About Patient Lists
The Commure Pro application supports the ability for a user for see all the patients they need to care for. A patient list is “built” from a combination of rules to automatically add patients, and also supports a user manually adding and removing patients from this patient list. Patient lists can also be shared with other users to support team-based workflows. Managing the creation and contents of patient lists is now a self-service feature of the Commure Pro system. With the proper permissions, users are able to easily create and manage their own patient lists without requiring support from Administrators. Both creation and management of patient lists can be performed on the Patient List tab. The Patient Search tab also allows users to manage their patient lists by giving them access to patients who are _not _on their patient list and to other providers’ patient lists (shared by other providers). For a provider, this is an easy way to look up information about a patient who is not under their direct care; they can view the patient’s demographic, visit, clinical, and charge information without having to add the patient to their patient list. Administrators who do not actually treat patients usually do not have a patient list. In this case, the Patient Search tab is their primary access to patient data. Users can search for each individual patient name from the census list, prior to viewing their information. The Patient Search tab allows you to find and add existing patients to your patient list or to manually register patients and then add them to your patient list. You can also search by a provider’s patient list to see all the patients on that list and view their data. This chapter primarily reviews the patient list management functions common to all patient list types (Lists, Views, Assignment lists) and patient list management functionality specific to Lists and Views that are found on the Patient List tab, since this is the main access point for these types of activities. Patient list management functionality specific to Assignment lists is covered in Using Assignment Lists.A user can be restricted to viewing data from certain facilities, using the preference Restrict Patient Access to Facilities for User’s Departments. If this is enabled, the user will only have access to the locations that the user has permission to view.
Types of Patient Lists
Commure Pro supports three types of patient lists, and these types will define the functionality associated with those patient lists.- List: This is the standard type of patient list. It selects patient visits based on user-defined criteria. For example, you might have a List called “My City Inpatients” which shows patients with an Inpatient visit type, with a location of City Hospital, where you are the Attending provider. You can add or remove patients to/from a standard List, as long as the List’s definition allows it.
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View: This type of patient list is a View onto other Lists and/or Views, with or without additional filters. A View can be a subset of a single List or View, a combination of two or more Lists or Views, or a subset of a combination of Lists and Views. When using a View, you can add or remove patients, however the patients are actually added or removed to/from the source Lists, not the View. Here are some examples of common usage:
- You have a List of all your patients called “My Patients.” However, when you are rounding in the hospital County General, you only want to see the Inpatients, Observation Patients, and ER visits that are still active (not discharged) in that particular facility. So you create a View called “County General – Rounding”, which only includes those visit types, and drops off the patients after they are discharged.
- You are a member of the Cardiology department, and once a month you are responsible for the on-call coverage for three of the ten members of your department, so you create a View called “Cardiology On Call.” This View combines your “My City Inpatients” List with the “My City Inpatient” Lists for the other three providers. For example, the View would include these Lists: the “My City Inpatients” List for yourself, the “My City Inpatients (Jones, Charles)” List, the “My Inpatients (Smith, Mary)” List, and the “My City Inpatients (Clark, Joe)” List. Now you can see your own inpatients, as well as those of the other three providers, all in one View.
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Assignment: This type of patient list is typically used in situations where responsibility for a pool of patients is shared among different individual providers, or teams of providers. You can add or remove patients to/from an Assignment list, as long as the list’s definition allows it. Assignment lists have three components:
- The master assignment list consists of the entire pool of patients who meet certain criteria. For example the “ER Assignment List” might consist of all patients with a visit type of ER.
- A sublist is created for each provider or team that will be treating patients from the pool. For the master “ER Assignment List,” you might have the “ER Jones” and “ER Smith” sublists, or the “ER Gold Team” and “ER Silver Team” sublists. Patients from the pool are assigned to each sublist.
- The Unassigned sublist is the list of patients from the master assignment list who have not yet been assigned to a sublist for an individual provider or team. All master assignment lists will have an Unassigned sublist.
Understanding How a Patient List is Created
Patient list creation is impacted by the version of InFacility logic used by an organization. There are two types of patient list InFacility logic: the “account-based InFacility” logic and the “most recent InFacility visit” logic. The following sections detail how a patient list is created for each type of logic. To determine which InFacility logic is best for your organization, consider if your ADT system uses the same account number across visit types (for example a patient moving from the Emergency Department (ED) to Inpatient (IP) has the same account number for both visits), the account-based InFacility logic should give you the correct visit on your patient list. If your ADT system uses different account numbers across visit types (a patient moving from ED to IP has one account number for the ED visit and a different account number for the IP visit), the account-based InFacility logic might cause both visits to appear on your patient list — in this case, the most recent InFacility visit logic might be a better option. Your organization can determine what you want providers to see on their patient lists and use the appropriate logic.Prior to version 9.2.0.2.31, the “most recent InFacility visit” logic was used for all patient lists. Starting in version 9.2.0.2.31, the “account-based InFacility” logic became the default logic. For version 9.2.0.2.34.8 or later, both types of logic are available using the Enable Account Based Infacility Calculation Type option on the Patient List Overview tab. This field controls which type of logic is used. Your system administrator will determine which type of logic is best for your organization and will set a default value for this field, which you should not change when creating a new patient list.
Patient List Creation Using the Default “Account-Based” InFacility Logic
Patient lists are specific entities and not created based on only a provider’s relationship to a patient visit. A visit can be associated with a patient list (also referred to as “qualifying” for display on the patient list) either through meeting a set of criteria that is part of a patient list definition, or because the visit was manually associated with the patient list. When defining any type of patient list, users can use time-based criteria associated with a visit type to determine when a visit is added and removed from the patient list. For many visit types, Commure Pro uses the concept of a “current visit” that indicates to the provider that the patient is currently in the facility (InFacility) for Inpatient visits. These InFacility Inpatient visits can additionally include Emergency Room, Observation, and Labor and Delivery visits; a visit where the patient is physically residing in the hospital/health center. Scheduled appointments or discharged visits are categorized as non-InFacility. However, while a discharged visit is no longer in the facility, it was considered InFacility in the past and might still meet patient list criteria. Any visit designated as InFacility (patient physically resides in hospital/health center) uses an InFacility calculation that defines the start and end dates for the visit as admit date and discharge date, respectively. An “InFacility” visit type is considered “Active” when the current date falls within the start and end date/time parameters for that visit type – these parameters collectively are considered the active range. The logic also considers account numbers and only selects one visit with the same account number for display in the patient list (the most recent visit that meets list criteria).The InFacility logic that considers account numbers is the default logic for 9.2.0.2.31 and later releases. Earlier releases use a different logic.
- When multiple InFacility visits have the same account number and meet the patient list criteria, only the most recent InFacility visit is displayed on the patient list.
- Other InFacility visits, with unique account numbers, that meet the patient list criteria are displayed on the patient list.
- Each non-InFacility visit (such as an outpatient appointment) that meets the patient list criteria and has a unique account number will be displayed.
- When an InFacility visit that meets patient list criteria is added to a patient list, that visit may not display in the patient list if there is a more recent visit with the same account number as the visit that was added. When multiple visits with the same account number meet the patient list criteria, the InFacility logic will select only one visit (the most recent visit) for display in the list. If a user then selects Actions > Why Patient Is On This List, a message displays in the Compare patient to list window explaining that the visit added to the list was not the qualifying visit (not the most recent visit). If an InFacility visit with a unique account number is added to a patient list, it will display in the patient list.
Patient List Creation Using the “Most Recent InFacility Visit” Logic
Patient lists are specific entities and not created based on only a provider’s relationship to a patient visit. A visit can be associated with a patient list either through meeting a set of criteria that is part of a patient list definition, or because the visit was manually associated with the patient list. When defining any type of patient list, users can use time-based criteria associated with a visit type to determine when a visit is added and removed from the patient list. For many visit types, Commure Pro uses the concept of a “current visit” that indicates to the provider that the patient is currently in the facility (InFacility) for Inpatient visits. These InFacility Inpatient visits can additionally include Emergency Room, Observation, and Labor and Delivery visits; any type of visit where the patient is physically residing in the hospital/health center. A scheduled appointment or a discharged visit does not indicate that the patient is in the facility. Any visit designated as InFacility (patient physically resides in hospital/health center) uses an InFacility calculation that defines the start and end dates for the visit as admit date and discharge date, respectively. An “InFacility” visit type is considered “Active” when the current date falls within the start and end date/time parameters for that visit type – these parameters collectively are considered the active range. With Commure Pro’s InFacility visit logic, the system can display multiple visits per patient in a patient list and what is or isn’t displayed is based on the following:- Each non-InFacility visit (scheduled visit such as an Outpatient visit) that meets the patient list criteria will be displayed.
- Only one InFacility visit will ever be displayed in the patient list. If there are multiple InFacility visits that meet the patient list criteria, only the most recent InFacility visit based on the admit date will be displayed, regardless of which InFacility visit meets the patient list criteria.
When an InFacility visit that meets patient list criteria is added to a Patient List, that visit may not display in the Patient List, as only the most recent InFacility visit is displayed. If a user then selects Actions > Why Patient Is On This List, the following message displays in the Compare patient to list window, to clarify the visit logic:Patient List displays the most recent visit for this patient, but a different, older visit was actually added to the patient list.
Understanding the Patient List Tab
The Patient List tab provides access to your favorite patient lists. On the Patient List tab itself, the words “Patient List” are followed by a number in parenthesis: this is number of patient visits currently displayed on your patient list. The Patient List screen consists of two major elements: your patient list on the left side of the screen, and a patient data display area on the right side of the screen. The Patient List area is located on the left side of the screen. This section displays your selected patient list. It contains all of the patients who meet the patient list criteria. The Patient List area is where you manage your patient list and view basic information about the patients on your patient list. The Patient Data Display area is located on the right side of the screen. This portion of the screen is used to show detailed information about any patient on your patient list, as well as to enter data such as clinical notes, orders, or charges. All of the display functions found on this portion of the screen are described in Displaying Patient Information.Viewing Patient Information in the Patient List Area
The Patient List area is located on the left side of the Patient List tab. It contains only those patients that meet the criteria of the patient list and any manually added patients. The information that is displayed for each patient visit is based on the patient list display criteria and can vary from patient list to patient list. However, typically you will see a patient’s full name, age in years, gender, location, reason for the visit, and one of these items: the length of stay in days or hours (for current inpatient visits), the discharge date (for discharged inpatient visits), or the scheduled appointment date (for outpatient visits). However, you can choose to add or remove other fields as needed. The patient list can display multiple visits for a patient based on whether the visit is an InFacility visit (patient physically resides in the facility) or non-InFacility visit (such as an outpatient visit).Types of Patients Found on the Patient List
On the Patient List tab and elsewhere in Commure Pro, you might see some patient names marked with quotation marks or an asterisk. These distinguishing marks mean that these patients were entered manually, directly in the Commure Pro system rather than through the organization’s source registration system. The table below describes each type of patient.
| Patient Type | Source | Where visible |
|---|---|---|
| Non-Verified (usually considered a temporary patient because their demographic data has not been confirmed by registration personnel) | Manually registered as a “non-verified” patient on the Commure Pro web application, or on a handheld device. | On all platforms: Patient name is enclosed in quotation marks (for example: “Jones, Mary”) |
| Verified (depending on your organization’s workflow, could be considered either a temporary or permanent patient) | Manually registered as a “verified” patient on the Commure Pro web application, or on a handheld device. Or, a patient that was manually registered as a “non-verified” patient on the PatientKeeper web application or a handheld device, and who is then subsequently marked as “verified” on the web application. | On all platforms: Asterisk appended to end of patient name (for example: Jones, Mary*) |
| Authenticated (permanent patient) | Interfaced from your source ADT/Registration System (for example, Cerner™ or MEDITECH®) | On all platforms: Patient name has no special identifiers (for example: Jones, Mary) |
Patient List at a Glance
Typically, a patient list is set up to display patient visits for patients who are currently in your care. Providers and administrators can define different patient lists to accommodate different working situations. Each patient list changes as patients are admitted or discharged (for inpatients), or have appointments (for outpatient visits). Patients are on a patient list for a predetermined amount of time, as specified in the patient list’s properties. If necessary you can add a patient from the organization’s census list to a patient list or manually create a patient or visit that is not on the census list and then add it to a patient list. You can also remove patients from a patient list. The ability to add, manually create, or remove patients is based on your user preferences. You can take a variety of actions to change the way your patient list is displayed in the Patient List tab. All of the controls for these actions are located at the top of the Patient List area. There are several items that control the Patient List area of the screen:- Collapse or Expand buttons: You can collapse the size of the patient list, and thereby increase the size of the Patient Data Display area, by clicking the collapse/expand button. The Patient Data Display area then takes advantage of a larger screen when displaying detailed patient information. The patient list collapses so only a part of the patient list is seen. The patient list position is sticky so it remains that way the next time you login.
- Actions drop-down list: Includes several options by which you can manage the contents of your patient list.
Depending upon your organization’s implementation and permission levels, some options may or may not be available.
- This Patient List options: Options to add, remove, or reassign patients on your selected patient list along with checking to see why a patient is on your patient list.
- Sort options: Change the order in which the patients on the selected patient list are sorted.
- Print options: Print a copy of the selected patient list, print a standard rounding report based on the selected patient list, or print a clinical rounding report based on the selected patient list where you or another user are the list owner.
- Manage This Patient List options: Options to edit, unfavorite, or view the patient list criteria of the selected patient list.
- Other Patient Lists options: Options to create a new patient list, find an existing patient list, or add a selected patient to other patient lists.
- Patient List drop-down list: Includes all types of favorited patient lists.
- Refresh button: Redisplay the selected patient list with the most up-to-date information.
Showing the Properties of a Patient List
There may be times when you wish to check how a particular patient list was set up. This is especially useful for a shared patient list where you are not the list owner. To review the specific properties of a selected patient list:- Select the Patient List tab and then select the Patient List drop-down located between the Actions menu and the Refresh button above the Patient List area. A list of Favorite patient lists will display.
- Select the desired patient list that you wish to review its specific properties from the drop-down list. The Patient List area will update with the contents of the selected patient list.
- Select the Actions drop-down next to the Patient List drop-down, and then select Show Properties.
- Overview - displays the Name, Owner, Description, Type, Enable Account Based Infacility Calculation Type, and Favorite status of the patient list. If the patient list is a view, you will also see Lists/Views to include. If the patient list is an Assignment list, you will also see the Assignment Sub Lists.
Prior to version 9.2.0.2.31, the “most recent InFacility visit” logic was used for all patient lists. Starting in version 9.2.0.2.31, the “account-based InFacility” logic became the default logic. For version 9.2.0.2.34.8 or later, both types of logic are available using the Enable Account Based Infacility Calculation Type option. Your system administrator will determine which type of logic is best for your organization and will set a default value for this field.
- Time-Based Criteria - displays the visit types and their add/remove timeframe for the patient list.
- Filter Criteria - displays any filters and any filter logic for the patient list.
- Display section - shows what fields are included and their layout for the patient list. Any sort criteria is also shown.
- Permissions - shows if you have add/remove patients rights, and displays the following information:
- Patient List ID
- Created By
- Created Date
- Last Updated By
- Last Updated Date
- (Optional) Click the Show Details link in the Overview sections if you wish to see who has the patient list as a favorite.
- (Optional) Click the Show Permission Details link in the Permissions section to display all the permissions given to users.
- Click Close to exit the Patient List Criteria window.