Please tell us how we can make AAA easier to use and more productive
Q) That's a lot of data on the home page - What am I looking at here?
A) It's a very information dense page and a lot to absorb but it's all there for a reason - don't be daunted as it will become very helpful once you get to know your way around it. Here is a 'tile by tile' explanation that should help.
Tile 1 (Event Log) is about the group and you. You can see how many tasks are outstanding in the group and therefore gauge how busy your group is as a whole.
You can also see how many of your colleagues are on or off shift, what your shift status is and your current role (Many of you do more than one job). If you tap this tile, you will open the event log where you can see a list of all events and tasks in the group. You can filter these events in a wide range of ways such as 'all my outstanding jobs' or 'all outstanding jobs in a ward'. If you touch and hold any of these events, a further set of options will be shown such as 'call the medic who requested the job' or call the ward the patient is in' or 'call the patients supervising medic'. For domiciliary systems, you will also get turn by turn directions on how to get to the patient (even if you are off-line or in an area of no connectivity).
Tile 2 (Patients) is mainly about patients in your care. It always shows the last action that happened to a patient in your care. As the state of the action changes, it will update. In the example below, a VITALS-REQUEST has been requested. As soon as that task changes to either 'IN-PROGRESS' or 'COMPLETE' the tile will update. It will just save you calling the person you asked to do the task to check if it's been done yet. Tap the patient name and you will go directly to their main record. At the bottom of the tile is a breakdown of the Triage status of all the patients in the group. In the example below, there is a total of four patients in the group and they are all in your care.
If you tap this button, you will be taken to the main patient selection list. If you then tap a patient, you will be taken to their main record.
Tile 3 (My Tasks)
In the example below, you have 8 tasks assigned to you of which 1 is new and you have not yet seen. The tile also cycles through your 3 most recent , the oldest and the newest or the 3 latest. You can set how the tile cycles and what it shows in the setting screen. It also tells you who has asked for the task and where the task is.
The tile is updated every 4 seconds and shows a range of data. You can also change what actions to show on this tile from the options menu. These options include :- Show the 4 newest tasks for patients in my care, the 4 oldest tasks or alternate between the oldest and newest. To change these options go to Settings > Options from the main hub.
Q) Where are the 'Touch' points and what do they do ?
A) There are quite a few and as we mentioned, the main Home page is very dense in the amount of data it is displaying
Q) What can I touch on the Timelines ?
A) Timelines are available on the Monitoring tab and on the main patient record. On the main patient record, there is one timeline just for meds and an additional one which shows everything. There are several touch points on the timelines and all have the same options.
Q) What can I touch in the Event log ?
A) A Single tap will open the event and show some more detail about the event. Touch and hold will again activate a context sensitive menu.
A Single tap on an event
You may now touch any of the options such as 'I Accept the task'
Q) How do I enter 'Vitals' data ?
A) The patient must first have a 'VITALS-REQUEST' task assigned to them.
To do this, select the patient from the Home - Patients tile and go to the main patient record.
At the bottom of that screen tap the 'Treat Button'.
Now scroll to the very bottom of the 'Actions list' as 'the ''Vitals-Request' task appears last in the list. Select the 'Request-Vitals' action and then swipe left
Add any detailed requirements you may have in the details text box. Swipe left again
Assign the task to either yourself or the medic you want to take the vitals
Create the task
Return to the Home screen.
Then from either the event log or the my tasks log (If you assigned the task to yourself) - Open the event (Or touch and hold) and then select from the menu - 'Respond to the event' or tap the 'I want to enter the vitals now' icon. You will then see the following screen :-
Tap the 'patient position' at the top to set the patients position when the vitals were taken. Now touch any of the vitals you wish to record (You only have to set the ones you need, You don't have to set them all)
If you touch 'Temp' for example, the following screen will be displayed :-
You can slide your finger round the dials or tap the center of the dial where you will be presented with the numeric keypad on which you can enter the figure directly.
Now Scroll to the bottom of the main vitals screen and enter any comments you wish to make and then tap the
'I have completed this task'
That's it. The vitals have now been recorded.
Q) How do I treat a patient, Add new patients or edit existing patient details ?
A) You must be on the main patient details page. At the bottom is a 'Treat' option, a 'Plus' option to add a new patient a 'graph' symbol and a 'pen' or edit details symbol.
To 'Treat a patient tap the treat icon.
You will now see the following screen (This is a PIVOT screen and you must swipe right to left (to get to pivot 2))
Select the treatment or action you wish to use on the patient. If the treatment or action is not in the list and you have admin or super user rights you can add a new action. Only a super user or the Group owner can add new actions.
You must now SWIPE RIGHT TO LEFT to complete the rest of the details about who you wish to assign the task to and any special instructions you want when the task is performed.
On Slice 2 of the PIVOT, enter any special notes you wish to apply or an ICD10 code or a phrase from the phrase library. These are automatically entered for you once you have made a selection.
If you now swipe right again, you will see the 'ASSIGN' slice. It is here that you assign the task to any member in your group (or yourself). In this case there is only one member in the group but you can have up to 20 members per group.
The pane also shows how busy each medic is (outstanding tasks), their distance to the patient and if they are on or off shift. If you tap the 'phone' icon, you can call the medic, tapping the edit button on the lower menu will give you a detailed view of the medics details. This includes details such as their medical speciality.
If you now swipe RIGHT to LEFT again, you will see the final slice where the task is actually created and made live. You are also show a 'preview' of how the task will appear. This is where you get a final chance to check the task is exactly what you want.
You now have two options - 'Create Task' or 'I've already done this'. If you tap create task the task is created as a normal task. Alternatively if you tap 'I've already done this' the task is created and automatically set to 'complete'. This is just a quick way for you to enter tasks you have done and may have forgotten but now want to retrospectively enter and record.
Either way, that's it. You have created a task or treated a patient.
Q) I have a group and I want to create another just like it - How do I copy the group ?
A) It's a feature we are working on at the moment.
Q) I want to move a patient from one group to another or pass the details to another group not owned by me - How do I do this ?
A) As with any conventional system, doing this would create two records for the same patient and soon both versions will diverge as treatments are added. We therefore don't make this easy to do by design but it can be done by e-mailing a copy of the patient record to yourself and then cutting and pasting the data into the other group.
Q) How many patients can I have in a group ?
A) You can have up to 200 patients in each group but you can have up to 10 groups per email account. This is not actually a limitation of the hardware \ system but more a usability limitation. Humans don't handle long lists very well and if you had 40 entries under the letter 'C' for example, it's still tiresome to scroll through that many entries.
Q) I have lots of 'Groups' but can't remember which ones I own and what the passwords are ?
A) Go to the 'settings' pivot then tap 'System' 'Options' and then tap the 'E-Mail me a list of my Groups' button. You will then be sent a list of all your groups and how to access them.
Q) Why is the 'Graph' button not available ?
A) In order to graph vitals, you must have at least two sets of vitals data for the patient.
Q) I used to have group called 'xxxxx' but it is no longer showing in my group list ?
A) If a group has no activity for 6 months we will delete it and all the data it contains. We will email you twice before doing so.
Q) Why is the 'Panic Button' button not available ?
A) The panic button needs to be enabled in 'settings'. Go to settings and enter the number you want called in the event of an emergency. Note however on Windows Phone the application cannot initiate the call without the permission of the user so you will still need to confirm that you want the call made. The emergency message however will be sent to other members of your group with no further action being needed. If the phone is in an area of no service, AAA will continue to try to send the message at 30 min intervals even if the application is not running. The other members of your team will receive a message informing them that you need help and a map of the devices current location but only when they open the AAA application.
Q) What are the Up\Down arrows on the Vital Signs telling me ?
A) The up or down arrows show which way the vital sign has moved since the last reading. We don't show arrows on the third line as we only compare the last three sets of data so we don't know if the value has risen or fallen on the third set of results as we would need the fourth set to compare it to. If no arrow is showing, this means the value is the same as the previous value and has not moved. If you need to see more vitals, go to the main patient record and view the graph. Touching any point on the graph will show the actual value and the date and time it was recorded. We show the previous 3 sets of vitals on all patient actions or treatments but this can be switched off in the system options.
Q) Can I see all the jobs I need to do in a Ward for a patient, by triage ?
A) Yes - When you are in a ward there may be several jobs you need to do to different patients so wouldn't it be useful if you could see all the jobs you need to do when you are there ? On the events screen at the bottom is a sort filter button. You can now filter jobs by time, reverse time, patient, location, triage of jobs for each medic.
Q) How do the Meds \ Prescriptions work ?
A) There are two types of prescriptions in AAA
One - Off prescription
When you create a 'Meds' or prescription task the second tab on the tasks screen will show options for dose, frequency, form and any instructions you wish to add. The default is a 'One Off Rx'
When this option is used, it is like any other task in that it can be accepted (the assignee is saying "I acknowledge that I have this job to do"), set to In-Progress (the assignee is saying I'm doing it now - perhaps they have to go to the pharmacy to get the drug), set to complete (the assignee is saying - "I've done it and the drug has been administered to the patient as you asked"). The task is complete and no further action can be taken i.e. it cannot be cancelled or amended.
Tab 2 of the treat screen showing One-Off medication selected
When the event is viewed in the patient record, it will be displayed as shown below (In this case it has been completed)
On going prescription
When this option is selected the task is used a little differently.
When the task is accepted (the assignee is saying "I acknowledge that I have this job to do"), when set to In-Progress (the assignee is saying I'm doing it now - perhaps they have to go to the pharmacy to get the drug), when set to complete (the assignee is saying - "I've done it and the drug has now started being administered to the patient as you asked and will continue until the stop date you have specified is reached")
The task can be cancelled at any point up until the stop date. If the stop date is reached, the task can no longer be cancelled and the medication is assumed to have run the full course.
Tab 2 of the treat screen showing an On-Going medication selected and 25 May 2016 being the chosen stop date
When this task is displayed in the patient record, it will appear as shown below together with the last three sets of vitals.
If you now touch and hold the event, you will be presented with a context menu that allows you to update the status of the task.
In the image below, we are about to set the task to Complete and as this is an On-Going med Complete means that the drug has started to be administered.
On the main patient record, the event will now be displayed as below indicating that the medication is 'On-Going', how long the drug has been administered for and how much longer it has to run.
Q) How do I E-Mail patient records to myself securely?
A) On the main patient record tap the ellipse(...) at the bottom of the screen and select 'email copy patient record to me'
AAA will now create an encrypted email attachment containing all the data for this patient and launch your email client with the data attached. With Windows phone, only the user can send emails so you must tap the send button in order to transmit the email. The data is 256bit AES encrypted and the key is your AAA group password. This is the only way to access the data within the email attachment. Once this E-mail arrives at your main PC or workstation, you can then open the file by entering your password and then cut and paste data from the e-mail into your main system. This method of transmission and encryption is compliant with both HIPAA and HITEC. This method is not perfect and we would like to do better and make is seamless but that requires interfaces into your main system and that exposes both systems to security vulnerabilities. Any other mobile or tablet system that interfaces directly to your main system must be carrying a 'key' to access the main system and this is often a security vulnerability.
So how secure is 256bit AES
"AES permits the use of 256-bit keys. Breaking a symmetric 256-bit key by brute force requires 2128 times more computational power than a 128-bit key. Fifty supercomputers that could check a billion billion (1018) AES keys per second (if such a device could ever be made) would, in theory, require about 3×1051 years to exhaust the 256-bit key space."
Every packet of data transmitted by AAA is encrypted with a 256bit AES key.
Q) How do I handover a patient to another medic?
A) On the main patient record screen, scroll to the bottom and you will see who the patient is currently in care of. Tap the edit or 'Change In-Care' icon and select how you wish to now be in charge of the patient.
Q) How do I create my own Clinic, Care home , Domiciliary clinic or Maternity clinic ?
A) When you create a group and are asked 'Create my work place' - On the selection screen choose 'Create your own\custom environment', 'Domiciliary System' or 'Residential Care Home'. When you do this AAA will build an establishment roughly matching the chosen environment. Depending on how close the match is, you can either delete these wards and beds or amend them to represent your environment. Once you have done this, then amend the establishment details accordingly. You should also remember to set the GPS coordinates for each ward. For a domiciliary system, no beds or wards are created and you cannot add or amend them.
Q) How do I make a user a Super User \ Admin ?
A) On the 'Contact' pivot select 'Contact a medic' then tap the medic name you wish to promote (or demote) 2/3's of the way down the screen is a toggle that enables or disables the superuser status for the medic. Note :- You must already be a super user to have access rights to set this parameter. You can only be granted these rights by another super user or the Group owner.
Q) Why can't I change my role ?
A) Only a super user or the Group owner can change medics roles. If you are neither of these, you will have to ask a super user or the group owner to change to change your role.
Q) Why can't I add a new role ?
A) Only a super user or the Group owner can add roles. If you are neither of these, you will have to ask a super user or the group owner to add the role you require.
Q) I have forgotton my access codes \ lost my password
A) For security purposes, AAA will not (and cannot) re-issue the access codes. You will need to ask the Group owner or a super users to remove you from the group and then re-add you. Do not lose your access codes.
Q) How do I take Vitals Quickly
A) Step 1 - Select the patient you want to take the vitals for by touching the 'Patient' tile on the main home screen.
On the first pivot of the main patient record, scroll right to the bottom and you will see 3 buttons
Tapping any of these buttons allow you to perform the task on the patient without using the 'create task or treat' options. For example if you tap the 'Request Medic Attend Now' button, If the patient has a 'Medic in charge' then that medic will be requested to attend the patient. If the Patient does not have a 'Medic in charge' then the request will be issues to 'Any group member'.