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Software User`s Manual

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1. PUB 120 Rev C doc 51 AFHCAN Software User s Manual Version 4 Possible Right Bar Area Buttons for Case Screen Before After Taking Case Taking Case Log Out Xo loi Ke Case Add Comment Take Case Figure 31 Example of variability in buttons presented in right bar area 3 2 4 Features of the Main Viewing Area The main viewing area of each screen presents the significant information instructions and program actions relevant to the overall theme and function of the screen 3 2 5 Features of the Left Bar Area The Case screen is one screen that makes use of the left bar area On the Case screen the left bar area 1s used to display thumbnail images and buttons indicating the contents of the case Clicking on a thumbnail image or button brings up the image form or information in the main viewing area Selected buttons will be darkened Selected thumbnail images will have a red border Other screens that utilize image information will present thumbnail images in the left bar area 3 2 7 6 Features of the Bottom Area The bottom area of the screen is used for entering comments naming images or information or image control tools An image cannot be saved until it has been given a unique name see Figure 32 PUB 120 Rev C doc 52 AFHCAN Software User s Manual Version 4 Digital Camera Screen screen Detail all LUGE CAAGIUGET est Image Image Name is required Figure 32 Example of image name in bottom a
2. You can move back and forth between these two screens as needed to add all the information When done go to the Send Case screen then back to the Start screen Details on all these processes will be provided later Start Anak do you want to do today Screen Create a New Case Add To Create r New Case Click here if you want to create a new case My Settings Case Screen Click here to view cases on your plate cases Cases To Review on hold your cases your group cases Log Out Click here to view cases you have sent that Cases You Sent are still open not yet archived Patient canner Search Archives Otoscope toscop Composite Composite S Video 2 Video 1 Video 2 Vital Signs Case Viewer Case Screen Case Viewer Log Out Click this button if you wish to send this case to another provider Click this button if you want to save your information for later use Click this button if you want to file Send Archive rapes Case Screen Discard Changes Click this button if you don t want to case Figure 6 Simplified sequence through the Big Four when creating a case PUB 120 Rev C doc 26 AFHCAN Software User s Manual 3 1 2 2 Viewing an Existing Case Version 4 As previously shown in Figure 6 the first button on the Start screen is the Create a New Case button which leads to the Add to Case screen The three buttons below the Create a New Case button begin the sequence
3. field means the data S Email Notification rCase Return Option _ cannot be changed dsherwood afhcan org Do you want cases that you send returned to you f thi individually or to your group Back rom IS screen Iwanftto racao emaila xes Return to the individual Duane Sherwood sent to me and my group No Return to the group Big Lake Clinic ie g a Return to the group Iditarod Clinic ask administrator to Return to the group Moose Pass Clinic make the change The Save button will turn green as soon as something on this screen is changed Figure 16 My Settings screen PUB 120 Rev C doc 39 AFHCAN Software User s Manual Version 4 The My Settings screen gives the user control over a number of personal settings and options The screen has four panels each with a different theme e Personal ID Information e Email Notification e Change Password e Case Return Option 3 2 5 1 Personal ID Information The Personal ID Information area of the My Settings screen allows the user to verify his or her full name and to add change or delete the appropriate suffix to be added to the name see Figure 17 The suffix indicates the qualifications or role of a healthcare provider The suffix appears on printed reports and in most other areas where your name appears in a case The administrator may have added your suffix when he or she set up your account A pull down menu is available for a
4. overview 25 Send Summary screen in tutorial 14 screen layout 48 Send To Whom screen in tutorial 14 Send Where screen in tutorial 13 server administrator role 38 39 cases in transit 51 configuration example image 45 configurations 45 connection image 43 connection status See working on line defined 43 64 email notification setup 41 general reference 2 in tutorial 13 list of when sending case 47 local and global providers 46 PUB 120 Rev C doc 69 Version 4 local or home server 47 server connection status general reference 50 in tutorial 5 13 server name general reference 50 in tutorial 5 13 server to server communication 46 schematic image 46 Set Default Recipient button purpose and use 32 setup user 38 Shutdown button in tutorial 20 software See AFHCAN Client Software Start screen function 23 general reference 37 39 40 41 63 image 23 26 27 in overall sequence 26 27 in tutorial 5 15 18 19 21 overview 23 working offline image 44 Take Case button general reference 51 purpose and use 31 Telemedicine button in tutorial 4 20 Test Case button in tutorial 6 sequence details image 34 test patient 33 test user 38 user roles 37 username defined 66 general reference 38 46 guidelines for creating 38 Username data entry box general reference 55 in tutorial 5 View button in tutorial 16 sequence details image 28 29 working off line gener
5. Case Screen The Send Case screen Figure 5 is where you decide what to do with a case when you have finished working on it A common action is to send the case to another provider Copyright 2000 2005 Aaska Native Tribal Health Consortium Al Rights Reserved Patient Bewell May 30 yrs F Case Iditarod Clinic C 50 User Sherwood Duane Log Out Click on Click this button if you wish to send z H H ase i Patient this case to another provider aor to view Name patient info Click this button if you want to save your information for later use Click this button if you want to file Archive this case away e Click this button if you don t want to Discard Changes save changes to this case Figure 5 Example of the Send Case screen 3 1 2 Overall Program Structure and Flow In general there are two main pathways through the software 1 the pathway where a new case is created 2 the pathway where an existing case is viewed These two pathways are described in the following pages PUB 120 Rev C doc 25 AFHCAN Software User s Manual Version 4 3 1 2 1 Creating a New Case Figure 6 shows the basic sequence through the four screens when creating a new case The sequence begins with the Add to Case screen Once the process of adding the first piece of information 1s complete the sequence goes to the Case screen where the information can be viewed To add more information go back to the Add to Case screen blue arrow
6. Line It will be sent when connection 1s reestablished The version number of the software currently running on your workstation is also shown 4 Selecting your own server press select MedNorth This Server PUB 120 Rev C doc 13 AFHCAN Software User s Manual Instead of sending a case to an individual you can send it to a group Administrators establish groups and assign individuals as members of the group For more on groups see Chapter 3 In this example however you will send the case directly to yourself 5 Beside your own name press Select Note the Send Summary screen at the right may be the first screen you see after you pressed Send above If you encountered this screen as the first screen after the notice push the New Recipient button and select yourself as the recipient The procedure is similar to what was described above The screen identifies the sender and the recipient From User Group User Server Server The screen also presents a summary of the case contents fues FORM FORM PEF Comments 6 After you have been selected as the recipient push PUB 120 Rev C doc 14 Patient Mustard Nancy 3 yrs F y i Clinic D4 Patient Mustard Nancy 3 yrs F y i Clinic D 4 Version 4 ase Test Iditarod ser Service Amy Who at MedNorth do you want to send to elect Big Lake Clinic elect dta elect Moc ass Clinic AFHCAN Software User s Manual Ve
7. Press The AFHCAN Client software terminates and the desktop is displayed end of tutorial PUB 120 Rev C doc 21 AFHCAN Software User s Manual Version 4 PUB 120 Rev C doc 22 Section 3 General Information This section has three goals 1 introduce important screens and provide an overview of the software s structure and flow 2 provide the background knowledge needed to be a competent user 3 describe some features of the software that are common to a number of screens 3 1 Key Screens and Program Flow There are four screens that are very important when using the software Knowing how to recognize these screens will help you navigate around the software Details on screen functions and features will be provided later e Start screen top screen in the software e Add to Case screen select patient and add medical information e Case screen view the contents of a case e Send Case screen when you are finished with a case send it to another provider or choose one of the other available options 3 1 1 Introducing the Big Four 3 1 1 1 Start Screen The Start screen Figure 2 is where everything begins All available functions are initiated from this screen Every operation in the software begins and ends here Help Button and ase ole Olt Screen Name SE a What do you want to do today Name of user currently Create a New Case Click here if you want to create a new case y gs logged
8. billing details and signing the form Pressing one of the Print buttons opens the selected printout in a print preview window as shown in Figure 37 The print preview window 1s a utility program incorporated into AFHCAN software This utility has its own controls for zooming in displaying multiple pages moving to the next page etc as shown in Figure 38 S a omla akik P peepee ed eee a gua a fia Ke 4 3 Case Iditarod Clinic C 50 Patient May Bewell printed by Duane E Sherwood on 9 28 2005 at 3 56 Page 1 of 1 PM COMMENTS Case created on Jun 23 2005 01 58 PM by Duane E Sherwood at MedNorth Duane E Sherwood Date 06 23 2005 Location 352BB407 6D98 4A2E 9FE2CE63FE2D9AA2 This case is for testing purposes Duane E Sherwood Date 06 23 2005 Location 352BB407 6D98 4A2E 9FE2CE63FE2D9AA2 You can type in comments and instructions here Duane E Sherwood Date 07 01 2005 Location 352BB407 6D98 4A2E 9FE2CE63FE2D9AA2 would like this patient to schedule an appointment with me in Anchorage at her earliest convenience Figure 37 Example of the print preview window PUB 120 Rev C doc 59 AFHCAN Software User s Manual Version 4 E 8 aio Q a Ja aM ed ed m Table of Contents Sent to Printer Find Text Single Page View Multi Page View Zoom In Out Magnification Previous Next Page Current Total Pages E Move Back or Forward Figure 38 Print preview window too
9. but should be changed by the user An administrator can overwrite someone s password but cannot find out what someone s password is Passwords are case sensitive An individual to whom medical care is given On the AFHCAN system each patient can be uniquely identified by the social security number 63 AFHCAN Software User s Manual Version 4 PC PC workstation PEF peripheral provider provider role real case Server PUB 120 Rev C doc personal computer A computer designed for use in the home or office by one user at a time includes desktop computers and laptop computers AFHCAN software is designed to run on a PC A personal computer including laptops running AFHCAN Client Software and connected to an AFHCAN network patient encounter form The patient encounter form is one of the forms available in AFHCAN software for documenting a patient s signs and symptoms A device connected to a computer On an AFHCAN Cart peripherals comprise the various medical devices attached to the cart The cart can capture images and data from these devices and add this information to a case Non medical devices such as the scanner and media reader can also be considered as peripherals In the context of AFHCAN software a healthcare professional at any level using the software to communicate patient data and medical information in support of patient care The term provider is often used interchangeably with the term use
10. by accessing an existing case so they follow a different sequence through the software see Figure 7 Once you have the case open the sequences are similar to those used in creating a case If you are able to take the case you can add to it by going to the Add to Case screen If the case is read only you can only view the case using the Case screen Sta rt aie do you want to do today Screen Create a New Case Click here if you want to create a new case Click here to view cases on your plate cases s Cases To Review on hold your cases your group cases Click here to view cases you have sent that are still open not yet archived Cases You Sent Search Archives Cases To Review Cases You Sent e Search Archives Add To Patient Scanner Composite Composite S Video 2 Video 1 Video 2 Vital Signs Case Viewer Viewer Click this button if you wish to send this case to another provider Click this button if you want to save your information for later use Screen Case Log Out Viewer Send Archive pena im Case Discard Changes pecans Screen 9 s his button if you don t want to ve changes to this case Figure 7 Simplified sequence through the Big Four when viewing an existing case PUB 120 Rev C doc 27 AFHCAN Software User s Manual Version 4 3 1 3 Other Useful Screen Examples This section introduces a few additional screens that are commonly encountere
11. cccceeeeeeeseeessssssesesseeeseseeeeseeeseeeeeeeees 51 Example of variability in buttons presented in right bar area ccc cecccccccecceeeeeeeeeeees 52 Exampl of imace name in DOOM Aled aossen rir aa a cannes 53 Clicking on column headings to sort LiSts ccccccssssseeesessesssseessseessseseseseeseeeeeeeeeeeees 54 Sequence for activating the image Control tOOls cc eeceeeeeeeeceneeeeseeeeseeeeeeeeeeeeeees 56 Sime he ata WINGO eeror E nE E ENE OTE O EENE E TEO 57 Prnt WAIN A ONY esse rssh ate taeis cont E canis E T wostliselasite 58 Example of the print preview Window sorrir narrar ITA 59 Print PEG VIG We window CO OS ete sete inanan iu aa NE aad 60 PUB 120 Rev C doc V AFHCAN Software User s Manual Version 4 PUB 120 Rev C doc vi Section 1 Introduction 1 1 Strategies for Learning AFHCAN Software 1 1 1 There is No Substitute for Experience The best way to learn the AFHCAN software is to jump in and use it The more you use it the better Feel free to experiment and see what the software will do Screens are designed around a logical workflow Messages will pop up from time to time to add details or to call your attention to specific items Test cases can safely be used for experimenting and learning 1 1 2 Achieve Quick Success New users are encouraged to follow the tutorial in Section 2 The goal of Section 2 is to help you experience success the first time you use the software 1 1 3 Expand your Knowl
12. must be filled in Patient Wood Albert 55 yrs M ise Iditarod Clinic K59 User Sherwood Duane Is this Patient Information Correct First Name Date of Birth mm dd yyyy Bs pz P s Gender ned Other Name City Home Phone B222 2222 E choose notto enter the home phor SSN i ooo 00 0000 E EAE Regional Health Record Please Provide Billing Information a es SLL tc te Woody AK 99999 Insurance Other Insurance Insured s Name Insured s ID Number SSN Village j000 00 0000 Regional Health Record iz ANMC Health Record A Real SSN is Required for a Real Patient Figure 14 The following errors were found in your form 1 Date of birth must be realistic OK tient Woodheat Douglas 37 yrs M se Test Iditarod Clinic K 60 a User Sherwood Duane Is this Patient Information Correct Woodheat Douglas Last Name First Name Middle Initial Date of Birth mm ddfyyyy Gender s Male city TA T 222 a Village DOOOKXK OOOO Zip Code Home Phone Regional Health Record ANMC Health Record Please Provide Billing Information Test A Insurance Other Insurance Insured s Name Insured s ID Number SSN Village Regional Health Record ANMC Health Record System Creates Dummy SSN for a Test Patient As Well As Dummy Health Record Numbers Comparing the patient information screens for real and test
13. number of suffixes If the desired suffix is not shown you can manually type in the appropriate suffix Contact the administrator for assistance in changing your name Personal ID Information First Name System administrator enters your name 7 when your account RE E EATEN is established Last Name Click on arrow to activate System administrator may pull down menu have entered a suffix indicating your title this screen allows you to add change or delete Pull down menu shows available suffixes titles Figure 17 Personal ID Information 3 2 5 2 Email Notification When you log into the AFHCAN software a message may appear on the You have 1 case Start screen indicating that you have one or more cases to review If you don t log into the software on a regular basis however you would not know if new cases had come in until the next PUB 120 Rev C doc 40 AFHCAN Software User s Manual Version 4 time you logged in To ensure incoming cases are not held up you can elect to have a notification of new cases sent to your regular email address In order for email notification to work the server to which your workstation is connected must be set up to support this feature Contact your administrator if you have questions on this There are two ways email notification can be activated Either your administrator can set it up when your user account is created or you can set it up yourself as sh
14. providers to view the information if needed 1 Press Archiving a case brings up a screen similar to the screen used for sending a case TO Group User Server 2 Press Archive PUB 120 Rev C doc 17 Version 4 atient Mustard Nancy 3 yrs F se Test4ditarod Clinic D4 Log Out Service Amy COMMENTS Add To 5 01 15 PM by Amy T Service at MedNorth Case Amy Sernice Date 8 15 2005 Location MedNorth Suggested the patient take some aspirin Add Comment Print Patient Mustard Nancy 3 yrs F Testditarod Clinic D4 Log Out Service Amy Click this button if you wish to send this case to another provider Click this button if you want to save your information for later use Click this button if you want to file this case away Archive Click this button if you don t want to save changes to this case Discard Changes Log Out AFHCAN Software User s Manual Version 4 Log Out What do you want to do today Shortly after pressing Archive the message indicating You have 1 case will be removed Create a New Case Click here if you want to create a new case My Settings Click here to view cases on your plate cases This completes a typical sequence for creating sending Cases To Review lt your cases your group cases reviewing and archiving a case Click here to view cases you have sent that Cases You Sent are still open not yet archived Continu
15. represented on the screen by buttons Each button has a short label indicating the action that results when this button is pressed or pushed The AFHCAN Cart is equipped with a touch screen monitor Simply touch a button on the screen to activate a button s function For those who prefer to use a mouse clicking on a button is exactly the same as touching it on the screen Simply move the mouse cursor over the desired button on the screen and give the left b mouse button a single tap If you are running the software on a PC workstation instead of a Cart using the mouse to click on buttons may be your only option In reference to on screen buttons or features the terms press push touch or click on all refer to essentially the same thing PUB 120 Rev C doc 3 AFHCAN Software User s Manual Version 4 2 3 Tutorial 2 3 1 Starting the Software on the AFHCAN Cart 2 steps 1 Turn on the Cart s power switch AFHCAN A sequence of Windows startup screens will be displayed first and then a screen similar to the one at Sa the right will appear Shutdown 2 Press Telemedicine The screen at the right will briefly appear during startup After a moment the Login screen will appear Continue with Logging In below Telehealth Network Client Please wait while the application starts 2 3 2 Starting the Software from a PC workstation 1 step 1 Double click the AFHCAN icon on your desktop SFHCAN Teleheal
16. server a list of names beginning with the letter B may or may not be displayed The Add New button is available for adding a new patient 6 Press 7 Leave all fields blank as shown If necessary place the mouse cursor in the field and backspace to delete any contents 8 Press Search By leaving the search fields blank the system returns a list of all the patients currently in the database Blanks are like wildcards which means match anything The Next button allows you to move to the next group of patient names in the list 9 Choose any available patient and press Select PUB 120 Rev C doc T AFHCAN Software User s Manual This screen allows you to verify the information for this patient Is this Patient Information Correct and Complete Last Name First Name The Edit button allows you to edit the patient information 10 Press The patient s name now appears in the upper bar Clicking on the circled I brings up a display of patient information Patient Mustard Nancy 3 yrs F Case Test Iditarod Clinic D3 User Service Amy 11 Press TOME Custom designed forms for entering patient medical histories have been created for various medical specialties Clicking on a plus sign expands the list of forms hidden in a category Clicking a minus sign hides the list under the category bar 12 Press Add PUB 120 Rev C doc 8 S V
17. terms user and provider are often used interchangeably Strictly speaking however not all users are healthcare providers some users are technical or administrative staff The AFHCAN software recognizes four types of users These four types are spoken of as provider roles A unique name assigned to a user that is entered during the login process Often a username is made from the first letter of the first name and the first seven letters of the last name Other methods for creating usernames can be used Under the domain of a server all usernames must be unique Usernames are assigned by an administrator 66 button See Plus Sign button Activity button in tutorial 17 Add button in tutorial 8 Add Comment button general reference 51 in tutorial 10 Add New button in tutorial 7 sequence details image 35 Add To Case button general reference 51 in overall flow image 26 27 in tutorial 11 17 Add To Case screen function 23 image 24 26 27 in overall sequence 26 27 in tutorial 6 8 11 17 overview 24 sequence options 37 administrator 38 AFHCAN Cart general reference principle components 1 V3 image 2 AFHCAN Client Software available features 38 defined 43 design philosophy 3 error checking 36 four major screens big four 23 functional description 1 general reference 2 learning strategies 1 minor variations required fields 37 security and confidentiality 2 31 starting from
18. the case number assigned by the system e archived cases completed cases that have been closed and filed away in the electronic records includes both real and test cases when work on a case is completed it should be archived archived cases can be viewed and comments on the case can be added but new medical information cannot be added Note Ifa case is not archived only the people who have handled the case can view it with the exception of the administrator who can view all open cases An important advantage of archiving is that it makes the case available to all providers connected to the system The three types of cases are clearly marked in the top bar area of the various screens as shown in Figure 10 PUB 120 Rev C doc 30 AFHCAN Software User s Manual Version 4 Top Bar Color Indicates Type of Case COMMENTS Debbie Cor Date 2 1 2005 Location MedNorth Duane Sherwood Date 7 1 2005 Location MedNorh Duane Sherwood Date 7 7 2005 Location MedNor 1 Top Bar from Real Case case is open Copynght 2000 2005 Aaska Native Tribal Health Consortium All Rights Reserved AFHCAN Client 4 3 Patient Bewell May 30 yrs F Case ditarod Clinic C 50 User Sherwood Duane 0 Cases in Transit 2 Top Bar from Test Case case can be open or archived Copynght 2000 2005 Naska Native Tnbal Health Consortium All Rights Reserved Patient Mustard Nancy 3 yrs F Case Test Iditarod
19. 7 10 Image Control Tools A considerable amount of the medical information that can be added to a case is in the form of a digital image Some of the available devices that can provide a digital image include the following e scanner e digital camera PUB 120 Rev C doc 55 AFHCAN Software User s Manual Version 4 e video otoscope e dental camera There are some image control features that are common to these screens The examples below are based on the Case screen Clicking on a thumbnail brings the associated digital image up in the main viewing area of the screen Double clicking on the image itself brings up the image control tools see Figure 34 pyright 20 2005 Alaska Nati Tribal Heahh C ortium All Right Patient Luther Kim 39 yrs F gt Iditarod Clinic C 52 Sherwood Duane Log Out COMMENTS Add To 005 06 25 AM by Duane E Sherwood at MedNort Case Add Comment Click on thumbnail to bring image up in main viewing area Log Out Add To Case Add Comment Picture tient Luther Kim 39 yrs F Double click on image Contro taro Clic pede to bring bring up image controls and Pan Window rash by Duane Sherwood at Iditarod Clinic on 6 24 2005 Figure 34 Sequence for activating the image control tools PUB 120 Rev C doc 56 AFHCAN Software User s Manual Version 4 One feature of the Picture Control screen is a small Pan Window in the right bar area see Figure 35 When the mai
20. Cart 4 starting from desktop 4 store and forward 2 structural overview image 26 27 tutorial 4 typical scenario for use 1 user roles 38 version number 5 13 working offline 13 44 AFHCAN Server See server AFHCAN Server Software 43 Index in tutorial 17 Archive screen in tutorial 17 Archive Search screen image 29 Back button general reference 37 in tutorial 7 purpose and use 54 Cart See AFHCAN Cart case archived 30 archiving 17 creating 26 creating image 26 creating new 5 custody of 31 defined 30 general workflow 1 2 grouped by category 16 list of 28 read only 31 real 30 reviewing 15 sending 12 32 taking 31 test 30 types 30 viewing image 27 viewing Overview 27 working offline 13 Case List screen image 28 in tutorial 16 overview 28 Case Return Option 42 Case screen activating picture controls image 56 function 23 general reference 28 56 image 24 26 27 49 in overall sequence 26 27 in tutorial 10 11 17 left bar area 52 overview 24 printing 58 screen layout image 49 varies with context 51 Case Send screen in tutorial 12 AFHCAN Software See AFHCAN Client Software Case Viewer button Archive button PUB 120 Rev C doc in overall flow image 27 67 AFHCAN Software User s Manual in tutorial 11 12 Cases To Review button in overall flow image 27 in tutorial 15 sequence details image 28 Cases You Sent button in overa
21. Clinic D4 ES CASE User Service Amy 3 Top Bar from Archived Case real case Copynght 2000 2005 Aaska Native Tribal Health Consortium All Rights Reserved AFHCAN Client 4 3 Patient Malone Rachael 77 yrs F 0 Cases in Transit Case Iditarod Clinic12 User Sherwood Duane Figure 10 Top bar examples for different types of cases 3 2 1 3 Taking a Case versus Read Only Cases The AFHCAN software ensures that only one person can modify a case at any given time Thus only one person at a time can have custody of the case When you create a new case or when you open a case sent directly to you as an individual you have custody of the case automatically Having custody gives you the right to add medical information When a case is sent to a group of providers and you are a member of that group you can view the case to see if it is appropriate for you to act on it but then you must actively take the case if you wish to add to it or send it to someone The software keeps track of the sequence and displays the button at the right when appropriate Take Case There are many situations in the software where you can view a case but cannot change it In these situations the cases are marked READ ONLY The status of read only pertains to your individual relationship to the case The following are some situations where cases are designated as read only e When you send a case to another provider or group it is
22. E 25 3 1 2 Overall Program Structure and FIOW 0 0 0 sssesssssssssssssssssssssssscssssssssssssssssseees 25 FEAE Creatine a NEW Case teach eigen heed catia eel a teraalus eh eaters tial oats aatest 26 Bol 2 VAG W Me al Ph XIS US CASS iss oe sieed a A E R E e vacasesiuuatectidatedtoe agente 21 Sid Other Usel Screen F xanple Seriana ATE EN 28 SN AEE E E E E E E E EE EE aee 28 2 edre O CECCUS 23 ae E eae le a re ea ees 29 3 2 Important Background Information sssechoireue so0deasesed vedands decuaanodtewensad dees bene vedexbadeddacsedtewenbieces 30 32 1 Characteristics Or ai CaS asenin a aa 30 SAA Whatis a E ase pennn a a A a a a a a 30 T e or OCIS ea a E E ve N 30 3 2 1 3 Takinga Case versus Read Only Cases cy nce ees 31 3 2 4 Ways toConclude Work ona Cas res nai a AE 32 Jaka How Cases are NimMmbDerediresners in aaia A ENEE E ARE 32 3 2 2 Patients and Patient Information ensena a a 33 PUB 120 Rev C doc lil AFHCAN Software User s Manual Version 4 3 221 Real Patients and Test Patients crosain nip aan OE 33 3222 Paen nonnai a a T aa aaa 33 3 2 2 3 Error Checking and Good Data Entry Practices 0cccccccseeseseseeseeeeeeeeees 36 DDD Regmired Fields eneren alana Spates atc ese hes haat See eh ae nai eal 36 3 2 29 Skippinge ReGUIneG FIC LAS grr atictet sel Rachael cet lace lt ested deel atta 37 3 2 2 6 Skipping the Patient and Demonstrating Equipment cccccccseseeeeeeeeens 37 F2 TYPES OL
23. First Name Middle Initial Date of Birth Gender Other Name Guardian Address City State Zip Code Home Phone Work Phone SSN Yillage Regional HR ANMC HR Insurance Other Insurance Insured s Name Insurance ID Version 4 SS Patient Information AN Patient information can always be displayed read only in a pop up window by clicking On the right side of the top bar are four items of useful information see Figure 30 software version number PUB 120 Rev C doc 50 name of the network server to which Cart or PC workstation is connected the status of the server connection Working On Line or Working Off Line the number of cases recently sent from this Cart or PC workstation that are still in transit AFHCAN Software User s Manual Version 4 Software Version Number AFACAN Client 4 5 Server Name and Connection Status gt J Cases in Transit Recently sent cases still in transit to server Moving the Mouse Cursor N over the Version Number reveals the software build number Figure 30 Top bar info and mouse over version number The software version number is only the first level of detail in identifying the specific software running on your computer When speaking with customer support or when evaluating the need for an upgrade it will be helpful to know the specific build number of the software The build number is a number used for controlling and defin
24. Form Testiditerod Clinic D3 Ar Clicking on a smiley face opens a window with PENG Health Aide aut Encounter ae automatic pull down menus for that topic feu pabis You can complete much of a form by clicking on available selections instead of typing all the information 15 Click on the down arrow in the box next to Drinks per day then click on one of the available choices a o 8 o a i 2 5 3 4 z s a 5 I z g E A Eee ee Ss Alcohol Use Drinks per day Drinks per week Prior DUI DWI Other alcohol history 16 Press PUB 120 Rev C doc 9 AFHCAN Software User s Manual Version 4 Patient Mustard Nancy 3 yrs F e D3 N Log Out Test Iditarod Clinic wad Service Amy as aai Community Health Aide Patient Encounter Form The selected information is entered in the field arame automatically Alcohol Use Drinks per day 0 e Ab T neadache Alcohol Use Drinks per day 0 17 Press Patient Mustard Nancy 3 yrs F Orma an oC Log Out Test Iditarod Clinic Service Amy sz Saving the form takes you to the Case screen which ideas Ae presents a summary of all information in the case ae Add All forms images and data associated with the case will be listed in the left bar of the screen So far this case only has an automatic comment and a form 18 Press Add Comment Patient Mustard Nancy 3 yrs F Oy ay R Test
25. HCAN Cart 5 steps Service A my What do you want to do today You can exit the software from any screen Create a New Case Click here if you want to create a new case My Setings Click here to view cases on your plate cases Cases To Review on hold your cases your group cases 1 Press Cases You E Search Archives Click here to search the archived cases If you have some unsaved data on the screen you may Wet de Tucan do ae encounter a warning message similar to the following P Create a New Case Click here if you want to create a new case co All UNSAVED Data Will Be Lost Are you sure you want to Log Out Are you sure you want to Log Out cases Cases To Revi 2 Yes No Click here to view cases you have sent that Cases You Sent are still open not yet archived Search Archives Click here to search the archived cases Yes iN Te Regardless of whether data may be lost or not you will be given a chance to confirm your choice to log out Are you sure you want to Log Out Yes No 2 Press PUB 120 Rev C doc 19 AFHCAN Software User s Manual The screen at the right is the same as the first screen you encounter when you power up an AFHCAN Cart Pressing the Telemedicine button would return the login screen 3 Press Shutdown A message asks you to confirm your decision to shut down the Cart Do you really want to SHUTDOWN the computer 4 Press A Windows screen w
26. Iditarod Clinic D4 Er og Out Service Amy COMMENTS Add To 5 01 15 PM by Amy T Service at MedNort Case 19 Type a comment in the available space at the bottom of the screen tbe Print SANE Suggested the patient take some aspirin 20 Press PUB 120 Rev C doc 10 AFHCAN Software User s Manual Version 4 P nt Mustard N 3 O ustar ancy 3 yrs F G G Log Out Test Iditarod Clinic Service Amy COMMENTS Add To The comment has been added to the case me AERE OEE AENA Add Comment Amy Semice Date 6 15 2005 Location MedNorth Suggested the patient take some aspirin aa 21 Press Patient Mustard Nancy 3 yrs F D3 i Log Out Test Iditarod Clinic Service Amy You can go back and forth between the Case screen and Patient a the Add To Case screen as often as you like to add images or data from attached medical devices Video Digital Otoscope Camera Details on the use of other buttons are provided in i i S Video 2 mpari Composite separate manuals for the various peripheral devices Video 1 Video 2 22 Press Tympano meter l Audiometer Spirometer Case Viewer f nt Mustard Nancy 3 yrs F Existing information in the case can be viewed from this e COMMENTS screen but new information must be added in the Add eo oe to Case screen Coarant Print For now we will assume all the medical information that should be added to this case has been a
27. Sets USEE ROICS are adsense eee eed teecs ee ina cota 37 arni ReaL U E era EENEN NENN 38 A2 Tes r USS E T T E A TS 38 I2 SEP SOLS a E I O 38 Di Ae NATIVES LIONS a a tes iba ane enn eat ates agen eat aaeet 38 3 2 3 5 Usernames Passwords and Security mossurs ouoir ee ee ANEA K 38 I EOS n S a S snaaenosman sane denna tsaasosundies 39 OSMO S e e E T eae 39 3 25 Personal ID Mormia On es E raece eee 40 3 2 5 2 Ea NOCA Oaa a aa a a 40 Taa Oane PASS WO oaia aa a E A E E AEA SoS 41 3 2 5 4 Case Return OPONSE a E RR 42 3 26 Basics of the AFHCAN NetWork forera aranna A ANON E es 43 F20 LAER CAN C Hent SOWIE a a TE E T E 43 3 2 6 2 AFHCAN Servet SOlW Ale secwtccss sarn a a E 43 3 2 6 3 Working On Line and Working Off Line ccccceeesesseseseessssssssseesssesseeeeeens 43 3 2 6 4 Typical Cart Workstation and Server Arrangement cccccceesssessseeeseeeeees 45 3 2 6 5 Server to Server COMMUNICATION issie e EE AE ENEN 46 3 2 6 6 Local and Global Providers and Groups c csssessssessssssssssssssssssssssseeseeens 46 Sea o aNd Sreem PCA S serrare na a E E O T E 48 321l Basie Screen Layout eieaa a E nee meek 48 Died TOMBI Eea S a E 49 3 2 7 3 Right Bar Features and Variations sxi6 8a nevis Ges iy acelin ae Rae ees 51 3 22 14 Features ofthe Main Viewing Afef 12 vscsdiscssadanadsctaansanvadagnuseveduses sadapedsctsavias sedans 52 32S Features of the Le Bab Are Ta EN 52 32 O Features orf De Botonr Are io oles s
28. Software User s Manual AFHCAN Client Software Version 4 Document ID PUB 120 Revision C AFHCAN Software User s Manual Version 4 The information in this manual was based on software build number 4 5 0 31 The names of providers and patients used in illustrations in this document are fictitious Every effort has been made to ensure this manual is accurate complete and useful Please notify us of any suggestions for improvement using any method of contact listed below AFHCAN Training Department 4000 Ambassador Drive Anchorage AK 99508 Phone 877 885 5672 toll free Fax 907 729 2269 Email customersupport athcan org Copyright 2006 Alaska Native Tribal Health Consortium All rights reserved No part of this publication may be reproduced stored in a retrieval system or transmitted in any form or by any means including photocopying electronic mechanical recording or otherwise without the prior written permission of Alaska Native Tribal Health Consortium PUB 120 Rev C doc AFHCAN Software User s Manual Version 4 Table of Contents Section Title Page SECHON L mrod ciO ssni an EE E leeisessensessaaneuses 1 1 1 Strategies for Learning AFHCAN Software lt c s 1s20 2c01s2 d2ssdesascnasaedaveancandteaannsdsnandesseeaneas 1 LEL Thercis No Substitute Tor EF epemem ei riian n a eN EEEO a l ELZ Achieve QUICK SUCCESS a ar EE E AEE E TEN AE OENES l Lia Expand your Knowlediessrrinneesa a a a cesta ae aton
29. al l LLA Be FIED itech tse E E ara hoa atlases l I2 Ovyeniewolthe AFHCAN Solva eena E A ENN 1 sechon2 Getin Started oreesa aa r E E EEEE 3 LEA NN OBO TEIN OUT A CUMIN Eck aa A A A E TAA EAA 3 2 2 iberactine with ihe S ltw are o aaa eeeee 3 Dey MMV OM aE E A NE EA dlbect aad ac atnsnoetdatae 4 2 3 1 Starting the Software on the AFHCAN Cart 2 stepS ccccccceceeeeeeeseseseeeeeeeeens 4 2 3 2 Starting the Software from a PC workstation 1 Step cceccccccccccccceeeeceeeeeeeeeeeeeeees 4 2 9 9 LO Coie Tn SIGNS herio ia a UTT lh ae ete eee 5 2 34 Creatine a New Case 23 Slep escbileiceci easel abe alter outcied Sebastes ensiaatiabeis Sep eetereceiyd 5 2 57 SENdinovd CASE SICDS lori reich EE ET EO OTA OTO EEE 12 23 0 IREviewile a OEA SPS eor n a a es 15 2 540 PRTC MIVING a C ase 2 SENS oiea E E E E AR OEE 17 25 8 ODAN HEPA Z SiC Os irian ee E E A E ees 18 2 3 9 Logging Off and Shutting Down the AFHCAN Cart 5 steps eeeeeeeeeeeeeeennnnnnnnn 19 2 3 10 Logging Off on a PC workstation 2 Steps ccccccccccccccccccceceeeeeeeeeeeeeeeeeeeeeeeeeeees 21 Section 3 General Infor mation cicien iae oee eaa ea aE E aS 23 Sul Key Screcnsand Prosram FloW oreen aa clea ese es 23 Sell nroducine M BIFU isos aac astute rad chennai nad on achana tees ad chance aaa A ates ous 23 SASTERA E O T A NE N 23 FELZ Add TO Case Ser Ce iraniana e A Aa 24 De Miss C Snee Ea a E N aba iraecss 24 Dedede GC AS SCEE asee aa a A O atic O
30. al reference 50 in tutorial 13 partial functionality 44 partial functionality image 44 working on line defined 43 general reference 50 in tutorial 5 13 status display image 44 workstation defined 1 43 64 AFHCAN Software User s Manual Version 4 general reference 2 3 13 32 38 41 43 46 50 61 62 63 64 65 identified in case number 32 logging out of software 21 network connection 13 simple network 45 starting software 4 Yes button in tutorial 8 19 20 21 PUB 120 Rev C doc 70
31. are User s Manual Version 4 Important Notice At this point there may be some variation in the sequence of screens There are two reasons why this would occur 1 You or your administrator may have selected someone to be a default recipient for your cases The sequence below assumes a default recipient has not been selected for you 2 The sequence may vary depending on the network your computer is connected to All Carts and PC workstations are connected to a network server Some servers are networked with other servers The sequence below assumes your server is connected to other servers If the screen immediately following this notice in the next step is not similar to the screen you see on your computer continue reading through the tutorial until you find the best match then resume following the sequence from that point forward ustard Nancy 3 yrs F i lee clini i SV J TN NN al STEGAS Test Iditarod ser Service Amy The server to which your computer is networked is identified in the upper right corner of every page Where do you want to send your case Select MedNorth This Server Select Group Medical Practice Select Health Organization AFHCAN Client 4 5 0 Cases in Transit Beside the server name MedNorth is an indication of whether the connection to the server is present or absent Working On Line or Working Off Line The software is designed so you can still develop a case while working Off
32. areas see Figure 27 e top bar e right bar e main viewing area Copyright 2000 2005 Aaska Native Tribal Health Consortium All Rights Reserved Send Patient Bewell May 30 yrs F Summary Case Iditarod Clinic C 50 AFHCAN Client 4 3 User Sherwood Duane Main Viewing Area From LKS User Group User Server Server Forms Comments PEF PCP Digital Camera us i injury trash ear tube ECG ECG Report ECG 14 03 59 Tympanograms Tympanogram CALIBRATION 13 59 58 Figure 27 Major areas of screen displays Right Bar New Recipient Set Default Recipient The Case screen splits off two additional areas from the main viewing area see Figure 28 e left bar e lower area PUB 120 Rev C doc 48 AFHCAN Software User s Manual Version 4 Top Bar Copyright 2000 2005 Aaska Native Tribal Health Consortium All Rights Reserved Patient Goodheart Mable 59 yrs F Case Iditarod Clinic C47 User Sherwood Duane Left Bar Main Viewing Area Right Bar COMMENTS Case created on Jun 23 2005 10 34 AM by Duane E Sherwood at MedNorth Activity RISE injury Tympanogram 10 37 28 Tympanogram eel 10 35 44 ECG Report Lower Area EJ ATELE Have this patient schedule an appointment with me at her earliest convenience Save DIRET Figure 28 Additional areas of the Case screen 3 2 7 2 Top Bar Features At the left of the top ba
33. ases ases Cases To Review Real Case Test Case Test cases use pretend patients Test cases allow you to try all the features of the software without risk to an SOAGE ore sit open not yet archived actual patient record Search Archives Click here to search the archived cases Log Out Test Iditarod Clinic D3 Service Amy The screen to the right is a typical example Exactly which buttons will appear on your screen depends on Patient Scanner the installation and the devices installed Video Digital Otoscope Camera The top bar is purple indicating that this is a test case Composite Composite A case number has been assigned by the software S Video 2 ieee ole Patient Case Test Iditarod Clinic D 3 User Service Amy Tympano atar Audiometer Spirometer 3 Press Patient Patient Search Log Out 4 Enter the letter b in the last name field Search for a Patient Last Name First Name SSN Date of Birth Regional HR 5 Press Search The software will produce a list of all test patients whose last names begin with B Upper case capital letters or lower case letters will work PUB 120 Rev C doc 6 AFHCAN Software User s Manual Version 4 In this example a message came up indicating none of the existing names in the database begin with the letter B No match found for these search criteria Because patient information varies from server to
34. ating a case PUB 120 Rev C doc 1 AFHCAN Software User s Manual Version 4 Antenna for wireless network l Video otoscope platform box Dental camera Touchscreen monitor Vital signs monitor Tympanometer audiometer Keyboard Mouse Upper drawer spirometer footswitch supplies Lower drawer scanner digital camera media reader Computer bay Power bay Figure 1 AFHCAN Cart Version 3 with typical devices attached Once the medical information has been assembled into a case the AFHCAN software is used to send the case over a network to another provider The receiving provider working at an AFHCAN Cart or at a PC workstation running AFHCAN software can open the case review the medical information add instructions or comments to the case and send it back to the originating provider This is just one example of a typical workflow Because the AFHCAN software reads and stores the images or data directly from the attached medical devices the receiving provider sees exactly what the originating provider sees with little or no loss of detail One important advantage of AFHCAN software is that it employs a store and forward strategy in handling the data Network communications can be subject to long delays if large amounts of data are being transmitted especially when network connectivity is a problem The AFHCAN software is designed to transmit a case over a period of time Once the case has been fully assembled at the
35. d as you gain access to the Big Four The four screens described above are where you will do most of the work on a case Be aware that Figures 6 and 7 above are simplified views and that there are many other screens involved in these sequences 3 1 3 1 Case List Screen Pressing the Cases to Review button is just one of the situations where you will encounter the Case List screen see Figure 8 The Case List screen helps you find a particular case Once the desired case has been located it can be opened in the Case screen as described previously Start Screen Start What do you want to do today Change Create a New Case Click here if you want to create a new case Cases To Review SEE cesta cosa yratycsceeay Case List Screen cases hidden under category bars Case List i SR Log Out User Sherwood Duane Sooo Click here to search the archived cases PATIENT NAME HR DOB M F Your Cases On Hold 4 Cases To Review Cases Sent To You 1 Cases Sent To Your Group Big Lake Clinic 3 q Cases Sent To Your Group Iditarod Clinic 1 Your Test Cases On Hold 1 Test Cases Sent To You 2 Push a plus sign to display the cases hidden under the category bar Case List Screen three cases revealed Case List Log Out ase PATIENT NAME HR Your Cases On Hold 4 Cases Sent To You 1 Cases Sent To Your Group Big Lake Clinic 3 View Carr Karen M 727 1965 F Iditarod Clinic C 68 View Go
36. d by the software can always be selected a different recipient can be designated as the default recipient by the user electrocardiogram A medical device that records and analyzes a patient s heartbeat Food and Drug Administration Providers or groups can be designated as global or local In the AFHCAN network one or more workstations are connected to a server Furthermore servers can communicate with other servers via a larger network system Providers and groups assigned to a particular server are local to that server When cases are sent to providers or groups assigned under a different server those providers or groups must be designated as global in order to appear on the sending workstation s list of recipients 62 AFHCAN Software User s Manual Version 4 group GUI hold local logging in network node password patient PUB 120 Rev C doc A defined list or set of providers to whom a case may be sent When a case is sent to a group all members in the group are notified that a case 1s available The first person in the group to take the case assumes responsibility for handling that case Normally groups include similar types of practitioners each of whom is qualified to handle the cases sent to that group graphical user interface The GUI includes the screen displays buttons data entry fields messages and other features that allow the user to operate the software A graphical user interface depe
37. dded 23 Press PUB 120 Rev C doc 11 AFHCAN Software User s Manual Version 4 2 3 5 Sending a Case 7 steps atient Mustard Nancy 3 yrs F y A CG Test ditarod Clinic D4 i F VARD Log Out In many situations the program will give you an opportunity to go backwards in the sequence If you discover you need to add to the case you can return to a an the Case screen and from there return to the Add to oe Case screen as mentioned above Click this button if you wish to send this case to another provider Click this button if you want to file Archive this case away 1 Press A Click this button if you don t want to Discard Changes save changes to this case Patient Mustard Nancy 3 yrs F OFT COMMENTS ae This example is just to demonstrate the idea of going one ae WS mh _ back Let s proceed with sending the case Comment Print 2 Press Patient Mustard Nancy 3 yrs F AAA TA se TestIditarod Clinic D 4 jr TASSI og Out er Service Amy u A 3 Details on the various choices available on this page are provided elsewhere Click this button if you wish to send this case to another provider Click this button if you want to save 3 Press your information for later use s Click this button if you want to file Archive this case away Click this button if you don t want to Discard Changes save changes to this case PUB 120 Rev C doc 12 AFHCAN Softw
38. e with Obtaining Help Search Archives Click here to search the archived cases 2 3 8 Obtaining Help 2 steps se Log Out User Service Amy What do you want to do today The AFHCAN software includes help pages Create a New Case Click here if you want to create a new case ay Seinge 1 Press Click here to view cases on your plate cases Cases To Review on hold your cases your group cases Click here to view cases you have sent that Cases You Sent are still open not yet archived Search Archives Click here to search the archived cases E Main Window Title DER LELE OBTEN LLE OR 0 E ladex Seach Fasl Q Versio The button in the upper left corner of each screen is the help button Pushing the button opens a window to a help page specific to the screen you are on Create a New Case Click here if you Selections Create A New Case Begin here to EATE Click here to vie Cases To Review on hold your ca IDEEA T POZE The help button also indicates the name of the screen Click here to view cases you have sent that Cases You Sent are still open not yet archived The X in the upper right of the help window red in this example is for closing the window Search Archives Click here to search the archived cases 2 Toclose the help window click on the X PUB 120 Rev C doc 18 AFHCAN Software User s Manual Version 4 2 3 9 Logging Off and Shutting Down the AF
39. ection of the software the administrator types in the appropriate IP address for the gateway and checks a box to indicate whether the SMTP gateway is on the server or a node AFHCAN support can help with the setup 1f needed PUB 120 Rev C doc 41 AFHCAN Software User s Manual Version 4 3 2 5 4 Case Return Options When you are finished adding information to a case the next step typically is to send the case to another provider The AFHCAN software will try to identify the most likely recipient for the case you are sending If it is able to identify someone it will offer that recipient as a first choice If the software cannot identify a likely recipient or 1f you want to change the recipient that is suggested the software will present a series of screens allowing you to manually select the person or group to receive the case The software has two strategies for identifying the most likely recipient e when creating a new case if you or your administrator has designated someone as your default recipient the name of that person or group is automatically selected as the recipient e when reviewing a case sent to you the person who sent you the case or his group will be selected as the recipient Your default recipient is the person or group you send cases to most of the time Exactly who is selected depends on your standard workflow and clinical relationships Initially your administrator may make this selection for you when yo
40. edge When you are ready to deepen your understanding of the software take the time to read through Section 3 Section 3 explains important concepts that skilled users should be aware of 1 1 4 Be Flexible The software can vary slightly from what is illustrated in this manual depending on such factors as e whether the software is running on a PC workstation or an AFHCAN Cart e the number and types of medical devices attached to the Cart e the configuration settings of the software e the version number of the software e where you are in the operating sequence 1 2 Overview of the AFHCAN Software AFHCAN software is a tool for communicating medical information from one healthcare provider to another via a communications network The AFHCAN software is designed to run on an AFHCAN Cart see Figure 1 but can also run on a PC workstation A PC workstation is an ordinary personal computer including laptops In a typical scenario a provider in one location sees a patient and desires a consult from a provider perhaps a specialist in another location The originating provider can use the AFHCAN Cart to develop a case history for the patient The AFHCAN Cart consists of a computer a network connection and a variety of attached medical devices such as a video otoscope or an ECG The medical devices generate digital images or data that is stored in the computer AFHCAN software associates the medical information with the patient thereby cre
41. er AFHCAN Cart or PC workstation running AFHCAN Software The AFHCAN Cart includes a computer touch screen monitor scanner digital camera and various medical devices such as a video otoscope dental camera ECG monitor and other items Alaska Native Medical Center A hospital in Anchorage providing healthcare to Native Americans in Alaska that operates under the auspices of ANTHC Alaska Native Tribal Health Consortium An organization made up of regional tribal health organizations that coordinates delivery of healthcare to Native Americans in Alaska A place where finished cases can be stored electronically on the server The only way to close a case is to archive it Archived cases can be viewed and printed and comments can be added to the case but the case cannot be reopened and medical information can neither be added nor extracted Advanced Telemedicine System The software package developed by AFHCAN The Net software is a version of ATS Advanced Telemedicine Workstation An obsolete name for an AFHCAN Cart 61 CaSe case sensitive CHA P client comment CPU data service default recipient ECG FDA global PUB 120 Rev C doc AFHCAN Software User s Manual Version 4 On the AFHCAN system a case is a collection of medical information and personal data for a patient usually associated with an episode of medical care A requirement placed on data entry fields where the use of capital or
42. es your group cases Click here to view cases you have sent that are still open not yet archived Cases You Sent Search Archives Click here to search the archived cases Figure 23 Limited functionality of working off line is indicated on the screen When Working Off Line new cases cannot be received and other information normally shared by the server such as patient information or new providers will not be available The patient PUB 120 Rev C doc 44 AFHCAN Software User s Manual Version 4 cannot be selected but the patient can be identified and personal information can be entered manually This information remains with the case but it is not added to the list of patients When the connection is restored the client and the server exchange data on the most recent electronic transactions except information about a patient entered manually while the Cart was off line The system ensures that all the information is brought up to date as needed 3 2 6 4 Typical Cart Workstation and Server Arrangement A single server connected to a single AFHCAN Cart or PC workstation comprises a complete functional AFHCAN system However a one cart configuration would be of limited value as a communications tool Normally a number of AFHCAN Carts and or PC workstations at different locations are networked via one or more servers Figure 24 shows how a server can link a number of Carts and PC workstations at different locations Any one pro
43. esssessseseseeeseesesesesesseseseeeeeeeees 31 SUCU Ora Case MUI DM n a a a R 33 Creatine real Or test CAISE S nns E T 34 Process TOP AG GINO anew Pall CU orrei rai aiin ne e e EE EE E 35 Comparing the patient information screens for real and test patients ccceeeeeeees 36 Reguired fields that can De Skipped merie n ETE EE nena 37 IVEY SS elin os SCUCE iui aes oe a a a ansie saa walan I aaaeaianalataewecanine saa 39 Personal ID IntOrmiatiO sas tenes eran siteuleaiu oxteass T an tteietietenaua 40 FETA NO GIT A ON oo lo ac ce a ea cnc onda AO sea A 4 Change PASS Wy OU yay es Saal a og i lar Sala eae og Plas Slane as 41 Case TEM OPON Sarnen a en E E E O 42 Typical network connections for AFHCAN Cart and server ccccceeesssssseeeseseeeeees 43 Working On Line Working Off Line connection status displays cccccccccccceeeeeeeeeeees 44 Limited functionality of working off line is indicated on SCLEEN ee ccceeeeeeeeeeeteeees 44 Hypothetical Server CONTSUratiONn sesucen a a a eae ES 45 Network nodes and server to server communication sssseesssssesesssssseeerrreeeessssssssssssrn 46 Seleciino servers and TeCIDICIUS rnriaransoica aa na a 47 Major areas Of sereen displays son acscase crccnostasscanei als caduedeseduniae iaai I A R E ia a 48 Additional arcas OL He Cases ecien a A T 49 Patient and User data i top DaF sasrnisanseroirein nen E a 50 Top bar info and mouse over version NUMBET
44. function allows you to enlarge or reduce the size of the image The Rotate button allows you to rotate the Rotate displayed image counterclockwise in 90 degree increments 3 2 8 Printing The information in a case can be printed from the Case screen Pressing the Print button opens the print window shown in Figure 36 What would you like to print Print The item currently showing in the Case Viewer Print case comments at end of form This checkbox Three types Pri only appears rint l l of printout Case Summary Text Only when PEF is displayed in viewer Print Case Summary for Billing Text Only The ECG software Note ECGs must be printed from the provides printing ECG viewer services for pE ECG reports Back Figure 36 Print window The print window offers three styles or types of printout e a printout featuring the item displayed in the case viewer area which could be one of the following depending on what s available in the case list of comments list of activities forms images data e asummary of the case text only listing the following information providers PUB 120 Rev C doc 58 AFHCAN Software User s Manual Version 4 consultation date list of information added to the case at each encounter list of case comments e acase summary for use in billing providing the following information list of comments and activities dates and the providers involved areas for writing in
45. h for a Patient LastName First Name SSN Date of Birth l A Regional HR Patient Add Screen Log Out Iditarod Clinic C32 Sherwood Duane Enter Patient Information Last Name First Name Middle Initial Date of Birth mmf ddfyyyy Gender Other Name Guardian Address City el State Zip Code Home Phone Work Phone SSN Village Regional Health Record ANMC Health Record Please Provide Billing Information Insurance Other insurance hs Insured s Name Insured s ID Number AFHCAN Software User s Manual Version 4 3 2 2 3 Error Checking and Good Data Entry Practices In most data entry fields what you type is what you get If you make errors they will be part of the permanent record for that case We recommend using standard capitalization for names In other words the first letter capitalized and the remaining letters in lower case Typing all upper case letters may be easier but the are actually more difficult to read In some fields the software will check for errors For example patient birth dates must be within a realistic range The software will check some fields for some errors but there are limits to error checking Do your best to be accurate 3 2 2 4 Required Fields Figure 14 shows a side by side comparison of typical data entry screens for a real patient and a test patient Data entry fields with a yellow star
46. ideo 2 Community Health Aide PE Version 4 Log Out s Test Iditarod Clinic D3 er Service Amy Is this Patient Information Correct and Complete Last Name First Name Middle Initial Date of Birth mm ddfyyyy Gender Other Name Guardian Address City State Zip Code Home Phone Work Phone SSN Village Regional Health Record ANMC Health Record Insurance Other Insurance Insured s Name Insured s ID Number ent Mustard Nancy 3 yrs F rat Test iditarod Clinic D 3 Log Out ser Service Amy Patient Scanner Wife G10 Digital Otoscope Camera Composite Composite Video 1 A OE 2 Tympano meia Audiometer Spirometer ent Mustard Nancy 3 yrs F EARP A e Test Iditarod Clinic D3 E co Service Amy Add Community Health Aide PEF Add Primary Care Provider Dermatology AFHCAN Software User s Manual Version 4 Log Out T a m ser Service Amy u oi ed a eel Forms with many data fields are too large to view on a Community Heakh Aide Patent Enoounter Porm single screen To see the remainder of the form you can press the scroll buttons in the lower right corner F iil 4 ti Zz iiil A 3 S Eii pE a 5 gg 13 Type headache in the space as shown T i 8 A 3 B i yz i 2 or A 34 re F A History Chief Complaint 14 Click on the Habits smiley face t Mustard Nancy 3 yrs F Encounter oa ancy Avis ua Log Out
47. ill appear telling you it is safe to shut down the computer 5 Turn off the Cart power switch PUB 120 Rev C doc 20 Version 4 Telemedicine Shutdown Do you really want to SHUTDOWN the computer AFHCAN Software User s Manual Version 4 2 3 10 Logging Off on a PC workstation 2 steps Service A my What do you want to do today You can exit the software from any screen Create a New Case Click here if you want to create a new case My Setings 1 Press Click here to view cases on your plate cases Cases To Review on hold your cases your group cases Click here to view cases you have sent that Cases You Sent are still open not yet archived Search Archives Click here to search the archived cases 2000 2005 Aasha Native Tribal Heath Consonium At Rights Reserves Patient Case If h dd h TRR encounter a warning message similar to the following p Create a New Case Click here if you want to create a new case cs All UNSAVED Data Will Be Lost Are you sure you want to Log Out es Are you Sure you want to Log Out aaa Cases To Revi Ba Yes No Yes No p Cases You Sent Click here to view cases you have sent that are still open not yet archived In all instances regardless of whether data may be lost 7 earch Archives Click here to search the archived cases or not you will be given a chance to confirm your choice to log out Are you sure you want to Log Out Yes No 2
48. in Click here to view cases on your plate cases Cases To Review on hold your cases your group cases Number Click h to vi h t that of cases ick here to view cases you have sent tha Cases You Sent are still open not yet archived sent to you for review Search Archives Click here to search the archived cases Figure 2 Example of the Start screen PUB 120 Rev C doc 23 AFHCAN Software User s Manual Version 4 3 1 1 2 Add To Case Screen The Add To Case screen Figure 3 is where you develop a case by identifying the patient and adding medical information The set of buttons you will see depends on the installation and the configuration of your software Patient Case Iditarod Clinic D 16 User Service Amy Software l case number Video Digital Otoscope Camera Composite Composite Video 1 Video 2 S Video 2 Tympano Sera Audiometer Spirometer Figure 3 Example of the Add to Case screen 3 1 1 3 Case Screen The Case screen Figure 4 allows you to view all the information in a case Case contents cas are represented as buttons or thumbnail images Click on an item Tn to display it in center of screen nuan Item selected for viewing has red border O Copyright 2000 2005 Alaska Native Tribal Patient Bewell May 30 yrs F ase Iditarod Clinic C 50 Log Out Figure 4 Example of the Case screen PUB 120 Rev C doc 24 AFHCAN Software User s Manual Version 4 3 1 1 4 Send
49. ined more fully in the section on AFHCAN Networks Figure 11 illustrates the structure of a case number Mustard Nancy 3 yrs F Test Iditarod Clinic D 6 2 tt Prefix for test cases o T Site name Cart designator Case sequence number Figure 11 Structure of a case number 3 2 2 Patients and Patient Information 3 2 2 1 Real Patients and Test Patients When you create a new case the first thing you must determine is whether it will be a real case or a test case Real cases are associated with real patients and medical information Test cases are associated with test patients having fictitious names and personal information Test cases and test patients are used for training purposes Figure 12 shows the sequence 3 2 2 2 Patient Information The process of identifying the patient associated with a case always begins with a search of the names currently in the database Searching first helps to prevent duplicate entries for the same individual Ifthe patient s name is not found you can add the patient s name and information as shown in Figure 13 Ifthe patient s name is found the software allows you to review the patient s information and edit it if necessary PUB 120 Rev C doc 33 AFHCAN Software User s Manual Version 4 Start Screen What do you want to do today Create a New Case ick here if you want to create a new case eee E reate a N ew Case Cases To Review Cases You Sent Search Archives What do
50. ing the software development process Moving the mouse cursor over the version number brings up a small text box showing the build number The same applies to the software version number displayed on the login page Server name and connection status have been discussed previously The Cases in Transit indicator lets the user know how many cases recently sent by the user are still in the process of being downloaded to the server As soon as a case has been completely received by the server the Cases in Transit count will decrease by one 3 2 7 3 Right Bar Features and Variations The right bar area of the screen is used for buttons that perform major program actions or that provide screen to screen navigation capability For any given screen the set of buttons displayed in the right bar area may vary depending on where you are in a sequence For example in the Case screen when you first view a case that has been sent to a group the right bar area will include a Take Case button Once you have taken the case the Take Case button will be removed the Add To Case and Add Comment buttons will appear see Figure 31 The idea of context related variability in screen displays applies to more than just the right bar area Simplicity and ease of use are design features of the AFHCAN software By eliminating buttons and information that are inappropriate or unnecessary it is easier to understand what is on the screen and what the available options are
51. into categories as shown in the example below Test Cases Sent To You 1 Your Cases On Hold 4 Cases Sent To You 1 Cases Sent To Your Group Big Lake Clinic 3 Cases Sent To Your Group lditarod Clinic 1 Your Test Cases On Hold 1 Test Cases Sent To You 2 Note that cases sent to your groups are segregated from cases sent to you personally Note also that test cases are clearly identified 2 Press CaseList Service Amy PATIENT NAME HR l If you happen to have multiple cases displayed locate the case you just sent to yourself Test Cases Sent To You 1 View Mustard Nancy OOOH 8 15 2002 3 Press View PUB 120 Rev C doc 16 AFHCAN Software User s Manual One item which was automatically added to the Case screen is the Activity button located on the left side of the screen The Activity button displays a list of everyone who has opened or viewed the case At this point you can press the Add To Case button to go to the Add To Case screen and add information to the case as described previously 4 Press 2 3 7 Archiving a Case 2 steps A case is considered open and active until it is archived Archived cases can be opened and viewed Comments can be added to an archived case but no new forms images or other medical data can be added When all work on a case is done it should be archived Not only does this keep the database of open cases smaller but it allows other
52. ll flow image 27 Change Password 41 Comment data entry box in tutorial 10 Create a New Case button in overall flow image 26 in tutorial 5 sequence details image 34 Discard Changes button purpose and use 32 Done button in overall flow image 26 27 in tutorial 12 15 17 Edit button in tutorial 8 Email Notification 40 FGM screen in tutorial 15 Form Choices screen in tutorial 8 Forms button in tutorial 8 functional description See device functional description global provider 46 group advantages of 39 default recipient 42 defined 63 defining 39 general reference 41 42 51 in relation to sites and workstations image 45 in tutorial 14 16 local and global 46 sending a case to 32 server to server communication 46 set up by administrator 39 taking a case 31 Help button in tutorial 18 purpose and use 49 help pages in tutorial 18 Image Name 53 laptop See workstation local provider 46 Log Out button in tutorial 19 21 purpose and use 49 Login button PUB 120 Rev C doc Version 4 in tutorial 5 login name See username login screen in tutorial 5 My Settings button general reference 41 purpose and use 39 My Settings screen case return options 42 changing password 41 email notification 41 image 39 overview 40 Personal ID Information 40 network node See node network server See server New Recipient button in tutorial 14 purpose and use 32 Next button in t
53. lower case letters is recognized as part of the matching criteria With case sensitive data the word Provider would not match the word provider for example In AFHCAN software applies to passwords Community Health Aide Practitioner A medical provider usually in a rural Alaskan village who provides primary health care under remotely provided medical supervision The portion of AFHCAN software that runs on an AFHCAN Cart or PC workstation Client software provides the screen displays that allow a user to use the AFHCAN software The client software communicates with a server and depends on the server to provide information and network connections One or more general notes or remarks included in a case central processing unit In general the term CPU is often used to refer to the main electronics box of a computer system Other parts of a computer system would include the monitor keyboard mouse and attached peripheral devices In the strictest sense the CPU is the part of a computer that executes computer instructions and performs calculations A component in the AFHCAN Net software that allows information to be communicated between a workstation and a server The data service runs in the background sending and receiving information whenever the network connection 1s available The name of a provider or group that is offered by the software as a first choice when a case is sent a different recipient than the one propose
54. ls Pressing the Print button in the preview window brings up a standard Microsoft window where you can select the printer change printer settings and print the report If your Cart or PC does not have a printer connected to it contact your administrator or IT department to have one installed PUB 120 Rev C doc 60 Appendix AFHCAN Glossary The following is a general glossary of AFHCAN terms and abbreviations Net dot net administrator AFHCAN AFHCAN Cart ANMC ANTHC archive ATS ATW PUB 120 Rev C doc A software development platform developed by Microsoft that AFHCAN adopted in the development of its 2005 software upgrade An administrator is a user who has been assigned a provider role of ADMIN An administrator is a special class of user who can access the administrative functions in the AFHCAN software Each AFHCAN cart is connected to a server Each server is controlled by one or more administrators Typical administrator functions include setting up providers with user accounts establishing connections with other servers and performing other technical functions that normally take place in the background Most administrators receive special training Alaska Federal Health Care Access Network AFHCAN 1s an organizational unit within ANTHC A telemedicine device designed by AFHCAN that allows medical data and images to be collected and stored into a computer and transmitted over a network to anoth
55. mbnail UPS PUB 120 Rev C doc In the AFHCAN system a site is a name associated with one or more AFHCAN Carts or PC workstations The site name is often based on the physical location of an AFHCAN Cart Site names must be established by an administrator first and then it can be assigned to the AFHCAN Cart or PC workstation when it is installed Sites can also be set up on the basis of functional areas or responsibilities within an organization social security number This number is assigned by the Social Security Administration and is used for identifying employees who participate in the Social Security System This number is often used as a unique identifier for an individual in financial medical military and other important records A method of communicating case information that stores all the information at the local workstation while the case is being developed then sends forwards the information over a network to another workstation or local server for review at a later time At the receiving computer communications software assembles all the information before the recipient is notified that a case is available The store and forward method significantly reduces the need to wait online while information is downloaded at the receiving computer Store and forward also overcomes many connectivity problems of wide area networks and satellite communications A synonym for telemedicine The use of telecommunications equipme
56. n image is enlarged only a part of the image is visible in the main viewing area The Pan window includes a tiny red rectangle to show what part of the overall image is in view You can click on hold and drag the rectangle to bring different parts of the image into the main viewing area Red rectangle shows area of image being dispayed Picture tient Luther Kim 39 yrs F Control Iditarod Clinic C 52 jeer Sherwood Duane Click on red rectangle hold and drag to view different areas of enlarged image Fit Zoom c soro Rotate gt J g Image Width Height 1 4 1 2 1X 1 5 2X 4 rash by Duane Sherwood at Iditarod Clinic on 6 24 2005 Image enlarged to 2X exceeds viewing area Figure 35 Using the pan window Image control functions are described below Brightness Contrast Fit Zoom Reload ie r r r r r r r Rotate atin The effects of image controls are temporary The Reload button reloads the original image Brightness Contrast Brightness and Contrast of the displayed image can be adjusted using the slider controls Fit The Fit function allows the image to be resized or T so the entire image fits fully into the viewing Image Width Height area Fit entire width fit entire height or fit whole image are the options PUB 120 Rev C doc 57 AFHCAN Software User s Manual Version 4 Zoom l Ea Ea Ea 124 172 1x 1 5 26 4x The Zoom
57. nds on graphics such as the mouse pointer pictures and clickable spots on the screen to help the user understand the choices available Placing a case on hold allows a user to temporarily save and exit from the case before it is sent This is useful if required data cannot be added to the case in a single session The case can be opened completed and sent at a later time by pushing the Cases to Review button on the Start screen Providers or groups can be designated as ocal or global In the AFHCAN network one or more workstations are connected to a server Furthermore servers can communicate with other servers via a larger network system A server administrator adds to and edits the list of providers who can log into workstations connected to his or her server With regard to that server these providers are considered local to that server The administrator also establishes groups and assigns various providers to the groups as appropriate Again these groups would be considered local to that server The process of starting a piece of software and identifying yourself as an authorized user A system of communications hardware computers and specialized software that allows computers to communicate with each other A computer dedicated to helping servers communicate with each other A secret word or code associated with a given username that users enter to verify their identity Passwords are assigned by an administrator
58. ng search criteria e begin with what you know such as first letter of the patient s last name the approximate date when the case was created the first letter of the name of the person who created the case the first character of the case number e think in terms of bracketing the desired record e use the minimal amount of information necessary for obtaining a reasonable result this is a skill that improves with practice e if you know an exact item you can go directly to the desired record social security number case number 3 2 7 9 Color Information The AFHCAN software uses color to generally indicate the importance of an item e red think twice the selection may have consequences or cause inconvenience e green indicates the typical path through the software e blue an alternative to the primary path or a relatively neutral selection e amber a special feature e grey a neutral path through the software e purple used to mark a test case or a test patient Textual information is typed into data entry fields but not all BaEEEEReers 3 data entry fields are available for entering new information Username When data entry fields are unavailable they will have a slight darkening of the background On the My Settings screen detail at the right the Username is shaded The user cannot enter information into this field Only administrators can change a username r T 3 2
59. no longer in your custody You can view the case but you cannot add medical information PUB 120 Rev C doc 31 AFHCAN Software User s Manual Version 4 e Archived cases are read only with one exception you can add comments to an archived case and then re archive it 3 2 1 4 Ways to Conclude Work on a Case There are four basic ways to wrap up the work you are doing on a case e send the case to another provider or to a group e place the case on hold Archive e archive the case Discard Changes e discard the changes you made during the current session Send Sending a case 1s fairly routine You can send to an individual provider or to a group of providers If you send most of your cases to a particular individual or group you a can designate the recipient you have selected as your default recipient Ifa Recipient default recipient has been established for you then pushing the Send button selects the recipient automatically and skips the sequence of screens for selecting a recipient You can always change the recipient The buttons shown at the right perform these functions Hold Placing a case on hold allows you to temporarily suspend work on a case so you can go on to something else and complete the case later One unique feature of placing a case on hold is that you can go back and edit the forms The ability to edit a form only applies when creating a new case Once a new case has been sent to another provide
60. nt and information technology to provide clinical care to individuals at distant sites and the transmission of medical and surgical information and images needed to provide that care from Mosby s Medical Nursing amp Allied Health Dictionary Sixth Edition A test case is a case created for training or demonstration purposes It allows users to practice using the software using a fictitious patient Test cases are clearly identified throughout the software A thumbnail is a miniature thumbnail sized copy of an image that is used for identifying and selecting an image for presentation in a full size image viewer Thumbnails are used because a number of thumbnail sized images can be offered in a small area of the screen This makes the process of selecting the best images or discarding bad ones easier because it gives you an overview of what you have uninterruptible power supply A device that automatically supplies emergency power for a short time when there is a power failure A UPS contains batteries that are charged when normal power is available 65 AFHCAN Software User s Manual Version 4 user username PUB 120 Rev C doc A user is someone who uses AFHCAN telemedicine software All users are assigned a unique username and password with which to log into the software The username and password are provided by an administrator In most cases a user will be a healthcare provider In the context of AFHCAN software the
61. odheart Mable 8 15 1945 E Iditarod Clinic C 47 5 23 21 View Smart Max 42 1963 M Iditarod Clinic C 29 6 20 2005 Sh Cases Sent To Your Group lditarod Clinic 1 Your Test Cases On Hold 1 Test Cases Sent To You 2 Case Screen Comment Figure 8 Examples of the Case List screen PUB 120 Rev C doc 28 AFHCAN Software User s Manual Version 4 3 1 3 2 Search Screens There are a few situations in the software where you will encounter a search screen A search screen allows you to enter search criteria so you can narrow the search see Figure 9 Only items matching the search criteria you enter will be included in the search results Blanks are like wildcards anything will match Leave all fields blank and all the records in the database will be returned If there are many records in the database it may take several minutes for the search results to be returned A good search strategy returns a limited number of records so you can quickly zero in on and select the one you are looking for If you try to enter too many search criteria you may get a message saying No match found for these search criteria Start Screen Start What do you want to do today Create a New Case Click here if you want to create a new case Preferences on hold your cases your group cases Cases To Review Caran You Sent Click here to view cases you have sent that E Archive Search Screen Archive Search Case Log O
62. on The selected column heading is lighter than the others Screen Detail from Case List Screen Selected column Selected column heading heading PATIENT NAME HR DOB y Your Cases On Hold 6 Your Cases On Hold 6 s Bewell M 3 18 1975 View ewel May View Bewell May 3 18 1975 Bewell M 3 18 1975 l 3 View ewell May View Bewell May 71971975 View Goodheart Mable 8 15 1945 View Wilderness Jack 11 18 1972 Hunter T 12 4 1948 i View unter rapper View Luther Kim D 5 1 1966 Sorted alphabetically Sorted by in ascending order date Figure 33 Clicking on column headings to sort lists 3 2 7 8 Intelligent Search Strategies There are two general situations where users will encounter search screens e when identifying a patient e when looking for a case In time the number of records involved may be quite large especially where archived cases are concerned In AFHCAN software the rule is that blanks are like wildcard characters anything will be accepted as a match Thus if you leave all fields blank the entire list of records will be returned If many cases have been archived it can take several minutes for the computer to process the search and return the results PUB 120 Rev C doc 54 AFHCAN Software User s Manual Version 4 The goal of entering search criteria is to return a small number of records that include the one case or patient you are looking for The following are some general pointers for enteri
63. or AFHCAN Cart and server To have full functionality the AFHCAN Cart or PC workstation must be communicating with an AFHCAN Server This is referred to as working on line The connection status Working On Line or Working Off Line is indicated by the software on the Login Screen and in the top bar as shown in Figure 22 PUB 120 Rev C doc 43 AFHCAN Software User s Manual Version 4 Screen Detail Top Bar REWMCAN Client 4 5 Log Out Server Name and Connection Status Screen Detail Login Screen AFHCAN Client 45 Username Password Exit Login Figure 22 Working On Line Working Off Line connection status displays The AFHCAN software version 4 and higher is designed to retain a considerable amount of functionality even if connection with the server is lost Working Off Line The loss of functionality will be indicated by blanked out buttons on the screen as shown in Figure 23 You can still create and send a case However the case will not actually be transmitted until server connection is reestablished Once connection is reestablished the case will be sent automatically Copyright 2000 2005 Aaska Native Tribal Health Consortium g SAN Client 4 5 Patient ste gt PELL 0 Cases in Transit Log Out ase User Sherwoo d Duane What do you want to do today Create a New Case Click here if you want to create a new case Click here to view cases on your plate cases Cases To Review on hold your cas
64. or message To continue with the demonstration select a patient name demonstrate the equipment view the information this is the same procedure you would use for creating a case and at the end select Discard Changes from the Send Case screen 3 2 3 Types of Users User Roles Everyone who logs into the AFHCAN software is considered a user The software recognizes four different types or classes of users e real users e test users e setup users e administrators PUB 120 Rev C doc 37 AFHCAN Software User s Manual Version 4 When the administrator creates your account he or she assigns you a login name username and a password The administrator also assigns you to one of the above user roles When you log in the system knows what type of user you are and makes the software features appropriate to your role available 3 2 0 1 Real Users Real users are usually healthcare providers who use the AFHCAN software to develop or review actual cases Most users on a system will be assigned this role 3 2 3 2 Test Users Test users are very similar to real users with one important exception test users can only create test cases This role may be assigned to non clinical staff who are involved in training students or to clinical staff who are learning to use the software 3 2 3 3 Setup Users Setup users are usually technical staff who install and configure the software Setup users cannot access the clinical features of the sof
65. own in Figure 18 Press the My Settings button on the Start screen then enter your email address and check Yes When selected the system will generate an email whenever a new case has been sent to you or to your group s Email Notification dsherwood afhcan org want to receive email Yes notification for new cases m sent to me and my group No Figure 18 Email Notification 3 2 5 3 Change Password It is a good security practice to change your password as soon as your account has been created see Figure 19 You must type in your current password as well as the new password The new password must be entered twice to ensure a typographical error was not made Create a password that someone cannot guess Avoid using the name of family members including the dog or cat Avoid short passwords and consider including a few numbers If you forget your password your administrator can enter a new one for you System administrator creates a unique Change Password username for logging in when your l account is established IATa uca dsherwood System administrator assigns a password which you can change at any time your current password must be entered here before you can change it Enter new password twice to verify spelling Figure 19 Change Password A note to administrators email can be handled by the server or by an attached node provided one or the other has an SMTP gateway established In the administrator s s
66. patients PUB 120 Rev C doc AFHCAN Software User s Manual Version 4 3 2 2 5 Skipping Required Fields Normally if you try to leave a required field blank the software will come back with an error message saying an entry is required However there are two required fields where you can check a box allowing you to intentionally skip that field should they be unavailable for some reason These are shown in Figure 15 Check the box to tell the system this field is being skipped intentionally The social security number is unique to each patient so no duplicates are allowed Figure 15 Required fields that can be skipped The Home Phone is required as a reliable way to contact the patient The SSN is required because it is a widely used identifier unique to each individual 3 2 2 6 Skipping the Patient and Demonstrating Equipment When working on an AFHCAN Cart you may wish to teach someone how to use one of the attached medical devices but have no need to develop a case The Add To Case screen allows you to select any of the available buttons it is not necessary to begin with the Patient button When you are finished with the demonstration you can press the Back button to return to the Start screen There are a few exceptions however Some peripheral devices such as the ECG will not function unless a patient name has been established If you try to use a peripheral device that requires a patient name the system will give you an err
67. r A provider role is a class of software user that defines which features of the AFHCAN software will be available to that user All users of AFHCAN software are assigned a provider role by the administrator Each provider role has different privileges with regard to the features they can access in the software The four provider roles are as follows SETUP_USER TEST USER REAL USER ADMIN The four provider roles are listed in order of increasing privileges Most users will be classified as REAL _USERs meaning they can create real cases Users assigned the ADMIN provider role are local administrators for the server to which a Cart or workstation is connected The software recognizes which provider role a user has when the user logs in and provides access to features in the software in accordance with the privileges granted to each role In contrast to a test case a real case is one involving a real patient and real medical information A computer running AFHCAN Server Software that provides connectivity and support to one or more workstations running AFHCAN client software The server stores the important information such as patient information provider information and case information A user with a provider role of ADMIN can log in at a workstation and access a number of special functions on the server 64 AFHCAN Software User s Manual Version 4 site SSN store and forward telehealth telemedicine test case thu
68. r a completed form can be viewed but not edited Other medical information and new forms can be added however Archive When all work on a case is done and no further information will be added the case should be archived Archiving a case is the same as closing it Archived cases can be viewed comments can be added but no new medical information can be added from forms or devices Discard Changes Discarding changes applies only to any new information added to the case during the current session If you were handling an existing case during the current session the case will revert to its previous state with the exception that your activity will be logged in the Activities list for that case If you are creating a new case pushing the Discard Changes button will delete the entire case 3 2 1 5 How Cases are Numbered Every case is assigned a unique case number by the software In the Net versions of the AFHCAN software 4 3 and higher the case number is built from the following elements e the site name that was assigned to the AFHCAN Cart or PC workstation at setup e a letter that identifies which specific Cart or PC workstations within a given site originated the case a site can have a number of Carts or PC workstations e a sequence number based on the number of cases created at that Cart or PC workstation e the word Test if it is a test case PUB 120 Rev C doc 32 AFHCAN Software User s Manual Version 4 Sites are expla
69. r communication 3 2 6 6 Local and Global Providers and Groups When a user account is set up the information is stored at the server Once a user has been given a username and password he or she can log into any AFHCAN Cart or PC workstation connected to that server In similar fashion groups are set up and stored at the server All the users and all the groups established under a server are considered local to that server The idea of local and global providers applies to server to server communications All users are designated as local or global by the administrator when their user accounts are created Similarly groups are designated as local or global when they are created In brief the significance of local and global is as follows e When sending a case to a provider or group on your home server you will be able to see all the users or groups both local and global who are established on your home server e When sending a case to a provider or group on another server you will only be able so see the users or groups designated as g obal under that server PUB 120 Rev C doc 46 AFHCAN Software User s Manual Version 4 If server to server communications have been set up the first step in sending a case 1s to select the desired server Your home server will appear in the list of available servers with the words This Server see Figure 26 If you select your home server you will be provided a list of all the users and all the g
70. r is the help button Pressing the help button opens the on screen help pages All the help buttons are context sensitive which means they know what screen you are currently on and will open a help topic that applies to that screen The name of the current screen is printed on the help button At the right of the top bar is the Log Out button The Log Out button allows you to exit the software You will be given an opportunity to confirm your decision to exit the software Be aware that you can log out even 1f the data you are currently working on has not been saved In most instances where logging out will result in lost data the confirmation message will mention this Immediately to the right of the help button is an information area showing who is currently logged into the software a case number if a case is open and the patient name if one has been selected Also listed is the patient s age and gender If you need to confirm patient information clicking on the circled I will bring up a window showing the patient s data see Figure 29 PUB 120 Rev C doc 49 AFHCAN Software User s Manual Patient Info if a patient has been selected Case Number if a Case is Open PE Name of person logged into software Figure 29 Patient and user data in top bar Patient s Gender Patient s Age Patient s Name SS mnr Patient Goodheart Mable 59 yrs F ase Iditarod Clinic C47 User Sherwood Duane Last Name
71. rea 3 2 7 7 List Navigation Tools and Scroll Buttons A number of screens display lists of items cases patients etc If the list is short enough the entire list will appear on the screen If there are more items in the list than will fit on a single screen navigation buttons will be displayed as needed so you can view the additional items In similar fashion forms that are too large to view on a single screen will include scroll buttons so you can move through the form and see all the information The following are some examples of these tools and buttons Press to expand a list of items hidden under a category bar Press to collapse a list of items into their respective category bar Poa Scroll up or down a form or other list one line at a time Scroll up or down an entire page at a time or whatever part of a page remains Move down or forward in the list Move up or backwards in the list ON PUB 120 Rev C doc 53 AFHCAN Software User s Manual Version 4 Move down or forward in the list lt lt Prev Move up or backwards in the list Step backwards through a sequence of screens without making changes If items displayed in a list include column headings clicking on one of the column headings will sort the records by the information in that column see Figure 33 Clicking on a column heading a second time will sort in the opposite direction e g from A to Z or Z to A for text informati
72. receiving location the local server the receiving provider is notified that a case is available The receiving provider can then open the case at his or her convenience The AFHCAN software ensures patient confidentiality by encrypting the data The AFHCAN software ensures network security by only allowing connections to known and verified Carts workstations and servers PUB 120 Rev C doc 2 Section 2 Getting Started 2 1 A Word of Encouragement This section is a tutorial that will help new users achieve quick success in using the AFHCAN software A basic but complete sequence for using the software has been broken down into easy to follow steps These steps are numbered and in bold We encourage you to perform these steps while actually using the software However it is possible to use this tutorial even if you don t have access to a PC workstation or Cart All the information you will see on your screen is included in this document Along with the steps are brief explanations about information on the screens If the brief explanation mentions a button or feature you are welcome to try it On the other hand if you wish to get through the tutorial more quickly you can skip the explanations for now and just focus on the numbered steps It should take about 30 minutes to complete this tutorial 2 2 Interacting with the Software The AFHCAN software is designed for ease of use Most of the actions you can take in the software are
73. roups established under that server and you can select a recipient from that list Screen Detail from Send Where Screen Where do you want to send your case First select the desired Select MedNorth This Server server z Select Group Medical Practice Select Health Organization Screen Detail from Send To Whom Screen Who at MedNorth do you want to send to Groups Select Big Lake Clinic Then celaet Select Iditarod Clinic the intended Select Moose Pass Clinic recipient at that server Users Select admin afhcan Select Carr Debbie Select Clancy Isabel Clayton Issac Figure 26 Selecting servers and recipients If you select a server that is not your home server the list of groups and users provided to you will include only groups and users who have been designated as global If you want to send a case to a recipient at another server but that recipient does not show up in the list of possible recipients it is either because he or she is not currently registered as a user or has not been designated as a global provider This is primarily an administrative issue Addressing this requires the two organizations to work together in establishing a new clinical workflow PUB 120 Rev C doc 47 AFHCAN Software User s Manual 3 2 7 Standard Screen Features Version 4 This section covers features of the screens that are common to most screens 3 2 7 1 Basic Screen Layout Most screens can be divided into three main
74. rsion 4 This screen confirms that the case has been sent Your Case Has Been Sent Your Case Has Been Sent While the case is being transmitted over the network it will say 1 Case in Transit in the upper right This notice may disappear quickly if connections are fast AFACAN Client 4 5 1 Case in Transi Once you have pushed the Send button the case is no longer yours Note that the top bar is no longer purple and patient and case number are blank Patient Case User Service Amy 7 Press 2 3 6 Reviewing a Case 4 steps User Service Amy What do you want to do today After the case has been sent the software returns to the Start screen Create a New Case Click here if you want to create a new case Since you just sent yourself a case the screen displays a SIT EAER message that a case has been sent to you and is ready for your review Cases You Sent Click here to view cases you have sent that are still open not yet archived Search Archives Click here to search the archived cases Normally a provider would send you a case when he or she wants you to take an action on the case such as providing a second opinion or making a treatment recommendation 1 Press Cases To Review PUB 120 Rev C doc 15 AFHCAN Software User s Manual Version 4 CaseList User Service Amy PATIENT NAME HR If you have a number of cases to review the software will divide them
75. se cannot guess Avoid using your own name or the names of people close to you as a password If you think someone else has discovered your password change it If you forget your password contact your administrator In some organizations the administrator s duties may be handled by someone who also has clinical duties In such cases the administrator might consider having two usernames one with the role of administrator and one with the role of real user For routine work this person would log on with the real user login name PUB 120 Rev C doc 38 AFHCAN Software User s Manual Version 4 3 2 4 Groups When sending a case you can send it to an individual provider or to a group of providers The advantage of sending a case to a group of providers is that everyone in the group is notified that a case has come in and anyone in the group can take the case and respond This minimizes delays that can arise when sending a case to an individual who happens to be on vacation when the case comes in This also helps to balance the workload within a group The healthcare organizations where AFHCAN software is being used are responsible for setting up clinical workflows and working relationships between providers Once the working relationships have been established groups can be defined Typically the members of a group will all be similar in their ability to respond to the types of cases normally sent to that group The administrator would work
76. th Client PUB 120 Rev C doc AFHCAN Software User s Manual A screen similar to the one at the right will briefly appear during startup After a moment the Login screen will appear Continue with Logging In below 2 3 3 Logging In 2 steps 1 Enter your username and password Your username and password are provided by your administrator ee Username Password jialll The software version the server name and the server connection status Working On Line are shown AFHCAN Client 4 5 2 Press Login 2 3 4 Creating a New Case 23 steps Your name appears at the top as the current user Patient Case User Service Amy 1 Press Create a New Case PUB 120 Rev C doc 5 Version 4 Telehealth Network Client Please wait while the application starts Username ooo E Exit Login Log Out What do you want to do today Create a New Case Cases To Review Cases You Sent Search Archives Click here if you want to create a new case My Settings Click here to view cases on your plate cases on hold your cases your group cases Click here to view cases you have sent that are still open not yet archived Click here to search the archived cases AFHCAN Software User s Manual Version 4 2 P ress What do you want to do today Change Click here if you want to create a new case Preferences Test Case What kind of case would you like to create zlate c
77. tware but can access features of the software that apply to installation Once the software is up and running there is no need to log in as a setup user 3 2 3 4 Administrators Administrators exercise considerable control over the network servers to which Carts and PC workstations are connected Administrators can help you solve a number of problems that might arise during use of the software The administrator functions are explained in detail in a separate document The administrator has access to all the clinical functions available to a real user 3 2 3 5 Usernames Passwords and Security Administrators create usernames and passwords for users A common system for creating usernames is to use the first initial of the first name combined with some or all of the last name The username for someone named Amy Service would be aservice On the AFHCAN system all usernames must be unique This means someone named Andrew Service might need to have a username like aservice2 Middle initials could be added in or other strategies for creating usernames can be devised Only an administrator can change your username Very often the first password the administrator gives you is one that both you and the administrator can remember easily For security and patient confidentiality change your password as soon as possible and keep it secret In the interest of network security and patient confidentiality you should create a password that someone el
78. ur account is created You also have the ability to set or change your default recipient at any time when you are sending a case The second bullet above is where the Case Return Option applies When you send a case to someone it is common for that person to reply by adding comments and sending the case back to you If you leave the Case Return Option as shown in Figure 20 your name will be displayed as the recipient when that other provider goes to send the case Alternatively you can select one of the groups to which you belong to be displayed as the recipient when that provider returns the case That way anyone in the group can follow up on the case you sent when it is returned Whenever anyone sends a case the sender can always select a different recipient than the one suggested by the software When you send a case to another pro vider the selection you make here will Case Return Option show up as the default recipient when that provider goes to send the case Do you want cases that you send returned to you individually or to your group this assumes the receiving provider typically sends a case back to the sender or to the sender s group Return to the group Big Lake Clinic Return to the individual Duane Sherwood Return to the group Iditarod Clinic All the groups you have been assigned AM ad eda te to if any will be listed here contact Return to the group Moose Pass Clinic the administrator to make an
79. ut Seale Archives ss Click here to search the archived cases Archive Search Screen Patient Information Patient Last Name Search Patient First Name Patient SSN Patient Date of Birth I I iil Case Number Case Number Date Range Search From this Date Through this Date i Creator Information Creator Name Search Case List Screen Case List Screen Case Screen Figure 9 Example of a search screen PUB 120 Rev C doc 29 AFHCAN Software User s Manual Version 4 3 2 Important Background Information 3 2 1 Characteristics of a Case 3 2 1 1 What is a Case In the AFHCAN software a case is a collection of medical information associated with a patient Usually a case is developed in conjunction with an episode of patient care In other words a patient comes into a clinic seeking help with a medical problem The patient s condition is evaluated and a treatment is recommended The medical information gathered in support of this episode of care would be a case If the patient returns to the clinic at a later time seeking help with a different medical problem a new case would be developed 3 2 1 2 Types of Cases There are three types of cases in the AFHCAN software e real cases open cases involving real patients e test cases open cases involving test patients test patients use fictitious names and data test cases are for training purposes the word Test is included in
80. utorial 7 purpose and use 54 node 46 defined 63 off line See working off line on line See working on line password changing 41 defined 63 general reference 38 46 guidelines for creating 38 Password data entry box in tutorial 5 Patient Add screen image 35 Patient button general reference 37 in tutorial 6 sequence details image 34 35 Patient Confirm screen in tutorial 8 Patient Encounter Form screen in tutorial 9 Patient Search screen in tutorial 6 7 Patient Select screen image 35 in tutorial 7 PC workstation See workstation Personal ID Information 40 Picture Control screen image 56 pan window image 57 Plus Sign button in tutorial 16 sequence details image 28 29 AFHCAN Software User s Manual Print button purpose and use 58 59 60 Real Case button sequence details image 34 real patient 33 real user 38 Reload button purpose and use 57 Rotate button purpose and use 58 Save button in tutorial 9 10 scroll buttons in tutorial 9 purpose and use 53 Search Archives button in overall flow image 27 sequence details image 29 Search button in tutorial 6 7 sequence details image 29 35 search criteria data entry box in tutorial 6 Select button in tutorial 7 13 14 Send button general reference 32 in overall flow image 26 27 in tutorial 12 14 Send Case screen function 23 general reference 37 39 image 25 26 in overall sequence 26 in tutorial 17
81. vider in the illustration can log in to a Cart or workstation and send a case to another provider or group at any connected location Server Description Server A Site Name Site Name Farvillage Nearvillage Clinic in Clinic in Village A Village B Tf Traveling Department in Regional Provider Medical Facility o AA AAAA Site Name Site Name Regional TravelCare C i Individual provider user working at that location T Member of the Internal Medicine group i Member of the Cardiology group Figure 24 Hypothetical server configuration PUB 120 Rev C doc 45 AFHCAN Software User s Manual Version 4 3 2 6 5 Server to Server Communication In the AFHCAN system servers can be connected together via special computers called network nodes see Figure 25 With server to server communications users who log in under Server A can send cases to users or groups under Server B Server to server communications are set up by system administrators with assistance from AFHCAN technical support staff Once a connection pathway has been defined it is as if one server 1s communicating directly with another server Being familiar with the idea of nodes helps put server to server communications into perspective Physical network connection Connection as seen by user Connection services working behind the scenes Figure 25 Network nodes and server to serve
82. with the healthcare organization to create useful names for groups and decide who should be in groups Useful names would be based on such things as the group s specialty function or location Group names are displayed in the Send Case screens Meaningful group names make it easy for someone to send a case to the right group Administrators set up groups on their servers by entering the group name and adding individual providers as members of the group When a new user account is created the user can be assigned to a group A user can be assigned to one group many groups or no group at all When a case is sent to a group the first person who views the case does not necessarily have to take the case If a case is more suited to another practitioner it is possible to view the case and then decide not to take it If not taken the case will remain available to the group Alternatively the case can be taken and forwarded to the specific individual who should see the case 3 2 5 My Settings The Start screen includes the My Settings button in the right bar area Clicking on My Settings opens up the My Settings screen as shown in Figure 16 Copyright 2000 2005 Alaska Native Tribal Health Consortium Al Rights Reserved My Patient Settings Case User Sherwood Duane m Personal ID Information __ rChange Password __ Fist Name uane Usemame Adakene Mele i ey aIKENe PEM Sherwood es background in a a n p Save
83. y changes Figure 20 Case Return Options PUB 120 Rev C doc 42 AFHCAN Software User s Manual Version 4 3 2 6 Basics of the AFHCAN Network As mentioned in the introduction the AFHCAN software is a communications tool that allows medical information to be packaged as a case and sent to another provider over a computer network This section introduces some basic ideas and terms regarding networks that skilled users should be familiar with 3 2 6 1 AFHCAN Client Software The AFHCAN Client Software is the software that runs on an AFHCAN Cart or PC workstation A PC workstation is an ordinary PC such as a laptop or a desktop computer The AFHCAN Client software is what the user sees when creating or viewing a case 3 2 6 2 AFHCAN Server Software AFHCAN Server Software is the next level up in the network A network server is a computer that supports and coordinates network communications In the AFHCAN system the server is the primary storage area for key system data The AFHCAN Client Software and the AFHCAN Server Software work closely together to exchange information about cases patients and users 3 2 6 3 Working On Line and Working Off Line Figure 21 shows a typical but basic setup for an AFHCAN Cart and server Computer Running AFHCAN Server Software Computer Running AFHCAN Client Software Network Wiring or Connection simplified Network AFHCAN Cart server Figure 21 Typical network connections f
84. y ics aad dass nds cp alas uepauea ease excuse aes 52 3 2 7 7 List Navigation Tools and Scroll Buttons cccccceeeceeeeeeeesesseeeeeeeeeseeeees 53 D2 FS Inteligent SSAC ISU ALS OSS oh Sacre ie eater iota hee a eset ale wat ee aed hit 54 32129 Color Informati OM asi ds sadiscnan sacs a A a E AE 55 J2 AlO imma OSC Omit Ol Tool rene anaes ssa den eked eyed asain 55 A PE me Se FS nD en nn es 58 Appendix A RHC AN GLOSSARY oiera tes cesvaleicitvs touts vaceussews dohwesvadsusitvedarstevadeursevedsiess A 61 List of Illustrations Figure Title Page 1 AFHCAN Cart Version 3 with typical devices attached ecccccsscceeeeeeeeeeeeeeeeeeees 2 2 Xan ple Or CuS lA SCLC seyor ineei densa hed aansuan Guna caadean A E E A 23 2 jExampleotthe Add to Case SCreem 0s isch S 24 A iExammple Of Me C ase screen a A A ras Matuaseamecduaesneslils 24 gt Example otihe Send Case screener AAE AAEE UE TA 25 6 Simplified sequence through the Big Four when creating a CaSe ce ceceeeeeeeeeettteees 26 PUB 120 Rev C doc IV AFHCAN Software User s Manual Version 4 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 21 28 29 30 31 32 33 34 35 36 37 38 Simplified sequence through the Big Four when viewing an existing case eeeeee 27 Examples or he Case ist Sree D rei esis cen we 28 Example Of a search Scree a N E EEE E iat ie ears 29 Top bar examples for different types of CaS S ccccceeess
85. you want to do today Screen Detail What kind of case would you like to create Change Click here if you want to create a new case Preferences What kind of case would you like to create Jate cases ases Cases To Review Real Case Test Case Real Case Test Case Click here to view cases you have sent that are still open not yet archived Cases You Sent Search Archives Click here to search the archived cases Real Case Test Case Add To Case Screen real Add To Case Screen test Patient Forms Scanner Patient Forms Digital Camera Composite Composite S Video 2 Composite Composite Svideo Video 1 Video 2 Video 1 Video 2 Tympano meter Audiometer Spirometer aa Audiometer Spirometer Patient Patient List of Test Patients In System Fictitious Names List of Real Patients In System Actual People Figure 12 Creating real or test cases PUB 120 Rev C doc 34 AFHCAN Software User s Manual Add To Case Screen Adc To ci Patient Patient Composite Composite uh 2 Sevens Video 1 Video 2 Iditarod Clinic C74 Sherwood Duane Audiometer Patient Select Screen Patient Iditarod Clinic C 74 Sherwood Duane Select Bewe Select Select Select Mahle Select Soodheart Mable 000 00 0003 Select Select Select Select Select Figure 13 Process for adding a new patient PUB 120 Rev C doc Version 4 Screen Detail Searc

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