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Cerner Health Conference

10/19 - 10/22
Washington, D.C.

Cerner Practice Newsletter
Volume 5 Issue 1, Page 2

ALL ABOUT TASK INTEGRATION
By Annie Bobiak

The Cerner Interactive Iview (Iview) is a direct charting flowsheet with bands and sections. Iview allows clinicians to enter, filter, trend and analyze data in one place. Task integration is the capability to view task indicators, chart tasks, and complete tasks/documentation from the Iview. When task integration is turned on it allows direct documentation the view to automatically update task list and Patient Access List. There is a visual indicator on the view to remind the clinician when tasks are due for a patient. All tasks can be accessed via the task indicator. These include:

  • Medications
  • Chart done simple tasks
  • Powerforms
  • Continuous IVs
  • Tasks that will be direct charted on Iview

The task icon on Iview will open up a task selection window. This window is driven by Positions to Chart on specific tasks, not task types. Therefore Phase X clients must audit every task for Positions to Chart if utilizing task integration. This window will show all Overdue, Current and PRN tasks for the patient that the user’s position is allowed to chart. Task integration queries the task_activity table for the patient’s tasks, so clients should consider table size to improve performance. Adoption of task integration has been seen when clients use task by location to hide task types for specific locations.

System performance issues have been reported in 2005 & 2007 code when task integration is turned on because the view must retrieve all the results as well as tasks when Iview is loading. In 2005 code, Iview will retrieve all results and tasks before making the view available to the end-user. The massive amounts of data retrieval results in 15+ seconds loading times for Iview. The enhanced_performance preference has been developed in 2007 code to allow staging of Iview load by retrieving results first, then orders and tasks. While has decreased Iview loading time, this preference has been associated to multiple defects in 2007 code.

Tasks haven’t changed in 2005 or current releases of 2007 code– they are still linked to Powerforms. Task integration goes to the powerform and checks to see if all required DTAs on the form are also in Iview. If all the required fields on the form are somewhere on the open view – it will open up the view for charting in the time column that the task was due.

In order for a task to complete using task integration, all required fields must be documented. If required fields are not documented when initiated by task integration, the task will go to “In process” and must be completed through Iview. Non-required fields do not have to be documented. If a powerform has no required fields – one DTA must be charted at the exact time the task is due to complete the task.

The Powerform to which the task is linked must not contain a powergrid or ultragrid, or conditional logic. If charting from the task icon and the Powerform contains a powergrid or an ultragrid or conditional logic, the system will present the Powerform layered on top of the Iview instead of taking the user directly to the view for charting. When the task is linked to a form with a power/ultra grid or conditional logic, it will not be applicable for direct charting. Therefore, if direct charting into the cells of the Iview, the task will not be completed automatically.

The last piece to consider is grace periods set on a task. This automatically sets to 30 minutes when a new task is built. The grace period is the number of minutes before and after a task’s scheduled time the task completion server will look to automatically complete tasks if all the required fields on the view are resulted. Caution must be used to ensure tasks are not completing automatically, we recommend setting grace period equal to zero to reduce the chance of inadvertent task completion.

Task integration is a useful feature of Iview especially when implementing the High Acuity flowsheet (Housewide Iview); however it has several integration points with tasks and forms. Task integration can be set at the position level, allowing flexibility according to position workflow. Cerner is moving towards a new Activity band to replace existing task integration in a later release of 2007 code. This band will not be associated to tasks, but rather activities. Activities will be linked to discrete charting elements instead of forms. Meanwhile, clients must consider system performance, task design and powerform design when discussing the functionality of task integration in an Iview implementation.