...
| Note |
|---|
This page is under validation. Information is still subject to change! |
| Table of Contents |
|---|
Introduction
This document contains UX guidelines that all medical software for hospitals that use the Vitalink medication scheme should comply with.
All software packages should also comply with the UX guidelines for every software package in Vitalink found here.
Terminology & Abbreviations
A list of the terminology used in this document can be found here.
...
Abbreviated list: the combined overview of all active medications from the local EHR and Vitalink can be shown in an abbreviated manner by means of the abbreviated list (if there is a Vitalink medication scheme for the patient). The following information is mandatory shown: product name, dosage and posology (with underlying information about the date and remark if relevant). The intention is to show this abbreviated list in relevant places, eg on the dashboard / start page when opening the patient's EMR, on the right side of the work screen (sumehr, prescription module, ...).
Legend
| Symbol | Meaning |
|---|---|
| The Home Medication EHR section is in sync with Vitalink. |
| The Home Medication EHR section is not in sync with Vitalink. |
| Admission medication. |
| User action. |
| User action that caused an error. |
| Automatic action. No user input required. |
Use Cases
1.Ambulant Visit
Ambulant visit is the use case where the patient visits the hospital without being admitted (= taken into care of the hospital).
NOTION! Local EHR information in this section always holds the HOME MEDICATION as opposite to the admission where there is mention of HOME MEDICATION and ADMISSION MEDICATION.
Basic flow: Home medication EHR section is already in sync with Vitalink
|
|
Variant 1: There is no Home Medication data in the EHR
|
|
Variant 2: Home Medication in the EHR is outdated vs. Vitalink medication scheme
|
|
Variant 3: Vitalink medication scheme changes
 |
|
2. Admission
A hospital admission is the moment when a patient is taken being admitted to the care of the hospital. It means the hospital is in charge of the care of this patient. This admission can be only for a couple of hours (policlinical, day clinic, etc.) or for several days, weeks, months and thus include an overnight stay. There are also different types of hospital admission: the admission can be planned e.g. for a surgery or can be an unplanned (urgent) admission e.g. in case of a car accident.
...
NOTION2 ! Medication during admission is never uploaded to Vitalink.
Basic flow: Home Medication EHR is already in sync with Vitalink
|
|
Variant 1: There is no data in the home medication of the EHR UITTEKENEN
Follow "Ambulant Visit - Variant 1" until step 4.
Continue with Admission - Basic Flow starting from step 2.
Variant 2: Home Medication is outdated compared to Vitalink UITTEKENEN
Follow "Ambulant Visit - Variant 2" until step 4.
Continue with Admission - Basic Flow starting from step 2.
Variant 3: Vitalink changes during hospital admission
|
|
Variant 4. Discharge over the weekend
Often patients with a long admission in the hospital are allowed a stay during the weekend at home. During this period the medication for the stay at home is treated as in the case of a discharge after an admission. After the weekend home stay, actions are taken as if with a new admission.
3. Transfer to other hospital
A transfer to another hospital takes place when the patient, in view of his treatment, is moved to an other hospital for further treatment without a previous discharge in the first hospital.
Basic Flow
In the case of a patient transfer to another hospital, the normal flow is similar as to the basic flow during admission. All medication updates are transferred to Vitalink as if it were a normal discharge.
In the case medication (e.g. intravenal medication, hospital specific medication) is not uploadable to Vitalink, the medication is passed on to the receiving hospital via the transfer note (via the hub, via the eHealth box or others). This is because information during and related to an admission is often hospital-related and not adaptable to home medication as is the purpose of the Vitalink format.
4. Home hospitalisation
Home hospitalisation is the use case where a patient is actually admitted to the hospital but the treatment is provided to the patient in his home. This means that the patient is not physically staying in the hospital.
Notion! It is important to update medication during home hospitalisation to Vitalink in order to make sure that in normal care or emergency cases primary care workers can also see and/or intervene in the Vitalink medication scheme of the patient.
Variant 1: Home hospitalisation with admission
In the case a patient is receiving his hospital treatment at home with admission in the hospital, the use cases follows the same steps as an admission.
Variant 2: Home hospitalisation without admission
In the case a patient is receiving his hospital treatment at home without admission into the hospital, the use cases follows the same steps as the ambulant visit.
5. Other use cases
No other use cases have been defined.
Import
Access to medication information.
Access to medication information in a hospital is unlike in primary care, not regulated by governmental guidelines. Each care organisation, including hospitals, are allowed to import and export Vitalink medication via the principle of circle of trust. It is thus up to the hospital security policy to allow hospital staff access to medication information or not. This means that the hospital security management can determine if e.g. administrative staff of a hospital department, a pharmacy assistent has access to the Vitalink information.
Automatic questioning of Vitalink
Mandatory
When opening a patient's EMR, it must be checked automatically if the registration of the informed consent is fulfilled, if there is a Vitalink medication scheme for this patient and whether the EMR has the most recent version of the Vitalink medication scheme.
...
- Display visually that the application is working on the Vitalink medication scheme.
- This can be done, for example, by a progress indicator or an icon indicating that the Vitalink medication scheme is loading.
- This can be done, for example, by a progress indicator or an icon indicating that the Vitalink medication scheme is loading.
- Display visually that the Vitalink medication scheme has been collected.
- This can be done, for example, by an icon indicating that all data from Vitalink has been retrieved (+ mandatory information: date & time of last download).
- This can be done, for example, by an icon indicating that all data from Vitalink has been retrieved (+ mandatory information: date & time of last download).
- If it is not possible to obtain data from the Vitalink medication scheme, also visualise it and indicate why there is a problem / what the problem is (in understandable language).
One combined overview of all active medication
Mandatory
It is important that the care giver has one overview of the active medication of the patient. Since information about the active medication can be found both in the local EMR and on Vitalink, the CG wishes to see this information in one combined overview.
...
- Show interactions between medication lines through an alert.
Interactive/Dynamic medication scheme
Mandatory
From the combined overview of all active medication it should be possible to open the complete medication scheme with the combined overview via one click.
...
- In addition to the name of the health care provider, show the specialty of the health care provider who has added or adjusted a medication line if this is given via Vitalink.
- Make it possible to drag medication from the 'chronic' to 'temporary' or 'if necessary' category, taking into account the corresponding specifications for each of these categories (eg with regard to the end date).
- Visualise medication that was prescribed during the current consultation in a different way (icon and / or color).
- Showing the version number is less important for the CG, but can be interesting for a print version of the medication scheme or for other reasons.
- The CG wants to know possible interactions between medication lines.
- In some cases, the CG may want to adjust the order of the medication lines in the Vitalink medication scheme.
- Make sorting possible on the columns of the medication scheme that is shown locally (eg alphabetically, per pathology (if indication is entered), per intake moment, most recently added medication on top (so also the last changes are at the top), chronic / temporary /If necessary.
- Visually indicate which column has been sorted.
- Ensure that this representation is remembered when opening the Vitalink medication scheme for other patients.
Export
Start Vitalink with one click
Mandatory
If there is no Vitalink medication scheme present or not yet used, it must be possible to start the creation / use it with one click.
...
- If starting with the creation of a Vitalink medication scheme, it is important that all active medication is automatically uploaded from the local EMR to Vitalink.
- It is not the intention that the caregiver will transfer all medication lines manually, line by line.
- Afterwards, details of intake, comments, ... can be entered on the medication scheme itself.
Prescribe
During an ambulant visit
Mandatory
Prescribed medication is automatically added to the medication scheme (combined overview), unless explicitly chosen not to. This means that the medication is entered via structured entry fields.
...
- If the CG decides to prescribe medication during the consultation, the shortened list of the combined overview (information derived from local EMR and from Vitalink) with product name, dosage, posology or the complete medication scheme (with the extensive combined overview) should be the base of the page on which they start when creating a prescription.
- On this prescription page it is important that the complete medication scheme can be opened with one click (if it is not already fully shown) or it can be displayed that the CG wishes to work with Vitalink (if this is not yet the case for the patient).
With regard to prescribing itself, the focus should be on its speed. This can be done by focusing on the simple prescription flow, which can simplify the user interface.
- Split the functionalities for easy prescribing vs. complex prescribing.
- Place the complex prescribing module behind a button / link. This can then be reached via one extra click (this is not a problem since complex prescribing (weekly scheme, 'phasing out' scheme, etc.) occurs less frequently). Belgisch Artsen Syndicaat or other health professional associations can provide best practices with regard to good interfaces for complex prescribing.
- Provide structured entry fields so that a one-off data input is possible (automatic transfer of data to the Vitalink medication scheme).
- Provide standard posologies for frequently used medication.
- Show the most frequently used dosage, administration unit, drug route, ... via eg radio buttons so that a quick selection is possible. Less used options can be included behind a choice menu (drop-down list).
- Simplify working with templates to save frequently used prescriptions (eg provide two action buttons: Prescribe vs. Prescribe and save as template).
- Simplify the addition of indications / pathologies (pharmacists & patients are asking for this).
Provide quick selections / suggestions for indications / pathologies per medication. In this way, the CG can send the most current indication to the Vitalink medication scheme in one click.If the suggestion of indication / pathology does not match, the CG should simply be able to enter another indication / pathology as free text.
- The CG can indicate whether or not medication can be shown on Vitalink, both in the prescription module and on the interactive medication scheme (combined overview).
- Ensure that prescription by substance name is possible (this is then adjusted by a pharmacy in the Vitalink medication scheme to the generic variant).
At discharge
TO BE COMPLETED
Validate the Vitalink medication scheme
Mandatory
After prescribing and completing the consultation it is important that the combined medication scheme is shown before validating and uploading.
...
- The CG must be able to open the medication scheme (combined overview) at any time before closing the patient's EMR.
- It is important that the 'to do' list for later validation of medication schemes and uploading to Vitalink can be managed efficiently.
Provide the CG with a reminder functionality in which he/she can set up to be reminded within x time to validate the medication scheme on the 'to do' list and send it to Vitalink.
Visualisation of the print version of the Vitalink medication scheme
Mandatory
It should be taken into account that an official print version of the medication scheme for the patient is offered by Vitalink, it is thus not mandatory to develop an own patient print for your EMR. This print should be visualised on the screen by the CG & possibly the patient during the consultation, or be printed to give to the patient.
Click here for more in-depth information regarding the Vitalink medication scheme print.
How to handle mistakes
Mandatory
If a medication scheme is removed from Vitalink and can not be fully visualised by the interpreting software package (eg if there is a problem with a medication line, posology or other), it is important to get as much information as possible on each medication line so that at least 'something' in the Vitalink medication scheme can be shown.
...