IMPAX 6.5.1 Client Knowledge Base: Extended > Getting started > Administration: Getting started
Emergency room physicians use the IMPAX Client to view the images for their patients and, sometimes, perform preliminary diagnosis, or wet reads. They also use the IMPAX Client to view the reports created by radiologists.
The following configuration is describes how to set up an ER workflow that handles viewing reports, making wet reads, and handling differing interpretations (when the preliminary diagnosis differs from the radiology report). This configuration is suggested only, as your site may have different workflow needs.
1. Create a role for emergency
Creating a role simplifies the task of providing ER users with the licenses, permissions, and preferences they need. As a shortcut, use the Emergency Department sub-role under Clinician in the default role hierarchy shipped with IMPAX. The Emergency Department role has default permissions and preferences that make configuration faster. If required for your workflow, you can create sub-roles under Emergency Department for Attendings and Residents.
2. Add ER physicians and residents to this role
Add clinicians who work primarily in the emergency department to the Emergency role as their primary role. If some clinicians cover different departments, you can place them into these specialty roles as their secondary roles.
3. Assign the Clinician license or Enterprise license to the emergency role
Licenses are assigned to roles; any users belonging to those roles can use those licenses. Assign a Clinician license or Enterprise license to the emergency role, and ensure that this is the default license for this role.
4. Modify the permissions for the emergency role
The set of default roles in IMPAX also has default permissions appropriate to those roles. For example, ER physicians would never have a permission that lets them dictate. But they will have the ability to add study comments as part of a preliminary diagnosis workflow. You can create different permissions, if required, for your specific workflows. Or, you can edit the permissions shipped with IMPAX.
Ensure that you have defined an emergency access permission for the Emergency role. This allows ER physicians to gain access to studies that would otherwise be restricted, but audits that access. Also include the General operation to Search for Open Studies (that is, perform a “wet read”).
5. Create a system-wide keyword for "differing interpretation"
Radiologists can add this keyword to the study if their report disagrees with the original study comments added by the ER physician. The keyword can then be used to populate the Differing Interpretations worklist.
As part of training for the radiologists, ensure they know how and when to add this keyword.
6. Configure the Text area to show the appropriate information
The Text area has three bars that can be expanded to show information: Order, Study, and Report. The position of these bars is remembered for new and for dictated studies. To ensure that the Study bar is positioned to show the study comments easily, impersonate the emergency department role, open a study with a New status in the Text area, and reposition the Order and Study bars (the Report bar can be closed). You can repeat this process for a Dictated or Approved study so that the Report bar is fully expanded and ER physicians can quickly see the report and its key images.
7. Create any favorite study comments that would be useful for ER physicians
ER physicians will use the Study Comments section in the Text area to add their wet read comments or to add extra clinical history. You can define a set of favorite study comments to use, based on studies from different modalities. For example, a comment for a Chest CR could be “Pneumonia”.
As part of training for ER physicians, ensure they know how to add study comments as part of a preliminary diagnosis workflow.
8. Create three standard worklists for the ER that are updated automatically
Use the following steps to create these recommended worklists.
Create three standard worklists with the suggested criteria:
| Worklist | Description | Criteria |
|---|---|---|
| ER Incoming New | Includes all studies that have been acquired for patients in emergency | Current Patient Location is ER Status is New |
| ER Incoming Reported | Includes all studies that have been reported for patients in emergency | Current Patient Location is ER Status is Approved* *At sites that do not use an integrated voice recognition system, add a second Status criteria with a value of Reported. Then physicians know when the radiologist has dictated the study, even though it has not been signed off. |
| Differing Interpretations | Includes all studies in which the radiologist's report differs from the wet read done in emergency | Keywords is differing interpretation |
Note that the criteria may need to change depending on the information available. For example, the Current Patient Location criteria may need to have multiple values to capture all ER patients.
Set the preference for the emergency role so that these worklists are updated automatically with incoming studies.
Impersonate the emergency role and add the emergency worklists to the List area.
This displays the worklists for every user in the Emergency role.
9. At the ER station or stations, disable automatic logout
In an ER environment, physicians are constantly walking up to and away from the IMPAX station. Automatic logout can hinder this type of use; therefore, you should disable automatic logout.
Normally, most ERs use single, color monitor stations. In the Configure area - Stations section, you can group the ER stations, then configure them all at once.
Topic number: 8932 Applies to: IMPAX 6.5.1 Client Knowledge Base |