Author: Dale Sahlberg - 9

Author: Dale Sahlberg - 9 -

GOLD EMAIL

Would it be nice to automatically send a NOTICE OF ADMISSION to a doctor when her / his patient has been admitted? This could greatly improve response times by doctors for treating a patient and would enhance patient care.

Below is an example of an email sent to DR. STEIN when his patient was admitted. All the TO, SUBJECT, PATIENT DATA in the message body was automatically entered – simply press The email was encrypted using gateway (domain / server level) encryption with the doctor being a recognized domain member.

Email can be encrypted and routed directly to its intended recipient. Unlike printed faxes, email messages can be read privately and the receiving party is the only one who can view the information. Email can be more secure (HIPAA compliant) than sending a fax to an office where other staff can view the printed patient data. Faxes with patient information should only be sent to secure receiving fax machines since the transmissions can be intercepted. Once the paper has printed though, how does an office keep that from disclosure?

Doctors who carry Palm Pilots, SmartPhones and other PDAs can be immediately contacted by email wherever they are – on the road, at another office or in a clinic.

The HIPAA Security Standard contains two subparts that relate directly to data integrity, data access and mechanisms for handling data.

These include:

· 45 CFR Part 142, § 142.308 (c). “Technical security services to guard data integrity, confidentiality and availability.” These are processes that protect information and control individual access to information.

· 45 CFR Part 142, § 142.308 (d). “Technical security mechanisms.” These are
controls that prevent unauthorized access to information that is transmitted across
an internal network or across the public Internet.

There are several methods for securing Internet e-mail:

1) Desktop to desktop encryption

2) Privately encoded web mail using PGP type programs

3) Gateway (domain / server level) encryption

4) HTML attachment using JAVA with a encryption key

Here is a display of the security settings for OUTLOOK:

By using secure email to send NOTICES OF ADMISSION, a hospital can improve hospital communications with its doctors while meeting HIPAA requirements for data confidentiality.

Currently 3270 applications do not have a function to automatically call up an email programs (OUTLOOK, Eudora or Thunderbird) and then transfer patient data to an email with associate data titles. Can GOLD be programmed so a user can send emails? Yes. GOLD offers more functions than 3270, two of which are useful for email programs. The two functions are:

A) GUI controller

B) Hyper-Link Controller

In the example below, the ADMISSIONS department is finishing the process of admitting a patient for Dr. Stein. He is always busy with office appointments and asked that he be notified when one of his patients is admitted. The prior notification method was a facesheet faxed by admitting to his office fax number. Dr. Stein rotates between two offices so the notices at the main office are often not read till he returns there. He carries a Palm Pilot with a Web browser, auto-get email software, super-fast Wi-Fi (802.11b), Word, Excel, PowerPoint and Healthy diagnosis / intervention software. He carries the Pilot with him so he has access to email wherever he is.

Now GOLD has a new method for notifying the doctor. At the bottom of the screen, there is an option to send an

When the patient registration screen has been filled out, there are two ways to send the email.

Staff can select the button and activate the email program by choice. That way only doctors who want to be notified will be sent a message.

The email controllers can be connected to the UPDATE button and will automatically activate the email program for ALL patients.

In the above example, only has the controllers tied to the button so this email is optional when admitting a patient. When selected, the OUTLOOK email program is automatically activated, the patient last name, first name, birth date and sex are transferred and the email is displayed in a separate window.

The email had the following data already present:

1) Doctors email address – this was read from PRDOC and inserted in the TO field.

2) Subject – NOTICE OF ADMISSION

3) Patient data with all titles and information listed in the message body.

Admitting staff can also type comments in the body and include a CC:

When finished, simply select the button to send the email.

PRDOC was coded to contain the doctor’s "PCDOCHEM" email.

WHERE "0PTADDXA" IS VALUED AND "0PTADDXB" IS VALUED

THEN {"UEMAIL" = CONCAT('mailto:', "PCDOCHEM", '?subject=Notice Of Admission', '&body=Your patient was admitted today at General Medical Hospital:', '%0A%0A', 'Last Name = ', "0PTADDXB",'%0A%0A', 'First Name = ', "0PTADDXA", '%0A%0A', 'Birthdate = ', "C0813", '%0A%0A', 'Age = ', "C0817")}

The doctors email address could have been selected from the address book if PRDOC had not been set up with the doctor’s email. Just leave the MAILTO empty: CONCAT('mailto:?subject

A) Define a new field UEMAIL -

B) Create a GUI controller –

C) Insert one of the following two code options in that controller –

Invision:

WHERE "0PTADDXA" IS VALUED AND "0PTADDXB" IS VALUED

THEN {"UEMAIL" = CONCAT('mailto:?subject=Notice Of Admission', '&body=Your patient was admitted today at General Medical Hospital:', '%0A%0A', 'Last Name = ', "0PTADDXB",'%0A%0A', 'First Name = ', "0PTADDXA", '%0A%0A', 'Birthdate = ', "C0813", '%0A%0A', 'Age = ', "C0817")}

Signature:

WHERE "N1001" IS VALUED AND "N1002" IS VALUED AND "N1009" IS VALUED

THEN {"UEMAIL" = CONCAT('mailto:?subject=Notice_Of_Admission', '&body=Your patient was admitted today at General Medical Hospital:', '%0A%0A', 'Last_Name=', "N1001", '%0A%0A','First_Name=', "N1002", '%0A%0A', 'Birthdate=', "N1009", 'Age=', "N1010")}

D) Create a HYPER-LINK controller –

E) Enter the “UEMAIL” field in that controller –

F) Add one of the following two code options to the predisplay –

Invision:

WHERE "0PTADDXA" IS VALUED AND "0PTADDXB" IS VALUED

Signature:

WHERE "N1001" IS VALUED AND "N1002" IS VALUED AND "N1009" IS VALUED

G) Build an button

H) Attach the controllers to the button for

optional emails or attach the to the for automatic emails.

I) Insert the button in a GOLD screen of your choice. When the is selected, , the OUTLOOK email program is automatically activated, the patient last name, first name, birth date and sex are transferred and the email is displayed in a separate window.

Now you can send email !

Explanation of the email code:

WHERE "0PTADDXA" IS VALUED AND "0PTADDXB" IS VALUED

Notation / Meaning
mailto: / Send to email address
?subject / Subject
&body / Message body
= / Separates each name and value, in the form name=value.
Separates name/value pairs, as in name1=value1&name2=value2
% / %0A represents a newline (line feed) character. Use "%0A" for a new line, use "%0A%0A" for a new line preceded by a blank line.

NOTE: You can use this in many GOLD pathways. By simply changing the data fields in the controller or adding more fields, you can use email for :

· Clinical / Orders pathways – inform the doctor when a certain test was scheduled or medication ordered.

· Patient Accounting – send a note from the PA application to a financial counselor with a question about a charge on a patient account.

· Patient Management – send an email of a patient requesting a visit to the Chaplain.