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Situation / Action

Information
1

OPTIONAL: Support staff starts preparation of the ambulant visit (eg. for staff meeting or oncology visit of the patient)
Vitalink medication scheme is imported.

2

The EHR requests the latest version of the Vitalink medication scheme. This action can be done manually by a user action, but is preferably done automatically.

Vitalink responds with the same version that is already present in the EHR Home Medication.

The EHR Home Medication section and Vitalink medication scheme are in sync.

3OPTIONAL: Home medication EHR can be updated in the combined overview during the preparation for the ambulant visit Vx'.
4OPTIONAL: Preparing of ambulant visit stops. The local medication scheme is now version 1'.
5Start ambulant visit.
6End ambulant visit. The caregiver made changes to the Home medication EHR. The Home Medication EHR is now Version 1".
7

The Home medication EHR version V1'' is exported to Vitalink.

The Vitalink medication scheme now becomes Version 2.

8

Vitalink sends the updated identification code for each medication (URI's) back to the EHR.

The EHR requests Version 2 of the medication scheme from Vitalink to update the version and URI's in the EHR.

9

The Home medication EHR is now on Version 2 of the medication scheme.

The Home medication EHR section and Vitalink are in sync.



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On

Example when the system is still working on the sync with Vitalink. 




  • In this wireframe, the home medication of the local EHR is visible. 
  • It is visible that the system is syncing with Vitalink (upper right corner).
    • This is done automatically, without interference of the healthcare professional.
    • It is important that the automatic sync starts when opening the EHR of the patient (and not only when opening the medication module of the EHR).
    • The healthcare professional should be aware that the system is syncing with Vitalink. Therefore it is recommended to use an icon and/or textual label expressing what the system is doing.
    • The sync can only be done with Vitalink if IC & TR are OK.


  • While syncing, the healthcare professional can do all actions in the medication module of the hospital software (add new medication, re-prescribe, transfer to admission medication, ...).
  • It is possible to validate the active medication list of the local EHR; but preferably this is only done when the Vitalink data are synced with the medication data of the local EHR. 
  • The automatic import and analysis of the information from the Vitalink medication scheme should take a minimum of time. Preferably 4 to 6 seconds or less; with a maximum of 10 seconds.








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Sync with Vitalink is completed. The vitalink data is displayed in a combined overview with the local EHR medication. Here it is visible that one new medication line is added via Vitalink.



  • Here, it is visible that the sync with Vitalink is completed (upper right corner). The healthcare professional can be informed about this by:
    • Using a meaningful icon, combined with another icon expressing a status.
    • Information about the latest validation date of the Vitalink medication scheme (in this case: 29.05. 2019, 19:30).

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  • If the user wants to obtain more information (e.g. validated by, sync info, version number, ...) or wants to do manually a new sync with Vitalink, this information can be provided via a tooltip when moving over this status information. For example: 

Image Modified                           Example when the latest validation was done by a general practitioner. 


Image ModifiedExample when the latest validation was done by a specialist
in an hospital (only the hospital will be visible)



  • When the sync with Vitalink isn't possible, it should be indicated that the sync couldn't be done successfully (status information). 
    • When doing a mouse over, more information about the failure should be provided via a tooltip. 
    • It should be possible to initiate a new sync with Vitalink. 

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  • When there isn't a Vitalink medication scheme for the patient, this should be indicated.

    • It should be possible to create a Vitalink medication scheme for the patient via 1 click.

    • When checking the check box in the example below, the medication list that it validated by the healthcare professional will be uploaded to Vitalink at the end of the contact.

      Image Modified

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On

Sync with Vitalink is completed. The vitalink data is displayed in a combined overview with the local EHR medication. Here it is visible that one new medication line is added via Vitalink.







  • In this wireframe (same as previous screenshot), the combined overview is visible. This means that the home medication of the local EHR is visualized together with the Vitalink medication data. 
    • It is important that the user can see at a glance what is new (added), changed, stopped on Vitalink in comparison with the previous active medication in the local EHR that the healthcare professional has checked with the patient during a previous contact.


  • It is important that there is a visual difference between data from Vitalink vs. data from the local medication scheme of the EHR.
  • In this example, it is visible that new medication was added on Vitalink.
  • It is important that a changed medication, stopped medication, added medication is clearly indicated (here: the label 'new' is used in combination with the Vitalink icon) (cfr. next wireframe).

  • List view vs. scheme view: the healthcare professional should be able to select the preferred view of the active medication list (combined overview).
    • The list view in the wireframe illustrates only an example. It should be adapted towards the needs of the healthcare professionals (extra columns, features, ...).
    • It is very important for healthcare professionals to have an hour scheme visualization. This means that the Vitalink data should be mapped on the hour scheme (link) which will result in an hour medication scheme that the healthcare professional is used to.


  • A 'Sort by' feature should provide sorting on alphabetical order, ATC class, CNK code, medication type (e.g. antibiotics), ... 
    • When using the sort feature, all items will be sorted in this way, each time within the section chronic, acute, if needed.


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  • There should be an action button/link to the print feature of the patient friendly medication scheme.


  • This combined overview should be enriched with features of the software (e.g. check on interactions, edit medication line, prescribe selection of medication, ...).

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Example when the system is still working on the sync with Vitalink. The healthcare professional can already validate (without sending data to Vitalink).

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Example when there is no Vitalink medication scheme for the patient. By default it is indicated that a Vitalink medication scheme will be created when validating the active medication.
The healthcare professional can uncheck this option and continue with only (internal) validating.

  • Since healthcare professionals are always validating the active medication when checking this with the patient, it will work the same in the combined overview: they will have to validate and in the same time, the information will be uploaded to Vitalink
    • By default all medication lines would be selected (check boxes will be checked).
    • When the sync with Vitalink is not yet done, and when the healthcare professional would like to validate already, it is possible to validate & continue. This means that no update to Vitalink is send for this patient.
    • But normally this shouldn't be this case since the sync & analysis of the combined overview should be done in 4 to 6 seconds or less; with a maximum of 10 seconds.
  • When there isn't a Vitalink medication scheme for the patient, this is indicated via status information. 
    • Next, the healthcare professional can validate and create a Vitalink medication scheme at the same time.
    • It should be set by default that if there not no Vitalink medication scheme, a new one will be created when validating the medication. 
    • The healthcare professional can uncheck this option and can continue with only internal validating the active medication. 


Image Added

The vitalink data is displayed in a combined overview with the local EHR medication. Here it is visible that one new medication line is added via Vitalink.


Image Added

The vitalink data is displayed in a combined overview with the local EHR medication. Here it is visible that one medication line is chanted via Vitalink. One medication line is stopped via Vitalink.








  • Here, it is visible that a new medication line was added on Vitalink. 
    • This medication line is visualized in a combined overview with the medication of the local EHR.
    • This new medication line is highlighted to indicate that this is data coming from outside the EHR.
    • This new medication line receives an icon, indicating the source.
    • This new medication line receives a label (new), indicating that it concerns a new added medication line.


  • When the healthcare professional agrees with the combined overview, he/she doesn't have to take any action.
  • Only when the healthcare professional doesn't agree, action should be taken (cfr. next wireframe with drop down menu).



















  • In this example, it is visible that one medication line has been changed on Vitalink. One medication line has been stopped.
    • These medication lines are visualized in a combined overview with the medication of the local EHR.


  • For the changed medication:
    • This changed medication line is highlighted to indicate that this is data coming from outside the EHR.
    • This medication line is visualized closely together with the related medication line(s) that already existed in the local EHR.
      • This can be done based on the unique URI that each medication line has. 
      • This can be done based on the product name, substance name, ...
      • By doing so, it is easier for the healthcare professional to analyse and decide on the medication lines.
    • This changed medication line receives an icon, indicating the source.
    • This changed medication line receives a label (change), indicating that it concerns a changed medication line.
    • The medication line that is changed becomes 'strike through'.


  • For the stopped medication
    • This stopped

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Image Removed

Here, it is visible that a new medication line was added on Vitalink. 
  • This medication line is visualized in a combined overview with the medication of the local EHR.
  • This new
      • medication line is highlighted to indicate that this is data coming from outside the EHR.
      This new medication
          • The stopped medication line receives another colour to make sure this attracts the attention of the healthcare professional.  
        • This stopped medication line receives an icon, indicating the source.
        • This
      new medication
        • stopped medication line receives a label (
      new
        • stopped), indicating
      if
        • that it concerns a
      new added medication, a change of an existing medication line, a stop of an existing medication line.
      • In this example, it is visible that one medication line has been changed on Vitalink. One medication line has been stopped.
        • These medication lines are visualized in a combined overview with the medication of the local EHR.
      • For the changed medication:
        • This new medication line is highlighted to indicate that this is data coming from outside the EHR.
        • This medication line is visualized closely together with the related medication line(s) that already existed in the local EHR.
          • This can be done based on the unique URI that each medication line has. 
          • This can be done based on the product name, substance name, ...
          • By doing so, it is easier for the healthcare professional to analyse and decide on the medication lines.
        • This new medication line receives an icon, indicating the source.
        • This new medication line receives a label (change), indicating if it concerns a new added medication, a change of an existing medication line, a stop of an existing medication line.
        • The medication line that is changed becomes 'strike through'.
      • It is highly recommended to not use too many colour indications for highlighting data coming outside the EHR.
        • Therefore, only one colour is used to indicated new medication & changed medication lines.
        • Another colour is used for highlighting stopped medication lines.

      8. Within the medication scheme, it should be possible to reactivate stopped/changed medication in a fast way (e.g. via drop down menu per medication line; see below).

      9. Within the medication scheme, it should be possible to check the history of this medication line (e.g. via drop down menu per medication line; see below).

      ...

        • stopped medication line.
        • The medication line that is stopped becomes 'strike through'.



      • When the healthcare professional agrees with the combined overview (agreement with changed medication line & stopped medication), he/she doesn't have to take any action.
      • Only when the healthcare professional doesn't agree, action should be taken (cfr. next wireframe with drop down menu).


      • It is highly recommended to not use too many colour indications for highlighting data coming outside the EHR.
        • Therefore, only one colour is used to indicated new medication & changed medication lines.
        • Another colour is used for highlighting stopped medication lines.


      Image Added

      Actions via drop down menu: possible to edit changed medication line, prescribe, reject, check history, ... 



      Image Added

      Actions via drop down menu: possible to re-activate stopped medication line, check history, ... 



      Image Added

      Quick access to most important features when validating, e.g. edit or reject changed medication line. More features are available via drop down menu.


      Image Added

      Quick access to most important features when validating, e.g. re-activate stopped medication line. More features are available via drop down menu.




      • For all medication lines, it is possible to do some actions per medication line.
        • This can be done by clicking on the arrow pointing down.
        • Next, a drop down list with actions appear.


      • Possible actions for a new / changed medication line are:
        • Edit (edit posology, comment, ...)
        • Prescribe (make new prescription for patient)
        • Reject (reject the change that was done on Vitalink, the previous medication line (this is now striked through) will become active again)
        • History (check history of posology etc)
          • In this case, the medication line can fold open, displaying an overview of all changes over xx time.
          • Another option is displaying a screen overlay with all changes over xx time.
        • Don't show on Vitalink (if the patient states that he/she doesn't want that a medication line is visible on Vitalink)
          • If selecting this feature, the icon appears on the medication line. In this way, the healthcare professional is aware of it during a next contact.


      • Possible actions for a stopped medication line are:
        • Re-activate (make medication line active again)
        • History (check history of posology etc)


      • The drop down list with actions visualized in the wireframe is only an illustration and is not restrictive. This can be enriched with existing features within the hospital software.









      • When validating medication and when confronted with several changes from Vitalink towards the local medication in the EHR, it can also be useful to have a very quick access to the most important features:
        • Edit & reject (in case of new/changed medication line coming from Vitalink)
        • Re-activate (in case of stopped medication line coming from Vitalink) 



      Image Added




      Image Added

      Example when the system is still working on the sync with Vitalink. The healthcare professional can already validate (without sending data to Vitalink).


      Image Added

      Example when there is no Vitalink medication scheme for the patient. By default it is indicated that a Vitalink medication scheme will be created when validating the active medication.
      The healthcare professional can uncheck this option and continue with only (internal) validating.


      End of the contact 

      • After checking the active medication with the patient, updating medication and / or prescribing medication, the healthcare professional will validate the medication scheme (the combined overview). 
      • Like already indicated:
        • When the healthcare professional agrees with the combined overview (agreement with changed medication line & stopped medication), he/she doesn't have to take any action.
        • When the healthcare professional doesn't agree, action should be taken (edit, reject, re-activate, ...).




      • Validating the combined overview will work the same as validating the active medication in the local EHR: they will have to validate and in the same time, the information will be uploaded to Vitalink
      • By default all medication lines would be selected (check boxes will be checked).






      • When the sync with Vitalink is not yet done, and when the healthcare professional would like to validate already, it is possible to validate & continue. This means that no update to Vitalink is send for this patient.
        • But normally this shouldn't be this case since the sync & analysis of the combined overview should be done in 4 to 6 seconds or less; with a maximum of 10 seconds.






      • When there isn't yet a Vitalink medication scheme for the patient, this is indicated via status information. 
        • Next, the healthcare professional can validate and create a Vitalink medication scheme at the same time.
        • It should be set by default that if there not no Vitalink medication scheme, a new one will be created when validating the medication. 
        • The healthcare professional can uncheck this option and can continue with only internal validating the active medication. 



      Image Added

      Example of notification when the healthcare professional validates the medication scheme without selecting all medication.  


      • If validating the active medication list / scheme without selecting all medication lines: 

        • A notification appears with the message to select all medication lines.

        • Below the action buttons, the medication list / scheme should be visualized.

          • In this way, the healthcare professional can easily check / select & validate towards Vitalink.



































      Image Added

      Example of notification when the healthcare professional closes the medical record without validating & updating the medication scheme towards Vitalink.



      • If closing the patient record without validating & updating the medication scheme towards Vitalink:

        • A notification appears with the question to update Vitalink or not.

        • Below the action buttons, the medication list / scheme should be visualized.

        • In this way, the user can easily check & validate towards Vitalink.





      Variant 1: There is no Home Medication data in the EHR

      ...