Scheduling and Registration

When scheduling in RIS via CRM interface, a RIS user account must be passed in to be used when locking/reserving results. However, when a single shared user account is used in this manner, the interface will return locked appointments if the userID that locked them is the same userID that is requesting time slots, thus multiple users attempting to use this method will see all locks made by another patient out on the web.

To support multi-user scheduling via CRM interface using a single shared user account, the web method exposed to the CRM has been updated.

Users can now still see timeslots they have locked by their session as available, but not see other patients' timeslots as they were locked by a different workstation id.

When interacting with patients, it is critical to confirm the patient's identity, and to document in the RIS that the identify verification was completed.

Currently, this action is captured in the following locations using the ID Verified checkbox:

When documenting that patient identification has been performed using the existing ID Verified checkbox, RIS will now display a new ID Verified by… dialog to document the specific verification method used, such as driver's license, passport, or wrist band.

The choices that appear in the drop down for verification method are configurable.

This new value will be captured on the Reception, Technologist Documentation, and Exam details screens. Note that while all three utilize the same lookup, each screen saves the user selection independently.

Contrast Injection screen showing the patient ID was verified by a Passport document.

1. Configure ID verification methods in the l_id_verification_method lookup table.

3. Enable the RegistrationBarcodeIDVerificationMethodCode SysConfig value if desired.

1. The l_id_verification_method lookup table is used to configure ID verification methods.

1. PromptForIdVerificationMethod (default is false) - Setting this value to true enables a dialog to prompt for a Verification Method value when the ID Verified checkbox is checked.

2. RegistrationBarcodeIDVerificationMethodCode (default is <blank>) - The Verification Method value used when opening the Registration screen via an ID’s Barcode.

Currently, an order from an EMR or other interface method to RIS does not automatically generate the billing entries for the procedure.

To support workflows that arrive a study via interface, RIS will now handle the case of no study item certification (SIC) rows being sent in the message (the sending system may not care or know about our billing codes).

Feature #21385 - Support reduced duration for additional procedures on the same order and room

Feature #21386 - Support searching for 0 minute duration procedures in scheduling

Feature #21388 - Combine consecutive procedures on the same order and modality in the appointment book

Feature #23118 - Access string to control combining of concecutive appointments

Currently, when a procedure is scheduled, there is a default duration that comes from the procedure code table (RIS also supports an alternate "automatic override" value). When an additional procedure(s) is added to the same order, the normal process is for the duration of the subsequent procedure to be populated with the same default value as if it was scheduled alone.

However, in cases where multiple procedures are being performed on the same modality (scanner/room), this full duration may not be required, as the patient preparation is already complete (they are already on the table), therefore an alternate duration (reduced or even 0) may be appropriate instead.

This feature enhances the handling of multiple consecutive procedures on the same order. Rather than treating each as an independent appointment, adjacent procedures can be adjusted in duration to accommodate the efficiencies of completing multiple activities in a single visit. Additionally, adjacent procedures can be visually combined, and overall duration reduced.

A new Alternate Duration column has been added to the ProcedureCode table, in addition to the existing suggested Duration column and "automatic override" value (see Note).

When an alternate duration is specified for a procedure code, that time be used for subsequent procedures rather than duration.

Valid column values are Null, and the numbers 0 to Max (max duration). The behavior when a subsequent procedure is added to an order with the same modality type as the previous study is:

· When the alternate value is Null, it will be ignored, and the original duration will be used as it is today (i.e. support legacy behavior).

· When the alternate value is 0 minutes, the procedure will be given start and end times identical to the end time of the previous procedure and they will display as combined.

· When the alternate value is non-zero, it will be used as the duration for this subsequent procedure.

1. If a modality or site/template/tech or rad duration "automatic override" value exists, it will be ignored for that instance and the duration of the subsequent procedure will come from the newly added procedure code column.

3. The search screen may display the original duration on each procedure (current search behavior), but the search results will offer the reduced time when it is a subsequent procedure. This behavior is necessary as the procedure is only 'subsequent' if the search engine is able to find a long enough consecutive time block to accommodate both procedures. If it needs to separate the procedures, the original duration will be used.

Scheduling Search now supports a duration of 0 minutes. This change is in support of the consecutive procedure functionality.

Scheduling search results will use scheduling interval to separate different timeslots.

Note that a subsequent procedure that is on the same order and on the same modality (room) but is NOT adjacent may NOT have a duration of 0 minutes (i.e. if not sharing the time slot, it must have its own duration).

With the above enhancements in place, RIS now supports combining consecutive procedures on the same order and modality in the appointment book. This is controlled with the SysConfig setting:

Previously, manually adjusting additional procedure displayed them as consuming a 5-minute time slot.

With this change, procedures will display in a combined entry in the appointment book:

· The first procedure will have the (normal) duration associated with that procedure.

· Procedures immediately following will be visually represented in the calendar as a combined item.

· Subsequent procedure of 0 duration start and end times will exactly match the end time of the previous procedure

· The new feature 21385 allows subsequent procedures to have a different duration for a subsequent study on the same order/modality (room).

· The description of the main procedure will indicate the presence of additional procedures, e.g. (+3)...

· The tool tip will list each of the overlapping procedures, including their duration.

Edit the ProcedureCode table to define an Alternate Duration per procedure as desired.

Schedule an order for two procedures with the same modality type. Search for appointments and choose one of the results that makes the procedures consecutive and save. The appointment book will combine the appointments and display the procedure breakdown in the tooltip.

· Schedule an order for two procedures with different modality types. Search for appointments, choose one of the results, and save. The appointment book will not combine the appointments.

· Schedule an order for two procedures with the same modality type, leaving a gap of time between the two procedures and save. The appointment book will not combine the appointments.

A new field has been added on the Clinical tab to display patient blood type as a dropdown list box. In the case of a HIS driven workflow, custom access strings make this a read only field. Blood type is stored on c_patient database table and is prepopulated on the form.

Previously, when multiple scheduling templates existed with overlapping date ranges, RIS would use the default duration rather than template duration, even if the template times did not overlap.

Now when multiple scheduling templates exist for the same modality, the template's duration override will be used unless the templates have both an overlapping date and times, in which case the default duration will be used.

Previously, RIS only supported creating modality closures and restrictions via the modality lookup table.

With this enhancement, schedulers are frequently adding non-recurring closures, can create these simple closures directly from the appointment book.

Users with permissions can use the new appointment book Create Closure context menu option to open a dialog to create a simple modality closure or restriction.

· Config.AppointmentBook.ModalityClosure (default = None) - Allows user to create modality closures and restrictions from the appointment book.

This enhancement changes the behavior of MRN search from the Patient Search screen to disregard leading zeros when searching.

Note that this change does not update the MRN as stored in the database, as the MRN for billing must include the leading zeros.

For example, an official MRN might be prefixed with one or more zeros, such as MRN 00012345. When a patient search is performed, it should locate this record whether the MRN search was specifically for "12345", "012345", or "00012345".

Note that search results will still include any leading zeros, and when the MRN in the search criteria is not an exact match to the MRN in the database, RIS will highlight the (legit) MRN in red in the search results:

When there are multiple studies with the same procedure group, selecting a room for one study can now automatically populate the same room into the other studies.

Currently when a Walk-in is performed, each study and each room must be selected. Similarly, when scheduling, a room can be manually select for each study.

However, when there is more than one study of the same procedure group, they will most likely be for the same room. This request simplifies re-using the same room for all studies that have a matching procedure group.

When multiple studies exist, selecting a room for one study will automatically populate the same room for the other studies, provided:

· The user has permission to schedule the other procedure in the same room, based on their schedule groups.

Two new access strings have been added, Clinical.Walkin.AutoCopyRoom to control this feature for Walk-in and Clinical.Schedule.AutoCopyRoom to control this for the Scheduling window.