OTIS

Careweb

The basic patient info system of the hospital. Generally quite good and internet compatible so you can use it from home. The basic info is on the web, at the CareWeb Help Pages. It is a big help to learn this early. Some useful points that may not be obvious:

You can check your attending�s schedule for the next day in clinic or endoscopy to get a heads-up on if it will be a busy day, or if endo won�t start until 9 AM.

Maintaining patient lists is helpful, and at the end of a rotation, you can use the security functions to export it to the next person.

Displaying the trend of labs over time "the flow" is very useful

Searching for labs done long ago is easy IF you know the lab codes � in the online pathology lab book (reached from main clinical page). A quick guide to common ones is at Lablist.

Groupwise

The basic email and contact program, helpful to learn early. The basic info is at GroupWise quickstart, and WebAccess. Check it daily, or you�ll miss out on a lot.

Endopro

The software for generating endoscopy reports. It has a lot of pulldown menus, so it works quickly. There will be times when you want to free text, and you can do that in Preview mode.

when the computers are first started up or rebooted, login is moppet, password is smokey.

Computers are turned off as soon as the last case is done � be sure to print out your last reports
A backup computer with endopro is at the back of the conference room if a computer in a room is not working
If there are problems with endopro, be sure that Ecap, endopro and endobase windows are open
When stuck, shut it down, reboot and log in. When in doubt, page Len Sitka at 1626.

Doing reports

First be sure patient is entered. � right click on the appropriate room and time box, enter the attdg first initial of last name, enter CPI, birthdate, procedure, etc. then hit ADD button � will appear in yellow. Often scheduled patients will have info already on the red list � hit icon with red lines at top bar, find patient, drag them to time/room slot. Edit to make it GI and informed consent, correct attending and procedure
Then R click patient � select IN ROOM � will change to blue
For patients for colon/EGD, often it is easier to enter the patient for both procedures at the same time.
Images � the patient must be entered and "in the room" on the computer (blue) if you want to capture images. If you start the report, you can�t capture more images. Ecap must also be up to capture images �check it if problems
If you want to Get images, R click and select procedure done (turns green), then select Get images
Drag the images you want to the R on the big screen, close the ones you don�t want, arrange them in the order you want by dragging. You can R click on them to annotate, add arrows. You can select font size and color. You can also select diagram of anatomy and draw arrows to where findings are. Then click on the yellow piece of paper icon on the top bar to go to the report.
If you have no images, R click on Pt entry, select Report
If you forgot to get your images first, go through the whole report then Save/Print with zero copies, then go back to Get images, select what you want, then click on the yellow paper icon to go to report and they will be incorporated.
Writing reports � Most everything is pull down menus, and things have to be selected and appear in the lower window before you hit Next.
Ask the nurse for totals of fentanyl and versed as you get started on the report � or peek at the flow sheet and find out for yourself.
Ask attending what appointment/scope followup they want � back in clinic in 8 weeks, colonoscopy in 5 years, etc.
Use lots of free text comments to describe findings � but avoid diagnoses/interpretations, and usually keep impressions concise.
Especially for Dr. Chey and Scheiman, describe findings exactly (size, localtion, color) as they detail, and print no more than one copy until they edit it. Generally a safe practice for all reports until you get comfortable with what attendings want. Otherwise you will kill many trees.
You can do more fine tuning in preview mode � but you can�t go back to edit mode and select from pull downs � so don�t go to preview until you are sure you�re done.
Enter paracentesis patients in the "Prep" Room on the R side of the screen � be sure to get total volume out, and amount of albumin infused, and cell count/diff before you write report.
Get a 3 ring binder to keep reports in � with dividers for EGD, EGD/dil, EGD/PEG, SB enteroscopy, flex sig, colonoscopy, liver Bx, paracentesis

Novell

This is a system that gives you space on the department of medicine server. You get two forms of space, which are "virtual" hard drives on the server - one is the H drive, which is your home drive, and only you have access. The other is the S drive, which is shared with everyone in the community. After you log in, you just save a document, and among your options (A drive, C drive) appear 2 new options - the H drive and the S drive.

- you can log in from any ACI terminal ( on the floors) or the computers in Henley, or in the MPU conf room, with the login: .uniqname.intmed.umich.edu

and password: your novell password

- remember to log out when done � ACI terminals have under Start/Programs/Novell logout. In henley you have to Start/Shutdown/close all programs and log on as a different user. How is this useful? - the H drive is straightforward - it works like your own personal hard drive accessible from any computer - you never need to tote a floppy around to have access to your files.

the S drive lets you share info - on the S drive, in the "everyone" folder, there is a "GI folder", in which you can save signout lists, presentations, talks, etc. that you want to share with others - so if there are two fellows on consults, you can be sharing and modifying one list - and Kelly can get at it at any time for billing. Or check out the Michigan themed case presentation powerpoint template we've seen a lot of in the last 3 months. Anytime you're working on a project with someone else, or if you've put together something that someone else could use, consider putting it on the S drive.

There is a lot of info on line at network basics

OTIS

The liver transplant patient database, this can help you find out all the details about a transplant patient that can be hard to find in the chart, including labs drawn from the outside, transplant status, etc.

From the UM Clinical page, click on UMHS Websites A-Z, then go to T, then click on Transplant (UM Staff page). Click on Liver. Click on Liver patient database.

Password: bilirubin

Click on the various buttons to get the info you need.

You can also go back to the Liver page, and instead of patient database, the various protocols for immunosuppression, rejection, and HepB post-transplant medical treatment are there. If you see a patient who is post transplant, you can check that their immunosuppression med doses are right (occasionally they aren�t).

ER computers

The ER has its own groovy computer system with vitals, notes, procedures, meds, etc.

To get in

Password: guest

Then click on the various tabs at the top of the screen to get around � includes a tab for DMI.

CPRS

The VA is a world unto itself, and has its own (very good) computer system, called CPRS.

The key is getting login and password before you are on call and have to see patients there

Basic training is available on line at http://vaww.vistau.med.va.gov/VistaU/CPRS/Vistacpr.htm

There are also basic auto-templates that you can use that can speed up note-writing and consults if you are doing a lot of them � check with John Inadomi for details.

Seimens Radiology viewers

You can see the results of all portable films (usually abdominal plain films) on the viewers on the floors between B and C on the Riverside, or in the units

Ovid medsearch

First you must get an account and password from the library � you have to physically go to the library and sign up (get your copy cards at the same time)

Go to the Medsearch web page from the main clinical page, log in. You can save useful searches you want to use again, or email search results to yourself others. If you�re interested in a particular research project, you can even set up an automatic search that re-runs itself each week and sends you any new results via email.

Electronic Journals

A great service from the library � many journals are available on line, as pdf files, so you can print them from anywhere. Go to the Taubman web site, login, click on electronic journals, and go alphabetically. If you�re doing a bunch, the printers in the 1^st floor cluster of the library are very fast and print double sided to decrease bulk and save trees.

Kerberos

The password that lets you log in from home � key if you want to verify what the ER is telling you while on call, look up a patient�s info while on call, follow up on a patient, or review your path from home.

This is used in conjunction with the dialin info

Dialing in:

It is probably best to get the Blue disc from the Computer Showcase (basement of Michigan Union on State Street and S. University) and start setting this up early. The best way to get the Blue Disc at least cost and most convenience is to order it as a group through the division. Gather up a group that is interested (you may also want to get the discounted Microsoft Office Premium at the same time), collect the money ($ 12 each for Blue Disc and Office Premium), give them to Patricia Lai with the written out group order. The instructions for configuring Windows to log in are on the web, at http://www.med.umich.edu/i/mcit/helpdesk/documents/Dialin%20W95-98.pdf

Body CT viewers

Frequently it is helpful to review a body CT yourself, but they are hard to find � either in the reading room, or in CT core, or the file room, or somewhere in between the 3 places. However, the viewers don�t move, and you can pull up your patient on the screen in the body CT reading room

Siemens viewer login: rad password: rad1 (that�s a one, not an L)

RTAS

The system for listening to radiology reports that have yet to be transcribed. Note that they are often preliminary, and interpretations may change dramatically after the attending sees the films.

Dial 2-2551, wait for message

Dial 02 for UH ( not Mott), wait for tone

Dial 999 999, wait for tone

Dial in the CPI #

To skip to the impression, dial 9

To hear the next film, dial 0

To hear the report again, dial 7

To hear reports on a different patient, dial #

Web pages

If you want to set up your own web page, put your fabulous powerpoint presentations on the web, or whatever -- start by calling itd (they are separate from MCIT - they are the main campus computer folks). Ask them to set you up with an account. That is the major bottleneck - call 734-4357. Then go to http://www.umich.edu/~websvcs/umweb/how-to-homepage.html. That will give you all the details you will need to get hooked up. Then you will need to design your page. The simplest is to take a document in word (like this handbook) or a presentation in powerpoint and Save As HTML. You could also get fancy and use Microsoft Front Page, or get really fancy and use FireWorks and DreamWeaver. Once you have made your page, you will need to upload it to your page. Use WS_FTP. Start it up, the host name is ftp.ifs.umich.edu. Click OK to connect, enter your uniqname as the userid, and your Kerberos password as the password. Once connected, click in the window on the right (the server window) on the public folder, then the html folder. Then go to the window on the left. Scroll down until you see the drive your html files are on, then click until you get to your files. Select the files you want to upload, then look in the middle of the screen for the arrow to the right. Click on it, wait, and when it makes a train sound, the transfer is complete. Enjoy.

MCIT

Your saviors if something is not working � call 6-8000 and they can reset passwords, check out problems, give you advice, walk you through problems, etc. If any of the above is not working, they are the first call to make. Please note that they don�t support all of this stuff, but they usually know who does if it is not them. Much of their basic info is online at MCIT training. Check it out.