Multi Graphing Clinical Data

• Vital signs are automatically graphed when an individual vital sign is selected. You can also graph the selected vital sign against a medication. (See Viewing Vital Signs for a Patient.)
• IO data is automatically graphed when an individual component is selected. (See Viewing Intake/Output for a Patient.)
• Lab components are automatically graphed when an individual component is selected. You can also graph the selected component against another component. (See Graphing Lab Results.)

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Viewing Clinical Data in a Table or Graph

1. Select a patient on the Patient List tab, or click on the Details icon from another option.
2. Select the amount of information you wish to display by clicking the Timeframe drop-down list. The date range you select here affects the items that are available for selection on the multi-graph screen. For example, if you select a Timeframe of Last 30 Days, only those medication administrations, lab results, and vital signs within the last 30 days will appear as selectable items on the multi-graph screen.
3. Click either the Medications, Lab Results, I/O, or Vitals display option, and then click Graph , located in the upper right corner of the summary window. The Multi-Graph window displays listing all the available medication, lab, I/O and vital components for the patient in a column on the left side of the screen.
4. Click on the lab components, medications, I/O, and vital signs that you want to graph or view in a table. You may select more than one of each. To deselect an item, click on it again.
5. As you select each item, it is automatically put in either a table or graph. You can choose the view you want by selecting either Table View or Graph View (located at the top left of the display area). The default is Table View.
   To clear the table and your selections, click the Clear button.
   As you select each component in Table View, a table is built displaying the following:
   • The date range and the time is listed in the horizontal headings and is based on the Timeframe that you selected on the Patient List tab. If you originally selected a large date range and not all the data is displayed, you can use the horizontal scroll bar to scroll through and view all the data. If you change the Timeframe in the Multi-Graph window (at the top right), the timeframe selected on the Patient List tab is not affected.
   • Each clinical item is listed in separate rows and any data associated with the date and time is displayed. You can continue adding or removing clinical items for the table by clicking on them from the drop-down lists.
   As you select each component in Graph View, a graph is built displaying the following:
   • The date range is always graphed on the horizontal axis and is based on the Timeframe that you selected on the Patient List tab. If you originally selected a large date range, and the items are too compressed to read on the graph, you can decrease the timeframe by selecting a new range from the Timeframe drop-down here on the Multi-Graph window. If you change the time frame in the Multi-Graph window, the time frame selected on the Patient List tab is not affected.
   • Each clinical item is graphed on a vertical axis. If the clinical items share a similar numeric range, they are graphed on the same vertical axis. If you select many items with differing ranges, additional graphs may be displayed, stacked one above the other, so that you can compare them over the same date range. You can continue adding or removing clinical items for the graph by clicking on them from the drop-down lists.
   • Any component values that contain any non-numeric characters (for example, “<2” or “>50”) are not included on the graph, but the components are listed in the legend.
   • You can display the exact value for a specific point on the graph by holding your mouse pointer over that point
   There are a few important points to note about graphing medications. When graphing medications, you are in fact graphing the recorded medication administrations. The numeric value at which each administration’s data point is graphed is the medication dosage. In addition:
   • If the medication dosage field contains a comment instead of a numeric value, it is graphed at zero.
   • If a medication was ordered but has not had any administrations, it is included in the drop-down list, but no data points are graphed.
6. After you are done viewing the information, click Close to exit the Multi-Graph window. Your view with the clinical data component selections will not be saved when you close out of the Multi-Graph window. If you wish to save the view for future use, you need to create a snapshot of it.

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Creating Flowsheets using Snapshots

1. Select a patient on the Patient List tab, or click on the Details icon from another option.
2. Select the amount of information you wish to display by clicking the Timeframe drop-down list. The date range you select here affects the items that are available for selection on the multi-graph screen. For example, if you select a Timeframe of Last 30 Days, only those medication administrations, lab results, and vital signs within the last 30 days will appear as selectable items on the multi-graph screen.
3. Click either the Medications, Lab Results, IO, or Vitals display option, and then click Graph , located in the upper right corner of the summary window. The Multi-Graph window display listing all the available medications, labs, IO, and vitals components for the patient.
4. Click Clear, if data is already displayed from another snapshot. Once you have no data displayed, click on the lab components, medications, and vital signs that you want to graph or display in a table. You may select more than one of each. For example, if you wish to set up a flowsheet that shows how a patient with diabetes is responding to treatment, you can select the Glu lab component, the Glyburide medication component, and the FSBG vital component.
   To deselect an item, click on it again.
   As you select each item, it is automatically put in either a table or graph depending if Table View or Graph View is selected at the top left of the display area (Table View is the default view).
   All snapshots can be viewed in either Table View or Graph View by selecting the desired view. The Commure Pro system remembers the view last chosen and when the snapshot is next selected, will display the last selected view.
5. Enter a name for your snapshot, in our example it is My Flowsheet, in the Save New Snapshot text box.
   If the snapshot is a commonly used flowsheet for all your patients, you may wish to make this snapshot the default view every time you use the Multi-Graph feature. Select the Make Default checkbox next to the Save New Snapshot text box before you save the snapshot.
6. Click Save to create your snapshot. The snapshot is now available in your Select Snapshot drop-down for use.

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Viewing Clinical Data Flowsheets Using Snapshots

1. Select a patient on the Patient List tab, or click on the Details icon from another option.
2. Select the amount of information you wish to display by clicking the Timeframe drop-down list. The date range you select here affects the items that are available for selection on the multi-graph screen. For example, if you select a Timeframe of Last 30 Days, only those medication administrations, lab results, and vital signs within the last 30 days will appear as selectable items on the multi-graph screen.
3. Select the desired snapshot from the Select Snapshot drop-down. The window will change to display the preset clinical data components for the selected patient. For example, if you selected the snapshot called “Diabetes Flowsheet” which uses the lab component Glu, medication component Glyburide, and the vital component FSBG in the Table View, you will see a table with these components displayed for the timeframe you selected. If you do not have any snapshots in your Select Snapshot drop-down, you can create snapshots and then manage those snapshots.

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Managing Flowsheet Snapshots

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Renaming a Snapshot

1. Click the Manage Snapshots link in the Multi Graph window. The Manage Snapshots window displays with all the available snapshots.
2. Click the Rename link next to the snapshot you wish to change. The Edit Snapshot dialog displays.
3. Enter the new name.
4. Click OK which will display a dialog stating “Snapshot has been renamed,” and then click OK from this dialog. You are returned to the Manage Snapshots window. From here you can continue to make changes to your snapshots.
5. Click Close to exit when you have completed all your changes.

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Changing the Component Sort Order in a Snapshot

1. Click the Manage Snapshots link in the Multi Graph window. The Manage Snapshots window displays with all the available snapshots.
2. Click the Sort Components link next to the snapshot you wish to change. For example, if we had a snapshot called Coag Flowsheet (which has two lab components - INR and PT and one medication - Coumadin), we would click this link next to it. The Sort Components window displays with tabs for each component type.
3. Select the desired component tab where you want to change the sort order of components. In our example we wish to sort lab components which is the first tab selected by default. INR and then PT are displayed as the sort order.
4. Select and drag the component whose order you wish to change, and then drop it into the new sort location. Continuing with our example, we select and drag the PT lab above the INR lab and drop it there. Now the sort order is PT and then INR.
   You should make all your sort changes to each component tab before saving your changes as saving will return you to the Manage Snapshots window.
5. Click Save which will display a dialog stating “Sort Components have been saved,” and then click OK from this dialog. You are returned to the Manage Snapshots window. From here you can continue to make changes to your snapshots.
6. Click Close to exit when you have completed all your changes.

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Changing the Default Snapshot

1. Click the Manage Snapshots link in the Multi Graph window. The Manage Snapshots window displays with all the available snapshots.
2. Select checkbox next to the snapshot you wish to make the new default.
3. Click Make Default which displays a dialog stating “Default Snapshot has been set,” and then click OK from this dialog. You are returned to the Manage Snapshots window. From here you can continue to make changes to your snapshots.
4. Click Close to exit when you have completed all your changes.

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Deleting a Snapshot

1. Click the Manage Snapshots link in the Multi Graph window. The Manage Snapshots window displays with all the available snapshots.
2. Select checkbox next to the snapshot you wish to delete.
3. Click Delete which displays a question dialog stating “Are you sure that you want to delete selected snapshots?” and then click Yes from this dialog. You are returned to the Manage Snapshots window. From here you can continue to make changes to your snapshots.
4. Click Close to exit when you have completed all your changes.