ESRD/AKI Mgmt Care Categories

The Patient Status section will display previously finalized patient status comments with an option to copy the comment into a current encounter note.  Finalized encounter note comments from the past 90 days are listed.  This section will display the comment(s) and the date of the encounter.  Comments displayed are from finalized encounter notes created in OneView.  Comments in an unfinalized OneView encounter note or a Falcon Silver encounter note will not be displayed.  Amended comments will display but the option to copy into the note is unavailable and will be greyed out.

Under the Fluid/BP care category, up to 120 days of treatment data can be viewed in this section.  All 120 days’ worth of the most common data such as target weight, treatment duration, and blood pressure will display on initial load,  The same day treatment vital data will display if the patient is receiving a hemodialysis treatment on the current day.  An orange dot to the right of a vital indicates that there are multiple vital details for that date.  Hover your cursor over the vital and a tooltip will appear with the vital data and treatment date.

In some care categories such as Fluid/BP, treatment data display if it is available for specific modalities.  An example would be, for the PD clinical visit, you might only see Target Weight and BP Sitting in this care category but for an In-Center Hemodialysis patient, there would be Pre and Post values.  Another example is when patients are transitioning to PD from Hemodialysis.  Both parameters may be visible until the patients’ historical data is fully transitioned to PD.  This same functionality is seen in the Adequacy care category with regards to lab data for a PD patient, which may have up to 70 lab results displayed versus an In-Center Hemodialysis patient may have only 12 lab results.  

In the Fluid/BP section, home treatment record (HTR) data enter into DaVita Care Connect (DCC) via a patient facing app for peritoneal dialysis (PD) patients will display.  The “Patient Home Treatment Records” option will only be available if there are home treatment records entered into DCC within 120 days from today's date.  This new feature is being rolled out by Palmer group and used for new PD patients only. 

Clicking on the “Patient Home Treatment Records” will expand or collapse the section.  When the section is expanded, the data can be shown in a table or graph view.  A disclaimer will display to the right of the view selections if the data has been manually entered by the patient.  From the table view, the Dextrose % icons are color-coded to represent the type of PD bags used in the treatment.

For the Adequacy, Anemia, Nutrition, and MBD care categories, up to 720 days of lab data can be retrieved in these sections.  180 days of most common lab data will display on the initial load while a “Show More” option will be available to display the remaining lab data for the care category.  When you hover your cursor over a lab value, a tooltip will display the result value, test code, reference range, collection date and time, and laboratory name.  

For PD patients, the PET (Peritoneal Equilibration Test) results will display in a section named “PET Transport Classifications” which is located below the Adequacy care category of the patient’s chart.  The date of the PET test displays to the right of the new section header. 

The section will include 5 ratios along with their corresponding values.  The 5 ratios are 0HR D/P, 2HR D/P. 4HR D/P, 2HR D/DO, and 4HR D/DO.  Each ratio will fall into a specific range of Low, Average Low, Average, Average High, or High.  

Click the ratio data to view the associated value ranges for that ratio. 

To view all data for the PET profile, click the “SHOW FULL REPORT” link.

Under the Anemia, Nutrition, and MBD care categories, the prescribed Snappy or Med Check treatment medications that were active for that lab draw date will display.  An orange dot to the right of a medication dosage indicates that there are multiple active orders.  When you hover your cursor over the medication dosage, a tooltip will appear with the medication name, dose, unit, route, frequency, start date, discontinue date and reason, end date, and protocol, if available.  To add, update, or remove medication data, the patient’s DaVita care team must be contacted.

NOTE: Treatment medications that are started and discontinued between 2 lab draw dates will not display in LAB DATES view.  Please use the TX DATES view to see the delivered medications.

To view the actual dosage of a treatment medication given to a patient while in a DaVita dialysis facility, select the “TX DATES” tab under the Anemia, MBD, and Nutrition care categories.  Study medications will be included but not any medications taken outside of the treatment.  

When you hover your cursor over the medication dosage, a tooltip will appear with the medication name, dose, unit, route, frequency, start date, discontinue date and reason, end date, and protocol, if available.  Select the “LAB DATES” tab to return to the prescribed medication view.

Under the Adequacy, Nutrition, and MBD care categories, the following treatment details will show for the patients:  Tx Time, Last Delivered date which indicates the last treatment for which the listed treatment parameters were delivered, Dialysate Potassium, Calcium & Bicarb, Prescribed BFR and the Dialyzer for hemodialysis patients.   For CAPD or CCPD patients, Target Wt, Total Fill Vol 24, PD Type, Total Fills, Dry, and Tidal treatment parameter will display.  Click ”SHOW MORE” to expand and see the full details. 

Access care category contains details regarding the patient’s dialysis access.  The primary access will display a trending bar with the data for the access concurrent, average blood flow rate, and dynamic venous pressure.

Each access card has a banner that signifies if the access is active or inactive.  “ACTIVE” tab is the default selection.  For the active access, the card will contain the primary and secondary access, if available, and displays the type, site, placement date, access age, surgeon, and access status.  A dropdown is available to view data for a specific access type.  The access that is selected from the drop-down has a blue banner.  The access not currently selected has a grey banner.

To view the inactive access cards, click the “INACTIVE” tab.  The inactive access card will contain the type, site, placement date, inactivation date, access life, and surgeon.  A dropdown is available to view data for a specific inactive access type.  The access that is selected from the drop-down has a blue banner.  The access not currently selected has a grey banner.

Missed treatments and Hospitalizations are published as a column in the Fluid/BP care category.  The MTx indicator designates a missed treatment and HOSP signifies a hospitalization.  If there are consecutive days missed, a count will show before the MTx or HOSP

When you hover your cursor over the MTx indicator badge, a tooltip appears that contains the missed treatment date and reason.  Hover over the HOSP indicator badge and a tooltip appears that contains the dates, reason, details, and diagnosis.  Additional care team notes will be available in future releases.

NOTE: Missed treatment and hospitalization care team notes reasons are not always supplied and therefore may display with no reason comment.  We only provide what is documented by your care team.

An orange Indicator displays for treatments where the “prescribed time not met”.  When the patient’s treatment time is less than the prescribed time by 10% or more, the “Actual TX Time” appears in orange.  Hover over the time and a tooltip displays the time cut along with the percentage of the prescribed time completed in parenthesis, the actual treatment time, date, and clinic.  The percentage of treatment time compared with prescribed time is calculated whether or not a care team note is entered.

Infection care category contains Microbiology, Serology and Body Fluid (for PD patients only) results.  Up to two years of results may be displayed. 

The Microbiology results are listed first in a card format.  The cards have a colored banner on the top of the card which represents the status of the lab result.  A grey banner indicates a preliminary result, while a blue banner indicates a final result with no growth, and an orange banner indicates a final result with growth. 

To view the full details of the microbiology results, click “View Report” and the microbiology final report will open.

The Serology, Monthly Lab Tests, Body Fluid Cell CT/Diff (for PD patients only) results display after the Microbiology results.  

Other care category has lab results that are not in any of the previous care categories.  Tests ordered that are not in the normal monthly test orders appear first.  The remainder of the results can be viewed by clicking “Show More”.  The list is in alphabetic order.

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