Understanding a Patient Context Integration

Vocera Platform supports the Vocera Messaging Platform (VMP) to process outgoing alerts, and provide patient context for the VMP supported smartphone applications.

Vocera Platform can facilitate alert delivery through VMP, including sending alert message, receiving alert responses, synchronizing VMP users to determine alert recipients, and solution integration for VMP users for alert processing. VMP can provide patient information to smartphone applications and attach patients to conversations, including searching for patients, retrieving a user's assigned patients, retrieving a configurable set of patient details, and retrieving a patient's care team to be added to a patient conversation. Vocera Platform provides a Vocera Patient Context Adapter, which is a RESTful service, to get patient context information, and a Vocera VMP Adapter, which utilizes the SOAP protocol, for alert delivery.

External Systems

Depending on the facility implementation, there may be four external systems sending data to both Vocera Platform and/or the VMP Server.

An external Active Directory (AD) system is implemented to send user data to both Vocera Platform and VMP. In order for this integration to work easily, both Vocera Platform and VMP should be connected to the same AD system. The important piece of shared data is the login of the user; both systems must map and store the user information in the same way so that when Vocera Platform sends a user login to VMP, it can find the correct user. Shown in the diagram, the AD system is connected to the VMP Server, while Vocera Platform can receive this data with an Vocera LDAP Adapter.

An external staff assignment system provides assignments to Vocera Platform, which are stored in the Vocera Platform database. These assignments are used to determine which users should receive alert messages, and for determining the care team for a patient. Shown in the diagram on the left side, Vocera Platform can receive this data with an assignment system adapter, such as Vocera ResponderSync Subscriber Adapter.

An external patient records system provides patient information for Vocera Platform, including which bed a patient is in. Having the right bed is essential to determining the correct care team for a patient with patient context. Shown in the diagram on the left side, Vocera Platform can receive this patient data with an ADT HL7 adapter.

An external patient monitor or other alerting system sends alert data to Vocera Platform. These alerts are stored in the database and will trigger Vocera VMP Adapter rules. Shown in the diagram on the left side, Vocera Platform can receive this alert data with a patient monitor adapter, such as AlarmNotification HL7.

Vocera Messaging Platform Adapter

Configure a Vocera VMP Adapter on the system in order to send alerts to the VMP Server for delivery.

The Vocera VMP Adapter must be configured to point to the VMP Server for the service URL. The service URL is expected to be in the format of http://<ip address>/wic.asmx. The user and password configured in the Vocera VMP Adapter also must be valid in the VMP Server for the connection to work. Vocera Collaboration Suite (VCS) will be presented with alerts from the configured user in the Vocera VMP Adapter, so the user should be chosen appropriately. See the Vocera VMP Adapter documentation for configuration details.

Shown in the diagram, the Vocera VMP Adapter will send alerts to the VMP Server when the database rules fire. Communication is bi-directional, and when the Vocera VMP Adapter receives user responses to alerts from the VMP Server, it will store these responses in the database.

Patient Context Adapter

Configure a Vocera Patient Context Adapter on the system to provide patient information when the VMP Server makes requests.

In the Vocera Patient Context Adapter configuration settings, the Client field should always be set to "VMP" in order to work correctly with the VMP Server. The Authentication Key must be copied to the VMP Server when setting it up, in order to work with this adapter. The Vocera Patient Context Adapter can be configured to pass along more data, if desired, using the Patient Detail Mappings settings. In addition, if there is an AirStrip integration, configure the Patient Property Mappings parameters to provide AirStrip with the data it needs. See the Vocera Patient Context Adapter documentation for configuration details.

Shown in the diagram, the Vocera Patient Context Adapter will query the database for patient data, and send patient data to the VMP Server for use in alerting.

Compliance Logger

The Vocera Compliance Logger Adapter is not specifically required for the Patient Context integration, but it is recommended to be enabled when there is an instance of Patient Context integration. The Vocera Compliance Logger Adapter captures significant compliance events, such as users logging into the system and accessing Protected Health Information (PHI). These logs capture who is accessing the information, when the information was accessed, and what information was accessed. In a facility where Patient Context integration is used and PHI is moving through the various adapters to be delivered to devices and caregivers, it is strongly recommended that the facility have records of who is accessing information via the Vocera Compliance Logger Adapter.

EMDAN Solution Setup

The Vocera Platform EMDAN solution provides a separate add-on VMP package; after installing the core Vocera Platform EMDAN package, install the VMP package. Various rules and conditions triggered by the Vocera VMP Adapter enable sending alerts to the VMP Server. Additionally, AirStrip parameters can be passed along in the Clinical rules when a facility uses an AirStrip integration.

Vocera Messaging Platform Server

The Patient Context integration requires Vocera Platform to send alerts to the Vocera Messaging Platform (VMP) server. The VMP Server needs to be configured to use the Authentication Key from the Vocera Patient Context Adapter and other settings to work with the Vocera VMP Adapter configuration in Vocera Platform. In addition, the VMP Server needs to be configured to get users from the same AD system that Vocera Platform uses to ensure the two systems have synced users. If the Vocera Patient Context Adapter is being used, the users will need to be given patient data access.

As shown in the diagram, Vocera Platform will send alerts to the VMP Server through the Vocera VMP Adapter. The VMP Server will send this message to Vocera Collaboration Suite (VCS), if the user is logged into VCS. The VMP Server can forward the message to a badge through the Vocera Voice Server (VS) if a user is logged into a badge instead of a VCS client. The VMP Server will receive responses and patient data requests from VCS, and will send these to the Vocera VMP Adapter and Vocera Patient Context Adapter respectively.

Voice Server

A Vocera Voice Server (VS) needs to be installed and configured for logging and analytics in a Patient Context integration. Additionally, VS facilitates communication for sites that have VCS clients and Vocera badges, as shown in the diagram. VS is used to forward messages to a badge when a user is logged into a badge and not VCS. When an alert is forwarded, the short message configured in the rule will be used for the badge, however, responses will function as normal for badges.

Vocera SIP Telephony Gateway

The Vocera SIP Telephony Gateway (VSTG) needs to be set up and configured when callbacks are being utilized in VCS. The VSTG allows the Vocera Voice Server (VS) to communicate with the PBX, which allows access to telephony.

Endpoints

This Patient Context integration is intended to deliver to mobile devices using the VCS client. In addition, it does support users using the VCS web client or forwarding to badges if a user is logged into a badge instead of VCS.