Features and Functionalities
Visual Dotlab© (VDL) is a comprehensive on-line patient management tool for Poison Control Centers. Visual Dotlab© is the 32-bit, Y2K compliant, GUI replacement for the 16-bit DOS DOTLAB© software package that has been in use since 1989. Visual Dotlab© is a client-server, transaction-based application that uses Microsoft SQL Server® as the data ‘back-end’. The user ‘front-end’ was created using object-oriented, data-centric, Microsoft Visual Foxpro® and a powerful and well-tested system framework package called Visual Promatrix©.
The developer of Visual Dotlab©, Terry Carlson. Pharm.D., has 15+ years of ‘on-the-phones’ Poison Center experience. Since 1989 he has been writing and enhancing the DOTLAB© system for Poison Control Centers. Since 1997 he has been the data systems analyst for the California Poison Control System. Visual Dotlab© is specifically designed to allow the poison specialist (CSPI) maximum flexibility in initiating, managing and documenting Poison Center exposure and information calls. The following are just some of the features that maximize the use of the CSPI's time and give Poison Center managers total control over their case data:
- Integrated zip code tables bring across area codes and county information upon the entry of caller zip code. City name can also be incrementally searched to deliver zip and county information.
- Service area hospital information is integrated into case entry and incremental search capabilities provide more flexible access to this information. The scope of hospital information has been greatly expanded in VDL. There is now no limit to the number of hospital phone numbers, addresses or personnel that can be stored. A powerful new feature, unlimited entry of specific hospital laboratory capabilities, has also been added.
- The Education Interface has also been greatly enhanced. Order processing, billing and payment tracking can all be managed from within the enhanced interface. Materials requests as well as media, lecture and any user-defined requests are supported.
- The ‘staff’ information database has been expanded to accept any and all addresses and phone numbers that may apply to any given staff person as well as any other additional information such as hire dates, evaluation due dates, etc..
- VDL supports multiple open case entry forms. Each form can contain different sets of data with a single toolbar controlling the form that is active (‘has focus’).
- Case follow-up tracking has been improved and enhanced. Case follow ups are tracked via a separate follow up form with multiple sorting and reporting options. The follow up form and the case entry form(s) are linked. If a user selects a case needing follow up on the follow up form, then moves to a case entry form, the case entry form record pointer will move to the appropriate ‘follow up’ case.
- No limitations on the number of substances that can be captured! If a patient ingests 12 substance, you can fully document (including mg/kg calculations) all 12 substances (including subcomponents of mixed products). Substances involved in an exposure are rated (tox hierarchy) by the user from most toxic to least toxic.
- Poisindex© specific substance codes, generic codes and product descriptors are seamlessly pulled into VDL records.
- Quick pick lists for AAPCC 7-digit codes. A user-definable quick pick list of common exposure substances alleviates time spent having to search Poisindex©. This has been greatly enhanced with incremental searching.
- Visual Dotlab provides hyperlinks to useful toxicology-related internet and intranet sites right from within Visual Dotlab©.
- An on-line calculator is available at the users fingertips. Calculation results are automatically dumped into the appropriate fields. Mg/kg calculations are automatically calculated once mg and weight values are entered.
- Date and time of exposure as well as date and time of call are stored. The date and time of exposure is very useful for calculating time since exposure for lab values etc. Date and time of exposure is automatically calculated based upon the call time and the entered ‘Time Since Exposure’. This value can also be manually entered, overriding the automatic calculation.
- Time since exposure is calculated & displayed. Every time you access a VDL record the system calculates the current time-since-exposure. This dynamic data point is not stored but is continuously calculated and updated. This is very useful information when evaluating current follow up cases.
- Last edit time: When a case is ‘refreshed’ from the server the system automatically displays how long ago the case was last edited.
- Defaulted fields based upon call type. Upon initiating a case approximately 50-60% of necessary field coding is already accomplished by defaulted values. The system automatically adjusts the defaults based upon human exposures vs. animal exposures vs. information calls.
- Unlimited text entry into a 'read-only' text memo file. The stored free text memo field is 'read-only'. This prevents previously entered case data from being modified. A temporary work area is opened for text information entry and this data is then 'appended' to the read-only area. The read-only file can now be read at any time, even while writing a new note. An enhanced editing session is available that lets users make the editing screen ‘full screen’ as well as select a favored font configuration. This configuration is ‘remembered’ by user by workstation.
- The free text editing session is automatically spell checked. Misspelled words display with a RED tilde underscore. Right clicking on a misspelled words prompts with correct spellings or alternatives.
- Restore last note function: The last note entered on a given case on a given workstation can be retrieved instantly and reinserted into the read-only memo.
- Data verification for internal data consistency - VDL provides and extensive data verification scheme that evaluates each exposure by over 250 different criteria for internal data consistency. The routine can be run by the CSPI at any time and generates a detailed list of any logical errors detected. The verification routine can be run under multiple filtered conditions giving the CSPI and PCC manager a detailed analysis of case coding and data quality. Coded unknowns are also evaluated and this gives the PCC director a solid look at the data ‘coding’ habits of staff.
- Data Triggers – Data triggers can be established that automatically fire additional data collection notifications or collection tools. For instance, symptomatic pesticide exposures seen in health care facilities are ‘reportable diseases’ in many states. Visual Dotlab already has a Pesticide Incident Reporting (PIR) interface that can be activated. As soon as VDL detects the substance involved is a pesticide related substance (determined by user-determined flags set on generic substance lookup tables) and the patient is in or en route to a health care facility, a prompting form fires to remind staff to collect additional needed PIR information. This information is then collected. A special report form is linked into VDL and this report can be Faxed directly to appropriate State and County agencies through a Networked Fax device. This same ‘data’trigger’ mechanism can be modified and utilized for prospective studies, etc..
- User definable protocols are supported. An extensive management protocol system allows for center-specific protocols to be available for appending into case records. The management standardization potential and obvious time savings with this feature are significant
- Case Templates – Standard case templates can be created by management to facilitate entry of cases involving common substances and toxins. Selection of a template changes the case coding defaults to reflect the template values. Standard free text is also incorporated into the templates but use of template history is optional and is determined by the user at runtime. These templates can be created from live VDL cases facilitating ease of creation. Regular staff DO NOT have template creation rights. This allows greater control and standardization of template content by managing directors and medical directors. The ability to create templates is a security feature that can be set at a user or security group level.
- Case copying with advancing sequential case numbers allow for rapid entry of multiple exposure cases. An exposure with twenty victims can be rapidly captured with very little extra effort beyond the thorough documentation of the primary exposure case. This has also been enhanced in VDL. Memo field information is now also copied and the user is prompted as to whether the wish to copy laboratory and vital signs data. A multi-case number field is available to enter the case number of the first of a series of multiple person exposures. Each copied case retains that ‘parent’ number making retrieval of all cases related to a multiple exposure easier.
- VDL has extensive context sensitive help for each field. By right clicking on a field the help for that fields entry is displayed. The data criteria for AAPCC data collection is online and provided in the context of the entry field. This is a great training tool for new staff and a great instant resource for seasoned staff.
- Laboratory and vital sign data collection has been moved from free text to reportable field entry! This provides an incredible new tool for evaluating the poisoned patient. An incremental search grid with ‘sortable’ columns provides instantaneous, on-the-fly reorganization of this data! This is a very powerful addition! To facilitate entry of this data a ‘lab panel’ interface prompts the user to select a ‘panel’. A single date/time stamp is then added. Users can then deselect any lab in the panel for which they have no value. The interface then creates the ‘panel entries’ in the case record and the values can then be entered. These panels are user definable and simple to construct. The same ‘panel’ functionality is available for symptoms entry.
- Printed Case output can be directed to E-mail, fax devices, Acrobat filesor Word Documents! Visual Dotlab© allows for easy redirection of printed case output. This is an extremely powerful addition. On cases requiring medical consultation a staff person can e-mail the entire case (either as direct e-mail output or attached Acrobat or Word Document) to a consultant/medical director. If a consultant then contacts the hospital, they can forward their note back to the staff person who can then cut-and-paste that information into the VDL record.
- Multiple preset and user definable query parameters for retrieving records from the ‘server’. Client-server applications can be very difficult for end-users to understand. VDL has easy to understand and simple to use defaults for case retrieval that make client-server seamless and less intimidating.
- Data auditing is extensive in Visual Dotlab©. User activity, field changes and memo field changes are extensively audited. A manager can look at auditing files and tell when a user logged in, what menus they accessed and what data they added or changed (including previous and new values). This is an important feature in on-line medical records systems!
- Visual Dotlab supports 3 levels of security based access to records.
1.) Menu level - With menu level security you can limit a given users access to all system menus. This access can be granted or denied by membership in security groups or individually by user.
2.) Control level – With control level security you can limit a users ability to use data controls. For example, a manger can allow one user access to the ‘delete’ function or the ‘add new’ function and deny another, either individually or by group. Users can granted or denied the ability to run routines, access forms, etc..
3.) Field level – A manager can determine right down to a field on a form what users can change a given value. For instance, some poison centers user poison information providers (PIPS). A CSPI can be allowed access to change the ‘peer review’ field and a PIP can be denied that right. This makes it impossible for a PIP to sign off his/her own cases.
- Login passwords are encrypted for increased login security. Users can also be granted hierarchical security clearance such that user level ‘H’ can edit login account information for users ‘H’->’Z’ but can not edit users ‘A’->’I’. This can be useful for allowing certain staff the ability to reset the passwords of others who may have forgotten their passwords. Password expiration is also supported as well as ‘grace’ logins’
- Maintaining user-defined lookup table values is a snap. If a user if given ‘F3 Edit’ capabilities in his/her user account, her/she can add new lookup values directly from the popup screen. Editing buttons are available to ‘F3 Edit’ users and are hidden from ‘non-F3 Edit’ users. This makes the entry of these values essentially ‘context sensitive’ and does not require exiting to an ‘administrative’ interface.
- Enhanced ‘free area’ support: The ‘F3 Edit’ capabilities discussed above make use of the free areas much easier. User defined data in these free areas is simple to create and manage.
- Visual Dotlab© has a powerful active data dictionary that gives managers total control over their data and forms. Screen prompts can be changed in the data dictionary without accessing system source code. Default values can be set and much, much more!
- The Visual Dotlab© Data ‘Backend’ has been optimized for Seagate Crystal Reports. The standard VDL case report and other data locator utility reports are built in Seagate Crystal Reports and are linked into Visual Dotlab using Active-X. The data dictionary provides all the information necessary to create adhoc reports using Crystal Reports® or other SQL-based report writers.
- Visual Dotlab Report Bank –The Visual Dotlab Report Bank is a collection of standard statistical, utility, productivity and Continued Quality Improvement (CQI) reports written in Seagate Reports by WBM Software. These reports are useful both for running standard reports against VDL data and as templates for other required ‘adhoc’ reporting needs that arise.
- Powerful data filtering capabilities exist in VDL. Filtering criteria can be saved ‘by user’ ‘by workstation’. A default set of useful data filters can be imported to provide a framework for a personal set of reusable data filters.
- Incremental searching of patient names, caller names, substances, and other fields makes locating cases much quicker in VDL.
- Extensive documentation is provided with Visual Dotlab. A 550+ page full system manual is provided that fully documents system issues like security and data control, etc.. A 100+ page users manual is also provided that is geared towards staff case entry.
- Multiple center system support: Visual Dotlab was written specifically to manage a Poison Control System operating multiple ‘division’ locations utilizing a Wide Area Network (WAN) computer network and an Automated Call Distribution (ACD) telephone system. Instantaneous access to system wide case data gives multi-division systems the power to take advantage of the economies of scale inherent in multi-division organizations. Visual Dotlab© seamlessly handles the transition of one division closing at night and another division taking their night calls. Each ‘division’ is assigned ‘ownership’ of regional hospitals. If one ‘division’ handles an initial hospital call ‘owned’ by another ‘division’, Visual Dotlab© assigns the case to the proper division and assures that case appears in the ongoing follow ups of the division who ‘owns’ that hospital. A staff person from one division cannot ‘close’ a hospital case that is ‘owned’ by another division. This helps assures a consistent interaction level between all service area Hospitals and the ‘ ‘Virtual Poison System’.
- On Line Analytical Processing (OLAP)/Data Analysis Services – WBM software now offers OLAP / Data Analysis Services setup and optimization. This extremely powerful DATA REPOSITORY feature allows real-time ‘drill down’ into a Poison Center’s case data for administrative and clinical purposes. This user determined, multi-dimensional analysis of case data gives Poison Center administrators, managers and medical directors a powerful tool to examine Poison Center data in ways never before possible. This ‘Meta Data’ or ‘data on you data’ is an extremely powerful tool. Although difficult to describe, once seen, it will become a tool that Poison Center management will not want to do without.
To ensure a successful go-live with Visual Dotlab©, WBM Software provides on-site installation and training. To unleash the power of Visual Dotlab©, CSPI training is essential. Extensive training is also provided to the database manager(s) to ensure proper file maintenance and data base administration. Training on the use of Seagate Crystal Reports© is also essential to understand the power it provides the end-user for ad hoc report writing needs. The report writer training provides detailed information on VDL database design and how the VDL backend has been optimized for Seagate Crystal Reports.
Visual Dotlab continues the legacy established by Dotlab©. Visual Dotlab© is a robust and powerful tool for Regional Poison Control Centers interested in becoming more efficient in the management and documentation of their call volume. It is being used in higher call volume centers as well as lower call volume centers. Visual Dotlab© is powerful because it has been developed in a Poison Control System using 4 busy centers as a software laboratory.
Terry S. Carlson, Pharm.D.
May 19, 2001
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Terry Carlson, Pharm.D.
Support Site http://www.wbmsoft.com/