Thank you for selecting EdocWriter for your patient discharge documentation requirements.

The primary purpose of EdocWriter is to provide health organizations the ability to implement a system to provide meaningful instructions and reiterate important facts that patients must keep in mind when they leave the health facility. Such capabilities include the ability to create prescriptions, provide doctor notes to outside organizations, or direct the patient to specific referral doctors.

A secondary purpose is to allow health organizations to deploy and customize the system to meet the requirements of diverse users. This system has evolved from a desktop focus to an enterprise focus. Specifically the product was designed to:

• be deployed on local area networks, wide area networks, intranets, or internets
• be able to communicate with external computer systems using the Health Level Seven standard
• be able to assure patient confidentiality when communicating with external health organizations to which patients were referred
• be able to incorporate the richness of presentation available in Internet browers
• be able to support the integration of personal computer devices
• insure data integrity through centralized control
• utilize the increasingly popular XML (Extended Markup Language) standard.

The product is designed to be easily implemented using default settings, and with more effort to customize every facet of the system. EdocWriter can be installed by a computer novice on a local workstation if no significant customization is undertaken. Custom or standard, once configured the product is designed to be deployed easily and rapidly to additional workstations.

Any new Windows computer can run EdocWriter. At a minimum you should have Windows 95 and 32mb of Ram memory. Most clients will deploy the system on a local area network, some on a wide area network, and others may choose to implement parts of the system on either a internet or intranet. Deployment on networks is more reliable but also more complex.

The remainder of this section is somewhat technical, so you may want to skip it unless you have a good understanding of computer technology.

The installation program will display a legal document indicating that the product is copyrighted, then ask for your name, and which directory to install to.

During installation, EdocWriter may notify you that it wants to install MicroSoft Data Access Components or Adobe's Acrobat Reader. These products are necessary for EdocWriter to communicate with the database and to print out this guide. However if you know you already have them installed, you may not want to reinstall. Reinstallation should not cause a problem.

If you want to use automatic updating from the internet, you will need MicroSoft's Internet Explorer 4.5 or above installed.

Be sure to set the security rights to the directory to allow both read and writer privleges over the install directory and sub directories.

If you have installed EdocWriter on a file server, it is necessary only to create a short-cut on the workstation desktop pointing to the EdocWriter file called "edocwriter.exe" on the file server and set the start in directory to the EdocWriter directory. EdocWriter will then configure the workstation the first time this short cut is started (i.e. clicked).

EdocWriter does this by initiating an install program that will set up the workstation. It will be necessary to restart the workstation after this install program completes.

The first time you start EdocWriter on each workstation, you will be asked to select the workstation site and set the printers that are going to be used.

At this point EdocWriter should be installed. You should be able to start the program from the desktop if you:

click on Start click on Programs click on the EdocWriter menu group click on EdocWriter

Start the program if you have not already.

The main window will be shown. It has buttons on the top right, a Instruction Categories List on the top left, a Physician User List on the bottom right, and a Selected Items List (none so far) on the bottom left.

At a minimum you need a patient name, doctor's name, and an instruction. The most simple discharge document would require the following steps:

click on the New Patient Button. enter the requested information (note the patient name will be added to the lower right list box). The cursor will move to the physician user 's list. double click the appropriate physician user name. EdocWriter can be set to automatically add the name of last physician selected . The cursor will move to the patient instruction category list. double click on the appropriate patient instruction category. A patient instruction list for this category will be displayed. EdocWriter can be set to display all the patient instructions immediately without selecting a category first double click on the appropriate patient instruction(note the patient instruction will be added to the lower left box.) click on the Print Button or push Function Key F5.

If your facility has the Health Level 7 interface enabled, to create a minimal patient discharge document would require the following steps:

click on the Pending Patient Button. An admitted patients list will be displayed. double click on the appropriate patient name. The patient name will be added to the lower right list box. The cursor will move to the physician user's list. double click the physician user name. EdocWriter can be set to automatically add the name of last physician. The cursor will move to the patient instruction category list. double click on the appropriate patient instruction category. A patient instruction list for this category will be displayed. EdocWriter can be set to display all the patient instructions immediately without selecting a category first double click on the appropriate patient instruction(note the patient instruction will be added to the lower left box.) click on the Print Button or push Function Key F5.

click on the Pending Patient Button. An admitted patients list will be displayed. double click on the appropriate patient name. The patient name will be added to the lower right list box. The cursor will move to the patient instruction list. double click on the appropriate patient instruction (note the patient instruction will be added to the lower left box.) click on the Print Button or push Function Key F5.

Okay, so we can produce a simple instruction. What is the rest of this stuff on the main menu? Although this initial menu is pretty self-explanatory, here is an overview:

On the top is the typical Windows Menu Bar with File, Search, Search Next, and Minimize options.

Here is a short description of each

There are a lot of options available here. Directions on options will be given in greater detail later, but a summary will be provided here because this part of the screen is so visible. In the upper left is a box that alternates between showing either Patient Instruction lists or Diagnoses lists. By default a Patient Instruction Category list is displayed here. If your organization wants to attach and print a diagnosis on the discharge instruction, there a number of options:

In the lower right is a Physician User List. Individuals can be selected and identified as the physician of record on the instructions.

EdocWriter is designed to encourage changing the initial menu to match your preferences and business requirements. For instance, by default the patient instructions were selected first by selecting the patient instruction category, and then selecting from a list of patient instructions. You could set the program to display the diagnoses first.

Temporarily: click on Test Display Alternatives within the on the Menu Bar at the top of the menu, then Show Diagnoses Initially To set the default: click on Modify Data in on the Menu Bar at the top of the menu, then System Settings, then Configuration, and check the Start with Diagnosis check box in the Test Display Alternatives section.

Instead of clicking on the third button, Show PI Instructions Category/Show Diagnosis Button, the user can set the list to appear right after the diagnosis selection. To change:

Temporarily: Test Display Alternatives in on the Menu Bar at the top of the menu, then Show PI List After To set the default: clicking on Modify Data in on the Menu Bar at the top of the menu, then selecting System Settings, then Configuration, and check the Display PI List After Diagnosis check box in the Test Display Alternatives section.

Do not like to use the mouse? This will present what MicroSoft refers to as a combination edit and list boxes. Instead of scrolling to the desired item, the user can type in the first few characters, and the list will automatically scroll to the desired place (it should be noted that even in a plain list box, entering the first character will cause the list to scroll to that part of the list). To change:

Temporarily: clicking on Test Display Alternatives in on the Menu Bar at the top of the menu, then Show (PI or Diagnosis) as Combo List To set the default: clicking on Modify Data in on the Menu Bar at the top of the menu, then selecting System Settings, then Configuration, Check the Use a Combo List for Patient Instructions check box in the Test Display Alternatives section.

To set the system for multiple care providers/assistants:

clicking on Modify Data in on the Menu Bar, click on System Settings, then Configuration, click on the appropriate box.

The user can edit items from this list by:

double clicking on the item to be edited. The instruction will be displayed in an editor. change the text as desired. enter an ESC keystroke or click on the window exit to terminate. Any changes made will be saved. Reselect the item if you decide to not save the changes.

As the user selects instructions to add to the patient's discharge document, they are listed in the box in lower right corner of the main window - the Selected Items List.

The user can delete items from this list by:

click on the item to be deleted. push the delete key on the keyboard.

Selected items can be modified by a right click on the item in the Selected Items list. A dialog box will be displayed.

A click on an option will:

Print the item. If the selection is a patient instruction the entire discharge instruction will be printed. Delete the item. This is the same as using the Del key. Edit the item. This is the same as a double click Save the item as a package. The user will be asked to enter a label to be displayed to the user. The default label is the current label. The user will also be asked to give the macro a name. This would allow the user to create their custom patient instructions.

Changing the selected physician

double-click on a new doctor name in the Physician Users list.

EdocWriter is designed to be customized. The more common types of modifications are presented in this section.

click on the Select an Existing Patient Button. A patient list will be displayed. click on the desired Patient. The patient will be added to the Selected Items List.

When first invoked, this presents a list of patients processed through EdocWriter for the current day.

There are two ways to add a physician not on the Current Physician Users list.

For the remainder of the EdocWriter session

If the physician's name appears in the Doctors Directory, click on the Doctors Directory Button, and then double-click on the desired name. The name will be added to the end of the Physician User Listfor the remainder of the EdocWriter session.

By default

Start and then click on the "Care Provider" button in the EdocWriter Modify program.. select Existing or New check the On Physician Menu List or the On Assistant Menu List check box.

Here is a list of the elements in the dialog window

click on the Prescriptions button from the main window. double click on the medicine you want. The cursor will skip to the Rx box. If you do not see the medicine you want, you can add it by using the Add a New Medicine button to the right in the System Table Modification group. press the down arrow key or click or enter the first characters of the prescription you want. select or edit any values in the Rx, Disp, and Sig combo list boxes by clicking in the list boxes or entering the values desired in the edit box. The values entered will be remembered and made available the next time. Prescriptions can require the user to input specific prescription information - for instance a specific quantity. Such information is denoted by two or more underlines ("__"). These lines should be replaced with values. EdocWriter will not allow the user to exit the dialog successfully unless such fields are filled with information. click on the OK button.

A work slip or Doctors Note is a note on behalf of a patient for an outside organization. It can be printed on a specific type of printer to allow for small forms. To create such a note:

click on the Doctors Note Button click on the desired Doctors Note. The instruction may request information from the user. The note will be added to the Selected Items list.

This type of note inserts instructions into the discharge document indicating the need for further medical attention.

click on the Follow Up Note Button click on the desired Note. The instruction may request information from the user. The note will be added to the Selected Items list.

A physician note can be included in the discharge instruction to add instructions specific to the patient

click on the Physician Note Note Button. A word processor type of dialog window will be displayed. after the text is entered, click on the OK button or hit the escape key.

A copy of the discharge document containing the referral follow-up text can be sent to the referral doctor can automatically or on an exception basis.

One time basis: click on File in on the Menu Bar at the top of the menu, then select Fax Current Discharge Document. EdocWriter will request the fax printer to use the first time each session. You will need to enter the fax number.

Automatically where patient confidentiality is assured The fax server must be installed and enabled Create a new template containing only appropriate text to be sent Map the new template to the template being provided to the patient When selected, the template to be sent will be added to the Selected Items List. If not deleted, it will be sent when the discharge instruction is sent to the fax number that exists for the referral doctor exists in the Doctors Directory

Automatically where patient confidentiality is not assured The fax server must be installed and enabled One a one time basis, use the Sqlloader to set all template map parameter values to equal their own key value. When selected, the template to be sent will be added to the Selected Items List. If not deleted, it will be sent when the discharge instruction is sent to the fax number that exists for the referral doctor exists in the Doctors Directory

If there is an instruction for a medicine, the system will print it in the discharge document. The medicine instruction is included by default with the prescription. check box.

Alternatively, medicine instructions can be printed without a prescription form being generated through the Medicine Instruction Button on the initial main menu.

To reset the printers

From the main EdocWriter window, click on File menu option, then click on Workstation submenu option. click on reset printers ... A dialog window will be displayed. click on the appropriate site. Click on OK The following two steps will be repeated for each type of output document A dialog window will be displayed indicating a printer has not been defined for a document type. Click OK. A printer dialog will be displayed. Click on the printer for the document. click OK.

Every button, dialog and list should have a default value. Hitting enter will automatically select the default value. For lists, the default value is highlighted, for buttons the default value will have a rectangle of dots (hard to explain, but it is obvious when you see it). For instance, when first started, an Enter invokes the New Patient Button. After the first name is entered, an Enter key will move to the last name, and after that an Enter will move to the Physician Users list, and so on.

The tab key will generally move you to the next button or list.

These keys can be used both to navigate about the main menu and about the list and combo list boxes. Using the arrow keys will move the "focus" (be highlighted) either up or down. Hitting the Down arrow key in a combo list box will cause the first element to gain focus, thereby allowing use of the Page Up and Page Down keys

These keys will cause lists and combo lists to rapidly scroll up and down. The lists must have "focus" (be highlighted)

The function keys at the top of the keyboard will immediately invoke movement to specific buttons and lists. The default mapping of the keys to the buttons or lists is -

• F1 HELP
• F2 START A NEW PATIENT BUTTON
• F3 SHOW DIAGNOSES/PATIENT INSTRUCTIONS BUTTON
• F4 PRINT INSTRUCTION BUTTON
• F5 EDIT INSTRUCTION BUTTON
• F6 DOCTORS DIRECTORY BUTTON
• F7 DOCTORS NOTES BUTTON
• F8 FOLLOW-UP NOTES BUTTON
• F9 PRESCRIPTIONS BUTTON
• F10 PHYSICIAN NOTE BUTTON
• F11 DOCTORS LIST
• F12 PATIENT INSTRUCTION/DIAGNOSIS LIST

The functions keys are mapped in a clockwise direction beginning with the upper right corner button.

A package is a set of instructions that have been saved to be recalled at a later time. The reasons for doing this is to save time and increase quality of care. Here are some specific reasons:

• to minimize errors you create a set of instructions and prescriptions that have been tailored for a specific situation.
• each physician may have their own library of specific instructions that have been customized for them.
• your organization see patients more than once. You want to create a set of prescriptions that they will receive each time they see you.

How to create a package

The standard Windows Drag and Drop facility is used to create new packages. Hopefully you are familiar with this, but if you are not, the instructions and a couple of tries should be sufficient to do it ... Select the instructions as you normally would. All the items should be shown in the Selected Items List. Drag the instructions by clicking on the first item, and then while simultaneously holding down the shift key, click on the last item to be saved. As you hold down the shift key you can keep the mouse clicked on the highlighted items. Drag them to the Instruction Packages button. A File Dialog will be displayed. You can release the shift key and mouse button. Click on the directories shown until you find the one you want. New directories can be created, but this must be done outside of the program using the standard Windows Explorer or My Computer tools. Enter the name you want to associate with the saved instructions, and click on Save.

How to retrieve an Instruction Package

Click on the Instruction Package button. A File Dialog will be displayed. Click on the directories shown until you find the name of the package that you want. Double click on the desired package. The package will be added to the Selected Items List.

The HL7 EdocWriter Interface Program acts as a HL7 server receiving notification of admission information from the computer software processing patient admissions. When it recieves this information, the HL7 EdocWriter Interface Program creates an XML command file containing the patient information and sends it to the Pending Patient Directory.

To start the HL7 EdocWriter Interface Program

From the Windows Desktop click on start click on programs click on EdocWriter click on HL7 EdocWriter Interface

Once the program has started, you should see a dialog appear like the one shown below:

A list of the various controls follows:

• In the upper right is a Display group. These radio buttons are used to set the type of information that will be displayed in the list box to the left. There are these choices:
  • display the raw input data
  • display how the segments are created from the input data
  • display the xml to be sent
  • display the parsed xml read from the configuration file
• Below this group is the Errors group. This will show the cumulative errors encountered on the HL7 port and writing to the Pending Patient Directory.
• At the lower left is the Control group. The Start will open the HL7 port, the Stop will close the HL7 port if it is not actively reading, and the Exit will terminate the HL7 port if it is actively reading and exit the program.

The TCP/IP socket port is used to communicate between the program and the client's HL7 facility (some other computer system). The port number will likely have to be changed to whatever arbitrary number the HL7 facility wants to use. At a minimum, this facility should send a packet consisting of a HL7 start character, MSH message, a PID message, and a HL7 end message character.

The Edocwriter HL7 interface will send back to this facility a packet consisting of a HL7 start character, MSH message, a MSA message, and a HL7 end message character.

In a perfect world all that is necessary to get the interface running is to start the program and wait for the data to be sent.

The Edocwriter HL7 interface reads a file called edochl7.xml containing configuration instructions. The file can define the following:

Both segments and the output XML is defined by the use of a constant or a variable pointing to another element. A variable can be recognized by the use of the & character followed by a segment field identifier. For instance:

<F3><VARIABLE>MSH.9</VARIABLE></F3>

means retrieve the value found in the 9th field of the MSH segment. The first field is the segment name field, and it is defined as position 1. This differs from the HL7 documentation where the MSH segment actually starts with position 0. Some segment fields contain more than one value. The HL7 name for the name (XPN) and address (XAD) fields are currently defined.

An example of the file follows:

The following is an example where the xml output is directed to one of two sites based upon the value of segment number 3 of the MSH message. If the value at this location is "SJC", then the data is sent to "PendingSiteOne", and if the value is "SFC" then the data is sent to "PendingSiteTwo".

<HL7-SERVER>

<SITE-ID-MESSAGE>MSH</SITE-ID-MESSAGE>
<SITE-ID-SEGMENT>3</SITE-ID-SEGMENT>

<SITE>
<DIRECTORY>PendingSiteOne</DIRECTORY>
<SITE-ID-VALUE>SJC</SITE-ID-VALUE>
</SITE>

<SITE>
<DIRECTORY>PendingSiteTwo</DIRECTORY>
<SITE-ID-VALUE>SFC</SITE-ID-VALUE>
</SITE>

</HL7-SERVER>

EdocWriter can automatically notify an external agency a patient has been referred to them through either fax or email. Additionally, a prescription can automatically be sent to a pharmacy via fax or email.

Patient privacy is an issue. The system has been designed to meet any privacy concerns by allowing the user to specify what information is to be transmitted. Specifically the discharge instruction is not sent, just a template associated with the selected follow-up note. If privacy is not a concern, this associated template can contain a command instructing that the entire discharge instruction is to be included.

The system can be configured to send faxes or emails (or both), either through a central server, or directly from each workstation. A central server is the recommended approach because it is more reliable and provides better control.

When the user selects a follow up instruction referring the patient to an outside care provider, EdocWriter will check to see if the auto fax or email functions are enabled, and secondly whether a template exists that is associated with the follow up instruction that has been selected. If these conditions are met, then a fax or email notification will appear in the Selected Items List. The user can delete this notification from the list, and it will not be sent. If not deleted, the fax or email will be sent when the Discharge Instruction is printed.

If implementing auto fax, verify that the EdocWriterFax exists in the list of printers on any workstation that is faxing. If it does not, a EdocWriter Autofax Installation program is available in the EdocWriter directory ( filename: Install AutoFax ). If a centralized server is being used, the printer would only have to be installed on the workstation the server program is being run on. If all faxes or emails are to be done by a central fax server, Enable the auto fax directory parameter in the Configuration table and specify the directory . This will cause EdocWriter to write information to the directory specified so it can be read by the server. If this parameter is not enabled, then the fax will be sent from the local workstation. Verify that the patient instruction structure includes the appropriate fax or email tokens . Verify that there is a fax templates for each of the follow-up notes that will result in referrals. Verify that there are fax numbers for each of the referral doctors. Verify that the file called edocmailserver.xml exists in the main EdocWriter directory.

The process is to first create a template of the type fax or Email, and then create a link to a template of the follow-up note type.

Create a new template per the instructions above click Select .. templates for Email or Faxes from the Template Maintenance Dialog. click Select .. templates for Email or Faxes from the Template Maintenance Dialog, and click on next. click on the follow-up note that you want to fax or Email automatically from the list box on the right side. click on the fax or Email template to be sent when the selected follow-up note is chosen by the user. click on the fax this and/or Email this radio button indicating if the relationship applies to either or both. click on the Add Relationship button.

A fax or Email template can include the token ADD_PI, which will cause the entire discharge instruction to be inserted in place of the token.

The EdocWriter Auto Fax and Mail Server is designed to run on a centralized computer and process fax and email requests from all sites. This is an alternative to sending such messages directly from each workstation to the recipients. Using a centralized server should reduce maintenance issues and increase reliability.

When the program is running it will periodically search for email or faxes that have been generated. When found, the program will send the information to the individual specified, and the information will be marked as have been sent. If the program is not running, email or faxes to be sent will continue to accumulate until the server program is run. After starting, the program will wait for the delay time period (approximately 20 seconds), and then begin searching. This is to allow the program to be started automatically whenever the computer server is restarted if the program is included in the list of start up tasks.

Once the program has started, you should see a dialog appear like the one shown below:

The following controls are available:

Configuration information is read from a xml file called edocmailserver.xml by EdocMailerServer and EdocWriter.

An example of the file is provided below.

<EDOCMAILSERVER>

<POLL_SECS>30</POLL_SECS>

<FAX>
<PRINTER> edocautofax </PRINTER>
<DRIVER> edocautofax </DRIVER>
<PORT> edocautofax </PORT>
<DIRECTORY> FAX </DIRECTORY>
<COVERPAGE_PATH> TemplateData\FaxCoverPage.pg </COVERPAGE_PATH>
<RETRY_SEND_COUNT>1</RETRY_SEND_COUNT>
<RETRY_DELAY_SECS>30</RETRY_DELAY_SECS>
<PREFACE_FAX>9,</PREFACE_FAX>
</FAX>

<EMAIL>
<DIRECTORY> EMAIL </DIRECTORY>
<MAIL-SERVER-ADDRESS> www.youremailserver.com </MAIL-SERVER-ADDRESS>
<SUBJECT-LINEY> Patient Referral </SUBJECT-LINE>
<REPLY-TO-EMAIL> replytoname@youremailserver.com </REPLY-TO-EMAIL>
</EMAIL>

</EDOCMAILSERVER>

A template is a file containing XML tokens and text used to display all the information that is given to patients. The information here is merged with information generated from the user's selections. Templates are divided into types and versions. Examples of types of templates are medicine instructions, follow-up notes, and output formatting templates such as a prescription form or discharge instruction header . Examples of versions are English Level 5 or Spanish.

Click on the Template Creation and Modification button will result in the following be displayed:

The Template Maintenance Dialog two groups, the Changes to template text group has:

• Edit an existing template (or create a new language version radio button which is used to modify the text of an existing template or to create a new version. If you already have an instruction for "Headaches" in English Level 9, then you would click on this to create a French version.
• Create a new template would be selected where no version in any language exists.

The Changes to table definitions group has:

• Just change where an existing template is listed radio button changes the information about the template in the database. This would be used to change the description or delete a template.
• Create an alias allows you to use list a patient instruction under multiple descriptive titles or categories. For instance the same instruction could be called "Fractured Arm" and "Broken Arm."
• Specify which templates to use for eMail or Faxes allows you to send a copy of a template that is purged of any information that should not be sent. For instance, a follow up note sent to a referral doctor may only contain information that the patient was referred and to contact the referee for additional information.

EdocWriter has many of the characteristics of a word processor application. It takes information stored on "boiler plate" documents and merges it with stored information and information entered by the user.

EdocWriter presents information to the users using HTML, the same technology as internet browsers. For those who are technically sophisticated, the program requires the source data be well-formed HTML as well. To press this a bit further, the program does not require that the source instructions be valid to a specified DTD, however the instructions provided with the system are.

Creating and editing source documents consists of using a HTML word processor to enter text and indicating the information to be inserted by placing tokens representing the desired information into the text. Although conceptually you can use any HTML capable word processor, many currently do not create well-formed HTML. We have modified the editor that comes with EdocWriter to create only well-formed text.

A token is a symbol within a template that informs EdocWriter to replace it with specific patient information. Tokens are available for almost any piece of information available on patients and doctors. When you select an instruction or note, EdocWriter will search for tokens in the templates (word processing documents) associated with those instructions and notes. EdocWriter then replaces the tokens with the actual information and adds the resulting merged information to the discharge document being created.

<?TOKEN "TOKEN-NAME" ?>

where "TOKEN-NAME" is replaced by the name of the specific information to be inserted.

The editor that comes with EdocWriter allows you to click from a list of tokens so you don't need to know this detail. However, for the more technical minded, an example follows.

Another token will result in the user being prompted to enter information. It is called a prompt token.

<PROMPT "QUESTION-TEXT" />

where "QUESTION-TEXT" will be used to form the prompt text. For instance, if the QUESTION-TEXT were to be replaced by "Please enter the number of stitches", then this will result in the Question Dialog displaying this text above a data entry box. The results of whatever the user enters replaces the prompt token in the text.

Again, the editor that comes with EdocWriter allows you to click from a list of tokens so you don't need to know this detail. However, for the more technical minded, an example follows.

To modify an existing template

Invoke the EdocWriter Modify Program Click on Template Creation and Modification button. The Template Maintenance and Modificaton property page will be shown. Click on the Edit an existing template check box, and then click on the Next button. The Select the template type ... list box will be displayed with the template types displayed. Click on the type of template and then click on the Next button. The titles of all the templates of the selected type will be displayed. Click on the template to be modified and then click on the Next button. The template versions will be displayed. Click on the template version to be modified and then click on the Finish button. An editor will be started, the template can be edited.

To create a new template template

Invoke the EdocWriter Modify Program Click on Template Creation and Modification button. The Template Maintenace and Modificaton property page will be shown. Click on the Create a new template check box, and then click on the Next button. The Select the template type ... list box will be displayed with the template types displayed. Click on the type of template and then click on the Next button. A dialog box with the title Enter the template title will be displayed. Enter the description of the template into the edit box. What you enter here will be displayed in the list boxes shown to users to make selections from. Click on the Next button. The template versions will be displayed. Click on the template version to be created and then click on the Finish button. An editor will be started, the template can be edited.

A care provider in EdocWriter is a user or referral person or agency. The same information is maintained for all care providers. Care provider information is maintained through the EdocWriter Modify program. To make modifications:

click on Modify Data on on the Menu Bar at the top of the menu click on Care Provider Information select Existing or New select New enter the appropriate data.

The Printer Table is control the format and number of copies for each of the type of output document types.

To modify Printer Table settings

Invoke the EdocWriter Modify Program Click on Printer Settings button. A tree list box containing all parameter settings will be displayed. The settings will be organized by output document type. Double-click on the item to be modified.

Medicines be created directly from the Prescription Dialog. Once this information is entered, it can only be modified by using the Modifiy EdocWriter Data program. New medicines can be created as well.

To create, modify or delete a medicine

Invoke the EdocWriter Modify Program Click on Medicines and Prescriptions button. A dialog window will be shown with a Medicine button and a Prescription button. Click on the Medicine button. A list of available medicines will be shown. Click on the one you want to modify or delete. If you want to delete, click on the Delete, otherwise click on Edit and a ...Select a Medicine Instruction or Doctor Note dialog windowwill be shown. Click on the desired medicine instruction if one is desired, or click on the No Instruction check box if none is to be used. You can also add text to the Note edit box. This text will be displayed when a user selects the medicine when creating a prescription.

Prescriptions be created directly from the Prescription Dialog. Once this information is entered, it can only be modified by using the Modifiy EdocWriter Data program. New prescriptions can be created as well.

To create, modify or delete a prescription

Invoke the EdocWriter Modify Program Click on Medicines and Prescriptions button. A dialog window will be displayed with a Medicine button and a Prescription button. Click on the Prescription button. A list of available medicines will be shown. Click on the one that has a prescription you want to modify. A list of the available prescriptions will be shown. Click on the one prescription you want to modify or delete. If you want to delete, click click on the Delete, otherwise click on parameter you want to change.

Clicking on this button allows for modification of the site configuration information. Two buttons will be shown: Internet and Configuration.

The Internet selection will modify data that deals with communications over TCP/IP. This would include email servers, ftp servers, and database servers.

The Configuration selection will modify data that is used to customize the program.

The Configuration Table is the foundation of any customizations. Each site is has a unique set of Configuation Table.

To modify Configuration Table settings

Invoke the EdocWriter Modify Program Click on Systems Settings button. The Modify System Configuration and Internet Settings dialog box will be shown. Click on the Configuration Settings button. A tree list box containing all settings will be displayed. The settings will be organized in groups. Double-click on the item to be modified. What happens next depends on the type of information required.

The Internet Table is used for parts of the program that utilize intra/internet tools and functions. There can be more than one set of parameters. The Configuation Table indicates the key value to be used.

To modify Internet Table settings

Invoke the EdocWriter Modify Program Click on Systems Settings button. The Modify System Configuration and Internet Settings dialog box will be shown. Click on the Internet Settings button. A tree list box containing all parameters settings will be displayed. The settings will be organized in sets identified by a key. Double-click on the item to be modified.

A picture of the dialog box invoked by the Workstation Communication button is shown below:

There are three groups of controls. Each group has an edit box indicating whether the function is enabled. Here is a brief description of each group:

This facility creates a instant message facility for users. It consists of a chat server running on a file server, and a chat client for each EdocWriter user. The chat server (filename: edoc_chat_server.exe) runs continuously directing messages. A chat client (filename: edoc_chat_client.exe) is started by EdocWriter on each workstation when it is started by the user. The chat client will be minimized in the system tray until the icon is double-clicked or a message to the workstation is recieved from the chat server.

Template Tokens are placed in EdocWriter templates to signal that information is to be inserted when the instruction is printed. For example, if the token <?TOKEN PATIENT-NAME ?> is found in an instruction, it is replaced with the name of the patient when the instruction is printed.

If a token is found in an instruction of a template type where there is no information available, it will be ignored. For example, if the token <?TOKEN RX-MED-NAME ?> is found in a Follow-Up Note instruction, it will be ignored because it is not clear what medicine, if any, is being asked for.

Listed below are the tokens available, and where they can be used.

User Interaction Tokens

User Interaction XML Markup

Unlike a token which is called a processing instruction, the Template List Box is composed of several parts:

<LISTBOX >
<LISTBOX-ITEM TITLE="I want to go up" VALUE="up" />
<LISTBOX-ITEM TITLE="I want to go down" VALUE="down" />
<LISTBOX-ITEM TITLE="I want to go out" VALUE="out" />
<LISTBOX-ITEM TITLE="I want to go in" VALUE="in" />
</LISTBOX >

Date and Time Tokens

Site Specific Tokens

Additional Care Provider Tokens

User Physician Tokens

Patient Tokens

These tokens that can be placed only in Follow-Up Note and Email and Fax templates. If a Follow-Up Note template type is selected that contains the <?TOKEN REFERRAL-NAME ?> token, then a list box will be displayed to select the referral from.

These tokens that can be placed only in Email and Fax templates. Email and Fax templates are currently generated only for Follow-Up Note templates.

Tokens that can be placed only in the template identified as Additional Care Provider Template parameter.

Tokens that can be placed only in the template identified as Prescription Filename or Rx Text Filename template parameters.

To disable or grey out the Reset Workstation Printers option from the File->Modify Workstation menu bar, insert the following token within the XML Button group shown above.
<NO-RESET-PRINTERS />

Four database tables are used to define these default values. All except for the Medicine Type table can be modified to better reflect the requirements of the organization.

This table is provided with the system. It would not be modified by the user, but the key values of this table are used as foreign keys in the other three tables listed above. The following list are the keys and names of the valid medicine types for which default values can be assigned:

This table is designed to be modified by the user. This table will have an empty string value (i.e. " ") for each of the medicine types. This will result in having just the name of the medicine listed as a default value. The system will automatically add the medicine name to each of the values specified in this table when the information is displayed in the Prescription Dialog.

This table can be modified using ACCESS or the Sqlloader program. An example of the SQL statement to add "100mg" as a default potency value would be:

INSERT INTO MedicineRx (FK_MED_TYPE, rx) values (1,'100mg');

The value 1 corresponds to the "Oral" medicine type key as shown in the prior section.

This table is designed to be modified by the user. Initially this table will be empty.

This table can be modified using ACCESS or the Sqlloader program. An example of the SQL statement to add "#10" as a default sig value would be:

INSERT INTO MedicineDisp (FK_MED_TYPE, disp) values (1,'#10');

The value 1 corresponds to the "Oral" medicine type key as shown in the prior section.

This table is designed to be modified by the user. Initially this table will be empty.

This table can be modified using ACCESS or the Sqlloader program. An example of the SQL statement to add "as needed" as a default sig value would be:

INSERT INTO MedicineSig (FK_MED_TYPE, sig) values (1,'as needed');

The value 1 corresponds to the "Oral" medicine type key as shown in the prior section.

Industry common standards have been used to facilitate the integration of EdocWriter into a heterogeneous software environment.

The EdocWriter SQL Loader (file name sqlloader.exe) is used to update the database during initial installation and program updates. It can be used as an alternative to the Modify EdocWriter Data Program to make changes to the database. To use this product:

create a text file containing sql commands terminated by a ";" and having ".sql" as a filename suffix click on start click on programs click on EdocWriter click on Run EdocWriter Sql Commands The program will start and show a dialog box displaying all the files that end in ".sql". click on the one you want, or click to the directory that contains the file you want. click OK and then click GO

If a syntax error is encountered, the program will allow you to exit or continue processing.

For batch processing, it is possible to invoke the program and specify the sql file on a command line. The syntax would be: sqlloader {filename}

To change the database EdocWriter uses requires an Windows ODBC driver for the particular database. This can be provided by the database vendor. EdocWriter installs two different drivers by default: MicroSoft Access and MySql (www.mysql.com). The MicroSoft Access is used for non-internet implementions and the MySql (www.mysql.com) for internet based implementations. A brief description of the process of changing to a different database than these two follows:

Purchase database license and install on host computer Install ODBC driver for the purchased database on each workstation Request from EdocWriter the SQL Database Table files or execute the ExportSql form in the ACCESS database. Execute the SQL Loader program to load the tables if the inter/intranet is being used, follow the directions in this user guide for Installing EdocWriter on the Inter/Intranet.

EdocWriter can be deployed partially or fully on a inter/intranet. The ODBC database driver is responsible for handling communications between EdocWriter. To inform EdocWriter to retrieve templates from a inter/intranet (hereafter called a TCP/IP connection) it is necessary to do the following:

The program will not be able to successfully start if a firewall is preventing communications with the database. By default, port 3008 is used.

Install the templates to a server supporting File Transfer Protocol (FTP) Change the Instruction Directory Path in the Configuration Table parameters to point to the new directory. Change the Enable Internet and Use Internet in the Configuration Table parameters to "yes" Change the Internet Table Parameters to reflect the FTP server being used.

Software developers can use the EdocWriter DTD to construct XML command files or read EdocWriter generated XML files. There are a number of applications where this capability would be used:

When user the users clicks on the Existing Patient Button or Pending Patient Button or the Instruction Package Button, EdocWriter reads and processes a file containing XML instructions. Here is an example of such a file:

The user can initialize, modify, or create XML using the mark up documented in the EdocWriter DTD. The user can also create their own XML parser using standard tools to extract information from these files.

Internally EdocWriter uses a single XML parsing engine to create the patient output, and (at least in theory) anything that the user does by clicking on EdocWriter buttons can be done by feed the commands directly to EdocWriter. A XML Command File can be enabled to be polled for XML commands. If the file exists, the commands will be processed as if they were entered by the user. One obvious application is to be able to integrate hand-held devices into EdocWriter.

When EdocWriter prints a patient discharge instruction, it also writes the HTML used to create the output to the Instruction Directory. This file is not used by EdocWriter, but is available for outside processes. The patient's XML and HTML have the same filename prefix (i.e. "YYYYMMDD_{LastName}_{FirstName}").

An html file can be displayed the first time a user creates a patient discharge instruction after EdocWriter starts; exiting the program and restarting will cause the message to be displayed again.

To implement this:

You need to enter your password. If you do not have your password, Email edocwriter at gmail.com or call 310-546-7435 .

If EdocWriter is being installed for the first time, then choose a directory on the file server. Do not install to the local workstation.

This message should not been seen if EdocWriter has already been installed on the file server and a workstation is being set up for the first time. The system may need to be updated: Email edocwriter at gmail.com or call 310-546-7435 .

If an update program is being run, then choose the home directory on the file server that has the system EdocWriter files.

Check the following:

If nothing happens at all, run MicroSoft's Visual C++ dll redistribution installation program. A copy of the program (filename is vc6redist.exe) has been placed in the EdocWriter directory. The workstation will need to be restarted.

The problem is the network is slow. The amount of time between clicking on the short-cut and the "is loading" splash screen is the time required to load the program itself. The amount of time between the splash screen and the menu display is the amount of time required to read the database and XML configuration files.

The system will look in the registry under HKEY_LOCAL_MACHINE/Software/EdocWriter for the printer name, device name, and port name for each of the document types. If these elements are not found, or a system error is generated when the system tries to create a print connection, then the program will request the user select a valid printer. Check for these issues:

The program reads the following XML files for configuration information:

Probable cause is the database was not closed correctly due to the abnormal termination of the system.

Repair the database by:

The system will look in the registry for the HKEY_LOCAL_MACHINE/Software/ODBC/ODBC.INI/EdocWriter key. If the key does not exist, the program assumes this is the initial use, and will configure the workstation by running the EdocWriter ODBC installation program (filename: edocinstallodbc.exe).

The first approach for any printer problem is to try a different printer driver if possible.

For version 2.2, use the HP4 driver instead of the HP4xxx driver.

For version 2.3 and up, the printer dialog allows the user to select bin and paper size constants. Reset the printers, and specify DM_PAPER constant to 1.

Concerning the HP 4300 and printing scripts to the manual tray, one client needed to specify no bin number but a paper size constant of 0. No paper constant exists in the list of contents for the standard size. The program will attempt to set the paper size to the specifications in the table Printer for each printer defined. The paper size constant of 0 is used in the system to indicate "use the existing value." A paper size of 0 does affect bin selection in current HP laser products.

Here are the DM BIN constants provided by MicroSoft:

Here are the DM PAPER constants provided by MicroSoft:

The patient data is maintained in an XML file, and is generated by the system. Email edocwriter at gmail.com or call 310-546-7435. Please use email and attach the file .

EdocWriter uses and creates XML files. XML is the use of tokens (i.e. <some_token>good</some_token>). An XML file must be well formed, meaning every start token ( the <some_token> ) must have a closing token ( the </some_token> ). Interleaved tokens will cause an error. Case matters in token comparisons.

If the XML is not well formed then a parsing error is created. The user can edit and correct the files.

Listed below are the steps that should be taken in order to reinstall the various database communication components. Usually just the first step will be required.