# Postings Details

The plug-in displays an on-click pop-up pane that includes two levels of detail for your patient's postings. On the left side of the pane, it displays a list of postings that fall within the following three categories:

- Allergies/Adverse Reactions
- Crisis Notes, Warning Notes, Directives
- Flags

For allergies and adverse reactions, the list displays the name of each substance (causative agent) that has triggered a reported allergic or other adverse reaction, followed by a brief description of the reaction's nature (hives, for example). For crisis notes, warning notes, and directives, the list displays each item's type (Crisis Note or Advance Directive, for example) followed by the item's date.

When you select an item on the list, the pop-up pane's right side displays details that vary according to your selection's category.

## Allergies/Adverse Reactions

For items in the Allergies/Adverse Reactions category, details include the following information. If the patient has no reported allergic or other adverse reactions, the detail portion of the pane displays the word None beneath the Allergies/Adverse Reactions heading.

- Causative agent (the causative agent's name—Metoprol, for example)
- Nature of reaction (information about the reaction's cause: allergic or pharmacological, for example)
- Signs or symptoms (the reaction's manifestation—anaphylaxis, for example)
- Drug classes (classes into which pharmaceutical causative agents fit—beta blockers, for example)
- Originator (the surname, first name of the person who entered the allergy or other adverse reaction)
- Originated (date and time the originator entered the allergy or other adverse reaction)
- Observed/historical (one word, Observed or Historical, that indicates whether a healthcare professional observed the patient's reaction or the patient reported the reaction)
- Severity (the plug-in displays this information only for observed reactions; information includes observation date and time and the reaction's severity—severe, moderate, or mild)
- Verified (formats are still under discussion)
- Comments (the plug-in can display multiple comments, each of which includes the author's surname, first name, and the comment's entry date and time)

If the patient has no reported allergic or adverse reactions, the detail portion of the pane displays the word None beneath the Allergies/Adverse Reactions heading.

## Crisis Notes, Warning Notes, Directives

For items in the Crisis Notes, Warning Notes, Directives category, details include the following information:

- Local title (Crisis Note, Clinical Warning, or Advance Directive, for example)
- Standard title (the plug-in displays standard titles only if they differ from local titles)
- Date of note (a user-entered date—dd-mmm-yyyy format—that helps the user locate the note)
- Entry date (the date a user entered the note—dd-mmm-yyyy format)
- Author (surname, first name format)
- Status (completed, or unsigned, for example)
- Facility (the name of the institution associated with the note)
- Note body (the note's text)
- Signature (the note author's signature—electronic signature, surname, first-name format; date and time of signature, dd-mmm-yyyy hh:mm format)

If patients have no notes or directives in their charts, the plug-in displays the word None beneath the Crisis Notes, Warning Notes, Directives heading.

## Flags

For items in the Flag category, details include the following information:

- Flag name (the flag's Category I or Category II name—Behavioral, High Risk of Suicide, or Urgent Address as Female for Category I flags, for example)
- Assignment narrative (a brief text description that the person who assigned the flag wants users to see—"patient has threatened violence in the past," for example)
- Flag type (Clinical or Research, for example—flag types are distributed with nationally released Patient Record Flags software packages)
- Flag category (I (National) or II (Local))
- Flag assignment status (Active or Inactive)
- Initial assigned date (the date on which an authorized user initially assigned the flag—mmm dd, yyyy@hh:mm:ss format)
- Approved by (the surname, first name of the user who assigned the flag or "Chief of Staff" if the site does not have ownership of the flag)
- Next review date (the date on which the flag is due for a review)
- Owner site (the site that currently owns the flag)
- Originating site (the site that originated the flag)
- Attached notes (notes that are attached to the patient record flag, displayed using the same format that crisis notes, warning notes, and directives use)

## Clinical Practice Environment

With its CPE (Clinical Practice Environment) application, the HMP Team Facing framework delivers software that serves healthcare teams and helps meet their needs in caring for our veterans. CPE software will help transition Veterans Health Administration from a chart-centric model of care to a team-based, patient-centered model of care through advanced clinical software and a modern software architecture. This software represents an effort to reestablish close clinician-IT collaborative relationships and to build field-driven, web-based modules that meet the following functional and technology goals.

- Functional Goals:
  - Comprehensive, coded, integrated data
  - Knowledge-driven, context-based decision support
  - Role- and conditions-based workflow-driven systems
  - Multi-patient, team-based care
- Technology Goals:
  - Open source, with a service-oriented architecture (SOA)
  - Web-based, with a flexible, scalable architecture
  - Context-aware, with an extensible, modular platform