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EHR & EHX Configuration


E.H.R. and/or eRx integration can be enabled through the admin interface.

1. Login as admin.

2. Follow the "Installation and Integration Configuration..." link in the system Administration section.

3. Enable integration by specifying a directory to which the tomcat server has access.

More details about integration included below...



E.H.R Import:


If set, records found in this location will be imported.

After enabling E.H.R. import, patient data will be periodically imported from XML files in the E.H.R. Input Location. Files in the E.H.R. Input Location will be processed only once. As processing of each file is completed, each file will be identified as "processed" by touching a marker file. For example, if the E.H.R input location is /usr/local/ehr.in, and an input file is present:

  /usr/local/ehr.in/patients.xml

Then, after processing the XML file a marker file will be created: either

  /usr/local/ehr.in/patients.xml.iaap-import-success

or if the XML file contains incorrectly formatted records, none of the records will be saved, a different marker file will be created and an error message will be recorded as part of the event log:

  /usr/local/ehr.in/patients.xml.iaap-import-failure

As long as either of these marker files is present, the corresponding XML file will not be processed again.

Patient records are matched to data in the XML import files by a clinic specific ID referenced as the ehrId attribute for each patient record. If a patient does not exist in the system with the provided ehrId, a new patient record will be created. If a patient does exist in the system with the provided ehrId, the values from the incoming file will be used to modify the existing patient record.

Address records are matched to data in the XML import files by a clinic specific ID referenced as the ehrId attribute for each address record. If an address does not exist in the system with the provided ehrId, a new address record will be created. If a address does exist in the system with the provided ehrId, the values from the incoming file will be used to modify the existing address record.
Format of the incoming files is

<ehrData>  
  <patients>   
    <patient ehrId="42">
      <firstName>James</firstName>
        <lastName>Kirk</lastName>
          <dateOfBirth>1940-01-03</dateOfBirth>
            <sex>Male</sex>
              <ethnicity>White / Non-Hispanic</ethnicity>
      <weight>200</weight>
      <weightUnit>Pounds</weightUnit>
      <height>72</height>
      <heightUnit>Inches</heightUnit>
      <parentGuardianOrEmergencyContact />
      <medicationAllergies>none</medicationAllergies>
      <currentAddress ehrId="923">
      <addresses>
       <address ehrId="923">
        <addressLine1>123 Enterprise Way</addressLine1>
        <addressLine2>Suite 100</addressLine2>
        <city>St. Paul</city>
        <state>MN</state>
        <zipCode>55101</zipCode>
        <phone>8675309</phone>
        <cellPhone></cellPhone>                                                                                                                                
        </address>
        <address ehrId="1522">
          <addressLine1>N83078 Marshal Rd.</addressLine1>
          <city>North Branch</city>
          <state>MN</state>
          <zipCode>55056</zipCode>
        </address>
      </addresses>
    </patient>
    <patient ehrId="43>"
    </patient>
  </patients>
</ehrData>
                                                                                                                                   
Patient Field Definitions:
ehrId                 required     maxSize = 50
lastName              required     maxSize = 50
firstName             required     maxSize = 50
parentGuardianName    optional     maxSize = 75
sex                   required     either Male or Female
ethnicity             required     one of
                * White / Non-Hispanic
                * White /  Hispanic
                * Black /  Non-Hispanic
                * Black /  Hispanic
                * Asian /  Pacific Islander
                * American  Indian or Alaska  Native
weight                required     a number from 1.0 to  999.99
weightUnit            required     either Pounds or  Kilograms
height                required     a number from 1.0 to  999.99
heightUnit            required     either Inches or  Centimeters
medicationAllergies   optional     maxSize = 100
currentAddress        optional     ehrId of one fo the  addresses.
addresses             optional     (see address field  definitions below)

Addreess Field Definitions:
ehrId                 required     maxSize = 50
addressLine1          required     maxSize = 45
addressLine2          optional     maxSize = 45
city                  required     maxSize = 25
state                 required     one of AK, AL, AR,  AS, AZ, CA, CO, CT,
                DC, DE, FL, FM, GA, GU, HI, IA, ID,
                IL, IN, KS,  KY, LA, MA, MD, ME, MH,
                MI, MN, MO,  MP, MS, MT, NC, ND, NE,
                NH,  NJ, NM, NV, NY, OH, OK, OR, PA,
                PR, PW, RI, SC, SD, TN, TX, UT, VA,
                VI,  VT, WA, WI, WV, or WY
zipCode               required     either a five or nine  digit number
phone                 optional     a ten digit number
cellPhone             optional     a ten digit number
The prescription export process will start 15 minutes after the application is started. After running to completion it will wait 60 minutes before executing again. WARNING: XML files with thousands of records may cause server performance problems. The suggested approach is to partition incoming data into multiple files, each with 1000 records.

E.H.R. Export:


If set, when each new encounter is complete, E.H.R. records will be written to this location.
After enabling E.H.R. export, encounters will be exported to subdirectories named by date. For example, if the E.H.R output location is /usr/local/ehr.out, encounters exported on October 31st will be written to
     /usr/local/ehr.out/2009-10-31

The encounter files themselves are named as:

    encounter-9813.xml

Where each file name begins with encounter-, followed by the encounter ID.

<encounter id="9813" noCurrentMedication="false" takingAsPrescribed="false">
    <createDate>2009-11-03 13:21:11.317</create>
    <providerName>Dr. David Funkenstein, III</providerName>
    <providerIdentifier>2</providerIdentifier>
    <facilityName>NW Office</facilityName>
    <facilityPhone></facilityPhone>
    <patient  iaapId="1" ehrId="42">
      <name>James  Kirk</name>
      <dateOfBirth>1940-01-03</dateOfBirth>
      <age>69</age>
      <sex>Male</sex>
      <ethnicity>White / Non-Hispanic</ethnicity>
      <weight>200  Pounds</weight>
      <height>72  Inches</height>
      <parentGuardianOrEmergencyContact></parentGuardianOrEmergencyContact>
      <address></address>
      <phone></phone>
      <cellPhone></cellPhone>
      <medicationAllergies>none</medicationAllergies>
    </patient>
    <peakFlow  noPeakFlow="false">465 Best</peakFlow>
    <triggers
      aspirinNSAIDs="false"
      cockroaches="true"
      coldAir="false"
      exerciseSports="false"
      houseDustMites="false"
      mold="false"
      outdoorAirPollution="false"
      pests="false"
      petsAnimals="false"
      pollen="false"
      respiratoryInfections="true"
      rodents="false"
      strongEmotions="false"
      strongOdors="false"
      tobaccoSmoke="false"
      woodSmoke="false"
      >
    <otherTriggers></otherTriggers>
   </triggers>
   <severityAndControl>
    <reverseEngineeredSeverity></reverseEngineeredSeverity>
    <asthmaSeverity>5</asthmaSeverity>
    <severityReassessmentChoice></severityReassessmentChoice>
    <asthmaControl>3</asthmaControl>
    <symptoms></symptoms>
    <nighttimeAwakenings></nighttimeAwakenings>
    <symptomControl></symptomControl>
    <activityInterference>None</activityInterference>
    <lungFunction></lungFunction>
    <lungFunction>Available</lungFunction>
    <exacerbations>>= 2/year</exacerbations>
    <fev1Fvc></fev1Fvc>
    <fev1PeakFlow></fev1PeakFlow>
    <actRange></actRange>
  </severityAndControl>
  <treatmentPlan>
    <desciption>Low-dose  Inhaled Corticosteroid</description>
    <step>3</step>
    <quickReliever>
      <medication>Albuterol HFA (Proventil HFA) – 90mcg  puff</medication>
      <dosageRegimen>2 puffs immediately</dosageRegimen>
      <chamberSpacerMask>Holding chamber without  mask</chamberSpacerMask>
    <nebulizer>
      <medication>Albuterol nebulizer solution (generic) – 1.25mg  3ml</medication>
      <dosageRegimen>2 vials immediately</dosageRegimen>
    </nebulizer>
  </treatmentPlan>
  <followUp>
    <when>33  Days</when>
    <provider></provider>
    <facility></facility>
    <phone></phone>
  </followUp>
  <confirmation>
    actionPlan=""
    prescription=""
    triggers=""
    guardianRelease=""
    actCompletion=""
    guardianEducation=""
    smokingCesation=""  >
  </confirmation>
</encounter>
The export process will start 10 minutes after the application is started. After running to completion it will wait 15 minutes before executing again.

eRX Export Directory:


After enabling eRx integration, prescriptions will be exported to subdirectories named by date. For example, if the eRx location is /usr/local/erx.out, prescriptions exported on October 31st will be written to
     /usr/local/erx.out/2009-10-31
The prescription files themselves are named as:
    prescription-9813-ics.xml
Where each file name begins with prescription-, followed by the encounter ID and a qualifier, ics in this example. (The qualifier uniqily identifies the prescription for treatment plan with more than< one medication.) Files to look for are prescription-###-chamber-spacer-mask.xml
     prescription-###-cromolyn-nedocromil.xml<
     prescription-###-ics-laba.xml
     prescription-###-ics.xml
     prescription-###-laba.xml
     prescription-###-ltra.xml
     prescription-###-itsi.xml
     prescription-###-nebulizer.xml
     prescription-###-oms.xml
     prescription-###-osb.xml
     prescription-###-quick-reliever.xml
     prescription-###-saba.xml
     prescription-###-theophylline.xml
The following example defines the structure of each prescription file.
<prescription> <dateOfIssuance>2009-11-03 13:21:11.317</dateOfIssuance> <patient iaapId="1" ehrId="42"> <name>James Kirk</name> <dateOfBirth>1940-01-03</dateOfBirth> <weight>200 Pounds</weight> <address></address> <medicationAllergies>none</medicationAllergies> </patient> <drugName>Beclomethasone Dipropionate HFA</drugName> <brandName>QVAR HFA</brandName> <strength>40mcg</strength> <unit>puff</unit> <dosageRegimen>2 puffs twice per day</dosageRegimen> <quanity>1</quanity> <refills>5</quanity> <provider> <name>Dr. David Funkenstein, III</providerName> <phone>867-5209</phone> </provider> </prescription>
The prescription export process will start five minutes after the application is started. After running to completion it will wait 15 minutes before executing again.

EHR & EHX Configuration (PDF: 23KB/8 pages)


 
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