics can be presented 9 3 National Reports National reporting is generated by national program managers VISN management and by facility management to review performance trends analytics as well as access to care and payment issues National reports are populated by rolling up information from the various stations clinics and facilities across VHA MedRed LLC and BT America 7 T As our scheduling database is designed to be an integrated enterprise wide database numerous scheduling reports can be rolled up to the national level This roll up does not require any data integration or retranslation Reference Section 4 Application User Manual Section 4 5 for directions on how to access reporting function Reference Appendix D 2 Operational and Wait Time Summary with Patient Detail Reports for example of metrics can role up to national level Ref
335. ure font is easy to read and matches style of report see Figure D25 below 255 Percentage of Time Utilized MedRed LLC and BT America i 4 Provider Utilization 100 87 70 60 50 Margaret Hills 40 Smith Thorns 20 20 23 10 o 2 1 2013 2 2 2013 2 3 2013 Figure D25 Req 9 12 Create a table title the table Clinic Availability Include the following columns for this table Clinic Show the clinic name if the clinic is has an open hour available for scheduling An available hour is classified when an appointment has been scheduled or changed and rescheduled for a particular time Show hour as available if appointment was cancelled Clinics with less than a one hour block of availability should not be shown Clinics can be shown as available even if provider is on vacation or during a provider s lunch break Providers do not have to tie to the Clinic Date Show the date the clinic is NOT booked with an appointment that is not cancelled which has been either scheduled or rescheduled for that date in MM DD YYYY format Available Time Slots for Appointments Only show the hours the clinic does not have an appointment booked based on appointment slots allocated in there scheduling policy A booked appointment is either an appointment which has been scheduled or rescheduled for that date and time and that has not been cancelled Req 9 13 Create a table title the ta
336. ure that VistA site on the upper right of the screen is CA Select VistA gt Facilities from the menu bar Click Select for the CA VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource Joseph Kirk Click Block List to view the table of blocked dates Click Add Block to view block details page gt Enter the following information Type Period Start 05 Aug 2013 07 00 Period End 09 Aug 2013 17 00 Reason Vacation Click Add gt Block just created time stamp is shown in UTC 189 MedRed LLC and BT America 7 lt gt Use Case 2 Step 14 Block or make unavailable a recurring period of time and include the reason for blocking Walkthrough 1 o o N o aeo N 10 Check the Reccurring option 11 Ensure that VistA site on the upper right of the screen is CA Select VistA gt Facilities from the menu bar Click Select for the VA Regional Medical Center to view facility details Click View Clinics Click the Select link for the Primary Care Clinic to view clinic details Click the Clinic Resources List link to view previously created resources Click Select for the resource Joseph Kirk Click Block List to view the table of blocked dated Click Add Block to view block details page gt Enter the following information Type Period Start 11 Jun 2013
337. ut a o 2 1 2023 Total 6 100 Figure D31 Req 10 8 For the Summary by Activity Type table display the following note under the table e Fill Note in light grey e Bold and place in Italics e Place beneath the Summary by Activity Type table e Create a solid line around note e Display as shown in Figure D32 Note Appointments which have been cancelled for the day are not shown in table or used to calculate rate please refer to the Patient Detail Table to see those appointments Figure D32 Req 10 9 Display a pie chart to the right of the Summary by Activity Type table that charts the percentage of appointments by activity type Title the chart Appointments by Activity Type e Display the data labels within the pie chart e Create legend o Fill legend in light grey o Create solid line around legend o Display as shown in Figure D33 262 MedRed LLC and BT America Appointments by Activity Type Figure D33 Req 10 10 The following can be used to determine Mental Health Appointments select from dbo StopCode where code in 198 379 299 t487 488 489 288 401 1400r TE324t TEIZ T3300 Tass 4027 280 257T 290 425 1200 and VistaSiteId 557 OR code in 188 198 369 t2781 481 482 266 315 13961 13951 EAT SO0G 209 T297 TOTS B38 267 azo 200 and VistaSiteId 555 OR code in 1200 1290 tA25 T3860 SaT
338. ver the basic philosophy that we opted for in this proof of concept is that VistA will remain the system owner of most patient s data Therefore we do not provide screens to update the patient s demographics data Nevertheless adding those is a fairly trivial exercise Reference Appendix A 3 instructions for Use Case 3 Steps 3 and 4 registering and verifying patient information 2 7 The system shall have the capability to allow patient appointments with multiple providers at multiple facilities Our enterprise approach allows the scheduler from any location to select appointment spots with different providers from multiple facilities Multiple appointments can be set up with linked relationships Further the telehealth function can connect patients to essentially any provider anywhere Reference Section 4 Application User Manual Section 4 6 for instructions on ways to make appointments Reference Appendix A 3 instructions for Use Case 3 Steps 9 scheduling multiple linked appointments Reference Appendix A 3 instructions for Use Case 3 Step 12 scheduling telehealth appointments between patient and provider locations 2 8 The system shall provide the ability to identify and verify the identification of the Veteran We have designed and implemented our scheduling application to import most Patient s data from VistA making the assumption that VistA will remain the system owner of most patient s data
339. with and test new functions incrementally during development The following provides an overview of the principal systems and components we believe will be predominantly impacted by user feedback during the agile development process in the product refinement stage User Interface UI Design The flow of the UI needs to be precisely aligned with objective scheduling processes based on the workflow of VA users across the enterprise Our subject matter experts can assist in formulating methods for capturing workflow and user experience in a way that may inform not only application design but also organizational practice 222 MedRed LLC and BT America Process Based Business Rules Objective scheduling processes need to be implemented through business rules While Health eTime currently has many configurable business rules enabling the scheduling process the interaction of the application and the users will continue to refine and expand these through the medium of the agile development process Encryption amp Access Control HIPAA compliant database encryption and communications encryption will be implemented Further user log on access control based on actual VA defined use Classes will be implemented This access control capability will be aligned with VistA standard Identity Management processes Scheduling Contest Development Phase VA Use Cases for Step 1 Evaluation VA Broad Requirement Sets Attch A B C etc for S
340. with appointment types that can be displayed to the scheduler and given to the patient when the appointment is scheduled Walkthrough 187 MedRed LLC and BT America 7 lt o 1 Select VistA on the upper left of the Home page 2 Select Facilities 3 Click onthe Select link next to a particular Facility e g VA Regional Medical Center gt The Facility Details will be displayed 4 Click Template List 5 Next select Add Communication Template 6 Enter Name Subject Template Type Medium and Recipient for the New Template 7 To upload the previously edited template click Choose File 8 This will open a new window prompting the user to selected the locally edited and saved file gt Upload previously create text file with instructions See Use Case 1 Step 7 9 Click Upload Use Case 2 Step 12 Set up multiple appointment types with designated time ranges on the same day Example a morning schedule may consist of only medication refill appointment types and the afternoon schedule may consist of only new patient appointment types Prerequisite Create Appointment type Refills set to 15 minutes Walkthrough This process shows how to set up 15 min Consult appointments in the morning and 30 min Follow Up appointments in the afternoon for a designated period of time Ensure that VistA site on the upper right of the screen is CA Select VistA gt Facilities from the menu bar Click Select for the VA Outpatient Clinic to view facility
341. y corporation that combines global presence and capabilities with healthcare domain expertise having successfully implemented and managed large scale health information technology and infrastructure projects across Europe and Asia Pacific BT is committed to building a long term trusted partnership with the VA and has embraced the open source medical scheduling competition as the first step in demonstrating this commitment 1 2 About Our Documentation Documentation and communication are critical components of effective open source development efforts We have taken great care therefore in designing and authoring documentation for this competition We have worked to convey a holistic understanding of our scheduling application and overall approach and believe our documents can be useful to the VA both in the contest evaluation process and in informing the design of a deployment strategy for the next generation scheduling module The relationships and interconnectivity of the document elements in this volume are explained below 1 2 1 Installation Guide In accordance with contest guidance we have developed an Installation Guide included as Section 2 of this document to explain how we have configured the contest VMs and installed the Health eTime application This guide is designed to help the Step 1 evaluators understand the conditions and environment in which the automated test scripts are being executed MedRed LLC and BT America AS

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