Patient Profile

From COVID-19 CY National eHealth Platform of the Ministry of Health for Inpatient and Home-monitoring and Treatment
Revision as of 21:45, 31 March 2020 by Covid19admin (talk | contribs) (Comorbidities - Social History)
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In this page the patient information given in the Patient Profile screen is described and presented. The description of the terms shown as links (blue font color) in the text can be found in the Terminology page of this wiki. By clicking them the page will be redirected to the corresponding section that the clicked term is located in the Terminology page.

How to Navigate

Figure 1 = Patient Profile Full Screen

The Patient Profile screen is divided in three sections:

  1. The Patient's Demographics and Covid-19 Severity Assessment (the Header of the screen as shown in Figure 1).
  2. The Patient Summary and Charts (Main Body of the screen as shown in Figure 1).
  3. The Patient's EHR (Footer of the screen as shown in Figure 1).

Demographic Data & Disease Severity Assessment

Figure 2: Page Header

The following information is listed for each patient in the header (Figure 2):

  1. Demographics and Hospital accommodation information
  2. Covid-19 Severity Assessment Values

Demographic Data

Basic patient demographics including name, age, sex, and weight are depictedon the leftmost side of the header. In the middle side, information about the hospital, room, bed number, and date of illness is provided.

ARDS - Mews - Glasgow

On the right side, three COVID19 disease severity assessment defined in the clinical treatment guidelines (therapeutic algorithm) issued by the MOH scientific committee are listed, namely ARDS, Mews and Glasqow. The date of last assessment is also displayed. The plus button next to each assessment triggers a modal (popup) window allowing the medical expert to enter the relevant data for updating the severity assessment for each of the three categories.

Add Assessment

The "Add Assessment" button appears on the top rightmost side of the header.

Figure 3 = Add assessment modal (popup) window

A window appears (shown in Figure 3), allowing the user to add the following data:

-Temperature (ºC)
-Heart Rate (/min)
-Urine output (ml/kg/h)
-Respiratory Rate (/min)
-Systolic BP (mmHg)
-pH (7.35 - 7.45)
-PaCO2 (35 - 45 mmHg)
-SpO2 (>93%)
-SaO2 (95% - 100%)
-HCO3 (22 - 26 mEq/L)
-PaO2 (75 - 100 mmHg)
-SpO2%
-Eye opening
-Verbal response
-Motor response

Patient Summary

Figure 4 = Patient Summary clinical information [main body left]

Figure 4 presents the Patient Summary as shown in the Patient Profile screen where the most relevant information describing the patient’s health status are summarized as described below.

Note that these fields are read only. To edit their values you must move to the Electronic Health Record section of the Patient Profile.
  • Comorbidities (find out how to edit this field here)
  • Social History (find out how to edit this field here))
  • Allergies (find out how to edit this field here))
  • Treatment (find out how to edit this field here)
  • Symptoms (find out how to edit this field here)

Medical Charts

Figure 5 = Vital signs and severity assessment indices charts [ main body right].

In the right side of the main body, vital signs and severity indices timeline charts render in a graphical manner the patient’s clinical status over time .

Vital Signs Chart

Figure 6 = Vital Signs Chart

Vital Signs Chart includes the parameters:

  • Heart Rate
  • Temperature
  • Systolic Blood Pressure
  • Diastolic Blood Pressure

Data, for these parameters, can be added by pressing the button "Add Measure" as shown in Figure 6.

PaO2/FiO2 and SpO2/FiO2 Chart

Figure 7 = ARDS related PaO2/FiO2 and SpO2/FiO2 ratio chart.

This chart presents the two primary ratios used in computing the ARDS and Covid-19 severity. The following parameters are used:

The first line of the chart (red color) presents the calculation of the division of the parameter PaO2 by the parameter FiO2 .

The second line of the chart (blue color) presents the calculation of the division of the parameter SpO2 by the parameter FiO2.

SpO2(%) Chart

Figure 8 = SpO2(%) chart

This chart presents the daily measurement of SpO2 parameter.

Electronic Health Record

Figure 9 = Patient EHR menu headings.

The Patient's EHR is located at the footer of the Dashboard screen. The Patient's EHR consists of six main categories, organized in a tab menu, as follows:

  1. Daily Monitoring
  2. Medication & Treatment
  3. Comorbidities & Allergies
  4. Symptoms
  5. Laboratory
  6. Demographics

Daily Monitoring

Figure 10 = EHR - Daily Monitoring tab (presenting the selected tab)

The Daily Monitoring tab of the patient's EHR is divided in 5 sections namely:

Vital Signs

Figure 11: EHR - Daily Monitoring tab - Vital Signs

In the Vital Signs section each column entry corresponds to a vital sign measurement, displayed in a chronological order, starting from the most recent. Normal reference values are given in the 2nd column in Figure 11 while actual values start from the 3rd column. Every actual value that lies outside the laboratory reference ranges appears in red font colour.

Using the "Add measure" button located on the top right part, a new, Vital Signs measurement can be added as depicted in the pop-up window in Figure 12.

Figure 12 = EHR - Daily Monitoring tab - Vital Signs - Add Measure

Arterial Blood Gas (ABG)

Figure 13: EHR - Daily Monitoring tab - Arterial Blood Gas (ABG)

In Arterial Blood Gas (ABG) Section, the Reference Values (2nd column in Figure 13) and the actual values (3rd column onwards in Figure 13) for each parameter of the ABG test are shown. The values are displayed in chronological order starting with the mose recent. Every actual value that lies outside the laboratory reference ranges appears in red font colour.

On the top right part of the Arterial Blood Gas section there is a button named "Add measure" which pops-up a new window, as shown in Figure 14. The values of the Arterial Blood Gas parameters can be added as a new measurement for the current day.

Figure 14 = EHR - Daily Monitoring tab - Vital Signs - Add Measure

On the top right part of the Arterial Blood Gas section there is a button named "Add measure" which pops-up a new window, as shown in Figure 14. The values of the ABG parameters can be added as a new measurement for the current day.

Infection-related Indices

Figure 15: EHR - Daily Monitoring tab - Infection-related Indices

In Figure 15 the information about the Infection-related Indices Section is presented. More specifically, for every test (shown in the 1st column of Figure 15) the following are given:

  • The References Values (2nd column)
  • The actual value of the last test results (3rd column)
  • The actual value of the immediately previous test results is given in the last column.

Every actual value that lies outside the laboratory reference ranges appears in red font colour.

Coagulation Function

Figure 16: EHR - Daily Monitoring tab - Coagulation Function

In Figure 16 the information about the Coagulation Function Section is presented. More specifically, for every test (shown in the 1st column of Figure 16) the following are given:

  • The References Values (2nd column)
  • The actual value of the last test results (3rd column)
  • The actual value of the immediately previous test results is given in the last column.

Every actual value that lies outside the laboratory reference ranges appears in red font colour.

Glasgow Measures

Figure 17: EHR - Daily Monitoring tab - Glasgow Measures

The parameters of the Glasgow Score are presented on a daily basis. The assessment of the patient based on the total Glasgow Score is also indicated in different colours for Mild, Moderate and Severe (1st column in Figure 17). Description on how the Glasgow Score is calculated can be found here.

Figure 18 = EHR - Daily Monitoring tab - Vital Signs - Add Measure

On the top right part of the Glasgow Measures section there is a button named "Add measure" which pops-up a new window, as shown in Figure 18. The values of the Glasgow parameters can be added as a new measurement for the current day.

Medication & Treatment

Medication

Figure 19: EHR - Medication & Treatment - Medication

Say here that we found these fields from patient summary and their values as well, coded etc?

Treatment

Figure 20: EHR - Medication & Treatment - Treatment

This section presents the treatments of the patient recorded for specific dates. Most specifically the following treatments are considered:

  • Intensice Care Unit
  • Oxygen Therapy
  • Nasal Cannula
  • Non-invasive Ventilation (NIV)
  • Nasal Mask Ventilation (NMV)
  • IMV with ECMO
  • CPAP and PEEP (if apply)

The DATETIME parameter defines the day and time of every Treatment set of entries.

Comorbidities & Allergies

Figure 21: Patient's EHR - Comorbidities and Allergies

The Comorbidities & Allergies section is divided in two main subsections. The left part presents all the comorbidities and the social history parameters and the right part presents the allergies a patient has.

Comorbidities - Social History

Figure 22: Patient's EHR - Comorbidities and Allergies - Comorbidities and Social History

Existing patient comorbidities can be added using the available check-boxes.

Social History parameters can be added in the same way.

If any changes/ updates are made using the checkboxes, the Save button must be clicked.

Allergies

Figure 23: Patient's EHR - Comorbidities and Allergies - Allergies

The right part presents the Allergies of the patient categorized as ...

If a new allergy must be added the button Add must be used to the corresponding table (...)

Symptoms

Figure 24: Patient's EHR – Symptoms.

The Symptoms Section is organized in a Table with five entries, as shown in Figure 24. In the first column, the datetime is shown, while in the remaining four columns, the Constitutional, the Upper Respiratory, the Lower Respiratory and the Gastrointestinal symptoms are defined.

Figure 25: Patient's EHR – Symptoms – Update Symptoms.

By pressing the button “Update Symptoms” on the top right of the screen, a new window pops-up which allows editing this table (Figure 25).

Laboratory

In this section, the laboratory information is organized in four sub-sections, each one shown as a table (See Figure 26). Most specifically the laboratories tests presented are:

  • Infection-related Indices
  • Coagulation Function
  • Hematologic
  • Biochemical

All these tables have the same format, which show in the first column the test name, in the second column the reference values of the respective tests and the third column and on, the actual values on a daily basis. The latter columns show the values of previous days. ?????

Every actual value that lies outside the laboratory reference ranges appears in red font colour.

Demographics

The Demographics tab include all the personal necessary data about a specific patient, as shown in Figure 27. The headers of these data are shown below: *Name

  • Surname
  • Date of Birth
  • Gender
  • Country
  • Address
  • Town
  • Region
  • Zip Code
  • Phone number
  • Email address

Contact Persons

On the bottom part of the Demographics tab, the contact person(s) of the patient are presented. The user has the option to add a contact person by clicking the button "Add contact". The user must fill:

  • Name
  • Surname (it’s not included on the UI)
  • Gender
  • Phone
  • Address (it is full address including Zip Code, Town, City, Country?)