PDF Archive

Easily share your PDF documents with your contacts, on the Web and Social Networks.

Share a file Manage my documents Convert Recover PDF Search Help Contact



EOL Blueprint (version 0.93a) (September 1 , 2014)(3) .pdf



Original filename: EOL Blueprint (version 0.93a) (September 1 , 2014)(3).pdf

This PDF 1.5 document has been generated by Acrobat PDFMaker 10.1 for Word / Adobe PDF Library 10.0, and has been sent on pdf-archive.com on 11/10/2014 at 19:03, from IP address 206.87.x.x. The current document download page has been viewed 570 times.
File size: 1.3 MB (84 pages).
Privacy: public file




Download original PDF file









Document preview


END OF LIFE
PROJECT

Functional
Requirements
Usability
Considerations
Blueprint – End of
Life

September 1, 2014

TV Net Project
End-of-Life Care Workflow & Functionality

EOL Project Blueprint by TV Net Project End-of-Life Care Workflow & Functionality is licensed under a Creative
Commons Attribution 4.0 International License.

2

Document Control
Version
• 0
• 0.1
Updated to reflect input from
clinician review of version 0,
plus more detailed reporting
specs, plus quality indicators
• 0.2 Updated to reflect input
from Morgan Price, Dennis
Lee and Bruce Hobson
• 0.3 Updated to reflect
feedback from FP and Dennis
Lee
Key changes:
• Label “Transition” changed to
“Severity of Illness”
• Colour change as an indicator
of when a form is due,
overdue, completed
• Reminder to clinician to ask
about privacy masking
whenever generating a report
that extracts data from EMR.
• Improved consistency in
names of data elements.
• 0.4, 0.5 Updated to reflect
feedback from Dennis Lee
and Cheryl Ulmer, and EOL
team
Key changes:
• Consistency in naming of
quality indicator terms
• Revision of names of items in
“dashboard” on main page
• Clarification of where to
insert comment in encounter
note when distributing a
document.
• Define EOL functionality
outside of stand-alone EOL
module
• Assessment tools: ESAS
changed to allow entry of 13

Modified By
Colin Partridge
Colin Partridge

Date / Version
Sept 16, 2013
October 21, 2013

Colin Partridge

December 1, 2013

Colin Partridge

January, 2014

Colin Partridge

January, 2014



10 score across each domain
in ESAS
Forms that need to be
approved by government
(Palliative benefits) need a
check box for “Approved”
0.6

Colin Partridge

January, 2014

Colin Partridge

Feb-March, 2014

Added descriptions for symptom
management pages
• 0.8, 0.9

Colin Partridge

April, 2014

Key changes:
• Additions and updates to list
of forms that need to be
returned
• Split out forms from “My
Voice”
• Updated list of telephone
numbers and websites
resources for the ”MD”
button
• Updates to symptom
management content for
pain, nausea, and
constipation
• Label “Severity of illness”
changed back to “Transition”
• Reporting queries divided
into queries for living and
deceased, and both absolute
numbers and percentages
• 0.91

Colin Partridge

April 28, 2014



Key changes:
• Terminology and labels
revised for the “dashboard”
area of home page
• Symptom management pages
should each capture a score
from 1-10. Note overlap with
scores from ESAS form.
• Screen shots updated to
reflect revisions


4

0.7

Key changes:
• “Forms” renamed
“Documents”
• “Home” control highlighted in
bold or colour
• Clarified when “My Voice”
dashboard flag should be
marked as completed.
• Clarification re ESAS_given
and SAT_given
• 0.92
Edits as per Dennis and Neil re
content of symptom management
documents and links.
• Further clarification about the
dashboard flag about “My
Voice”
• 0.922a
Added creative common license
sentence on page 1 of document
• 093
Minor edits to incorporate experience
with EMR implementations to date

5

Colin Partridge

May 26, 2014

Francis Lau

August 27, 2014

Colin Partridge

Sept 1, 2014

Preface
In order to provide comprehensive EOL care, a multitude of processes need to be initiated and
monitored. Doing this without the aid of an organized support tool is a practice likely to include care
gaps.
An end-of-life( EOL) tool needs to be able to recognize the workflow typical of primary care practice
when dealing with patients requiring end of life care. Coupled with this is the need to address the
reality that EOL care can be approached from the perspectives of:





Stage of terminal illness
Role of the individuals involved
Patient’s physical/emotional/spiritual needs
Tasks to be done.

The end-of-life (EOL) tool specifications described below are designed to support primary care providers
in providing optimal care to patients reaching end of life. Keeping the above perspectives in mind, the
tool focuses on streamlining workflow while encouraging thorough EOL care that addresses both the
clinician’s and the patient’s needs. The tool specifications also recognize that while comprehensive
functionality is important, in primary care patient contact time is limited. Clinicians need rapid access to
resources. Intrinsic usability and rapid access to commonly-used tools are key design considerations
recognized during the development of the tool specifications.
The EOL specifications described in this document contain details about content that should be
included, and a suggested user-interface. The authors realize that different EMRs offer varying
functional capabilities. Therefore, to implement the specifications, the content, interface and
implementation may need to be modified to work effectively within the confines imposed by different
vendors. In some cases, users or developers may need vendor support to implement the EOL tool.

6

Formatted: Underline
Formatted: Font: Italic

Table of contents
Preface .................................................................................................................................. 6
Table of contents ................................................................................................................... 7
Introduction .......................................................................................................................... 9
1.

Goals of tool: ............................................................................................................... 9

2.

Design principles: ......................................................................................................... 9

3.

Components: .............................................................................................................. 10

Background for vendors and developers .............................................................................. 11
Design elements - description .............................................................................................. 13
1.

Sections in the menu..............................................................................................................14
A.
1)
2)
3)
4)
B.
C.
D.
E.
F.
G.

Home ...........................................................................................................................................................14
Registry ....................................................................................................................................................16
Care plans ................................................................................................................................................16
Summary ..................................................................................................................................................17
Forms .......................................................................................................................................................17
Assessment Tools.........................................................................................................................................18
Symptom Management ...............................................................................................................................19
Family and Grief ...........................................................................................................................................22
Reports.........................................................................................................................................................22
MD ...............................................................................................................................................................23
PSP ...............................................................................................................................................................24

4.

Design elements to be embedded within the EMR ..................................................................25

5.

Optional design elements.......................................................................................................25

Workflow ............................................................................................................................ 27
1.

Planning .................................................................................................................... 27

2.

New EOL care ............................................................................................................. 27

3.

New EOL care – follow-up visit.................................................................................... 28

4.

EOL Care – later stages ............................................................................................... 29

5.

EOL Care – Family & grief ........................................................................................... 30

6.

EOL Care – Reporting.................................................................................................. 30

Appendix A - Design elements detailed description .............................................................. 33
Appendix B – Data Elements ................................................................................................ 57
Appendix - C Documents ...................................................................................................... 64
7

Appendix D – Quality Indicators ........................................................................................... 66
Appendix E – Alerts & Reminders ......................................................................................... 73
Appendix F– Symptom management ................................................................................... 76
1.

Pain ........................................................................................................................... 78

2.

Nausea & Vomiting .................................................................................................... 79

3.

Constipation............................................................................................................... 81

4.

Dyspnoea ................................................................................................................... 82

5.

Delirium ..................................................................................................................... 83

6.

Depression ................................................................................................................. 83

7.

Anxiety ...................................................................................................................... 83

8.

Fatigue ...................................................................................................................... 83

9.

Anorexia .................................................................................................................... 84

10.

Last days and hours .................................................................................................... 84

11.

Crisis orders ............................................................................................................... 84

8

Introduction
The EOL tool specifications described later in this document were developed after careful consideration
of a variety of patient-centred, clinician-centred, workflow-centred, and usability factors. The outcomes
of this analysis, and their implications for the design of an EOL tool are reviewed below.

1. Goals of tool:





Facilitate improved EOL care by:
i. Consolidating clinician access to comprehensive EOL resources
ii. Reminding clinicians of available patient resources in EOL care
iii. Assisting clinicians in choosing appropriate resources at different levels of disease
burden
iv. Improving inter-provider and inter-disciplinary care
v. Providing EOL assessment and scoring tools
vi. Providing tools to assist in patient management (E.g. narcotic switching guidelines)
Facilitate the recording of EOL care interventions
Facilitate in-office analysis of EOL-related care

2. Design principles:










9

Tool should be portable across vendor platforms, recognizing that components will need to
be deployed in different formats, depending on the vendor
EOL tool will only be used sporadically, so must be easy to use even after prolonged gaps
between uses.
As much as possible, tool should match clinical workflow
Different clinical situations dictate different needs from the EOL tool, so certain functionality
needs to be duplicated within the tool. For example, grief counselling resources are
appropriately included under the EOL transition “death and bereavement”. However,
access to grief counselling resources should also be made available under the topic of
resources for family.
Tool should be user-friendly in:
i. Being “lean” so as not to overwhelm casual users, and also to enhance usability on
small-screen devices.
ii. Minimizing the number of steps needed to perform tasks.
iii. Hiding extraneous information (E.g. date that a handout was printed), yet making it
visible if desired (E.g. by mouse hover over name of handout)
Data entered into the tool should be used to auto-populate forms, etc. where appropriate
Tool should implicitly and explicitly prompt/remind clinician to do tasks relevant to each
stage of EOL care.


Related documents


12patient specific education
eol blueprint version 0 93a september 1 2014 3
how emr saves time and cost
mini v5 002006
marketingportfolio 5
emr platform for doctors


Related keywords