Visual Dotlab©
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.
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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.
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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.
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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..
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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’).
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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.
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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.
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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.
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Visual
Dotlab provides hyperlinks to useful toxicology-related internet
and intranet sites right from within Visual Dotlab©.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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..
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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!
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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.
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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’
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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.
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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.
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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!
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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.
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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.
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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.
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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’.
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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
For More
information:
Terry Carlson, Pharm.D.
E-mail tcarlson@wbmsoft.com
Support Site http://www.wbmsoft.com/