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• 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.

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

Example 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. 

• 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 is validated by the healthcare professional will be uploaded to Vitalink at the end of the contact.

    

• In the examples above, each time Vitalink is addressed as external source.
• If Réseau Santé Wallon is addressed as external source, the RSW icon & textual label should be used.

• If Réseau Santé Bruxellois is addressed as external source, the RSB icon & textual label should be used.

Ambulant visit - Basic flow: Home medication EHR section is already in sync with Vitalink

• When the sync with Vitalink is done, it is visible in the wireframe that there is no difference between the home medication of the local EHR and the medication on Vitalink. 
  • If there would be a difference, the medication lines coming from Vitalink would be highlighted & labeled (cfr. next wireframe). 

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

• When the sync with Vitalink is done, it is visible in the wireframe that all medication lines are coming from Vitalink. There was no home medication in the EHR.
  • It is visible that the medication lines are coming from Vitalink due to the highlighting colour, the icon & the label 'new'.

Variant 2: Home Medication in the EHR is outdated vs. Vitalink medication scheme (part II)

• 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 medication line is highlighted to indicate that this is data coming from outside the EHR.
    • 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 stopped medication line receives a label (stopped), indicating that it concerns a 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.

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

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

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

Ambulant visit - 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 to edit, reject, re-activate, ...the medication lines until correct.

• Validating the combined overview will work the same as validating the active medication in the local EHR: the healthcare professional will have to validate the medication scheme and at the same time, the information will be uploaded to Vitalink. 
• By default all medication lines would be selected (check boxes will be checked) to upload to Vitalink. 
  • The healthcare professional can de-select medication lines in the exceptional cases they would not wish to share those with other healthcare professionals.
  • This action entails a big risk and thus a specific confirmation should be asked if the healthcare professional is sure he/she does not want to update medication line X to Vitalink. 

• 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. 

• 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.

• 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.

• When a change or other action is necessary, the healthcare professional can start from here (using the drop down list with actions).

Example of screen overlay with visualization of patient friendly medication scheme. As from here, it is also possible to validate & update the medication scheme towards Vitalink.

Patient friendly medication scheme 

• An alternative for validating & updating to Vitalink at the end of a contact is doing so when having the patient friendly medication screen open. Often this one of the last actions the healthcare professional does when working in the patient file.
  • The healthcare professional can choose if he/she wants to print or wants to print & immediately validate the medication scheme towards Vitalink. 
  • In this way, the healthcare professional doesn't need to validate anymore before closing the patient file in the EHR. 

Image Modified
Example of a dashboard page, visualizing the combined active medication overview of the patient (Vitalink medication lines + local EHR medication lines).

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Example of dashboard page, visualizing the admission medication when the patient is hospitalized. 

• It can be useful to have on the homepage / dashboard page of the patient file of the EHR a reduced / abbreviated list of the active medication.
  • In this way, the healthcare professional can see in a glance, when opening the patient file, some basic information on what medication the patient is taking & what the changes are regarding to the last visit of the patient.

• This reduced list of active medication should also present to combined overview of the active medication of the EHR & the medication coming from Vitlaink. 
  • The software / user can decide which information is useful to shop in such a reduced combined overview. 
  • It is recommended to display at least the product name, dosage & posology.

• This reduced combined overview will work in the same way as the complete combined overview.
  • In the wireframe, it is visible that the local active medication is visualized. In the meantime, the system is syncing with Vitalink (automatically).
  • It is clearly indicated that the system is working on the sync with Vitalink.

• In this example, it is visible that the sync with Vitalink is completed.
• A reduced combined overview is displayed. 
• It is visible that on Vitalink one new medication line was added.

• The healthcare professional should be able to do some actions (manipulations on the medication lines) as from here, or as from the complete combined overview).
  • It should be possible to go to the home medication module of the EHR with one click (e.g. by clicking on the title bar 'home medication').
  • If a sorting mechanism (e.g. on ATC class) is selected in the complete combined overview, the same sorting mechanism is used in this reduced combined overview.

• When the patient is hospitalized, a 2nd tab or sub navigation 'Admission medication' should appear on the homepage / dashboard page: representing the home medication in a reduced way.

• When opening the EHR when the patient is hospitalized, this 'Admission medication' tab should be opened by default. 
  • The healthcare professional will be able to navigate to the Admission medication module of the EHR via one click.
  • When in the tab 'Admission medication', no Vitalink indication is visible. 
  • All medication lines coming from Vitalink are validated or rejected or edited by the healthcare professional before transferring the home medication towards the admission medication.