Cardex

The 'Cardex' system is a Departmental Information Management System devised and developed entirely within the Manchester Heart Centre. The 'Cardex' team is lead by a clinician, Dr Adam Fitzpatrick, and includes software developers, nurses, management and administration personnel, and liaises with users to tailor the system to ever updating requirements.

Cardex was devised to meet the need for an integrated information management system within the integrated departments of cardiology and cardiothoracic surgery in the Heart Centre. Cardex is a modular system incorporating modules for the diary/scheduling, a core patient database which derives its data from the Hospital Information System, clinical specialty modules, reports generator, correspondence and stock control.

We are developing ways of networking the x-ray images required for clinical decision-making and more efficient patient care, along with wireless technology to collect information at the bedside. We are actively exploring ways of linking electronically with District General Hospital referral centres and with primary care groups.

The Cardex system has been developed using an Omnis Studio front end and a DB2 database. It has been developed as a multiplatform system running on both PC's and Apple machines (and shortly with access via PDA palmtop devices). The system can also be accessed through wireless devices and off-site via Modem & ISDN with secure connections.

Users Guide

Contents - Use the box below to selectect parts of the user guide

Users Introduction Logging In Diary User View How to create an event Category Types Ward Location / Summary Private Events Patients Private Patients Trusted Users Date Options in Diary Add, Edit & Delete To Do, Print & Day View Week's & Day View Summary Examples Staff Contacts Add Contacts Patient Finder

Introduction

The Diary is one of the essential parts of the Cardex computer system. Its main purpose is to help every member of staff effectively manage their time, and also to enable them to communicate with each other. Over the past few months, there have been some quite radical changes in the way the Cardex Diary has been set up.

Users
Every member of staff in the Heart Centre (MHC) should have their own Diary User in the system. If you don't think you have a user, or cannot remember your password, contact either John , Phil or Nikki ext. 4269 or 5796. Or email :help@cmmc.nhs.uk

Your User is your point of entry to the diary. It is, if you like, your doorway into the MHC Diary. This is important, as it reflects the fact there are no longer individual diaries for different members of staff, but one single Diary to which everyone has access.

Logging In

You first need to log in using your user name and password and select the Diary from the top right hand corner of your screen (see screen below) . After the Diary button is selected, you will enter into the main page of the Diary, which illustrates the events, and messages put on by different users around the Heart Centre. The Diary runs under two main functions, a Diary View and a User View.

Main menu after log-in process

Diary View

A Diary view appears at the top left-hand corner of your screen. It consists of a list of Categories containing sub-functions that have been set up for users to minimise the duplication of data. A User can create their own Diary view by simply going to File--> Preferences and Diary Views, and creating a New View select all the sub-functions that relates to him/her in one way or other (e.g. meetings, labs, theatres). When you are happy with your selection simply save it and return to the main page.

User view

A User View contains a list of teams that has already been set up for users to select. A user selects a team from the list depending on their job and the team they work for. So for example, the team members which may come under APF Team would be (Dr Adam Fitzpatrick and his secretaries) and so on. You can create your own team by going to File, Preferences and User View, and from there creating a New View by selecting a team name and the staff who needs to be listed in your team and press Save. After you save it, the team name is now listed in your User View for you to select.

How to create an Event

In order to create an event, firstly select the day/date in week events and double click, or select Add Event box on the top of the screen. The Event box should now appear on your screen. Note that the Event Owner box has already been filled in with your name. However if you are creating an event on behalf of another user, you can change the event owner with the actual owner as long as the real owner has selected your name as a trusted user. (For more information see Trusted Users).

Category

Every Diary entry has to be entered into pre-designed categories that have been designed to cater to all of our requirements. The Categories are intended to be much more general in order to share the data. For example, all meetings will be entered into the Meeting Category, regardless of who owns them or who is to attend. Thus, a Secretaries' Meeting would be entered into the User Secretary, with a Category of Meeting.

The Cath Lab categories are there for Cardiologists' to enter details of the procedures they will be performing and the Theatre Categories are there for the CTO Surgeons to use in the same way. Each procedure must be assigned to the correct Lab or Theatre, in order to allow Users to interrogate the system over Lab/Theatre usage. This will assist in the scheduling of the Labs/Theatres, but Consultants should still enter the details into their own User, so that they become the Owner of the Diary entry. Other Users can view these entries provided they have selected the relevant Consultant's User in their User View.

Types

The available types will vary depending on what category you have selected for your diary entry. For example, a category of Cath Lab1 will allow you to select from a variety of Types. Further types can be added if required by notifying a member of the IT team. The Types of Cath Lab procedure will be taken from the list of service lines for procedures that are currently performed in the Labs, eg LV+C for an angiogram. These Types will display the procedure itself on the screen.

Ward

Pre-designed selections of Wards have been set up for users to select. All the wards within MHC are listed which allows selecting the ward, depending where the patient is admitted. If you feel there is no need to enter a Ward detail then simply leave the section blank.

Location / Summary

As in Ward section, location also has a pre-designed set of selections within the MHC. It will be useful to add this detail especially in Meetings and Seminars where the recipient needs to know the location of the event. If there is any location that you might think would be useful to put in please let a member of the IT Team know. The Summary box is designed to write a summary of the Event. When you are creating an Event the summary needs to be entered, so that you or other users know what the Event is about. The summary will then be displayed on the Main Diary View.

Private Events

In order to enter a personal entry i.e. appointment with the Dentist or reminders of family Birthdays, there is a function available in the Category section known as "Personal" and of Type "Private". It has been designed only for the user to view the messages without allowing anyone else to view (For more information see Categories and Types). Private events may still be made available to selected individuals through the use of the List Users button. This would allow only those selected users to view and access the message. The use of the private box should be exercised with some caution, reserving it for truly private events. This is because any event marked as Private will not appear on the screens of other department members even though they have the relevant Category in their Diary View. By using this facility inappropriately, we will lose the great advantage of the network Diary system; namely it's ability to share the information between interested parties. You may, for example, feel that only you need to know when you are on holiday, but this information is valuable to others and should be shared with them through the Diary.

Patients

There is a box on the Diary event screen for the patient's details to be entered by selecting them from either the Cardex database or downloading them into Cardex from PAS. It is essential if we are to gain the full benefits of the Cardex system that these details are entered from the database, rather than just typing the name into the Summary field. In order to select a patient, click on the Select option shown above and it will take you to the Patient Finder. After the required information is added, the system will bring up the list of patient/s. Select the required patient details and double click to add them to the event. However if the patient list is blank then you may need to select the Download button and request the file from PAS.

By selecting a patient from the database, links are automatically forged between the Diary event and the Patient, allowing quick retrieval of their personal details through the system. It may take a few moments longer to input the event, but it will save time later.

Private Patients

Private Patients are often treated in the MHC facilities. In order to assist the scheduling process, these events will still need to be entered into the correct Lab/Theatre Category. All Surgeons have two lists of functions, e.g Dr Adam Firtzpatrick has two lists of functions; one for normal use and the other for Private Patients containing PP in the end of the name like Adam Fitzpatrick PP. It is important that their secretaries would be made trusted users for both functions in order to input Private patient details on their behalf.

Trusted Users

A Trusted User is a facility available in the system that allows users to set others as their Trusted users. The facility to appoint Trusted Users may seem worrying to some people, but it simply allows those Users to make entries into the Diary with the Owner shown on the screen as the person attending the meeting instead of the person inputting the event. So for example all the Cardiologists' have to make Sue Kemply (Catheter Lab Administrator) as their trusted user in order for Sue Kemply to input procedures on the Cardiologists' behalf. In addition, they will need to make Jenny Walsh (Catheter Lab Stock Co-ordinator) a Trusted user if she is to book their meetings with Representatives. For CTO, Andrea Dayson (waiting list Co-ordinator) will need to be a Trusted User of the Surgeons in order for her to enter for them. Also it will obviously be necessary for every Consultant to make their Secretaries Trusted Users. You can make a user as your trusted users by going to File, Preferences, Trusted User. The setting up of the Trusted Users for each individual will need to be completed before the department as a whole can operate effectively through the Cardex Diary. If it is to work properly and provide the benefits that are possible through the sharing of the information about what is happening throughout the MHC, everyone needs to put some initial effort into getting it set up correctly. If you are unsure as to what you need to do, please contact John, Phil or Lindsay for further help and information.

Date Options available in Diary

These options allow users to browse past and future events or to select a specific date that they wish to view.

Add, Edit or Delete Events

To create a new message a user can either Double click on the screen or select Add Event from the option bar. Edit and Delete event buttons would modify or delete the whole event.

To Do, Print, Day View

The To Do button enables users to view any events that have been marked as To Do when the event was created, with each entry having a priority. We also have the option to Print Diary entries out for the Day, Week and a Snapshot of the Week so that we can see what is happening today or for the whole week.

Another feature is the More Info button, which, when clicked will give you the option of displaying a Patient/Contact and GP and record for an event (if this Information has been linked to properly in the Event). So, if we link the record to a patient, this option would show us the patient's record as well as their GP's details, but if we linked it to a Contact then we would only be able to display the contacts details.

Week's and Day View

Once a user is logged into Cardex and runs the Diary, he/she will automatically view the Week's events. The Week View is set up for the users to see forthcoming events of the week including today's events. However the information available in the Week View is limited and you can only see part of the information about each event, (see appendix 1). If you want a daily view of events rather than a weekly one, simply go to either the Main Menu and select Diary Day or select the appropriate button on your screen. This option will allow you to view the days events in greater detail. To return to the Week View, simply repeat the process, and instead of selecting Day View, select Week View or, instead select the same button on the screen.

Summary

The entire Cardex Diary has been simplified for your use. Please use it as much as you can, in order to allow us to iron out any small problems, as there will be some even though the new implementation has been carefully thought out and designed with you in mind. There are some members of staff in the Heart Centre who have not yet received any training in the use of the Cardex Diary.

If you feel that you require a training session, please let me know as soon as possible so that arrangements can be made. Your co-operation is much appreciated. Any comments are welcome.

If you have any queries, please contact: John, Phil or Nikki on ext. 4269

How do I enter ...

1) My Holiday?

User	Category	Type	Comment
Self	Holiday	Am	Morning off.
Self	Holiday	P.m.	Afternoon off.
Self	Holiday	All Day	Day off.

2) My Colleague's illness?

User	Category	Type	Comment
Colleague	Absence	Sick

3) My attendance at a conference?

User	Category	Type	Comment
Self	Absence	Conference

4) My attendance at a funeral?

User	Category	Type	Comment
Self	Busy	Unavailable

5) My giving a training session?

User	Category	Type	Comment
Self	Busy	Training

6) My performing some private work-related function?

User	Category	Type	Comment
Self	Busy	Unavailable

7) My performing a procedure?

User	Category	Type	Comment
Self	Cath Lab n	Service line code

8) My performing an operation?

User	Category	Type	Comment
Self	Theatre n	Cardiac / Thoracic

9) My attendance at a Consultants' Meeting?

User	Category	Type	Comment
Consultants	Meetings	CTO	Kerry will do this for you!

10) My attendance at a secretaries Meeting'?

User	Category	Type	Comment
Secretary	Meetings	All	Kerry will do this for you!

11) My Meeting with a Representative?

User	Category	Type	Comment
Self	Meeting	Representative

12) My Friend's Birthday?

User	Category	Type	Comment
Self	Personal	Private	Only you can see

13) My appointment at my doctor's?

User	Category	Type	Comment
Self	Personal	Private	Only you can see this.

14) My On-Call commitment?

User	Category	Type	Comment
Self	On-Call	On-Call
Self	On-Call	Cardiologist
Self	On-Call	Cardio Regs
Self	On-Call	Surgeons
Self	On-Call	Surgeons Regs
Self	On-Call	Senior Nurses
Self	On-Call	CMHT

15) My attendance at an outreach clinic

User	Category	Type	Comment
Self	Absence	Outreach

How do I see........

1) My Holiday?

User	Users in Set	View	Categories in View	Comment
Self	Self	Holiday	Holiday	Only own holidays shown

2) Holidays for my team?

User	Users in Set	View	Categories in View	Comment
Team	Own Team Members	Holiday	Holiday	Shown for all team members

3) Holidays for all Secretaries?

User	Users in Set	View	Categories in View	Comment
Secs	All Secretaries	Holiday	Holiday	Holiday Shown for all Secretaries

4) My team colleagues' absence?

User	Users in Set	View	Categories in View	Comment
Team	Team members	Absence	Holiday + Absence

5) Procedure in the Labs?

User	Users in Set	View	Categories in View	Comment
Cardio	All Cardio Consultants	Cath Labs	Cath Lab 1,2,3	Show all MRI procedure

6) My operating schedule?

User	Users in Set	View	Categories in View	Comment
Self	Self only	Theatres	Theatre 3,4,7,Alex	Shows all own operations at these sites

7) My schedule for the week (Secretary)?

User	Users in Set	View	Categories in View	Comment
Self Work	Self + Secretary	Work	Meetings + Holiday + Absence + Busy +Personal	Shows all events for these Categories

8) My schedule for the week (Consultant)?

User	Users in Set	View	Categories in View	Comment
Self work	Self + Consultants	Work	Cath Labs/Theatres + Meetings + Holiday + Absence + Busy + Personal	Shows all these Categories

9) My personal commitments?

User	Users in Set	View	Categories in View	Comment
Self	Self	Personal	Personal + Busy	Include Busy to see private events in work time

10) The departmental On-Call rota?

User	Users in Set	View	Categories in View	Comment
Consultants	All Consultants	On-Call	On-Call	Could be refined to show only Cardio or CTO On-Call rota

ADDING EVENTS TO THE CARDEX DIARY

Non-Medical Events

Click on Add Event

If you are adding the event for a colleague, click on the event owner box and select their name (You have to be a trusted user of that colleague)

· Select the Category that you wish to enter eg. meeting and then the sub-category Of Type eg. Team Briefing.

Select a location (if the meeting is to be held at a venue that isn't listed then leave the field blank).

Enter brief details of the event in the Summary field

Enter the date and time of the event (either using the arrows or by typing them in)

If you wish you may add the event to your "To do" list and assign it with a priority status. You may also choose to make the event private to just yourself and a selection of other users (eg. doctors appointment). If so click on the appropriate tick-box. (To enable selected colleagues to view the event, click on List Users, select their names from the list and Save.)

If you want the event to be a repeat event (eg a weekly meeting) click on Repeat and indicate in the relevant box how often you want the event to be repeated and for how many occurrences.

Add any further details that you think may be useful to add in the Details box (eg. venue, names, telephone numbers etc).

Click on OK to add the event to the diary.

Medical Events

Click on Add Event

If you are adding the event for a colleague, click on the event owner box and select their name from the pop-up box (You have to be a trusted user of that colleague)

Select the category that you wish to enter eg. Lab 1 and the sub-category eg. LV&C by clicking on the relevant boxes

You may wish to enter the patient's ward details by clicking onto the ward field and selecting the appropriate ward form the list that appears

Enter the patient's name in the Summary field

Enter the date and time of the event (either using the arrows or by typing them in)

If the event that you are adding is a medical procedure then you need to enter the patient's details in the Patient field. To do this click on the patient field and choose Select. This will take you to the Patient Finder. Enter the patient's case note number into the relevant field and select Search. If the patient details don't appear then they need to be downloaded from PAS. Click on Download and then Request Download of listed numbers. Wait for a few seconds (approximately 20-30 seconds) and then click on the Search button again. (NB. If the details do not appear wait for a further few seconds and then click on Search again.) When the patient's details are displayed on the screen, double click on them and they will be copied over to your event.

Add any further details in the Details box if required.

Click on OK to add the event to the diary.

NB. To view the event in the diary, check that you are in the correct view.

Contacts

Contacts is a database used for the purpose of storing contact details for all members of staff in the Manchester Heart Centre and those who are associated with it e.g. contractors, medical reps and other departments within the MRI, etc.

A user can find contact details either by using specific information to search i.e. a surname or a list of all contacts can be produced enabling the user to browse through the list.

If you wish to add a contact to the database, simply click on Add New Contact and complete the contact's details on the form. The field Familiar provides an extra search criteria other than the person's name. For example, if the contact you are adding is a medical rep you could enter the name their company under Familiar or perhaps a persons department if they work in the hospital.

Adding a new contact

Once you have completed as much detail as possible, click on Save and the contact will be added to the database.

To search the database for a contact you can search under Surname, Forename or Familiar. To view all records in the database, leave the search fields blank and click on Search.

The biggest advantage of the Contacts database is that all contact information is stored centrally and is available for all MHC staff to view for future reference. If you store all of your contacts details in Cardex you can then access all records from anywhere in the Heart Centre.

Patient Finder

The Patient database is an essential part of the Cardex system and is designed to link in with every part of the system, from the Diary, to the CTO module to the Cardiology module. It has links to the PAS system which enables data to be downloaded and kept as up-to-date as possible.

The main function of the Patient database is to store the details of each patient that passes through the Heart Centre. The user can enter the Hospital number to see if the patient is already on Cardex. If the patient is not yet listed in the Cardex system then his or her record can be downloaded from PAS.

To search for a patient on Cardex

1. Enter the hospital number into the Case Note field
2. Click on Search
3. If a record does not appear then the user will need to download it from PAS.

Click on Download. That will open the Download Requests screen. Click on Request Download of Listed Numbers. After a delay of about 10 - 20 seconds (to allow the download to take place), click on Search and the patient record will appear. If it does not appear immediately, click on Search again.

If you double click on a record it will display the patient's details (including name, address, age, religion etc.) which have all been downloaded from PAS.

You will notice on the Patient Finder screen above that when a record is selected the following information for that patient becomes available: GP Details, History, Pacemaker, Next of Kin and Reports.

GP Details will provide the user with the name and address of the patient's GP which have also been downloaded from PAS.

By clicking on List Patients a user can see all the patients that have passed through the system who are under the care of that GP. Copy GP Address and Copy Patient Address will copy names and addresses onto the computer's clipboard enabling a user to paste the details into a Word document.

By clicking on History a user can view the date of any diary events for that patient e.g. date of surgery, date of Cath Lab procedure.

Pacemaker will allow a user to view any pacemaker details if the patient has undergone a procedure.

Next of Kin displays the patient's next of kin's name and address and provides a facility to copy the details so that they can be pasted into a document if desired.

If you do not have the patient's hospital number you can undertake a search using the patient's surname which will produce a list of all patients of that surname.

Any Questions ??

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