Understanding Epic Treatment Team Configuration

The Epic Treatment Team solution stores assignments from an Epic system, and then allows the Assignment Manager to manage the activity of those assignments.

The Vocera Platform EMDAN solution contains an optional package for an Epic Treatment Team. This supplemental XML package includes conditions related to managing assignments on the Assignments dataset, the Vocera Assignment Manager Adapter, and the HL7 Epic ADT adapter. See the documentation for additional details.

After installing the core Vocera Platform EMDAN solution package, install the optional Epic Treatment Team package and follow the instructions and prompts provided in the package. Replace the HL7 ADT adapter with the HL7 Epic ADT adapter instance; do not use both adapter instances.

This optional Epic Treatment Team solution package is supported on Vocera Platform 6.0.0 or later, and requires the Vocera Platform EMDAN 1.10 solution core package.

Operation

The Epic Treatment Team data flow occurs in a two step process. The first step is to create the assignments in the Vocera Platform. Epic sends ROL segments from the ADT feed in HL7 to the Vocera Platform. The HL7 Epic adapter instance stores these segments as individual assignments, assuming they have matched the segment definition in the message type. These assignments are linked to a patient. The adapter stores other values including the role of the caregiver, and the assignment start and end dates, if provided. Finally, it is possible to receive updates for assignments from Epic. When data is altered, as compared to the initial assignment, such as a caregiver adds an end date to an assignment, then the assignment will be updated in the Vocera Platform.

In the second step, after the assignment has been stored in the Vocera Platform, the Vocera Assignment Manager Adapter instance manages the assignment. The adapter will make the assignment active, inactive, or move it when a patient is transferred. Every three minutes the adapter queries the Vocera Platform core based on the conditions configured in the Vocera Assignment Manager Adapter instance for both active and expired assignments. Any assignments that meet these conditions will have their activity updated accordingly. In addition, the adapter subscribes to the Patients dataset; when a patient moves to a new bed, all previous assignments will be expired and new assignments will be created for the new bed.

ROL Message Handling

The HL7 Epic ADT adapter contains two message definitions; the first is designed to catch A08 HL7 messages with role information, and the second is defined to catch all HL7 messages (including A08).

When an HL7 message comes through that fails to match the "ROL" segment definition in the Epic ADT-A08 message definition, it will be caught in the ADT Messages message definition. The result is that an audit event error will NOT be fired.

Because no audit event error is fired, it is possible that Vocera Platform will not be notified of misconfigured HL7 messages. The HL7 adapter perceives the HL7 message as valid because the PID and PV1 segments are accepted, but it will not actually store the ROL information which prevents the Vocera Assignment Manager Adapter from managing those assignments.

To test that the HL7 Epic ADT adapter is configured correctly, it is recommended that the catch all HL7 message definition should not be active during testing to ensure that all messages with ROL segments are stored with assignments as desired.

Determining Conditions for the Vocera Assignment Manager Adapter

Conditions will need to be created and configured for the Vocera Assignment Manager Adapter to ensure it activates and expires assignments as desired. Here are a few recommended questions to ask to determine some edge cases (this is NOT a complete list):