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DRSS USER MANUAL VERSION 3.11 AND ABOVE

1. Y Show patients who already have a time scheduled Delete Appts Set Appointment Boundaries Figure 28 Invite list Figure 28 shows a selection of patients that have been dragged into the invite appointments list on the left hand side of the screen These patients can now have a letter sent to them using the button See the letters and documents section of this manual As these patients consequently book fixed appointments See fixed appointment booking they will be dragged from this invite list to a fixed appointment therefore this list will get shorter as patients book themselves appointments The call and recall centre whose role it is to send out invite letters will return to this list a few weeks later and generate a reminder letter to any patients remaining in the list A third and final letter can be generated a few weeks after that to any patients who have still failed to book an appointment By clicking on the Update Due Date button twelve months can by added to the remaining patients due date thus preventing them from appearing in the due list at next Months call Page 32 of 54 Commercial in Confidence Orion Imaging Fixed Appointment Booking Booking fixed appointments is a similar process to that of open appointments however you are now dragging the patient to a set time slot in a set location This is done by selecting Fixed Schedule in the Clinic Details Clinic Type field The default when s
2. 0 seconds 16 11 2005 17 5 O seconds 16 11 2005 185 0 O seconds 16 11 2005 18 0 0 seconds p Time Remaining Grading Resource First Full Grading First Full Grading First Full Grading Complete l en p The image Library icon opens another query builder for captured Images Figure 46 however this screen will also include completed grading allowing you to retrospectively view already graded images The columns returned when performing a search include Patient ID is the NHS number or local Authority number that uniquely identifies the patient Name Includes the patient s full name Surname First name and initial Urgency If any images have been flagged as urgent then this column will be populated allowing you to grade theses images first Patient ID Mame Urgency Status O o 7043541689 Kane Richard S By First Full Grading The next unlabeled column will contain a padlock icon if this image is open by another user which will prevent you from editing the record until the other user if finished and closes the record Orion DRSS E xj Another computer is currently using these images You will only have READ permission YS IF no other workstations are currently viewing these images then please contact your system administrator ta reset the server Do you wank to continue to view the images Yes Mo Status Shows the status of the images
3. Appointments and Schedule i 7 x Schedule Screening Days Patient Appointments Bucket venue gt Bucket Resource y Search Search Clinic Appointments 13 02 2007 Search Criteria DRS5 No Name DOB Time PIN ane Postcode 003767 JACKSON TOM 08 01 1949 Hospital No Other ID 1006888 Yandamm Lucy 07 09 1952 010101 Test Test 01 01 1907 Surname Forename 010199 Davies Gregory 14 07 1947 Se r Try 1018483 Burroughs Tom 06 05 1977 ds GEBR ignore z a y yj 1020776 Potter Richard 26 12 1936 Archive Status Omit y 1024716 Faylen Julie 07 03 1932 Flag Status font HE 1027701 Finneran Carolyn 19 11 1969 1037426 Kane Catherine 15 03 1948 GP Find GP 047284 Crawford Lyne 27 08 1986 Green Meadow Hospital Find Surge 1057100 Faylen Lucy 18 01 1933 HONE p Due Ignore patients Default Location Ii fs f Use today s date Ly SR who have a future appointment after this clinic x All y Search New Search Append 211 Patients 1 selected sa Name JACKSON TOM DRSS User Manual Version 3 8 andamm Lucy Test Test Davies Gregory 3 Burroughs Tom Potter Richard 4 Faylen Julie Finneran Carolyn Kane Catherine Crawford Lyne Faylen Lucy Burroughs Clara Hadley Rod zj al ES PL ber A PA E TA Show Full Screen Update Due Date Clear Report Suspend Clinic
4. aie i Miss Lisa Matthews Right Eye 1 Correction Method Unaided s 1147076022 Right Eye 2 6 18 Correction Method Pinhole Sex Female Left Eye 1 Correction Method Unaided Date of birth Left Eye 2 6 12 Address Ethnicity Language Not Stated Reg Blind Reg Part Sighted Tel SP Religion Language wr Allergic to drops guage Wr not Stated Diabetes Type Diagnosed 2 2 2002 Figure 33 Quick Patient Information Live The green bar under the patient details is the patient status bar and reads in this case Live however if a patient has been archived the button would be red in colour and read Archived By hovering the mouse pointer over the status bar a shortcut showing the reason for the archive will be displayed This may for example read Patient Deceased which would be useful if a grader was grading the image retrospectively and the patient had since passed away Right Left Welw 4 Yiew 1 Correction Method Spectacles ma lt a E i uw mu E lx Orion Imaging This group of buttons enables you to switch between viewing the Right or Left eye and between viewing a single image or splitting the screen into 4 and viewing up to four images at one time The buttons that have been depressed will change to blue indicating that this button 1s being used Capture Capture Source Topcon a vimicro USB PE Camer Conne
5. Miss Slim 20 Long Site Lane General Hospital Mext visit fe 30 01 2007 tl xl Select Ophthalmologist uot Entered Next visit o l B El Select Finally the X button allows you to remove the current GP Diabetologist or Ophthalmologist Optometrist section Is the next section below and stores information such as who the optometrist is the last optician visit and whether the IP was measured and the result Optometrist hot Entered El Select Last Optician visit A gt IOP Measured TOP Mormal Optometrist This is where you can select the name of the Optometrist this works in the same way as the GP Details and Diabetologist fields For the Optometrists to be available in this section they must be first entered via the contacts section Last Optician Visit Is self explanatory and would be the date of the last visit to an Optician IOP Measured Is a dropdown selection listing Yes No or Don t Know options where you would enter if the IOP Intraocular Eye Pressure was measured at the last opticians visit IOP Normal again this is a dropdown selection box where if the JOP Measured field is YES you would enter the result from options of Yes No Don t Know Rechecked or Referred Allergic to drops MiTropicamide Appointment attend _ Phenylephrine Hydrochloride ees alia Cxyclopentolate Hydrochloride a id See Ophthalmology Review Screen Loc ne Default Screening Location Next due 25 06 2
6. Date fields throughout the application have a calendar dropdown as seen in figure 8 Dates can be entered long hand by using a standard dd mm yyyy format You can also click the blue dropdown field to the left of the field this will activate the dropdown calendar showing the current date To navigate the calendar click the right and left arrows in the month bar at the top of the calendar click the desired date to populate the date field and close the calendar DRSS User Manual Version 3 8 Page 9 of 54 Commercial in Confidence Orion Imaging Changing Your Password All users of the application will be issued with their own unique username and password It is important that users always use their own password to log into the application as their details will be logged against activities whilst logged in The application accounts can be set up in a number of ways from within system setup e g passwords not to expire force user to change password after a set number of days or accounts to be enabled and disabled between dates How this is done will be discussed in the system administration section of this manual However users will have the opportunity to change their own password to one that is more memorable to them Change Password Change Password a 1 x Change System Password ah Es You can change the password you use to log into the Orion DRSS software Enter your old password and new password into the boxes b
7. appointment did not take place and again the additional information is free text where you can quantify the reason for the exception Grading CURRENT Screening Details Technical Failure Fundus gradable l Additional Details Exception Additional Details a Figure 35 Grading CURRENT button opens a grading form enabling you to grade the images Only users that have grading authority will have access to this button Full details of the grading form will be discussed in the Grading section of this manual A The Lib button Abbreviation for Library opens a library of stock bench mark images that can be loaded locally via the system administrator This button can be useful when comparing your image against an image in the library Hover the mouse thumbnail to see the control tip text showing the name of the image Disc cent 4 Figure 36 Print Stock Image Library Use the print button to print the image on screen Note printed images are not gradable quality however may be useful to produce a hard copy of an image to keep in patients files or to give to patient as a souvenir DRSS User Manual Version 3 8 Page 44 of 54 Commercial in Confidence Orion Imaging Exit The Exit button will close the image capture screen A message box prompting you to save the images will appear if you have not already done so d 2 34 The recycle bin is available to discard the images befor
8. for example if a patient 1s under the care of screening service then the admin department may use this to filter out making those patients appointments because their appointments would be the responsibility of the screening service Patient under sole care of screening service Patient under sole care of screening service Patient referred to ophthalmologist From screening service Patient is currently under specialist ophthalmology care Mot known whether patient is under specialist ophthalrmoloc The above diagram shows the options available in the Under Care Of dropdown box Appointment Attendance On clicking this button an Appointment Attendance form will open figure 18 and list all the appointment history for this patient The information includes the date and time of the appointment the venue and attendance status e g DNA or attended etc This information is pulled from the information entered in the attendance field on the eye screening tab during a screening episode Appointment Attendance y x Appointment Attendance for JACKSON TOM This screen displays attendance and cancellation information about previous appointments and will also say if a previous appointment belongs to a clinic that has been suspended Future appointments are not displayed Oo Dae Steering Venue Attendance O O 19122005 09 30 00 Malpas Health Centre DHA 03 01 2006 11 42 39 Mot available Attended episode not linked to an
9. 0 Vandamm Lucy Flag Status omit r GP Find GP Surgery Find Surgery Ignore patients wno have a Future appointment after this clinic Default Location All Search New Search 4ppend 623802 Green Iris Patient RSS Now Mame Oe an Show Full Screen Show Full Screen The search half of the screen contains two tabs Search or Search Clinic The search tab enables you to search for individual patients and then drag them over to a time slot on the appointments screen If your project is sending out open appointments you should click the Search clinic tab then search for the date the letter was sent This date should be on the patients letter you can then find the patient from the list the list can be sorted in ascending order by clicking on the column header You can then drag them to the appointment time slot in the same way as the patient search Cancelling Appointments for open appointments you should drag the appointment back into the invite list so that the call amp recall staff can see that the appointment was cancelled This will prevent the patient getting missed DRSS User Manual Version 3 8 Page 35 of 54 Commercial in Confidence Orion Imaging CAPTURE Now we have booked appointments for our patients the next stage is that they attend and go through the screening process This involves some data capture such as Visual acuity eye drops administered and possibly some information ab
10. 1 Green G Plane RGB CIB Crop camma Box Enhance Annotation ling Zoom 14 Resize 100 UNDO CLEAR RESET Fit to window True Size Not urgent Ho l Save Episode Comments Add Screening Details Grading CURRENT Lib Print Exit I gt 0 1 21 4 b Figure 32 Image Capture Screen Figure 32 shows the image capture screen after it has been populated with four digital images I will first explain the components of the screen before going through the patient journey and what will happen as a patient attends the screening program Mame Matthews Lisa ID 1147076022 Resource Central Server Date 00 00 00 In the top right of the screen is some basic information about the patient sitting in front of your camera Name ID NHS Number or local authority number Resource Name of your centre and current Date Matthews Lisa If you click the button containing the patients name this will open the Quick Patient Information screen figure 33 This is a view only screen showing some basic patient demographics without the need of exiting the capture screen The screen contains such information as Name Address Visual Acuity Allergies etc see figure 33 for a full list of fields included DRSS User Manual Version 3 8 Page 40 of 54 Commercial in Confidence Quick Patient Information Patient Flags None Demographics Visual Accuity Data
11. Arrangements for referral Reporting Notes The cream area allows you to enter free text alternatively you can click the dropdown box below each field to see a list of pre selected sentences Select the appropriate sentence and click on insert DRSS User Manual Version 3 8 Page 48 of 54 Commercial in Confidence An SL Orion Imaging Current Grading 1 Background M Maculopathy Other Findings Figure 41 Summary tab Summary tab is split into two sections Current Grading which pulls thorough what you have ticked on the grading form View only Other Findings 1s free text for you to type any other findings during the examination Summary Grading Date 19 02 2007 Overall Grade M Maculopathy F Unsure of ane on more features Patient Referral and Review Override default review period Review Not For Review Override default referral period Referral Urgent Workflow Override Override normal workflow Select next workflow stage arbitration A Next Workflow Stage second Full Grading Preview Report Save Cancel Figure 42 Save Tab DRSS User Manual Version 3 8 Page 49 of 54 Commercial in Confidence Orion Imaging Save Tab allows you to overview your grading before finalising it by clicking on the save button Summary Section shows the grading date and overall grade Patient Referral and Review This is calculated dep
12. O seconds Mot set 6238027177 iGreen Iris E First Full Grading 3 16 06 2006 14 2 0 seconds Mot set 10207767653 Potter Richard P First Full Grading 11 16 06 2006 14 3 0 seconds Mok set 106 7043541689 lane Richard 5 2 First Full Grading 1 16 06 2006 14 4 J0 seconds Mot set 1025215079 Crawford Clara M First Full Grading 11 21 06 2006 14 4 O seconds Mot set Figure 45 Query Builder for Captured Images The Grade Image icon opens the Query Builder for Captured Images Figure 45 this is used to view all the images in the system awaiting grading A normal search would be to select At my level in the Image Status field and then click the button This would list all the images waiting grading at your grading level you can then click on anyone in the list to access the images as in figure 32 and start grading However this form is a query Builder and works in a similar way to the patient search form therefore if you would like to find a specific patient using the Patient ID or Surname or patients that have been captured on a specific Date of Capture or at a specific Resource then enter the appropriate criteria and click on the Perform Search button to return a list of theses patients Image Status This dropdown box includes At my level or below At my level All The recommended would be At my level if you choose At my level or below for example and you are an
13. Patient Demographics Patient ID NHS Y Last attended Next Appt Jump ta Next Appt eS Booking Ref Extra ID 2 Extra ID 3 Title First Mame Initial Oo Surname Type Correspondence Name No Sexi D O B Street Home Tel Locality work Tel Post Town POTTERSEY Mobile County E mail Postcode 3 Patent tonbants Hospital No Po thee TD fT Patient Data Diabetes Care Data Eye Screening Eye Screening Summary Patient Notes Episode Motes Ethnicity Religion t Y Language fw not Stated Interpreter Required 7 Reg Blind Ej MPAA Diabetes Type Reg Part Sighted DO Lagos JS al GP Details select Diabetologist Next visit Edd hl er Ophthalmologist Next visit i o S EE Select Optometrist uot Entered Locate Last Optician visit O TOP Measured IGF Normal Language Allergic to drops Bi Tropicamide Phenylephrine Hydrochloride H Cyclopentolate Hydrochloride Appointment Attendance See Ophthalmology Review Screen Loc No Default Screening Location Mext due _ 00 A Under care of m add Edit Archive Seb Hag Save K a og si Figure 13 Patient Demographics form Create Episode DRSS User Manual Version 3 8 Page 14 of 54 Commercial in Confidence Orion Imaging The patient demographics form shown in figure 13 can be split into three distinct section
14. application e Adding Editing Screens Patient Contacts A xXx Patient Contacts All of the patient contacts for the currently selected patient are listed below To see the details of a specific person click on their name Responsibility Status Po Relationship to Patient PC Contact Name CO Phone Home a Patient Contacts a Patient Contacts All of the patient contacts for the currently selected patient are listed below To see the details of a specific person click on their name SS Responsibility Status Relationship to Patient Contact Name Phone Work x Phone Work Phone Mobile E mail Phone Mobile x z Phone Home hhh rT eso a Figure 7 Form in view mode Figure 6 Form in edit mode When opening forms throughout DRSS the field s colour is initially white as seen in figure 7 In this mode the form is view only and before you can enter or edit data you need to click the or buttons at the foot of the form When you do this the field colour becomes cream as seen in figure 6 and often many of the fields become dropdown selection fields You can now edit the form then click the button to save your work e Date fields PR p 1 if Reg Blind Reg Part Sighted GP Details Diabetologist lalola i ou Bi Optometrist 26 7 26 a a E Today 6 12 2006 Figure Date field calendar TOP Measured
15. change depending on the status e g the status of Archived Deceased would change the bar colour to red Title First Mame Initial Surname Type Correspondence MName Mo Sex D O B Street Home Tel Locality Work Tel Post Town POTTERSBY Mobile County E mail Postcode Patient Gontacts Hospital No Other ID This section holds the main patient demographic information Name Address DOB etc This part of the screen can be viewed and feeds all patient details throughout the application Title This field is a dropdown selection field and contains most possible titles e g Mr Mrs Dr etc if additional titles need to be added to the list this can be done via the controlled vocabulary option in system admin This will be covered in the system administration section of this manual First Name This is the patient s first or Christian name Initial This field stores up to one character and is intended for a middle initial of the name it is not a mandatory field and therefore can be left blank if required Surname This field is to store the patient s surname DRSS User Manual Version 3 8 Page 15 of 54 Commercial in Confidence Orion Imaging Type This is a dropdown field containing Correspondence Home and Visiting This is to record the type of address stored Correspondence is the default option and is where any patient letters will be sent however addi
16. e g First Second Arbitration Grading or completed Resource shows which resource the images where captured at Episode Shows which episode visit the images refer to Date shows the date and time the images where captured DRSS User Manual Version 3 8 Page 53 of 54 Commercial in Confidence Orion Imaging Time Remaining shows the time remaining to grade the image if you have downloaded the images to a local machine as described in the Request Grading section Grading Resource shows which grading resource was used at the point of grading if set Grading Reports Grading Report a xj Grading Reports Patient ID Auto Grading Report Grading report new Date Captured Ignore Grading Report Grading Status Final Graded Printing Status at Printed Resource All x New Query Browse Prine Edit Add 6 records found Jones Eliza 16 11 2005 Pending Printing Unknown 112 Month Resci 3436401013 Anderson Frank 16 11 2008 Pending Printing poko Not For Review 5702356391 Mandrake Emily 16 11 2005 Pending Printing Unknown 12 Month Resci 6238027177 Green Iris hep 1 2005 Pending Printing Unknown 12 Month Resci 010101 Test Test 03 01 2006 Pending Printing Unknown 12 Month Pesci 0037674570 JACKSON TOM 23 06 2006 Pending Printing Unknown ii Month Pesci Figure 47 Grading Report Screen The Grading Reports screen allows you to view completed
17. field and is used to enter the name of the venue Clinic Start Time End Time Clinic Start Time os llo End Time 17 100 This is where you setup the default opening times of each clinic Each field is a dropdown selection box where you would first set the hours and then the minutes Appointment Length is a dropdown selection box for you to set the default appointment length in minutes This is a default length but can be changed at the time of making the appointment if necessary Patients per App defaults to 1 but should be set to the number of Optometrists Cameras you have resources for If you book patients in say blocks of 3 but only have one camera then this should still be set to 1 Lunch Start Time End Time Use Lunch Start and End Time Lunch Start Time End Time H venye ID Use Lunch Start and End Time Lunch start and end times are used to set up the default lunch breaks Non appointment times they work in the same way as the Clinic Start and End Time fields but only become active after ticking the Use Lunch Start and End Time tick box Venue ID is the second mandatory field It accepts alphanumeric data but must be unique for each clinic Screening Notes is a free text field used to enter any notes you would like to keep about the venue Screening Location Is also a free text field about the location however this field can be mail merged onto appointment letters therefor
18. will be active when in edit mode and clicking it will save any changes made will exit from edit mode without saving any changes DRSS User Manual Version 3 8 Page 21 of 54 Commercial in Confidence Orion Imaging Create Episode is clicked to create a new episode This would be a walk in appointment discussed in more detail in the Patient Appointments section ACCESSING PATIENT DETAILS Within this section we are going to look at several methods of accessing and finding patient details within the DRSS database Finding a Patient Using the NHS Number The first method we are going to look at is using the NHS number or Local y Authority Number Depending on the number your Trust is using If you have the NHS or Local Authority number Patient unique number at hand then the quickest way to access the demographics screen is to click the Patient icon Patient ID NHS Last attended 30 06 2006 14 30 Next Appt NONE Jump to Next Opp Booking Ref Extra ID 2 Extra ID 3 Patient Double click the Patient ID field this will remove any number currently in the field and the background field will change to blue Enter your patients unique ID number This would be ether a NHS or Local Authority number and press return The screen will go directly to your required patient Using the Patient Search Screen The next method we are going to look at is the Patient Search screen Very n often you do not have all the informa
19. 007 w Under care of Patient under sole care of screening service Allergic to drops This area contains a list of drops available to dilate the patient s pupils next to each is a tick box where you can record if Tropicamide i a a the patient has an allergy against any particular ityopentolste Hydrochloride type of drop If a tick is entered next to any of the drug types then the background colour will turn red to alert the user In addition to the background colour turning red a message y box will p romp t the user that the Patient A This patient is allergic to Tropicamide dilation drops has an allergy when Op me the eye Please click Yes to confirm that you have read and understood this message screening form during an episode a DRSS User Manual Version 3 8 Page 19 of 54 Commercial in Confidence Orion Imaging Screen Loc is a dropdown selection box where you can select the normal screening location The options include No Default Screening Location or any of the locations set up as screening venues See setting up clinics Next Due is a date field used to enter the date the patient is next due for screening this field is also automatically populated after grading Depending on the result of the grading the patient will be put into a workflow process to calculate the next due appointment date Under Care Of This field is used to enter the name of the department who the patient is under the care of
20. 4 02 2007 12 00 00 1147076022 Miss Matthews Lisa 14 02 2007 13 30 00 1225836204 Miss Shelby Clara H 14 02 2007 14 00 00 e KANE CHRISTINE W 14 02 2007 14 30 00 1268041041 Mr Hadley Thomas H 14 02 2007 15 00 00 Figure 30 Capture Query Screen This screen 1s essentially a search screen where you enter the criteria of the patients you are looking for this would usually be the current day s clinic In the example above I have entered the criteria to return all the patients who have an appointment at Green Meadow Hospital on 14 02 07 and then clicked the button Location This will list all the clinic locations set up in the system Date of Appt is a dropdown box where you can select On Before After or Between You use this in conjunction with the date fields to its right to enter the date of the appointment DRSS User Manual Version 3 8 Page 36 of 54 Commercial in Confidence Orion Imaging Filter This field allows you to filter out patients at a particular status of the appointment The options include Include all patients Exclude patients who have arrived Exclude patients who have been dilated or Exclude patients who have been captured Therefore a receptionist for example could filter out patients who have arrived leaving the list showing only patients still to arrive a Last updated i Status The status column shows an icon of a tick tear drop or 08 11 2006 11 13 00 v explanation mark
21. Commercial in Confidence Orion Imaging DRSS USER MANUAL VERSION 3 11 AND ABOVE PREPARED FOR All Users of DRSS Version 3 8 DATES 14 02 2008 COINS APE For further information please contact Tony Snell Applications Trainer CIS Heathcare The Studio Oldbury Road Cwmbran NP44 3JU Tel 44 01633 868811 Email tony snell cis healthcare com FILENAME VERSION DRSS User Manual 3 8 Copyright O cis healthcare 2008 Commercial in Confidence The information contained in this document is confidential and proprietary to cis healthcare It shall not be disclosed duplicated or used in whole or in part for any purpose without the prior written consent of the Company DRSS User Manual Version 3 8 Page 1 of 54 Commercial in Confidence Orion Imaging Document Information Tony Snel CIS Healthcare Attention All users of version 3 8 Date Submitted 14 February 2008 Document Revision Date Version Description Author 14 February 2008 Tony Snell 7 y Aa MA Y DRSS Manual Version 3 8 DRSS User Manual Version 3 8 Page 2 of 54 Commercial in Confidence k P Orion Imaging TABLE OF CONTENT TPK Or COMO E E E EEE 2 A E oot easel naa AN 3 A e UU E E S 4 Eor o ne On OE asia aia 5 UNES WO DR gt E E 7 Setting Up Groups amp Contacts ooooocccnncccccccconononncnnnnnnnnnnnnnononnnnnnnnnnnnnnnnanos 11 Adding amp Editing Patient DetallS ooonccnnnncnnnooccnonnnononono
22. DOO me 14 02 2007 10 46 Episode 1 of 3 14 02 2007 13 30 00 Edit Archive Set Flad Save Cancel Greate Episode Figure 31 Eye Screening Tab DRSS User Manual Version 3 8 Page 37 of 54 Commercial in Confidence Orion Imaging This is the screen that you would fill in during a screening appointment 1 Recorded VA RE 1 Recorded VA LE These fields are where you record the visual acuity of the patient They contain two fields each the first 1s a dropdown option containing all the types of aids used during the test e g spectacles pinhole etc The field to its right is another dropdown box containing all the possible results This list is locally customisable and can contain your preferred standard 2 Recorded VA RE 2 Recorded VA LE These fields work in the same way as above but are intended for recording a seconded visual acuity should a second test be carried out These fields are not mandatory First Dilation Drug is where you select the drug type and concentration to the right of this field is another dropdown box Defaults to 1 where you can enter the number of drops applied If a patient has an allergy U to any of the dilation drugs then this A This patient is allergic to Tropicamide dilation drops can be recorded on the Patient Data tab A message box will appear as Please click Yes bo confirm that you have read and understood this message you enter the eye screening tab i
23. Orion Imaging The top section of the grading form contains some basic demographic information about the patient screening date location and current grading level First grade second grade or arbitration grade Right Eye Left Eye Visual Acuity Unaided Jere ng lUnaided lero bi Pinhole 6718 Spectacles ejz Image Quality Below the Current Grading Level field the screen is split down the middle on the left is the header Right Eye everything under this refers to the right eye and similarly on the right is the header Left Eye everything under this refers to the left eye The reason that the Right Eye is on the left and so on is because when examining a patient there right eye is on your left Visual Acuity is pulled through from the VA fields on the eye screening tab Image Quality are mandatory fields and refers to the quality of the images taken The options include Good Faire or Poor If poor is selected then the tick boxes on the grading form disappear making it not possible to grade from a poor image If the Image Quality field is not populated then you will not be able to save the finished grading report Grading Notes Summary Save O No Retinopathy Mone 1 Background microaneurysms retinal haemorrhagests any exudate 2 Pre proliferative venous beading venous loop or reduplication intraretinal microvascular abnormality IRMA multiple deep round or blot haemor
24. Page 17 of 54 Commercial in Confidence Orion Imaging Diagnosed This field relates to the date the patient was diagnosed with diabetes however this is not a traditional date field and to populate this field click on the button to its right After populating the diagnosed field the years since diagnosed date is calculated and appears to the right Diagnosed EN 1004 12 years When asking patients when they were diagnosed with diabetes they may give you a date the age they were at the time or the number of years ago 1t was This button will allow you to enter information using any of these options and then will calculate back the diagnosed date and populate the diagnosed field X To use this dialog box select the radio button to the left of the date method the patient is Cc giving you for their diagnosed date This will This date I make the field to the right editable Type the Years ago date number of years ago or age of the patient en A at the time then click the Apply button Apply Cancel GP Details This is where the patient s GP is recorded however this field is not editable therefore to populate it you need to click on the button to the right This will open the Browse Contacts dialog box Type the doctor s name without the title then click on the button A list of all the contacts where the type field is GP will be listed under the surgery they work You can either double click o
25. Version 3 8 Page 7 of 54 Commercial in Confidence Orion Imaging Many of the features and techniques used are consistent throughout the application I will cover a few of them here Navigation General Navigation System menus are in the form of labelled icons down the left hand side of the screen Menus are 1n groups Menu Group Patient amp Contacts Change Password Screen Query Builder For Captured Images Image status At my level or below Query Builder For Captured Images Image status All Grading Reports Grading Reports Query Builder Photographer Import Import Screen Preceded with DRSS Importer applet Photographer Photographer System Admin System Admin System Admin System Admin System Admin System Admin System Admin System Admin System Admin Reporting Patient Mail Merge CSV Generator PAS Import Empty In order to navigate to your required screen select the menu group you require by left clicking on the pale blue title of the group figure 5 Patient and Contacts Figure 5 Title bar of menu group The group will expand and the icons within the group will become visible To open your desired screen single click the appropriate icon See the table above to confirm which icon navigates to your required screen DRSS User Manual Version 3 8 Page 8 of 54 Commercial in Confidence Common Features Orion Imaging The DRSS software contains several features that are common throughout the
26. ame DOB amp Postcode Click the button All patients fulfilling those criteria will be listed below To then open the patients demographics screen double click the desired patient from the list Clicking on the button will delete any previous search results and clear the criteria field ready for a new search The Close Query button will close the Patient query builder screen Search and Report The other Report buttons will be discussed in the Print Report reports section of this manual Hew Query Preview Report Close Query Edit Report Don t show episodes DRSS User Manual Version 3 8 Page 24 of 54 Commercial in Confidence Orion Imaging SETTING UP CLINICS Before patient screening appointments can be made the clinics need to be set up This involves two processes the first being entering all the screening venues into the application This is a one off process that would normally be done before the DRSS screening program goes live and should only need updating if a new venue opens or an existing venue is changed The second process is to set up the scheduled screening days This is an ongoing process that needs to be done several weeks in advance of the appointments The lead time length of time an appointment can be booked in advance of appointments will vary from trust to trust but would normally be around three months Screening Venues A Setting up or editing screening venues is done be clicking on the
27. appointment 22062006 09 30 00 Green Meadow Hospital DNA 23062006 13 56 51 Mot available Attended episode not linked to an appointment 30062006 14 30 78 Mot available Attended episode not linked to an appointment or 0742006 10 30 00 Lashes Clinic DNA Figure 18 See Ophthalmology Review At the time of print this screen had not been signed off therefore clicking on this would show the following message box Documentation on the Ophthalmology screen will be produced after sign off of this screen Orion DRSS Y xj T Warning This screen is For evaluation purposes only and should not be used to hold any medical data relating to live patients Please confirm that you accept this by clicking Yes below DRSS User Manual Version 3 8 Page 20 of 54 Commercial in Confidence Orion Imaging Along the bottom of the patient demographic screen is a toolbar with the following buttons Add Edit Archive Set Flag Save Cancel Create Episode KIX gt J is used to add a new record Clicking on this will change the field background colour to cream and make it editable is used to edit an existing record Again the field colour will change to cream making records editable is used to archive patients eon them from database Over time you will need to remove patients from the database through either death or moving out of the area rather than deleting them you would archive them This would have the affec
28. apters covering specific functionality of the application which should also tie in with your own job role or patient journey therefore you should be able to refer to the chapter of the manual you are interested in without prior knowledge of previous chapters This approach will involve some repetition to anyone reading the manual from cover to cover Other training materials available include face to face training with course notes exercises and presentations available on CD and an interactive computer based training aid with video clips and self evaluation quizzes which is currently undergoing development If you would like a copy of the CBT CD when it is available then please contact the CliniSys support team on 01633 486300 or email them at diabetessupport clinisys co uk DRSS User Manual Version 3 8 Page 4 of 54 Commercial in Confidence 7 Orion Imaging LOGGING ON OFF Before you can start you must locate the Orion DRSS icon Your system installer should have set you up with a desk top icon labelled Orion DRSS like the one seen in figure If you cannot see this icon you can find it in the Map iz following folder To make logging on in Figure 1 future easier create a shortcut on your desktop to do this right click and drag the icon to your desk top when you release the mouse select create shortcut here from the shortcut menu If you cannot find the icon in this location please contact your system administrator After locat
29. arbitration grader you could run the risk of grading a Patient and then not having another higher level grader who could arbitrate it Reset The Reset button clears the list allowing you to perform another search Jump to Patient Jump to Patient will open the images of the selected patient alternatively double clinking on a patient name will do the same action DRSS User Manual Version 3 8 Page 52 of 54 Commercial in Confidence Orion Imaging Image Library Imaging Query E x Query Builder for Captured Images Please select the criteria For the images which you would like to view and then click on PERFORM SEARCH to see a list of all episodes which match the selected criteria Patient ID Surname Date of Capture ptf sl Resource lan Patient GP Search For GP Image Status fan Include urgent cases only f Interesting Case Jump to Patient Reset Matched 55 Records Statys Resource Patient ID Name 2444160320 Jones Eliza E es Anderson Frank 5702356581 Mandrake Emily 74487042016 Harper Rachel 2083044819 Robbins Richard H 6653422222 Patton Susan B 16230027177 areen Iris 1268041041 Hadley Thomas H First Full Grading 2752783300 Keaton Dean E First Full Grading 11 Figure 46 Query Builder for captured Images Episode Date 16 11 2005 16 4 16 11 2005 17 4 16 11 2005 17 4 16 11 2005 17 4 16 11 2005 17 5 16 11 2005 17 5
30. be taken to different menus when logging on How the authorities are set up will be discussed in detail in the System Admin Tools chapter but for now this training will cover all aspects of the application however you may not necessarily have access to all the features discussed in this document If you feel you should have access to specific areas but don t please contact your system administrator This application is an end to end solution covering all aspects of the eye screening process This includes importing patient data call and re call of patient appointments through to screening capture and grading The chances are that you will only be involved with part of this overall process however it is important to remember that how you use the application will affect other users A key point of any I T project is that all users sing from the same song sheet use the same options and terminology in text boxes in order for all departments to see and understand the full picture of the patients journey A typical example of this would be entering patient notes there are several areas within the application where notes can be entered each for different purposes Your business process should clearly state which areas should be used for which purpose and which drop down options should be used to define which status and which fields your trust consider mandatory E g do you require patient ethnicity and how will you record DNA s DRSS User Manual
31. ccnnnnnonanonnnss 14 Accessing Patient Details ncoomooniiato icono i ZZ A cube EE T EE 25 Panem A DOMME matando 30 A 36 e UN Ay 46 AAA A Error Bookmark not defined DRSS User Manual Version 3 8 Page 3 of 54 Commercial in Confidence Orion Imaging INTRODUCTION This DRSS Diabetic Retinal Screening Solution user manual is intended for users of version 3 8 of the application This document is intended to cover all aspects of the user interface It is not a technical document and does not cover installation configuration or system requirements The document covers general user guidance and functionality of the application however no specific business processes are discussed therefore users will need to have a good understanding of their own procedures when using the application as not all topics covered in this manual will apply to all users of the application New users of the application should attend a customised training course which will concentrate on that individual s job role and the aspects of the application they will be using Customised training by a CliniSys application trainer can be organised by contacting your CliniSys project manager alternatively in house training can be given by one of your own product specialists No previous knowledge of this or any other release of the application is necessary however it is assumed that users will have basic computer keyboard and mouse skills This manual has been divided into ch
32. cial in Confidence Orion Imaging Clinic Detail Clinic Details Clinic Details Below are listed the current details for the selected clinic Change the clinic by clicking in the Clinic List below and modify and settings that you need to If any settings are not available it is likely that patients have already been assigned to this clinic Clinic List Green Meadow Hospital gt 0 sabe 16 01 2007 w Hour foo Minute foo y Clinic End date 16 01 2007 a Hour 23 Minute ss gt Active Clinic Start Date 16JD1J2007 we Y Hour loa Minute Iso Active Clinic End Date 601 207 v Hour 16 Y Minute fao Clinic Type z Schedule y Delete Cancel Aoi ia Figure 25 Clinic Details If you are happy with your default setting then you need not go any further than the previous step however you may need to change the defaults To do this double click the clinic you have just set up this will open the clinic details screen figure 24 From here you can set the clinic Start and End Date and Time This is the time the clinic is open or available from You can also set the Active Clinic Start Date this is the time between the first and last appointments Clinic Type the default is the Fixed Schedule actual appointments the other option is Open Schedule invite list Delete OK Lancel Spp Health Care Assistant None Photographer None Resource bl Reassign Current c
33. ct This capture group refers to the camera and camera software you are using The two dropdown fields would normally default to the correct camera however 1f you have several cameras in your clinic you may need to select your camera before clicking on the button You must click on the button before the camera will talk to the DRSS software When you do this the button will change to and the word Ready will appear in the top right hand of the screen You are now ready to take the pictures After taking several Normally 4 successful images click the Disconnect button before labelling and saving the images DRSS User Manual Version 3 8 Page 41 of 54 Commercial in Confidence Orion Imaging The next group of buttons are filter or manipulation buttons enabling you to view the images in different ways It 1s important to understand that you are not affecting the original image when using these buttons and you can always return to the original image by clicking on the button You can however save any changes that you make by right clicking the image and selecting Burn annotation onto image and save this will create an additional image without affecting the original image Green The Green button removes reds and blues from the image giving it a green tint This is sometimes used to get a better definition of the blood vessels against the back of the eye 5 Plane The G Plane button removes all colours giving the ima
34. d enter the criteria of the patients you would like to invite to a screening clinic In the example to the left we have entered criteria of Surgery Green Meadow Hospital Use today s Date Ignore Who have future Who have a future appointment after this clinic patients appointments after all this clinic Patient 4opointments Search Clinic Open Schedule Fo Other ID ae Forename Omit 33 m Find GP Find Surgery EE Due Search New Search Append This will return all the patients that are registered at Green Meadow Hospital that are due an appointment as at today s date and who do not have a future appointment already booked after this clinic date Page 31 of 54 Commercial in Confidence Orion Imaging After setting the criteria of the patients you would like to invite to a clinic click on the button a list will appear below in this example 211 patients If you would like to add additional patients to the list you can enter additional criteria and click the button this will add the additional patients to the end of the list You can now select and drag the desired patient list to the left hand side of the screen To select all the patients in the list click the first name in the list press and hold the shift key then scroll to the last name in the list and click All the names will be selected whilst still holding the shift key drag the names to the left hand side of the screen
35. dence Orion Imaging Grade Image Imaging Query Query Builder for Captured Images Please select the criteria For the images which you would like to view and then click on PERFORM SEARCH to see a list of all episodes which match the selected criteria Patient ID pe surname FO Date of Capture a2 Y Resource fle Patient GP FE Search For GP Image Status at my level or below Include urgent cases only f Interesting Case Perform Search Reset Matched 20 Records Jump to Patient Patient ID Name Urgency Status Resource Episode Date Time Remaining Grading Resource ep T SERED ep i ie A A K 17448704206 Harper Rachel First Full Grading 11 16 11 2005 17 4 0 seconds Mot set 12083044819 Robbins Richard H First Full Grading 11 16 11 2005 17 5 o seconds Mot set 6683422222 Patton Susan E First Full Grading ii 16 11 2005 17 5 0 seconds Mot set 1266041041 pedos Thomas H First Full Grading if 16 11 2005 18 0 o seconds Mok set 2702783388 estan Dean E First Full Grading 1 16 11 2005 18 0 O seconds Mot set 3162167264 Matthews Annie L First Full Grading 1 16 11 2005 16 0 0 seconds Mok set 3331040819 Doyle Jim E First Full Grading 1 16 11 2005 18 0 o seconds Mot set 6122077127 Lowery Lionel First Full Grading 11 16 11 2005 18 1 10 seconds Mot set 10037674870 JACKSON TOMM First Full Grading 1 03 01 2006 11 4
36. e could be used to add directional information for patients After populating the above fields click the button to save your work The button will remove a clinic from the application DRSS User Manual Version 3 8 Page 26 of 54 Commercial in Confidence Orion Imaging Scheduled Screening Days To setup scheduled screening days click on the Appointments icon found A in the Patients and Contacts group You must schedule screening days CE make appointments available before you can book patients an Appointments appointment Appointments and Schedule Schedule Screening Days Patient Appointments January 2007 X Bucket Resource X Bucket Venue X Central Server Ed Green Meadow Hospital EJ Mobile van X Hopwood Surgery x Lashes Clinic X Malpas Health Centre Clear Show only selected locations Clear Show only selected resources Schedule Figure 23 Calendar showing scheduled screening days Select All Go To Date After clicking the Appointments icon the scheduled screening day s calendar figure 23 screen will open showing the current month You can navigate the calendar by clicking the right and left green arrows at the top of the screen You can also navigate the calendar by clicking on the button at the bottom of the screen From here you can either manually enter the date or click the blue v arrow to open the calendar and select the date you re
37. e grading form Figure 39 Assessing Episode 3 of iol xj Patient Mame Lisa Matthews Date of Birth foajnaji950 Patient ID 1147076022 Screening Date MA Resource venue Green Meadow Hospital DRS5 Locality Mot found Current Grading First Full Grading Unknown i RightEye eye Visual Acuity lUnaided al fere X Unaided z fere Pinhole erie Spectacles fei 12 Image Quality Grading Motes Summary Save O No Retinopathy Mone 1 Background microaneurysms retinal haemorrhagests any exudate 2 Pre proliferative venous beading venous loop or reduplication intraretinal microvascular abnormality IRMA multiple deep round or blot haemorrhages 3 Proliferative new vessels on disc NYD new vessels elsewhere HVE pre retinal or vitreous haemorrhage pre retinal Fibrosis tractional retinal detachment M Maculopathy exudate within 1 disc diameter DO of the centre of the fovea LI circinate or group of exudates within the macula C retinal thickening within 1 DD of the centre of the fovea if stereo L available Dl any microaneurysm or haemorrhage within 1 DD of the centre of the L fovea iF YA lt 6 12 P Photocoagulation C Focalfgrid to macula C C peripheral scatter C A r 8 8 OO OOOO OOOO OO O OOOO OOOO OO O O Figure 39 Grading Form DRSS User Manual Version 3 8 Page 46 of 54 Commercial in Confidence
38. e saving If you have an image that is not suitable for grading and you wish to discard it at take another one Click and hold the thumbnail image then drag it to the recycle bin and release The image will be deleted from DRSS If the button on the thumbnail bar is active like the one to the left then this is indicating that there are images from a previous screening already in DRSS for this patient Clicking this button will open an additional thumbnail bar showing the images from the previous episode figure 37 You can then select the image you would like to view and then click the Use button this will bring the image down onto the first thumbnail bare allowing you to compare images from the previous episode against a current image Left Macular 1 Right Macular 1 Left Nasal 1 Right Nasal 1 igure 37 Viewing images from a previous episode Left Nasal 1 Close la dl Figure 38 Comparing an image from a previous episode with a current image DRSS User Manual Version 3 8 Page 45 of 54 Commercial in Confidence Orion Imaging GRADING Grading the images may be done immediately after the capture of the photographs or retrospectively depending on your business processes workload and grading authority Level If you are a grader and wish to grade the images immediately after the capture Possibly while the patient is still present the clicking on the button from within the capture screen and this will open th
39. ed to the camera The Locations and Resources are listed at the bottom of the Scheduled screening days screen figure 24 All the Locations and Resources in your trusts project will be listed at the bottom of the form however when setting up clinics you would only be interested in your own clinics therefore you can filter the list to only show your own clinics by putting a x next to your own clinics and resources then putting a tick in the Show only selected locations resources box this will filter the list to only show what you are interested in thus preventing you from making mistakes The button removes all the x s so that you can make a new selection To setup a screening day or days you first select the day or days you would like to setup You then drag left click and hold your location then drag to the required day and release the mouse You would do this with both a location and a resource y You will get a message box reading Would you like to Z Would you like to assign the resource Optoms to the location Green Meadow Hospital assign the resource selected resource to the location E A selected location Click and your selected day should then look like the day on gt the left Your scheduled screening day is now set using the default fa Green Meadow Hospital gt setting of the clinic as created when setting up the clinic Tue DRSS User Manual Version 3 8 Page 28 of 54 Commer
40. ed using the CSV importer For instructions on the importer see the CSV Importer section under the linked application section at the end of this manual This section will concentrate on adding Groups and Contacts manually Contacts Group Highlands Surgery Contact Contact Dr Mc Fadden Dr Jones Patient Mr Carter Patient Mr Ross Patient Mr Green Patient Mr Smith Patient Mr Davies Figure 10 Groups amp Contacts Structure Above 1s a typical structure of groups and contacts The group is the top of the structure and would typically be the Surgery Hospital or Clinic whilst below that would be the contacts within that group e g GP Practice Manager or Receptionist Further down would be the names of patients linked to the GPs Dialectologist or Ophthalmologist DRSS User Manual Version 3 8 Page 11 of 54 Commercial in Confidence Last Modified Grader on 15 06 2006 13 17 57 Group Details Enter data below that relates to each group that you want the DRS software to contain This usually is a hospital GP practice or surgery this can be selected using the Type dropdown You can add a new person to this Group by clicking on the Add Person button Name vision OF Hope Hospital Type MHS Hospital Mo Mame Go Street Long Site Lame t s S S C S S Locality TTT Townicity Morth Mersey County Liverpool Postcode L25 3Ex P Ph
41. elow Old Password New Password Confirm Appl Password Cancel Figure 9 Password dialog box To change your password click the Change Password icon found in the Patient 4 Contacts group The Change Password dialog box will open as seen in figure 9 Type in your old password then type your new password now type it again to confirm and click on the to save the changes As you type your new or confirmed password the characters will be represented with asterisks this is to prevent onlookers observing your password Your new password is now set and you will need this the next time you log into the system DRSS User Manual Version 3 8 Page 10 of 54 Commercial in Confidence Orion Imaging SETTING UP GROUPS amp CONTACTS Within the DRSS application is a groups and contacts section this is intended to i store contact information such as Clinics Groups and GP s Contacts you can also store user contact information such as Ophthalmologists or Photographers This information can be used like a Yellow Pages of contacts and is also used to link patients to specific GP s or surgeries Contact information can be added at any time however it would be useful to add all your surgeries and GP s before going live with the application this is so that when adding patients the GP for the patient is already in the application If you have this information in an electronic format it can be import
42. ending what tick boxes you ticked on the grading form and should not need amending providing your projects workflow process are set up correctly However each field has a corresponding Override default tick box Using this override option allows you to edit the corresponding field e g a 12 month review could be upgraded to a 6 month review It would not be recommended to downgrade a default Workflow Override Again the next workflow stage will be automatically calculated e g second grader arbitration grader etc however this can be overridden using the override tick box Next Workflow Stage calculated to show the next stage of the grading Preview Report The Preview Report button allows you to access Print or view the grading report The grading report is a hardcopy report summarising what you have found during the grading How the report looks is locally setup but would normally include a letter to the patient and a letter to the patients GP More information on how to print and preview reports will be covered in the Letters and documents section Save The Save button 1s used to finalise and save your completed grading Note This button will not be activated 1f you have not completed information for booth Right and left eye Cancel The Cancel button allows you to exit the grading form without saving your work DRSS User Manual Version 3 8 Page 50 of 54 Commercial in Confidence Orion Imaging At the beginning of thi
43. etting up the clinic The clinic will then look like that in figure 29 Appointments and Schedule CAN _ Green Iris 6238027177 Pe Asd s Figure 29 Fixed Appointment Window Components of the screen Green Meadow Hospital gt Optoms 7 The first field at the top left of the screen shows the clinic location and resource that you are viewing If you have several clinics running on the same day then you can swap between the clinics you are looking at by changing the option from this dropdown box Below the location and resource is the date of the appointment you are viewing along with the number of appointment slots You can click the right and left buttons to step forwards and backwards between the clinic days DRSS User Manual Version 3 8 Page 33 of 54 Commercial in Confidence Orion Imaging gr Al Green Iris 6238027177 Me The majority of the left hand side of the screen 1s taken up with the appointment area This comprises of a time line indicating the time of the day The time line can be changed to show different time intervals by right clicking and selecting a different scale The blue colour represents a non appointment time e g lunch The pink colour represents an appointment time and the cream area with the patients name represents an appointment pareen Iris 6238027177 Bi 3 The appointment slot its self can be moved to a differen
44. eview Screen Loc rio Default Screening Location Next due ee a hal Under care of Patient under sole care of screening service Figure 15 Patient Data Tab The bottom 1 3 of the screen contains several tabs where additional patient information can be stored The Patient Data tab contains general information such as ethnicity and religion which are becoming required NHS minimum data fields The fields on this tab will be explained in this section the other tabs on this form will be discussed later in the manual under the relevant section Ethnicity This is a dropdown field containing all the possible ethnic options Religion This is a free text field to record the patient s religion Language Is a dropdown box to select the spoken language of the patient Language Wr Is also a dropdown box to record the written language of the patient Interpreter Required Is a tick box which can be ticked if an interpreter is required Reg Blind This is a tick box which when ticked indicates that the patient is registered as blind To the right of this field is a date field to record the date the patient was registered blind Reg Part Sighted This field and the date field to its right work in the same way as the Reg Blind field above but refer to being registered partially sighted Diabetes Type Is a dropdown field where you can select the diabetes type of the patient e g Type 1 Type 2 DRSS User Manual Version 3 8
45. f the ves no patient is recorded as having an allergy to any of the drops used Batch Number Expiry Date It is now an NSC requirement that the batch number and expiry date is recorded for any dilation drugs applied These fields are intended to record this information however recording this information can be time consuming therefore after entering the batch number and expiry day for your first patient this information will stay as a default for the remainder of your session Note you will need to update these fields when you open a new box of drops After entering the dilation drugs and recording the batch 14 02 2007 10 46 number and expiry date you should now press the Save button This will place a tear drop icon on the status bar and also in the capture query screen along with recording the date and time the drops were given This is useful for photographers during busy clinics as they will be able to see how long patients have had the drops in Second Dilation Drug Batch Number Expiry Date To the right of the first Dilation Drugs field is an identical set of fields labelled Second Dilation Drugs these fields are to be used only if the first drugs were not successful and a second drug needs to be applied These fields are not mandatory in the system Attendance This field is to record the patient s attendance or not and includes options such as Patient arrived late but was seen Patient cancelled or Patient did not a
46. field is used to search on any part of the address field e g street town or county You can enter any part of the address and browse the results returned will be all patients with your criteria in their address Tel No Containing used to enter the patient s telephone number As with the Address containing field Tel No Containing will search all the patients contact numbers Home Work or Mobile Sex this field defaults to ignore therefore your search will ignore the sex of your patient however you can change the dropdown selection box to Male Female or Not Specified in order to refine your search Post Code used to enter the patients post code Date of Birth is used in conjunction with the date field to its right The DOB field defaults at on therefore your search will return any patients born on the date entered to the right However you can change the value to either Before or After By doing this you can find patients older or younger than a set date depending on the date you enter on the right DRSS User Manual Version 3 8 Page 23 of 54 Commercial in Confidence Orion Imaging Appointment Date This field and the date field to its right work in the same way as the Date of Birth fields described above its default value is ignore therefore a normal search will ignore any appointment dates however you can change the value to either on before after or between The between option makes a second date field visible and your result
47. ge monotone or gray appearance again this sometimes helps the definition of the image Rab RGB is the abbreviation for Red Green and Blue Clicking on this button brings up a slider bar next to each colour enabling you to adjust the amount of red green or blue in the image C E C B stands for Contrast Brightness this allows you to adjust the contrast or brightness of the image To adjust the contrast of the image click and slide the mouse from left to right over the image To adjust the Brightness click and slide the mouse vertically over the image Crop Crop allows you to crop the image To use this button click then drag a rectangle over the image to crop down to that size gamma Gamma automatically adjusts the middle tones of the image without affecting the blacks or whites Similar to contrast Box Enhance Box Enhance allows you to select an area of the image and view that selected area in negative colour Annotation The annotation button opens up an annotation tool box fig 34 which allows you draw and make comments on the image Note after annotating the image you should right click and select Burn HN fer annotation onto image and save in order to save your comments e ae Figure 34 DRSS User Manual Version 3 8 Page 42 of 54 Commercial in Confidence zoom 24 The zoom button allows you to zoom in and out of the image in 25 increments A left mouse click w
48. grading at various printing status then produce a number of reports From this screen Figure 47 the person who s job it is to print the grading reports can enter criteria to list completed grading where the Grading Status is pending By then selecting Auto Grading Report and clicking Print the appropriate report will be printed according the outcome of the grading Depending on the letter template your Trust requested a normal report would produce to letters one for the GP and another addresses to the patient DRSS User Manual Version 3 8 Page 54 of 54
49. il Figure 14 Patient contacts form Sex is a drop down field containing Male Female and Not Specified D O B Is a date field used to store the date of birth The date can be entered using the dd mm yyyy format or by using the calendar tool Home Tel One of several telephone numbers that can be stored for each patient DRSS User Manual Version 3 8 Page 16 of 54 Commercial in Confidence Orion Imaging Work Tel The patient s work telephone number Mobile The patient s mobile telephone number E mail This field is to store the patients e mail address Hospital No This is where the patient s hospital number would be stored Other ID This field can be used to store any other IDs you may wish to store for the patient Patient Data Diabetes Care Data Eye Screening Eye Screening Summary Patient Motes Episode Notes Ethnicity Religion A AA al Language nio Stated Language Wir Mot Stated Interpreter Required E Reg Blind E Diabetes Type Reg Part Sighted Diagnosed ff Choose GP Details not Entered El Select Diabetologist not Entered Next visit 1 Select Ophthalmologist hot Entered Next visit To ea Select Optometrist hot Entered Locate Last Optician Visit IOP Measured TOP Normal Allergic to drops Bi Tropicamide A HOCIREICRR GEOR ance Phenylephrine Hydrochloride PR Eyclopentolate Hydrochloride eae See Ophthalmology R
50. ill zoom in and a right mouse click will zoom out Orion Imaging Resize 100 Resize 100 will increase the size of the image by 100 this will make the image very large and could distort the image if use too much True size may be a better option UNDO Undo will undo the last action taken one step backwards CLEAR Clear will clear the image from the viewing screen so that you can replace 1t with another image RESET Reset will remove any filters effects that you have added to the image and return it to its original state Fit Eo Window Fit to Window will resize the image so that it will fit within the viewing area True Size True Size will size the image to its original size Possibly 2 mega pixels depending on your camera this as the effect of zooming in as fare as you can without distortion At this size you will not see the full image on your screen therefore you will need to drag 1t around the screen to focus in on the area you are interested in To do this click and hold the mouse The curser will look like a grasping hand then move the image around the screen ho urgent 7 EE This drop down box allows you to mark a set of images as Urgent Urgent Interesting Case or Routine The default option is Not Interesting case urgent and can be changed to any of the other options to bring Routine attention to the set of images Save Episode Save Episode is used to save the images to DRSS before click
51. ing the Orion DRSS icon double click to open the logon screen fig 2 From here you can see the version and release number of your copy of Orion DRSS This manual refers to version 3 8 If your copy is prior to this then please contact your system administrator and request an upgrade You now have just 3 fields to fill in before you can access the application This information should have been issued to you by your system administrator Orion DRSS Orion DRSS Database v ggg LOGON Figure 2 Log on screen DRSS User Manual Version 3 8 Page 5 of 54 Commercial in Confidence Orion Imaging You are now ready to enter your Username Note this is not case sensitive Now enter your Password Note this is case sensitive therefore must be typed exactly as issued to you If you type either your Your user account was not recognised by the system Please check your username and password and try again Figure 3 Username or Password incorrectly this will result in the appearance of the message box shown in figure 3 You can have up to three attempts to logon before the application will reject your attempts and close the logon screen If this happens repeatedly please contact your system administrator and request your password be reset If your password is difficult to remember you will have the opportunity to change your own password once logged on To see how to change your own password refe
52. ing this button images can be dragged to the bin without saving You will be prompted to save 1f you attempt to close the image window without saving Notes MR CLARENCE E ANDERSON 0753075415 Comments Comments allows you to add comments about the images click the add button and then add your comments The date and time the comment along with who made the comment will automatically be added to the note coe me DRSS User Manual Version 3 8 Page 43 of 54 Commercial in Confidence aaa Orion Imaging This Add button allows the user in import external images against the current episode Clicking on the Add button will open a standard windows image import dialog box from hear navigate to the image you which to import and then click on the Save button The image will then appear as a thumbnail in the same way as if you had just taken the picture with the camera Screening Details Clicking on this Screening Details button opens the Screening Details dialog box Fig 35 this screen brings reflects the same information shown on the Eye Screening tab This information can be entered either here or from the eye screening tab depending on you job role and the most convenient for your self Technical Failure would be changed to Fundus Unreadable if the images are not suitable for grading the Additional Details text box allows you to add free text details Exceptions is a dropdown box of reasons why the
53. ions include Passed driving standard detect test Failed driving standard detect test Eye Test Normally used by optometrists to record that an eye test was given or recommended Options include Full eye test recommended Full eye test not recommended Full eye test carried out Concurrent Examination is used to record the type of concurrent examination If one took place if for example the original examination method was not possible Options include No concurrent Examination Direct ophthalmoscopy Indirect ophthalmoscopy Slit lamp biomicroscopy Patient Capture Issues is used to record if it was not possible to take a photograph The default is Fundus Gradable however if a photograph is not possible this can be changed to Fundus Upgradeable Unclassified This would result in a B being entered on the status bar and the patient would go into a work flow of having an appointment made to attend a Slit lamp biomicroscopy clinic Images Capture After all the relevant fields have been populated you are now ready to take the photographs Click on the Image Capture button DRSS User Manual Version 3 8 Page 39 of 54 Commercial in Confidence Orion Imaging Image Capture Episode Number 0 W x Name Matthews Lisa ID 1147076022 Resource Central Server Date 00 00 00 Right Left Yiew 4 View 1 Capture Capture Source Topcon w HTAC oO ISR pce VIMICRO USB PC Camel Connect
54. linic days Below are listed all of the available days within the selected clinic IF you wish to remove a day From the clinic untick it From the list below and then apply the changes by using the Apply button above Fri 19 Jan 007 Sak 20 Jan 2007 Sun 21 Jan 007 Mon 2 Jan 007 w Tue 3 Jan 007 w vd Jan z 007 Figure 26 Clinic Details Expanded screen DRSS User Manual Version 3 8 Page 29 of 54 Commercial in Confidence Orion Imaging By clicking on the green dropdown button seen to the left the Clinic Details screen will expand revealing additional information See Figure 26 From here you can enter Health Care Assistant this could be a receptionist or nurse on duty in the clinic however for the names to be available in the dropdown they should have been previously set up as a contact with relevant job title and type Photographer again the photographer on duty in the clinic can be selected providing they have previously been set up in the contacts section Resource field is dimmed out because the resource was assigned when the clinic was set up Current Clinic Days If a few or full Month of clinic days have been set up at the same time then each day will be listed in this section with a tick next to it If you would like to cancel any of the scheduled days then you can un tick the required day This would be useful quicker if for example you screen every day except Tuesdays Set up the f
55. ocal Authority number depending on what your trust uses Archived By default this field is populated with Omit therefore your search will only include current Not Archived patients This is a dropdown selection field with other options of Include or Only Include will incorporate archived as well as current patients where as Only will only return archived patients This field can be used in conjunction with the field to its left Explained in the next paragraph Archive Reason This field is unlabeled but sits to the right of the Archived field It is a dropdown selection field that contains all the reasons a patient can be archived and is used in conjunction with the Archived field You can for example filter your results to only return patients that have been archived because they have Moved out of the area or who are deceased Hospital Number used to find patients by their hospital number Other ID used to find patients by the value stored in the Other ID field on the patient demographics screen Surname This field is used to field patients by surname This as with all fields will use a Starts with criteria E g if you are not sure of a spelling you can enter the first few letters and the results will show all the surnames that start with the letters you entered Forename can be used to enter the full forename or just an initial when used in conjunction with surname Address Containing This
56. one 0123 9876 ooo Fax Jo123 9875 Locality INothPCT Ref Arr PN E mail visionHope NPCTnhs couk O GP Code 236548875 Motes Test Location For training Venues Retina Rooms Orion Imaging Lashes Clinic gt Conbacts within this group Below are listed all of the Person contacts which are linked to this Group Double click on one bo view ik Dr Chris Lens GP Mrs I Boz Grader Cr Tom Glazier Ophthalmologist Mr I Pupil Ophthalmologist Save Cancel Delete Add Person Figure 11 Group Details Form Above 1s the Group Details form in edit mode accessed by clicking on the contacts button The cream fields in the top 2 3 of the form are the group details including name address and contact details the bottom 1 3 of the form show contacts within the group these are added by clicking on the button after saving the details Free Text Fas Free Text Group fax umber a to separate areas e g North PCT South DRSS User Manual Version 3 8 Page 12 of 54 Commercial in Confidence Orion Imaging Ref Arth Referral Authority e g GP to arrange referral Group Email Address GP Code Mandatory field to store practice code Notes Free text memo field use to keep notes about group Venues list Used to list screening venues within this group Add to this list by selecting from dropdown box below and clicking on the button Drop Down List of all venues that can be added to the Venues list above New venue
57. out their diabetes We will then go on to capture the eye image via the camera and then proceed to grade the image G The first job of the day would be to get up a list of the appointments for the days clinic to do this click on the CAPTURE icon Left from the CAPTURE photographer menu group This will open the capture query screen Figure 30 Capture Query aa a xj Capture Query To find appointments that have been set up for capture sessions use the search criteria below ou can then select the appointment that vou wish to capture images For From the resulting list and double click on it to proceed to the patient information screen An exclamation mark in the status column indicates that the patient has arrived a tear drop indicates that they have been dilated and a tick mark indicates that they have been captured i Location Green Meadow Hospital Resource optoms Date of Appt Jon 14 02 2007 Y and 13 02 2007 Patient ID Filter Include all patients Surname 11 records found Patient ID Marne Appointment Date Time Last updated Status Flag 10207767653 Mr Potter Richard F 4 02 2007 09 30 00 6238027177 Mrs Green Iris C 14 02 2007 09 30 00 0247162132 Miss Faylen Julie F 14 02 2007 10 00 00 0277018227 Miss Finneran Carolyn Y 14 02 2007 10 30 00 678274851 Miss Burroughs Clara Y 14 02 2007 11 00 00 0753075415 MR ANDERSON CLARENCE E 14 02 2007 11 30 00 1008205427 Mr Keaton Thomas 1
58. ow Remove Appomntment Break Add new appointment break 7 Stark time foo foo End time foo yoo 4dd Appointment Break Start times 09 30 End time fis 7 30 Save Start End Times Appointment start and end times DRSS User Manual Version 3 8 Page 34 of 54 Commercial in Confidence Orion Imaging Clear The clear button will remove any search results ready for a new search Report The report button opens the report dialog box to enable you to send letter print reports This will be discussed in more detail in the letters and documents section of this manual Suspend Clinic On clicking the Suspend Clinic button all the scheduled appointments will be removed from the clinic view the button will then change to Restore Clinic You can then navigate to a different day and restore the appointments to the new day Search Search Clinic Search Search Clinic Search Criteria oai io _ _ uu 5 y Patient ID e Clinics _ ____ Location fan Search Hospital Ho Other ID Resource fan Clear ia jareen Forename ri Date fon m 13 02 2007 wilisio2s2007 y 13 02 2007 to 13 02 2007 Bucket Venue gt Bucket Resource Archive Status omit r Appointments DRSS No Test Test Faylen Julie Kane Catherine JACKSON TOM Davies Gregory Burroughs Tom Potter Richard Faylen Lucy Finneran Carolyn Crawford Lyne
59. quire Click and the screen a a will go to the date you require Today 31 1 2007 DRSS User Manual Version 3 8 Page 27 of 54 Commercial in Confidence Orion Imaging Types of Clinic Before we look at setting clinics up it is important to understand the two different types of clinics that we can create in DRSS Fixed schedule is the default clinic type and is used to refer to actual screening clinics where patients are going to book fixed time appointments Open schedule clinics refer to an area where a list of patients who are due an appointment can be stored These lists are then used to send out invitation letters open appointment As patients subsequently book themselves fixed appointments they are removed from the open appointment list and into a fixed appointment this will be covered in more detail in the appointments section Setting the scheduled day days e 2 O o a x Bucket Resource x Bucket Venue x Central Server EJ Green Meadow Hospital Ea Mobile vani x Hopwood Surgery x Opkoms X Lashes Clinic X Malpas Health Centre Clear Show only selected locations Select All Go To Date Clear Show only selected resources Schedule Figure 24 Locations and Resources list To setup a screening day you need two items in place the location This 1s a list of screening venues setup in previous chapter and a resource this is the camera or technically the laptop or PC connect
60. r click on the button to close the form and populate the GP Details field back on to the patient demographics screen Browse Contacts xX Search Search Text Shaw Search Results lt lt List GF Contacts gt E e Hopton Surgery 12 Hopton Grove anar Shaw a aos Hulton Health Centre 20 22 High Street aed My Clinic F ision OF Hone Hospital 20 Lona Site Lane Figure 16 Brows Contacts When the patient demographics form 1s not in edit mode the button Discussed Hopton Surgery General Practice above reads Locate Clicking on this button will open the GP form Figure 17 showing details of 12 Hopton Grove that patients registered GP Pottersby Figure 17 DRSS User Manual Version 3 8 Page 18 of 54 Commercial in Confidence Orion Imaging Diabetologist Ophthalmologist Both the Diabetologist and the Ophthalmologist fields work in the same way as the GP fields explained above except when searching in the Browse contacts form it will only return the relevant type Diabetologist or Ophthalmologist as selected in the type field when creating the contact Next to this field is an unlabeled dropdown field allowing you to select where the specialist is based e g General Hospital GP clinic etc Next Visit Is a tick box which enables the date field to its right here you can record the next due date against the relevant specialist GP Details pr 4 Shaw 12 Hopton Grove E Select Diabetologist
61. r to the Changing Your Password section Finally you should select the Database you would like to access The default database will normally be the correct option but can be changed if you have access to several databases you will be informed if you do have access to more than one database Now click on the button to access the application Your screen should now look similar to the one in Figure 4 Orion DRSS Logged on as ADMIN Unknown User Authority to Orion DRSS Database lex a Patient A Batch Add Patients F Find PATIENTS N GP Patient Updates Contacts A Screening venues F Find CONTACTS Appointments Change Password Note Your access rights will determine which group of icons you have on display by default You can change the group shown on the left by clicking on the group header DRSS User Manual Version 3 8 Page 6 of 54 Commercial in Confidence Orion Imaging Logging off Now that you are logged into Orion DRSS you can choose several ways to log off again Note it is important to save any work you are doing before you exit the application ioj x Orion DRSS is a windows based program therefore you can use the standard Figure 4 Maximise Minimise Restore and Close buttons located at the top right hand side of each window see Fig 4 Using the Al close button within a window will close just that window and using the close button of the application will close the enti
62. re application As well as the standard windows close button Orion DRSS has its own built in Log Off icon This can be seen as the bottom icon in the Patient and Contacts group Use this icon when ever you need to switch users Clicking on this icon will return you to the logon screen Fig 2 you can then either enter another user name and password to allow another user instance change the database you are looking at by selecting another database from the database dropdown box or exit the application all together by then clicking on the windows close button Fig 4 Log OFF OVERVIEW OF DRSS Now that you can successfully log in and out of the Orion DRSS application let me give you an overview of the application before we get too involved with any specifics As we have seen already the Orion DRSS application is Windows based therefore you will find that there are very often several ways of achieving the same goal This manual with show and explain a good methodology for each process however you may well find your own way of achieving the same goal e g right clicking the mouse will often reveal a shortcut menu Many individuals would be involved within a normal eye screening service each with their own jobs and responsibilities The Orion software reflects this by including a comprehensive level of user authority profiles This in affect means that each user potentially could have access permissions to different parts of the application or
63. rhages OOOO OO O OOOO OO O Grading Tab is an electronic version of your grading form This form contains all the possible scenarios needed for diabetic screening The form can be locally customised therefore your form may not look exactly the same as the screen shot above To the right of the form is a scroll bar allowing you to scroll down the form revelling more tick options To use the form simply click to tick the relevant issue Note the right side of the form refers to the left eye and visa versa as discussed above DRSS User Manual Version 3 8 Page 47 of 54 Commercial in Confidence Orion Imaging Grading Motes Summary Save Grading Notes Suggest optometric referral For refraction Po suggest optometric referral For refraction Insert Suggest optometric referral For refraction Suggest review of lipid status Suggest review of Blood Pressure Fair image quality occasional grading errors may occur Poor image quality significant grading errors may occur Early Maculopathy not requiring referral 12 months rescree Early Preproliferative changes not requiring referral 12 mor Grade indicates need for 12 month rescreen hd Insert Arrangements for referral Reporting Notes El AS E Po H Insert El AS Insert Figure 40 Notes Tab Notes Tab is split into four areas allowing you to enter notes for each of the following sections Grading Notes Reason for referral
64. s fields above the green status bar between the status bar and the patient tabs and below the bottom blue status bar We will look at each section in turn Patient 1D us Last attended Next Appt Jump ta Nest Appt Booking Ref Extra ID 2 Extra ID 3 PATIENT STATUS Patient ID This is a mandatory field and would normally be the patients NHS number however some projects may choose to use their own local authority number In either case it must be a unique number and the number type should be selected in the dropdown box to the left If a NHS number is entered validation prevents non valid numbers being entered Last attended This field is automatically updated with the last appointment date that was attended Next Appt Again this field will be automatically updated with the date of the next made appointment When this field is populated the Jump to next Appt button will become active clicking on it will jump to the appointment screen on the date of the appointment Extra ID 1 2 3 These fields can be utilised to store any additional references numbers your project would like to store The labels on these fields can be customised to your liking How to do this is covered in the system administration section of this manual PATIENT STATUS This status bar is automatically updated with the current patient status This includes things like appointment due archive status etc The colour of this status bar will also
65. s are added to this drop down via the screening venues icon See the Screening Venues section on how to do this Edit Delete Add person The and buttons at the bottom of the Group details form enable you to add a new group or edit an existing record on clicking these buttons the labels will change to and enables you to delete a record The blue right and left buttons are used to step back and forth between existing groups The Add Person button 1s used to go on to add contacts that work within this group Clicking on this button will open the Person Details form see figure 12 Last Modified Admin on 06 12 2006 13 19 38 _ xj This form works in the same way as the Person Details groups form and is used to add personal Enter data below that relates to a person that you want the DRSS software to details of contacts that work within the contain This is usually a GP Ophthalmologist or Diabetologist this can be selected using the Type dropdown The person is linked to whichever Group group Most fields are self expl an atory the that you have currently selected Title Dr mua Type drop down is used to state what Forename type of contact this is e g GP Sumame Photographer Grader etc It is important e ervice User Esa p that this field is completed correctly to No Name 20 enable GPs Diabetologists etc to be linked a EEE and found when linking to patients on the Locali
66. s section I mentioned that you can either grade an image immediately after taking the image or retrospectively You may be a secondary or arbitration grader and need to access any images that need to be graded at your level The following few paragraphs will explain some of the tools used to access images in the system awaiting grading or just access the images Request Grading a Grade Images e Triage Library ro Grading Reports Figure 43 Grading Menu Request Grading Remote Grading Request x Remote Grading Request Number of gradings to request i Request Status Your request for 1 episode to grade has been generated and added to the queue for sending ta the server Figure 44 Remote Grading Request Form If you are a grader but do not have direct access to the central server database e g you could be a privet optometrist or you may do some grading from home you can use the Request Grading icon to open the Remote Grading Request form Figure 44 This allows you enter a number of grading that you would like to download to your local PC You can then grade them and the results will automatically be uploaded back to the central PC after completion or the images will automatically return after a set period Normally 3 days if not graded Note This facility will only be available with certain topologies How your network is setup DRSS User Manual Version 3 8 Page 51 of 54 Commercial in Confi
67. s will return any patients with an appointment between the date entered in the first date field and the second GP used to find patients registered with a particular GP however you do not type directly into this field instead you click the Search for GP button to its left Browse Contacts xi search Search Text flens Search Results lt lt List OF Contacts gt gt vision OF Hope Hospital 20 Long Site Lane Elias Lens Chris Figure 21 Browse Contacts This will open the browse contacts screen figure 21 you can then type the name of the GP and click the button All the GP s in your contacts list with that name will be listed Double click or click the button to pull through the contact information into the GP field Surgery is used in the same way as the GP field by clicking on the Search for Surgery button again this will open the browse Contacts screen figure 21 however this time will only return surgeries previously entered via groups under the contacts icon Resource Name is used to find patients who have been screened at a particular resource Clinic The dropdown list includes all the resources set up via the Screening Venues icon Flagged is used to find patients that have been flagged e g someone who needs wheelchair access By default the value is ignore and therefore will ignore any flags unless selected After entering a selection on criteria fields a typical search would be Surn
68. showing the current status of the 0811 2006 11 13 00 a appointment 08 1 2006 11 14 00 Tick Treatment completed Tear Drop Dilation drugs applied Explanation Arrived but not yet dropped Mark Resource This is a list of all the resources PC s attached to cameras set up in the system Patient ID is the NHS or Local ID number to uniquely identify the patients Surname is the surname of the patient Now we have a list of expected patients we can double click anywhere on the patients line to open the patient s demographics screen and go directly to the screening tab figure 31 ready to start the screening process Data Capture Patient Data Diabetes Care Data Eye Screening Eye Screening Summary Patient Notes Episode Notes ist Recorded YA RE Unaided ere ist Recorded vA LE Unaided w fere y 2nd Recorded VA RE Spectacles les ens 2nd Recorded YA LE spectacles Bl fe 12 First Dilation Drug Tropicamide 1 i Second Dilation Drug bi if Batch MNumber Expiry 5683195 31 03 2007 ee Batch Number Expiry EER v Attendance Arrived late but was seen Driving Visual Field Failed driving standards field detect test Consent Consent given for screening Eve Test Full eye test recommended Examination Method jRetinal Y Concurrent Examination No concurrent eo hi Appointment issue Patient capture issue Fundus Fundus gradabe EEO DOO me
69. spital Find Surgery Surgery use today s date E CAN TA y CAN J Who have a future appointment after this clinic Due Ignore patients Default Location Search New Search Append 211 Patients DRSS No Name JACKSON TOM Wandarnmn Lucy Test Test Davies Gregory Burroughs Tom Potter Richard Faylen Julie Finneran Carolyn Kane Catherine Crawford Lyne Faylen Lucy Burroughs Clara Hadley Rod z I Tn E IV Show patients who already have a time scheduled Delete Appts Show Full Screen Clear Report Restore Clinic Update Due Date Set Appointnent Boundaries Figure 27 Patient Appointments Tab After setting up an open appointment clinic See clinic details above click on the Patient Appointments tab Figure 27 This screen is split into two halves the left hand side is where the list of patients that have been invited to attend a clinic will be stored The right hand side Search Search Criteria Patient ID Hospital No Surname Date of Birth Archive Status Flag Status GP Surgery Due Ignore patients Default Location 211 Patients DRS No bt Joos7e 2 lon 6sss Bamio 4 Jo10199 5 018483 DRSS User Manual Version 3 8 Postcode JACKSON TOM Yandamm Lucy Test Test Davies Gregory Burroughs Tom is split into three tabs Search is the tab where you woul
70. t of removing the patient details but without losing any episode statistics When searching for patients you can choose to include archive patients thus bringing them back into play Archive Setup Please select the reason For Archive Deceased Active Ophthalmology care Moved out of area Medically unfit For screening DNA x Z PE requested NFA Registered Blind Partially Sighted Spook returned From Royal Mail Patient denies he she is diabetic Ophthalmology Referral Oph Disch Recall pending DAA x 1 de edo ds rere Figure 19 shows the Archive dialog box On ee clicking the Archive button this screen would open you would then select the reason you have chosen to archive the patient together with a date and then click the Select Archive button If a patient was archived e g for the reason of moving out of area and then moves back you can un archive them without losing any historical data Date of archive 31 01 2007 Figure 19 Set Flag this button is used to flag patients e g patients who need wheelchair access The reasons can be customised by individual Set Patient Flag Trusts To set a flag click the Set Flag Select the Flag you would like to apply to this patient button and then click the correct radio button and then finally click on the Save button When searching for patients you can filter by flag Delete Flag Wheelchair user Save Cancel button
71. t time by hovering the mouse pointer over the blue border on the left until it changes to a cross arrow See image above and then dragging the appointment up or down the screen into a new time slot The appointment length can also be changed in a similar way by hovering over the bottom border then dragging the appointment slot larger or smaller Delete Appts The Delete Appts button at the foot of the screen will remove any appointments scheduled in for that day therefore this should only be used if you intend to cancel an entire day s clinic Confirm Episode Deletion OS On choosing this option you will be prompted to provide a reason for the deletion by Provider or by Patient By provider reason hot specified This information will be recorded for the benefit of the annual report 30 Minute Intervals Av 15 Minute Intervals 10 Minute Intervals 5 Minute Intervals Please confirm that you wish to delete all episodes By Patient reason not specified Set Appointment Boundaries Set appointment Boundaries allows you to set additional non appointment times E g set some administration time MEA xi Selecting this option will open the gt ei appointment Boundaries dialog box seen BEBE ESE EETA SEU here on the left From this screen enter the Current appointment breaks times you would like to add a break then click the Add Appointment Break button this will place a blue Non appointment across the schedule wind
72. tion about a patient you would like BES The patient search screen enables you to enter whatever criteria you have Click the Find PATIENT icon and the Patient Search screen will open Patient Query Builder Patient Search Search Criteria 2 Enter the details of the patient or patients you want to search For in the boxes below Patient ID Archived omit Hospital Number fF Other ID A Surname Forename Address containing Tel No containing Sex Ignore Postcode Date of Birth Jon Pa Require Interpreter Appointment Date Ignore a v aF Search for GP Surgery Search for Surgery Resource Name Flagged Ignore Figure 20 Search Criteria fields DRSS User Manual Version 3 8 Page 22 of 54 Commercial in Confidence Orion Imaging Figure 20 shows all the fields available when entering the criteria of patients you are looking for Ideal criteria to enter would be the patient s first name surname DOB and post code however you can enter any combination of criteria shown in figure 20 As a general rule Less is More e g if you were just to enter Smith in the Surname field then your patient would be among 100 s of other Smiths The more information you enter the fewer results you will get however the more likely it is that you could make a mistake and miss the result you are looking for Patient ID This field is for the NHS number or L
73. tional addresses can be stored by changing the drop down to another type and adding the additional information Name No This is the property name or number that you are recording Street The street name of the address you are recording Locality Locality part of the address e g village Post Town Town part of the address County County part of the address Post Code Post code part of the address Patient Contacts This button enables you to add contact information for the patient e g partner parent or carer This could be useful if you need to contact a partner if a patient is unable to drive after a screening Clicking this button will open the patient contacts form as seen in figure 14 This works in the same way as all the forms within the application to add a new patient contact click the Add button The Responsibility Status contains options such as legal guardian or parent carer Relationship to Patient contains options such as parent spouse sibling etc Patient Contacts Y xj Patient Contacts All of the patient contacts for the currently selected patient are listed below To see the details of a specific person click on their name Responsibility Status o Relationship to Patient rr Contact Mame Phone Horie Phone Work Phone Mobile The white area at the top of the form will list all the contacts on record click the name to make it the active record E ma
74. ttend The options in this dropdown box are locally customisable Note at the end of a day s clinic any patients that did not attend should be recoded as such using this field Consent Again it is a NSC requirement that you record that the patient has given consent for their screening program therefore this field is mandatory Failure to populate this field will result in you not having access to the capture screen Options include Consent given for eye screening and Consent given for eye screening and research DRSS User Manual Version 3 8 Page 38 of 54 Commercial in Confidence Orion Imaging Examination Method is used to record the type of examination intended and would usually be Retinal Photography but other options include Retinal photography Direct ophthalmoscopy Indirect ophthalmoscopy Slit lamp biomicroscopy Scanning laser Appointment Issues Is used if there is an issue with the appointment this could be a problem with the equipment or that you cannot take a picture due to an issue with the patient A free text box below this field allows you to type up a fuller description of the problem Options include Equipment functional but patient could not be screened Equipment failure Operator error Administrative reasons Medical contraindication Other exception Driving Visual Fields is used to record that you have informed the patient that they will not be fit to drive after having the drops administered Opt
75. ty townjcty onmes patient demographics screen The GP County liverpool Postcode L25 3Ex Code field is mandatory and in the case of Phone GPs is the national GP Registration Fax ME i 4 number In the case of other contact types emi t must be unique and could be a Notes 3 combination of name and number The Responsible for referral tick box should be ticked if this person is the person who is responsible for the referrals at this practice The Group field is read only and shows the group you are linking this contact against Gp Code Responsible for referral The button enables you to Group Mision Of Hope Hospka change the group e g in the case of a a eS transfer The Show Group button opens the group form Cancel Figure 12 Person Details Form DRSS User Manual Version 3 8 Page 13 of 54 Commercial in Confidence Orion Imaging ADDING amp EDITING PATIENT DETAILS q een This section discusses manually adding or editing patient details Note With many projects adding and editing patient details is the responsibility of the GP and is not done by the end user Check this with your own project manager before changing any patient details The initial patient import will probably be done electronically using the CSV Import tool for guidance on how to use the Import tool see the CSV Importer section of this manual Orion DRSS
76. uf Screening Venues icon from within the Patient and Contacts group es This would open the Screening Venues screen figure 22 Es Screening Venues In the list below are the available Screening Yenues that are present in the Orion DASS database Select one From the list below bo review or edit it Or press the Add button to add a new venie Available venues Bucket Venue Green Meadow Hospital Hopwood Surgery Lashes Clinic Malpas Health Centre Retina Rooms faz clinic Venue name Clinic Start Time Z 00 End Time no 00 Appointment Length Y Patients per 4pp fi Lunch Start Time a al End Time Venue ID Use Lunch Start and End Time 7 Screening Notes Screening Location Figure 22 Screening Venues Screen DRSS User Manual Version 3 8 Page 25 of 54 Commercial in Confidence Orion Imaging This screen is where you enter the details of each screening venue in your program When you first open the screen the field colours are white click the button to make the form editable as seen in figure 22 The cream filled fields are editable and the pink filled fields are mandatory Available Venues This is a list box listing all the venues that have all ready been setup To edit any of the currently setup venues double click on the venue in the list this will bring its details into the form below and are ready for editing Venue Name This is the first mandatory
77. ull month in one step and then deselect each Tuesday PATIENT APPOINTMENTS Once the clinics have been set up within the system you can start to book patients in for appointments Depending on how your project is to be run appointments will be either open appointment a letter inviting the patient to book a slot of their choice or a fixed appointment a letter stating a fixed time and venue of their appointment We will discuss each of these processes separately starting with open appointments Open Appointments Process The Patient phones the Optometrist of their choice and books an appointment Central Admin office will GPR send open appointment my invites to overdue Patients Ss Optometrist screening Clinic Central Hospital based Server The Optometrist will directly view the list of patients who have received invites and drags them into their own clinic removing them from the bucket appointment list DRSS User Manual Version 3 8 Page 30 of 54 Commercial in Confidence Orion Imaging Appointments and Schedule i xj Patient Appointments Search Clinic Open Schedule Schedule Screening Days Bucket Venue gt Bucket Resource y Search Search Criteria Appointments 13 02 2007 Patient ID Hospital No Surname Date of Birth Archive Status Flag Status tT Postcode ther ID A Forename o oa Omit a GP Find GP Green Meadow Ho

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