CRIS

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CRIS
   Login
   Main Menu
   Search
    Pt Entry
    Demographics
    Navigation
    H & P
    Dialogues
    DSM
    Reports
    Scales
    Tx Planner
    Saving Notes 

CRIS Quick Reference

Login Page Authenticates the user.

Main Menu Click the appropriate module (where you are working i.e. emergency room).

Search Page You have 2 options for entering a patient

  • Search the Department of psychiatry’s patient records for an exiting patient

  • Search the entire Duke University Medical Center’s patient list for an existing patient

Non-Duke Users

  • Create a temporary non-system patient (no medical history number)

New Entry or Review Dialogue Box: Allows users to view a previous visit or create a new one.

Demographic: Basic demographics of a patient. Navigation via the slide bar (left) or navigate bar (right).

Navigation (Figure # 1 )
CRIS is a hub and spoke design.  In the center of the clinical hub is the History and Physical or Progress Note forms. From the hub a user moves to spokes or dialogue boxes where information is entered in the program.

            Moving within the application

  • Green fonts Indicate sections where you can click on and go.

  • Blue fonts Indicate where you are in the program.

Data Entry - Free Text and Data Elements

  • White background free text (i.e. information the user types in on the keyboard)

  • Gray background data elements (i.e. information entered via CRIS dialogue

History and Physical/ Progress Note Forms (Figure # 2)

CRIS builds a history and physical collecting free text (white areas) and data elements (gray areas) from dialogue boxes and combining them to create an evaluation/progress note.  The forms have a free text for every data area to allow the user as much flexibility as possible

CRIS Dialogue Boxes (Figure # 3)

Dialogue Boxes are defined as areas within the program that manipulate information whether asking a question, or picking from a list.  Information is stored in patient database tables that are manipulated to perform a function such as filling in forms or creating a patient evaluation.  The dialogue boxes information accesses the knowledge database, which underlies the user interface.

Trend Symptoms, Mental Status Signs, Stressors, Side Effects (Figure # 4)

Symptoms, MSE Signs, Stesssors and Side Effects Can be trended overtime

Every items is placed on a 7 point CGI Severtiy Scales.  User will see four elements

1. B = Baseline Visit Value
2. L = Last Visits Value
3. = Present Value
4. Text Color = Gray Inactive
                    = Black Active, Include in the note

Symptoms Dialogue: Progress Note rates symptoms over time on a CGI scale (Figure # 5)

  1. Click the diagnosis

  2. Rank the symptom

  3. Delete or add symptom

Reports Module There are three ways to print reports:

  • Print ICON is located in the top left of the speed bar
  • Reports is located at the bottom right of navigation bar, and will take user to reports page.
  • Menu > Patient > Reports (will take user to the reports page)

Scales Module There are three sections:

  • Choose a scale: Allows the user to pick the psychiatric scales they will be administering
  • Administer a scale Administration of the scale (i.e. pick scale and target symptom)
  • View a scale: Longitudinal view of the patient care (i.e. pick scale and target symptom)

Treatment Planner Module (Figure # 6)

  • The Tx planner module is used for treatment plans re-certification, termination and transfer notes
  • Works on a hub and spoke navigation like History and Physical
  • Has two unique dialogues boxes:
    1. Treatment plan where users can create treatment plans (BioPsychoSocial)
    2.  Functional scale on patient condition

Saving a note: Before a note can be save a required set of clinical and financial information must be present they include: 

  • Required Fields- Clinical
    • Diagnosis - all notes need a diagnosis even if it DSM “V71.09 No Diagnosis”
    • Allergies - all patients must have an allergies list even if it is NKDA
    • Medications - (Medication Management only) - Present medications (Figure 7)
    • Side Effects : (Medication Management only) - Documentation of side effects to medications
    • Outcome - CGI Functional scale always keyed to baseline
  • Required Fields -  Services/Management (Figure 8)
    • Attending Name - we need this for legal purposes
    • Clinic Name – i.e. for residents Psychiatric Outpatient Clinic
    • Action code - this is a Medicaid requirement i.e. for residents “DM”.
    • Service Rendered - Pharmacological management or therapy.

DSM-IV online

The entire DSM is on-line within the application.  On-line diagnosis can be seen by double clicking any diagnosis in the psychiatric diagnostic page (Figure 9)

 

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