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MPages at Lpch - Thus Far

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Lucile Packard Children's Hospital at Stanford

Lucile Packard Children's Hospital at Stanford (LPCH) has a long history of using Cerner applications including PowerChart. The document discusses clinical and technical challenges LPCH has faced in using MPages, including how to store resources and implement AJAX functionality. It provides examples of current and future MPages projects at LPCH like integrating external databases into genviews and developing multi-patient dashboards for different units.

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MPages Development Conference LPCH MPages Overview Seattle March 30, 2009
Introduction Chris Longhurst, MD, MS Medical Director of Clinical Informatics, LPCH Assistant Professor of Pediatrics, Stanford Joshua Faulkenberry Senior Web Applications Engineer, LPCH
Outline Overview Lucile Packard Children’s Hospital at Stanford LPCH history with Cerner MPages Clinical challenges and solutions Technical challenges and solutions Future projects
Lucile Packard (Women and) Children’s Hospital Overview Opened in 1991 Major pediatric/obstetric hospital associated with Stanford University Patient stats (2006) 13k Discharges 5400 Deliveries 106k Clinic visits 280 Active Beds 40%+ critical care patients Centers of Excellence (6) Top 10 children’s hospital by US News & World Report in 2007
LPCH Information & Knowledge System (LINKS) Overview Cerner selected as LPCH partner for IT applications in 2002 LINKS phase 1 went live 9/2005 – “ Conversion ” from legacy system included 13 “nets” LINKS phase 2 went live 11/2007 – “ Clinical Transformation ” = CPOE using PowerPlans and clinical documentation (using IView)
LPCH Development History with Cerner 2005 Co-developed PowerChart Outreach 2008 - 2009 IView Dynamic labels development partner PRISM development partner MPages development partner (1 st remote hosted site)
Clinical Challenges and Solutions Data review Accessing external clinical databases Integrating clinical decision support tools Pediatric risk of mortality adjustment
IView Use By Role in 24 Hours
“ Rounds” tab 1.0 (RTF Genview)
Rounds tab 2.0 (MPage)
Clinical Decision Support Tool Integration
 
Technical Challenges and Solutions Where to store MPage resources Worked with Cerner to identify a standard location for all Remote-Hosted clients (In progress) Loading HTML files into a tab Identified two methods to load HTML files directly into a tab on PowerChart as MPages
Technical Challenges and Solutions Discovering the mechanism for true AJAX in MPages Reverse engineered Cerner's code, discovering how to implement a fully functional XMLCclRequest Complete separation of client and server development Developed the “CCL as a Service” (CCLS) architecture – allowing CCL engineers to focus on the Backend and Client-side engineers to focus on the “Frontend”
Video demo Illustrating AJAX and realtime waveforms
Future MPages Projects at LPCH Continued GenView improvement Plan to combine multiple current GenView tabs into single, customizable “Pt Summary” tab with user-selectable widgets – Dr. Dan Imler * (imlerdl@stanford.edu) Continued external resource integration Transplant database (OTTR) – Dr. Scott Sutherland (suthersm@stanford.edu) Personal health record (Google Health) integration – Drs. Chris Longhurst / Dan Imler Multi-patient dashboards Med/surg – Drs. Chris Longhurst / Dan Imler NICU – Dr. Jon Palma * (jpalma@lpch.org) CVICU – Dr. Andy Shin * (drewshin@stanford.edu) PICU – Dr. Natalie Pageler (npageler@lpch.org)
CVICU Dashboard Mockup
Google Health Mockup
Google Health Mockup
Acknowledgements Mattice Harris Manager Web Services, LPCH Ed Kopetsky Chief Information Officer, LPCH
Questions Chris Longhurst – clonghurst@lpch.org Joshua Faulkenberry – jfaulkenberry@lpch.org

More Related Content

MPages at Lpch - Thus Far

  • 1. MPages Development Conference LPCH MPages Overview Seattle March 30, 2009
  • 2. Introduction Chris Longhurst, MD, MS Medical Director of Clinical Informatics, LPCH Assistant Professor of Pediatrics, Stanford Joshua Faulkenberry Senior Web Applications Engineer, LPCH
  • 3. Outline Overview Lucile Packard Children’s Hospital at Stanford LPCH history with Cerner MPages Clinical challenges and solutions Technical challenges and solutions Future projects
  • 4. Lucile Packard (Women and) Children’s Hospital Overview Opened in 1991 Major pediatric/obstetric hospital associated with Stanford University Patient stats (2006) 13k Discharges 5400 Deliveries 106k Clinic visits 280 Active Beds 40%+ critical care patients Centers of Excellence (6) Top 10 children’s hospital by US News & World Report in 2007
  • 5. LPCH Information & Knowledge System (LINKS) Overview Cerner selected as LPCH partner for IT applications in 2002 LINKS phase 1 went live 9/2005 – “ Conversion ” from legacy system included 13 “nets” LINKS phase 2 went live 11/2007 – “ Clinical Transformation ” = CPOE using PowerPlans and clinical documentation (using IView)
  • 6. LPCH Development History with Cerner 2005 Co-developed PowerChart Outreach 2008 - 2009 IView Dynamic labels development partner PRISM development partner MPages development partner (1 st remote hosted site)
  • 7. Clinical Challenges and Solutions Data review Accessing external clinical databases Integrating clinical decision support tools Pediatric risk of mortality adjustment
  • 8. IView Use By Role in 24 Hours
  • 9. “ Rounds” tab 1.0 (RTF Genview)
  • 10. Rounds tab 2.0 (MPage)
  • 11. Clinical Decision Support Tool Integration
  • 12.  
  • 13. Technical Challenges and Solutions Where to store MPage resources Worked with Cerner to identify a standard location for all Remote-Hosted clients (In progress) Loading HTML files into a tab Identified two methods to load HTML files directly into a tab on PowerChart as MPages
  • 14. Technical Challenges and Solutions Discovering the mechanism for true AJAX in MPages Reverse engineered Cerner's code, discovering how to implement a fully functional XMLCclRequest Complete separation of client and server development Developed the “CCL as a Service” (CCLS) architecture – allowing CCL engineers to focus on the Backend and Client-side engineers to focus on the “Frontend”
  • 15. Video demo Illustrating AJAX and realtime waveforms
  • 16. Future MPages Projects at LPCH Continued GenView improvement Plan to combine multiple current GenView tabs into single, customizable “Pt Summary” tab with user-selectable widgets – Dr. Dan Imler * (imlerdl@stanford.edu) Continued external resource integration Transplant database (OTTR) – Dr. Scott Sutherland (suthersm@stanford.edu) Personal health record (Google Health) integration – Drs. Chris Longhurst / Dan Imler Multi-patient dashboards Med/surg – Drs. Chris Longhurst / Dan Imler NICU – Dr. Jon Palma * (jpalma@lpch.org) CVICU – Dr. Andy Shin * (drewshin@stanford.edu) PICU – Dr. Natalie Pageler (npageler@lpch.org)
  • 20. Acknowledgements Mattice Harris Manager Web Services, LPCH Ed Kopetsky Chief Information Officer, LPCH
  • 21. Questions Chris Longhurst – clonghurst@lpch.org Joshua Faulkenberry – jfaulkenberry@lpch.org

Editor's Notes

  1. TRANSITION TO CHP slide: a bomb dropped… the ultimate unintended consequence