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Joint Legacy Viewer (JLV) 2.6.2 User Guide282892598989April 2018Version 1.2 Department of Veterans AffairsOffice of Information and Technology (OIT)Revision HistoryDateRevisionDescriptionAuthor04/24/20181.2Further edit requested. Submitted for PM approvalAbleVets04/17/20181.1Review comments addressedAbleVets04/11/20181.0Delivered for reviewAbleVets03/14/20180.1Initial draft of artifact from last approvedAbleVetsArtifact RationalePer the Veteran-focused Integrated Process (VIP) Guide, the User’s Guide is required to be completed prior to Critical Decision Point #2 (CD2), with the expectation that it will be updated as needed. A User Guide is a technical communication document intended to give assistance to people using a particular system, such as VistA end users. It is usually written by a technical writer, although it can also be written by programmers, product or project managers, or other technical staff. Most user guides contain both a written guide and the associated images. In the case of computer applications, it is usual to include screenshots of the human-machine interfaces, and hardware manuals often include clear, simplified diagrams. The language used is matched to the intended audience, with jargon kept to a minimum or explained thoroughly. The User Guide is a mandatory, build-level document, and should be updated to reflect the contents of the most recently deployed build. The sections documented herein are required if applicable to your product.Table of ContentsIntroduction1Purpose of the Guide1Guide Conventions2Terminology2Assumptions2System Requirements2Getting Help3Logging in to JLV4VHA User Log In4VBA User Log In6Editing Your User Profile at Log In6Selecting a UI Theme7Community Data Display7Logging Out of the Current JLV Session9The Elements and Functionality of JLV10The JLV Portal Pages10Default View10System Menu11Viewing System Status12Patient Context Management13Customizing JLV16Setting the UI Theme16Using the Accessible Theme’s Functionality19User-Restricted Access to Patient Data22VHA Users Viewing DoD-only Patients22VBA Users Viewing Patients with DoD Data23Access to DoD Sensitive Records24Patient Searches25PDWS Search Rules and Supported Searches26MVI Search Guidelines26Patient Search Using DoD ID26Patient Search Using SSN27Advanced Patient Search Options29Family Member Search30Recently Viewed Patients List32Widgets34Accessing and Opening Widgets34Widget Navigation and Display Options35Widget Toolbars36Minimized vs. Expanded Widget View37Date Range Filters37Viewing Connection Status40Displaying Widgets on Custom Tabs43Refreshing Data in a Widget44VistA Imaging Viewer44Using Report Builder45Printing53Widget Functionality54Patient Demographics Widget54Patient Flags and Alerts54Race Data Terminology Normalization55Demographics from Community Partners56Viewing Third-Party Insurance Information56Documents Widget57Documents Widget Data58Viewing Documents59Viewing DoD Sensitive Data60Display and Filter Options60Terminology Normalization61Community Health Summaries and Documents - VA62Community Health Summaries and Documents - VA Widget Data62Viewing VA Community Health Summary Documents63Military Health System (MHS) GENESIS Widget64MHS GENESIS Widget Data64Viewing MHS GENESIS Documents65Troubleshooting67Special Instructions for Error Correction67Login Page Error Messages68System Error Messages69VA VHIE Server Error Message72Acronyms and Abbreviations73Table of FiguresFigure 1: Single Sign-On Page for VA Users5Figure 2: Edit Profile Link on the JLV Login Page7Figure 3: Community Data Display Option8Figure 4: JLV Log Out Icon9Figure 5: References Widget10Figure 6: JLV Tools on the Portal Pages11Figure 7: More JLV Functionality11Figure 8: System Status on the JLV Login Page13Figure 9: Context Indicator13Figure 10: Suspending Context14Figure 11: CCOW Warning Message15Figure 12: CCOW Error Message15Figure 13: Context Synchronization Failure16Figure 14: Blue (Default) UI Theme17Figure 15: Green UI Theme17Figure 16: Dark Gray UI Theme18Figure 17: Gray UI Theme18Figure 18: Accessible (508 Compliant) UI Theme19Figure 19: Navigation Using Elements with Keyboard Focus21Figure 20: Document Details with Keyboard Focus22Figure 21: VA User Restricted Access Dialog23Figure 22: VBA User Audit Notification23Figure 23: Restricted Access Notification24Figure 24: DoD Sensitive Record and Audit Dialog Box25Figure 25: DoD ID (EDIPI) Search27Figure 26: SSN Search28Figure 27: Additional Identifiers Needed28Figure 28: Advanced Search Options29Figure 29: Sponsor SSN Search31Figure 30: Family Members Dialog Box32Figure 31: Recently Viewed Patients List33Figure 32: Widgets on the Patient Portal34Figure 33: Widget Tray34Figure 34: Date Range Filters Applied38Figure 35: Quick Date Range Filter Options39Figure 36: Start and End Date Display Filter40Figure 37: Connection Status Indicator41Figure 38: Connection Status Window42Figure 39: Connection Status Details42Figure 40: Add Custom Tab Icon43Figure 41: Add Tab Dialog Box43Figure 42: Camera Icon in the Image Column44Figure 43: Thumbnail and Link in Details View45Figure 44: Report Builder Icon45Figure 45: Current Report Tab46Figure 46: Patient Reports Tab47Figure 47: Report Builder Pane and Add Record to Report Option48Figure 48: Report Builder - Document Ready Dialog Box48Figure 49: Report Builder Pane49Figure 50 Name Report Dialog Box50Figure 51: Patient Reports Tab - Report Ready and Delete Option51Figure 52: Report Ready Message and Indicator51Figure 53: Report Contents Window52Figure 54: Delete Reports Dialog Box52Figure 55: Patient Demographics Widget54Figure 56: Patient Flags Indicator55Figure 57: Patient Flags and Postings Details55Figure 58: Standardized Race Data56Figure 59: Insurance Information57Figure 60: Documents Widget, Minimized View58Figure 61: Documents Widget, Expanded View59Figure 62: Details View of a Document60Figure 63: Standardized Name and Code–Documents Widget62Figure 64: Community Health Summaries and Documents - VA, Minimized View63Figure 65: Community Health Document64Figure 66: MHS GENESIS Widget65Figure 67: CCDA Document66Figure 68: Login Error - CAPRI Patient Selection Restrictions67Table of TablesTable 1: JLV User Profiles1Table 2: ESD Contact Information3Table 3: Accessible Theme Keyboard Shortcuts20Table 4: Navigation Icons and Actions35Table 5: Widget Toolbar Icons36Table 6: Error Messages and Resolution Steps68Table 7: System Error Messages69Table 8: Community Health Summaries and Documents - VA Widget Error Message72Table 9: Acronyms and Abbreviations73IntroductionBorn from a joint Department of Defense (DoD)-Department of Veterans Affairs (VA) venture called JANUS, Joint Legacy Viewer (JLV) was directed by the Secretary of the VA and the Secretary of Defense in early 2013 to further support interoperability between the two departments. JLV is a centrally hosted, Java-based web application managed as a single code baseline, and deployed in separate DoD and VA environments. Its browser-based, graphical user interface (GUI) provides an integrated, read-only view of Electronic Health Record (EHR) data from the VA, DoD, and Veterans Health Information Exchange (VHIE) community partners, within a single application.JLV eliminates the need for VA and DoD clinicians to access disparate viewers. The GUI retrieves clinical data from a number of native data sources and systems, then presents it to the user via widgets, each corresponding to a clinical data domain.Users can create and personalize tabs, drag and drop widgets onto tabs, sort data within a widget’s columns, set date filters, and expand a widget for a detailed view of patient information. Within each widget, a circular, blue icon indicates the data retrieved is from a VA source; a square, orange icon indicates that the data retrieved is from a DoD source; and a hexagonal, purple icon indicates data that the data retrieved is from VA VHIE partners.This document is intended for VA JLV users supporting the:Veterans Health Administration (VHA)Veterans Benefits Administration (VBA)Table 1 describes authorized JLV users and their responsibilities.Table 1: JLV User ProfilesUserDescription and ResponsibilitiesDoD ClinicianDoD clinicians who access patient EHRsVHAVA clinicians and administrative staff who access patient EHRs to assist in providing health care servicesVBAVA administrative staff who access patient EHRs to assist in Veterans benefits administration processesPurpose of the GuideThe purpose of the User Guide is to familiarize VA users with the important features and navigational elements of JLV.The major features of the JLV GUI include:Access to patient data (through widgets)Patient context managementUser-restricted access (Break the Glass)Use of the Report BuilderOption to use the accessible (508 compliant) interfaceGuide ConventionsThis document is designed for both online and hardcopy consumption.Cross References are indicated by blue, underlined text and provide a hyperlink to figures, tables, and other sections within this guideEmphasis is expressed by bold and italicized textThe information symbol calls the reader’s attention to additional informationTerminologyThe following standard terms are used throughout this guide:Patient Portal: The page that displays patient data through widgetsProvider Portal: The landing page, or default view, of JLV that appears after logging in to the application that displays widgets and the tools that enable quick access to basic featuresTabs: Tabs display the Patient and Provider portals, and present user-customized views of widgetsWidget: A component of the JLV interface that enables a user to view information or perform a functionWidget Tray: An expandable and collapsible tray at the bottom of the portal pages that provides access to all widgets available for placement on the portal pagesAssumptionsThe User Guide is written from the perspective of VA JLV users, assuming the following:You can open, navigate, and use a web browserYou can use web-based applications, their menu options, and navigation toolsYou have the Uniform Resource Locator (URL) for the JLV Login page, a system username, and the Access/Verify codes required to launch JLVYou are using the functionality of JLV to support VHA and/or VBA workflowsSystem RequirementsJLV is optimized for use with the VA standard browser, Internet Explorer (IE) version 11. To ensure proper viewing of patient data and other application elements, it is recommended that JLV is viewed using:A monitor set to a minimum screen resolution of 1024 x 768The approved browser, with the browser’s zoom percentage set to 100JLV must be accessed through IE versions 9 and above. Other web browsers may function, but are not certified for support. It is also recommended that Adobe Reader be installed on the user’s system.Getting HelpFor how to information within JLV, please see online help. For access to JLV training videos and additional JLV training materials, please visit JLV Resources.Prior to contacting the Enterprise Service Desk (ESD) for support (Table 2), please refer to Section 2, Logging in to JLV, for detailed information about how to access JLV, and to Section 6, Troubleshooting, for suggested resolution steps and troubleshooting information.If you are an authorized user, are having trouble logging in to JLV, or are experiencing other application issues, please contact the ESD via telephone or by using the YourIT self-service portal for assistance.NOTE: Unregistered users should contact support to request access to JLV.redactedLogging in to JLVAuthorized, registered users within the VA and DoD are provided access information to log in to JLV. VHA users who have access to the Computerized Patient Record System (CPRS) are automatically authorized to use JLV. VBA users must contact the ESD for access.Refer to Section 6, Troubleshooting, for more tips on logging in to JLV.1441191106549Users who are not authorized to access JLV will see an Access denied message. If you believe you received the message in error, please contact the ESD.The JLV Login page displays the last successful and unsuccessful log in attempts in the lower left corner, along with the date, local time, and the Internet Protocol (IP) address from which access was made, or attempted access failed.PLEASE NOTE: There is no functionality available for changing a user identification (ID) and password in JLV. For information about login errors, Access code errors, or Verify code errors, see Section 6, Troubleshooting.VHA User Log InThe log in steps detailed below apply to VHA users accessing JLV through a URL. To log in to JLV:Enter VHA’s URL for JLV into the address bar of your Internet browser (redacted)Once SSOi is enabled, all VA users will be redirected to the VA Single Sign-On page (Figure 1)VA users must sign in to, and be authenticated by, the Single Sign-On system in order to access JLVOnce SSOi is enabled, users with a Personal Identity Verification (PIV) exemption may select any of the alternate authentication options available through the VA Single Sign-On Login page for access to JLV. PIV exemptions, if required, can be obtainedfrom the ESD.Figure 1: Single Sign-On Page for VA UsersOnce authenticated by the Single Sign-On system, you are redirected to JLVRead the important user consent information regarding access to a Government information system, and click I AcceptOptional Step:Users of Assistive Technology can check the Accessibility Mode option in the top-right corner, above the JLV Login page fieldsIf selected, JLV opens and displays the application in the 508-compliant Accessible User Interface (UI) theme (See Section 3.2.2, Using the Accessible Theme's Functionality, for detailed information)Enter your VA login credentials:Enter your CPRS Veterans Health Information Systems and Technology Architecture (VistA) Access CodeEnter your CPRS (VistA) Verify CodeSelect VA from the Agency fieldSelect your VA Medical Center or regional Health Care System from the Site fieldClick LoginVBA User Log InThe following instructions apply to VBA users accessing JLV. To log in to JLV:Enter the VBA’s URL for JLV into the address bar of your Internet browser (redacted)All VA users will be redirected to the VA Single Sign-On page (Figure 1)VA users must sign in to, and be authenticated by, the Single Sign-On system in order to access JLV1477386150364Users may select any of the authentication options available through the VA Single Sign-On Login page for access to JLV.Once authenticated by the Single Sign-On system, you are redirected to JLVRead the important user consent information regarding access to a Government information system, and click I AcceptIf desired, check the Accessibility Mode option in the top-right corner, above the JLVLogin page fieldsIf selected, JLV opens and displays the application in the 508-compliant Accessible UI theme (See Section 3.2.2, Using the Accessible Theme's Functionality, for detailed information)Enter your login credentials:Enter your Compensation and Pension Record Interchange (CAPRI) Access CodeEnter your CAPRI Verify CodeSelect VA from the Agency fieldSelect Veterans Benefits Admin from the Site dropdown listClick Login Users with any CAPRI patient selection restrictions will not be able to log in JLV.Editing Your User Profile at Log InOne method of setting application configuration options (customizing) is by using the Edit Profile link (highlighted in Figure 2) to access the user profile fields through the JLV Login page.The subsections below discuss the options to set the UI theme, and to enable/disable the Include Community Data function via the Edit Profile link.User profile options can also be set within JLV. See Section 3.2, Customizing JLV.1107499100072The selected options are saved to the user profile by clicking Save and Login and remain set for all subsequent JLV sessions until changed by the user.Figure 2: Edit Profile Link on the JLV Login PageSelecting a UI ThemeSelecting a UI theme sets the font color and foreground/background colors of the JLV GUI for the widgets, toolbars, and dialog boxes. Theme color options are Blue (Default), Green, Dark Gray, Gray, and Accessible (508 compliant). The UI theme choices appear below the Agency and Site fields, as seen in Figure 3.1136063273199The Accessible theme provides larger fonts, enhanced tab and keystroke functionality, and screen reader compatibility, compliant with Federal accessibility requirements and Section 508 standards. Refer to Section 3.2.2, Using the Accessible Theme's Functionality, for more munity Data DisplayChecking (enabling) the Include Community Data option will tell JLV to query for, receive, and integrate patient data from external VA VHIE community partner data sources. The community data setting is in the bottom half of the Edit Profile dialog, seen in Figure 3.Regardless of this setting, VHIE community data is available in the Community Health Summaries and Documents - VA widget. See Section 5.3, Community Health Summaries and Documents - VA, for detailed information.1083310-23932VBA users do not have access to community data and will not see the Include Community Data option.Figure 3: Community Data Display OptionLogging Out of the Current JLV SessionTo end the current session and exit JLV, click the Log Out icon (highlighted in Figure 4) at any time.Figure 4: JLV Log Out IconA JLV session will end automatically after 30 minutes of inactivity. You will receive a warning that the session will be ended after 25 minutes of inactivity. Automatic termination of a session logs you out of the application and displays the Logout page. To initiate a new JLV session, close and reopen the browser and return to the JLV Login page.Actions in JLV that are considered activity are changing patients, refreshing widgets, opening or closing widgets, adding or removing widgets from the portal pages, and adjusting date ranges.The Elements and Functionality of JLVThe JLV Portal PagesAfter a successful log in, your username is shown in the upper right corner of the application, and the JLV portal pages are displayed. The JLV portal pages are:The Patient Portal The Provider Portal Default ViewUpon log in, users will see the Provider Portal . The portal displays the Patient Searchdialog box and the References widget by default.1136063152676CPRS users who select a patient within CPRS, then launch JLV are taken directly to the JLV Patient Portal , where the records for the patient selected in CPRS are displayed.5743194-31202The References widget (Figure 5) is shown by default on the Provider Portal. The References widget displays hyperlinked references to online resources. Click a reference link to access the associated website. Click the Add icon + to add a new reference link.Only the reference links you add can be deleted. To delete a reference link, right-click the link and select Delete URL. Users will not be able to delete reference links included in the default widget configuration.Figure 5: References WidgetThe Patient Portal displays a selected patient's clinical records and other patient-centric information.New JLV users will see a preconfigured, default widget layout on the Patient Portal when a patient is selected. The default layout includes the Allergies, Problem List, Documents, Outpatient Medications, and Lab Results widgets.1136063265821Users can configure the layout of widgets on the Patient Portal and create multiple widget tabs, as described in Section 3.2, Customizing JLV after Log In, and in Section 4.1, Accessing and Opening Widgets. Customizations are saved to the user profile and remain until manually changed.System MenuEach portal page has a toolbar (highlighted in Figure 6) that enables quick access to the following features:Configuration Options: Click the Settings icon in the top-right corner of either portal page to set user preferences, including the UI theme (Refer to Section 3.2, Customizing JLV)Report Builder: Click the Report Builder icon in the top-right corner of either portal page to create custom reports (Refer to Section 4.8, Using Report Builder)Access Online Help: Click the Help icon in the top-right corner of either portal page to open online helpLog Out of JLV: Click the Log Out icon to log out and close the current JLV session (Refer to Section 2.4, Logging Out of the Current JLV Session)Figure 6: JLV Tools on the Portal PagesThe following functions can be completed from the portal pages (highlighted in Figure 7):Perform a Patient Search Switch between the Patient Portal and the Provider Portal View the system status View Context Management status Open the widget tray Open Widget Tray ^ (bottom-right corner of the portal pages)Figure 7: More JLV FunctionalityViewing System StatusThe system status reports the condition of the JLV application as a whole. If there is a system status alert, the warning icon is displayed to the left of your username. Hovering over System Status provides additional information.NOTE: The System Status reports the overall condition of the JLV application, while the Connection Status reports the condition of the connection between JLV and its externalresources. See Section 4.5, Viewing Connection Status, for more information.JLV displays the system status on the Login page, below the user credential fields (highlighted in Figure 8), and at the top of the Portal Pages (Figure 7).When all monitored systems and services are online and connected, a green icon appears next to the status message JLV data sources are available on the JLV Login pageWhen one or more of the monitored systems or services is offline or unavailable, a yellow warning icon appears next to the status message JLV is having problemsNotification of unavailable systems persisting longer than 10 minutes should be reported to the VA Enterprise Service Desk (Section 1.4, Getting Help)When the jMeadows Data Service is unavailable, a red icon appears next to the message, JLV is having problems, jMeadows Data Service is unavailable, JLV may not function properlyUsers may not be able to log in to JLV, or view patient data, until the jMeadows connection is restored.Figure 8: System Status on the JLV Login PagePatient Context ManagementClinical Context Management (CCOW) is a way for applications to synchronize the display of clinical context, based on the Health Level 7 (HL7) CCOW standard. If CCOW-compliant applications are sharing context and one of the applications changes the data display to a different patient, the other applications will switch to display that same patient.JLV is context management-enabled. When context is enabled, a patient change made in one context-enabled application (i.e., CPRS) will trigger the same change in JLV. The same effect is shown vice versa; that is, when a patient is selected in JLV, it triggers a patient change in other context-enabled applications.Context management is enabled by default, and JLV will attempt to connect to the context vault upon a valid login. The context status appears in the top-right corner of the portal pages. When context is established, the Context On icon is shown. When context is suspended, the Context Suspended icon is shown.Figure 9 shows the context indicator location on a JLV portal pages. In this example, context is suspended.Figure 9: Context IndicatorSuspending Context Context can be manually suspended. To manually suspend context:Click the Context On icon The CCOW warning message, Are you sure you want to break patient link? appears (Figure 10)Click Yes to continueOnce context is suspended, the Context Suspended icon is displayed on the portal pages. When context is suspended, patient changes will not be reflected in either JLV or other CCOW- enabled applications.Figure 10: Suspending ContextEstablishing ContextWhen context is suspended, it can be reestablished manually. To establish or reestablish context:Click the Context Suspended icon The CCOW warning message, Are you sure you want to rejoin patient link? appears (Figure 11)Click YesOnce context is established, the Context On icon is displayed on the portal pages.Figure 11: CCOW Warning MessageUnable to Communicate with VaultIf JLV is unable to initiate context management upon log in, the user will see the CCOW Error message (Figure 12). Click OK to continue. The Context Suspended icon is displayed on the portal pages. If the CCOW error persists, contact your local service desk for assistance.Figure 12: CCOW Error MessageContext Synchronization FailureIn the event that JLV is unable to reestablish context, a CCOW Error message is presented (Figure 13). This indicates context is suspended. Click OK to continue. The Context Suspended icon is displayed on the portal pages.VBA users will encounter the error message (Figure 13) at each log in, as there are no CCOW system components installed on their computers.Figure 13: Context Synchronization FailureCustomizing JLVConfiguration options can be set within JLV by clicking the Settings icon.Setting the UI ThemeThe UI theme setting is a part of the user profile. Choosing a UI theme sets the font, foreground, and background colors of the widgets, toolbars, and dialog boxes. Once selected, the UI theme is stored in the user profile, and remains set until changed. The available UI themes are Blue (Default), Green, Dark Gray, Gray, and Accessible (508 compliant).To set the UI theme within JLV:Click the Settings icon in the upper right corner of the portal pages (Figure 6)The User Configuration dialog box opensSelect the desired theme and click SaveAlternatively, click Cancel to exit the dialog box and restore the previous themeFigure 14: Blue (Default) UI ThemeFigure 15: Green UI ThemeFigure 16: Dark Gray UI ThemeFigure 17: Gray UI ThemeFigure 18: Accessible (508 Compliant) UI ThemeUsing the Accessible Theme’s FunctionalityThe Accessible theme includes larger fonts, enhanced tab and keystroke functionality, and screen reader compatibility to support Federal accessibility requirements and Section 508 compliance.113606355267The Accessible theme is available for users who have adaptive technologies installed on their computers.Keyboard Focus and Screen NavigationKeyboard focus is the highlighting of a screen element, field, or control that enables interaction with, and navigation of, JLV through the use of the keyboard and keystrokes. The item in focus is outlined in gold as a visual indicator of the element, field, or control with keyboard focus that will receive information typed on the keyboard.JLV uses common Windows keystrokes (Tab, Shift + Tab, arrow keys, Enter), and keyboard shortcuts to move the focus to all menus, and activate all functions on the menus. All user interface items are accessible via the keyboard under the Accessible theme.Pressing Enter or the Spacebar when an element that provides action is in keyboard focus performs the associated action. For example, pressing Enter or the Spacebar when the Settings icon is in focus opens the User Configuration dialog box. Using the arrow keys or the Tab key moves between keyboard focus items to navigate through screen elements. A complete list of accessible keystrokes is provided in Table 3.Table 3: Accessible Theme Keyboard ShortcutsKeystrokeDescriptionApplication & Portal NavigationALT + 4Press to transfer keyboard focus to the main or top screen elementOn a portal page, focus is transferred Patient Search or the patient tab in theDemographics widgetIn a widget, focus is transferred to the More>> linkIn a dialog box, focus is transferred to the dialog box’s Close buttonENTERPress to initiate the action associated with the item in focusTABPress to transfer keyboard focus to other user interface itemsESCPress to return keyboard focus to the panel containing the user interface item with keyboard focus, or to exit a window, widget, or tabSPACEBARPress to activate any user interface item (for example, click a button)Arrow KeysWhen focused on a widget, press the arrow keys to change page viewing in a widget's data tableWhen focused on a dropdown list, press the down arrow key to view list contentsCtrl + rWhen working with Report Builder, place keyboard focus on a record in a widget and press Ctrl + r to add the record to the Report Builder paneTab PanelsArrow KeysUse the left and right arrow keys to change tab panelsTo add a tab panel, press the right arrow key until the last tab (labeled with a plus sign) is selected. A dialog box prompts for the new tab nameTo close a tab, focus on the tab panel and press EscWindows or Dialog BoxesTABPress to transfer keyboard focus to other user interface items within the window or dialog boxAdding Widgets to a Portal PageNumber positionTo add a widget from the widget tray using keystrokes:Determine which column (1, 2, or 3) in which to place the widgetFocus on the desired widget icon in the widget tray and press the 1, 2, or 3 key, depending on the column chosenAccessible Theme Screen NavigationAn element with keyboard focus is the starting point for screen navigation. Pressing the Enterkey when a screen element or icon has keyboard focus mimics a mouse click.Figure 19 depicts the Documents widget with keyboard focus. Focus can be changed by pressing the Tab key. In this example, pressing the Tab key shifts the keyboard focus from the Documents widget to the widget immediately below the Documents widget. Pressing the Tab key again shifts the keyboard focus to the widget at the top of the next column.1136063185430To view hover text where available, focus on the element within the widget that has hover text. After a small delay, the text will appear as if the user hovered over the element with a mouse cursor.Figure 19: Navigation Using Elements with Keyboard FocusIn Figure 20, the Document details window has keyboard focus. Move through the toolbar buttons by using the arrow keys, or by pressing Tab. Move to Close (X) and press Enter to close the details window. After closing the window, keyboard focus returns to the last element that had keyboard focus prior to opening the window.Figure 20: Document Details with Keyboard FocusUser-Restricted Access to Patient DataVHA Users Viewing DoD-only PatientsVHA users are permitted to view the records of patients considered DoD-only, meaning they either have no VA identifiers or are not registered in the Master Veteran Index (MVI). The VA requires that these actions be audited. If an attempt is made to access DoD-only patient records, the VHA user is asked to specify the purpose for access. The purpose options presented to the user are: Emergent Care, Clinical Care, or Authorized Administrative Use (Figure 21).Once the purpose for access is selected, clicking Agree to be Audited & Access this Patient Record (Figure 21), displays the requested data, and audits the action. The access purpose, organization of the VA provider, date, username, IP address, user’s Internal Entry Number (IEN), host system’s ID, and patient’s Electronic Data Interchange Personal Identifier (EDIPI) are captured in the audit record.Figure 21: VA User Restricted Access DialogVBA Users Viewing Patients with DoD DataVBA users may see one of two different dialog boxes, depending on whether or not the patient is registered for care in the VA. If the patient is registered for care in the VA, they are in MVI.Patient registered in MVI: VBA users are permitted to view the records of a patient who is registered in MVI, but the VA requires that these actions be auditedAfter performing a patient search and selecting a patient from the search results, a VBA user will see the audit notification (Figure 22) if the patient they selected is registered in MVIAfter agreeing to the audit, the VBA user can access the patient’s recordFigure 22: VBA User Audit NotificationPatient not registered in MVI: VBA users are not permitted to access the records of a patient who is not registered in MVIAfter performing a patient search and selecting a patient from the search results, a VBA user will see the restricted access notification (Figure 23) if the selected patient is not registered in MVIClicking Cancel returns the user to the previous screenFigure 23: Restricted Access NotificationAccess to DoD Sensitive RecordsAll JLV users are audited each time a sensitive DoD record is accessed. Auditing applies to sensitive documents, lab panel results, outpatient encounters, or progress notes records. For each attempt to access sensitive data, JLV records the user’s name, organization, Social Security Number (SSN)/EDIPI (for DoD users), PIV (for VA users), location, patient identifiers (patient last name, first name, middle initial [MI], SSN/EDIPI [DoD only], MVI [VA only], and date of birth [DOB]), data accessed, date and time, and reason for access.113606354886The audit prompt is seen each time access to a sensitive record is attempted, even if the user has been previously audited for the same record.JLV notifies users before they are audited. The message is triggered when the user clicks a masked record that is marked ** Sensitive **. An example of a masked record displayed in a widget and the audit notification are depicted in Figure 24.After the user selects the purpose for viewing the record and agrees to be audited, the sensitive data is displayed in the Details view of the widget.Figure 24: DoD Sensitive Record and Audit Dialog BoxPatient SearchesThe core function of JLV is to display patient information on the Patient Portal . Use the Patient Search feature to perform a patient search, perform a family search, or use the advanced search options.JLV determines which enterprise service to use for a patient search, based upon the search criteria:If the EDIPI or Sponsor SSN is entered, JLV utilizes Patient Discovery Web Service (PDWS) for the search (See Section 3.4.1, PDWS Search Rules and Supported Searches, for details)If the EDIPI or Sponsor SSN fields are empty, JLV utilizes MVI for the search (See Section 3.4.2, MVI Search Guidelines, for details)PDWS Search Rules and Supported SearchesWhen JLV utilizes PDWS for patient search, the applicable rules and rule sets required for the PDWS interface must be used:Rule Set 1: When searching by SSN, the full nine-digit SSN must be entered, and the Last Name or DOB must also be suppliedThis is true for search by patient SSN, as well as Sponsor SSNRule Set 2: If you do not have the patient’s SSN, you must supply ALL of the following identifiers: last name, first name, DOB, and genderBlanks in any of these four required fields will generate an errorA 10-digit string is required for telephone numberThe following search combinations are supported when PDWS is utilized:DoD ID, also referred to as the EDIPIPatient SSN and Last NamePatient SSN and DOBSponsor SSN and Last NameSponsor SSN and DOBLast Name, First Name, DOB, and Gender (ALL identifiers must be entered)MVI Search GuidelinesJLV utilizes MVI for a patient search when the search parameters include the patient’s name and SSN. MVI requires the full last name is entered when the patient’s SSN is entered. MVI may also require entering the patient’s first name and DOB to increase the efficiency of the search, and the likelihood of locating the patient. An example would be searching for a patient with a common last name, such as Smith or Jones.Patient Search Using DoD IDTo perform a patient search using the DoD ID (Figure 25):Click the Patient Search icon at the top of the portal pagesThe Patient Search dialog opensEnter the 10-digit patient DoD ID (EDIPI) in the DoD ID fieldFigure 25: DoD ID (EDIPI) SearchClick SearchThe search results are displayed in the lower third of the dialog box, under the Search Results tabClick a patient’s name in the search results list to open the associated recordThe Name, SSN, DOB, and Gender columns in the results list provide information to assist with patient identificationAfter selecting a patient, the Patient Portal opens and displays the selected patient’s dataPatient Search Using SSNTo perform a patient search using the patient’s SSN:Click the Patient Search icon at the top of the portal pagesThe Patient Search dialog box opensEnter the patient’s full, nine-digit SSN in the SSN field (Figure 26)When searching by SSN, either the last name or the DOB must be entered to perform the searchFigure 26: SSN SearchClick SearchIf the required patient identifiers are not provided, hover text appears, indicating the information necessary to complete the patient searchIf a match of patient names cannot be made, enter additional identifiers (first name, DOB) to refine the search (Figure 30)Figure 27: Additional Identifiers NeededThe search results are displayed in the lower third of the dialog box, under the Search Results tabClick a patient’s name in the search results list to open the associated recordThe Name, SSN, DOB, and Gender columns in the results list provide information to assist with patient identificationAfter selecting a patient, the Patient Portal opens and displays the selected patient’s dataAdvanced Patient Search OptionsAdvanced patient search options in the Patient Search dialog box allow for the use of additional patient identifiers when performing a patient search.To search using advanced patient search options:Click the Patient Search icon at the top of the portal pagesThe Patient Search dialog box opensClick the <<Show Advanced Search Options link under the *Last Name field (seen in Figure 26)Enter the patient identifiers in the appropriate search fields, as desiredAdvanced search option fields include *DOB, MI, Gender, Address, State, City, Zip, and TelephoneFigure 28: Advanced Search OptionsClick SearchIf the required patient identifiers are not provided, hover text appears, indicating the information necessary to complete the patient searchThe search results are displayed in the lower third of the dialog box, under the Search Results tabClick a patient’s name in the search results list to open the associated recordThe Name, SSN, DOB, and Gender columns in the results list provide information to assist with patient identificationAfter selecting a patient, the Patient Portal opens and displays the selected patient’s dataFamily Member SearchA family member search can be performed using the Sponsor SSN field in the Patient Searchdialog box.To perform a family member search:Click the Patient Search icon at the top of the portal pagesThe Patient Search dialog box opensEnter the SSN in the Sponsor SSN fieldThe Last Name or DOB of the patient must also be entered in the appropriate fields (Figure 29)Click SearchIf the required patient identifiers are not provided, hover text appears indicating the information necessary to complete the patient searchThe search results are displayed in the lower third of the dialog box, under the Search Results tab (Figure 29)Figure 29: Sponsor SSN SearchClick a name in the Search Results listThe Family Members dialog opens (Figure 30)The sponsor’s identifiers and a list of dependents are displayed in the dialogClick a name in the list of family members to open the associated recordAfter selecting a patient, the Patient Portal opens and displays the selected patient’s dataFigure 30: Family Members Dialog BoxRecently Viewed Patients ListUsers who have previously logged into JLV, searched for a patient, and viewed that patient’s records, can see and access a list of recently viewed patients. A recent patient is defined as a patient whose record has been viewed (opened) by the user.NOTE: The Recently Viewed Patients list does not include search history or recent search results, only a list of patients whose data was accessed and viewed. The list is limited to 10patients.To open the list of recently viewed patients:Click the Patient Search icon at the top of the portal pagesThe Patient Search dialog box opensClick the Recently Viewed Patients tab in the lower third of the Patient Search dialog boxA list of recently viewed patients is displayed (Figure 31)The Name, DoD ID, SSN, DOB, and Gender columns in the results list provide information to assist with patient identificationClick a patient’s name in the Recently Viewed Patients list to open the associated recordAfter selecting a patient, the Patient Portal opens and displays the selected patient’s dataFigure 31: Recently Viewed Patients ListWidgetsWidgets are elements on the JLV portal pages that display data specific to a clinical domain. By default, widgets are displayed in minimized view on the portal pages (Figure 32), but can be expanded to view additional details. The list of available widgets is provided in a horizontal tray at the bottom of the page.113606355775Widgets may take anywhere between 10 seconds to 90 seconds to load, depending on the date range settings.Figure 32: Widgets on the Patient PortalAccessing and Opening WidgetsWidgets can be opened, rearranged, and closed. All available widgets are displayed in the widget tray, at the bottom of the portal pages (Figure 33).Figure 33: Widget TrayTo place a widget on the Patient Portal:Open the widget tray by clicking the Open Widget Tray link in the bottom-right corner of the portal pageUse the scroll bar arrows < > at either end of the tray to see all widget choices-OR-Click the More Widgets >> link to scroll through the list of widgetsClick and hold a widget in the tray, then drag it to the portal page and drop it in the desired locationThe widget is docked on the portal page, and opens in minimized viewClose the widget tray by clicking the Close Widget Tray linkWidgets can be closed (removed from the portal page) by clicking the Close icon in the top- right corner of the widget. Rearrange the widgets displayed on the portal page by dragging and dropping them.Widget Navigation and Display OptionsEach widget has tools and display options available to navigate through, and change, the display of data. The vertical scroll bar allows the user to move through, and view, the widget’s data. The options at the bottom of a widget provide various ways to see all the records loaded for the widget’s clinical domain.Navigation icons and actions are detailed in Table 4.Table 4: Navigation Icons and ActionsNavigation Icon/ActionDescriptionGo to Previous PageChanges the focus of the widget to the previous group or page of records within the results display.Jump to PageChanges the focus of the widget to the page number selected.Go to Next PageChanges the focus of the widget to the next group or page of records within the results display.More >>Go to Expanded ViewAvailable in minimized views only. Opens the expanded view of the widget in a secondary window.1-25 of 55Record Display IndicatorIndicates the number of records displayed in that widget page out of the total number of results for that widget.Display SettingClick Show All to open all records for a given widget in aShow All/scrollable window.Show PagedClick Show Paged to return to the display of records groupedby pages.When there are more than 25 records available in a widget, they are grouped in Show Paged view. Records 1 through 25 can be viewed by using the widget’s vertical scroll bar. Records 26+ can be viewed by using the page navigation options, in the lower left corner of the widget, to jump to subsequent pages. The expanded view of a widget contains a Show All link, whichopens all records for that widget, in a scrollable window. Click Show Paged to return to the display of records grouped by pages.Widget ToolbarsThere is a toolbar in the upper right corner of both the minimized and expanded views of each widget, and most dialog boxes. Toolbar icons vary by widget, open dialog box, and window. Table 5 describes the functionality of each toolbar icon.Table 5: Widget Toolbar IconsIconNameFunctionAdd to Report BuilderAdds the information displayed in the window to the Report Builder. This icon is available for supported domains when a record has a Details or Notes view that displays in a standalone window.CloseRemoves the widget from the portal screen or closes a dialog box.Column SettingsUsed to configure the columns within the widget. Turn on or off the columns displayed by checking the column names that appear in the pop-up box and checking Apply.Configure FilterUsed to filter on specific record types or other elements within the widget, including a date filter. If a date range filter is applied in an open widget, the date range is displayed in the widget header.Note: After setting a filter, the Close Filter option is enabled in the widget. Clicking Close Filter will restore the full display of records within the widget.Copy to ClipboardCopies the content of the open window to the clipboard for pasting into another application. Copy to Clipboard is disabled in the widget toolbar after clicking Show All within a widget.Connection StatusBoth icons provide a status indicator for DoD, VA, and community partner data sources. The circle with the lowercase “i" indicates all sources are available. The yellow triangle warning indicates one or more data sources are unavailable. Clicking either status icon will open the connection status details in a separate window.Note: Connection status updates are not available from the Clinical Reminderswidget.PrintPrints the contents of the open window. Printing is disabled in the widget toolbar after clicking Show All within a widget.Note: It is recommended that JLV users have the latest Adobe Reader installed for the Report Builder and other printing features.RefreshRefreshes the widget or window display. Only the data within that widget’s dataset is updated.RxConverts the medication data within the widget to text, and opens the text in a pop-up window. Available from the Outpatient Medications widget.IconNameFunctionSite ListOpens a list of community sites where the patient has been seen (only available from the Community Health Summaries and Documents–VA widget).VHIERefreshRefreshes VHIE-enabled widgets with the community partner data stored in the VHIE cache, in addition to refreshing DoD and VA data.NOTE: The VHIE Refresh icon is shown in VHIE-enabled widgets only when Include Community Data is enabled. (The Community Data option will be available in a future release.)Minimized vs. Expanded Widget ViewEach widget can be displayed in either a minimized (default) or an expanded view. Minimized view displays a simple list of the available patient data for a clinical domain, arranged in reverse chronological order by default. Expanded view provides a detailed list of similarly arranged patient data. When the expanded view of a widget is launched, it opens in a new, separate window that displays more attributes of the records in the widget, including additional, sortable columns of data.The Community Health Summaries and Documents - VA widget does not have an expanded view. Instead, a document opened from the minimized view of the widget isdisplayed in a new, separate window.Click the More >> link at the bottom of a widget to launch the expanded view, and see the additional display and functionality options.Date Range Filters1616836465240Patient data displayed within a widget can be filtered by date range. If a date range filter is applied, the selected range is indicated in the widget header, below the title. Click the Configure Filter iconor the Filtered Date Range link on the widget toolbar to change the date range of the data displayed (Figure 34).Figure 34: Date Range Filters AppliedThere are two ways to filter the date range of data displayed in a widget: the Quick Date Range filter and the Start and End Date filter. If the expected information does not appear in the widget display, use the date filter options to change the date range.Changes made to the date range in a widget persist from minimized to expanded view, patient to patient, and session to session, until the widget is either removed, or the daterange is changed.Quick Date Range FilterUse the preset, Quick Date Range filter to set or limit the display of patient records within a particular widget. This option is available by clicking the Filtered Date Range link, or by clicking the Configure Filter icon in a widget on the Patient Portal.Clicking a Quick Date Range filter refreshes the data displayed to show only the records for the selected range. The options represent time counting back from the present day (for example, selecting 2y will display only records within the last 2 years). Examples of preset date ranges include 1w (last 7 days), 6m (last 6 months), and 3y (last 3 years).1136063191284The Quick Date Range filter is contextual. If today is February 2, 2017, the preset filters will count backwards using that date. If today is April 16, 2017, the preset filter will count backwards using that date.Figure 35 highlights the Quick Date Range filter options in the expanded view of theDocuments widget.Figure 35: Quick Date Range Filter OptionsStart and End Date FilterUse the Start Date and End Date filter to display data for a specific time range. The start and end date fields are available at the top of multiple widgets by clicking the Filtered Date Range link, or by clicking the Configure Filter icon .The Start and End Date filter is static. If the start date is set to June 2, 2016 and the end date is set to June 2, 2017, the data in that date range will display, no matter what today’sdate is.Figure 36 provides an example of the start and end date filter fields in the expanded view of theRadiology Reports widget.Figure 36: Start and End Date Display FilterTo set a custom date range:Click the Calendar icon next to Start DateSelect a month, day, and year start date for the display filter98298099422NOTE: The custom date range option requires that a specific day is selected within the calendar. If no day is selected, the custom date range will not be applied.Click the Calendar icon next to End DateSelect the month, day, and year end date for the display filterWhen both a start and end date have been chosen, click ApplyThe widget refreshes and displays only the records that fall within the custom date range. The date range in use is displayed in the widget header.Viewing Connection StatusJLV widgets display the status of their connection to VA, DoD, and Community Partner data sources. Connection status information is available for each widget, except Clinical Reminders.982980172943NOTE: The Connection Status reports the condition of the connection between JLV and its external resources, while System Status reports the overall condition of the JLV application. See Section 3.1.3, Viewing System Status, for more information.The Connection Status icon on a widget toolbar indicates the state of the connection to VA, DoD, and community partner data sources. There are two status conditions:? all sources are connected (available)? one or more sources are not connected (unavailable)Figure 37 shows a connection status indicator icon displayed on the Documents widget toolbar.Figure 37: Connection Status IndicatorClicking a Connection Status icon opens a standalone window with information about the connection to data sources (Figure 38).Figure 38: Connection Status WindowClicking the >Show All Active Interfaces link in the Connection Status Window (Figure 38) opens a Connection Status Details View (Figure 39).Figure 39: Connection Status DetailsDisplaying Widgets on Custom TabsYou can use the custom tabs feature to create additional widget configurations for ease of use and quick reference. Changes made to portal page layouts (widget layouts and custom tabs) are saved to the user profile, and are displayed in future sessions.To create a custom tab:Click the plus sign + beside the existing tabs on the portal page (Figure 40)Figure 40: Add Custom Tab IconThe Add Tab dialog box opens (Figure 41)Figure 41: Add Tab Dialog BoxType the name of the new tab in the Add Tab dialog box and click AddClick the Open Widget Tray link within the new tab space to display all available widgetsClick, hold, and drag each of the desired widgets to the screen Tab configurations remain as set, until manually changed.Click between tabs at any time, without losing each tab’s configurationTab layouts persist, even when a patient change is madeCustom tabs can be renamed by double-clicking the tab nameRefreshing Data in a WidgetThe data displayed in a widget can be refreshed by clicking the Refresh icon . This action retrieves data from VA and DoD sources and refreshes the individual widget’s display.A widget will display the VHIE Refresh icon if the widget supports community partner data, and the Include Community Data option is enabled. When you click the VHIE Refresh icon, JLV sends a new query to VHIE sources for Community Partner data.Clicking the VHIE Refresh icon in one widget refreshes all other open, VHIE-enabled widgets.1136063111909If the option to Include Community Data is disabled, the VHIE Refresh icon will not be displayed in any of the widgets that support the display of community data.VistA Imaging ViewerJLV integrates access to the VistA Imaging Viewer (an external application), allowing VA users access to VA imaging artifacts for supported clinical domains (widgets). Users can open an instance of the VistA Imaging Viewer through JLV. For more information regarding the VistA Imaging Viewer, please see the VistA Imaging SharePoint site.A camera icon displayed in the Image column (Figure 42) of the Documents, Outpatient Encounters, Procedures, Progress Notes, and Radiology Reports widgets indicates that one or more images are associated with that record. Clicking the camera icon within the widget opens the VistA Imaging Viewer in a standalone window and displays the associated image.Figure 42: Camera Icon in the Image ColumnIf a record has one or more images associated with it, the Details view of the record includes a display of a thumbnail in the top-right corner of the window (Figure 43). Below the thumbnail, a link that reads, Click image to open viewer, is also displayed. Clicking either the thumbnail or the link opens the VistA Imaging Viewer and displays the associated image(s).Figure 43: Thumbnail and Link in Details ViewUsing Report BuilderThe Report Builder feature is used to create custom reports using patient data and records displayed in JLV widgets. Content for reports can be selected from either the minimized or expanded view of a supported widget. Report Builder is accessed from the toolbar in the upper right corner of the Patient Portal (highlighted in Figure 44).Figure 44: Report Builder IconThe Report Builder pane is comprised of the Current Report tab (Figure 45) and the Patient Reports tab (Figure 46).The Current Report tab (Figure 45) is used to build the custom report. The patient data and/or records are listed here as you select and add them. The records can be previewed and can be arranged in the desired order for the final report.Figure 45: Current Report TabThe Patient Reports tab (Figure 46) presents a list of all completed reports, the status of the report generation progress, the date the report will expire, and a hyperlink to the contents of the completed report.Figure 46: Patient Reports TabCreate a custom report:Click the Report Builder icon (highlighted in Figure 44)The Report Builder pane opens (Figure 47)Select records to add to the report:Any record or demographics data within a widget can be added by right-clicking the entry in an open widget and selecting Add Record to Report (Figure 47)The record will be added exactly as it appears in the widget3699890103546Click the Add to Report Buildericon within any detailed Demographics tab to add demographics data, which will appear at the top of the report by default1900682276900If the desired record has a Details or Notes view, click the Add to Report Builder iconon the toolbar of the open Details or Notes window to add the additional record informationSome DoD documents do not have associated Details or Notes. Clicking on their name in the list of documents will present the dialog box shown in Figure 47Some DoD documents can only be added to Report Builder by opening the Details or Notes view of the document (Figure 48)Figure 47: Report Builder Pane and Add Record to Report OptionFigure 48: Report Builder - Document Ready Dialog BoxThe selected records appear in the Report Builder windowUse the navigation arrows to the right of the listed records (highlighted in Figure 49) to arrange the records in the desired order in the generated reportRecords can be removed by clicking Clear Selected Record or Clear All(highlighted in Figure 49)Figure 49: Report Builder PaneWhen a record is selected for the report, it appears in the Preview of Record area of theReport Builder pane (Figure 49)Click Build (highlighted in Figure 49) to validate the selected records and prepare the reportIf a record is added to the report without an error, there will be a Ready notation next to it in the Status columnIf a record cannot be added to the report, an Error notation will appear next to the recordName the report when prompted and click OK (Figure 50)Figure 50 Name Report Dialog BoxThe Patient Reports tab opens and displays a report processing indicator in the StatuscolumnWhen processing is complete, the Status column displays either COMPLETED orERROR (Figure 51)An ERROR in the Status column does not indicate the report failed to build, it is an indicator that one or more records could not be included in the generated reportBoth COMPLETED or ERROR entries will include a Contents link (Figure 51), which provides a list of the records that will appear in the generated reportFigure 51: Patient Reports Tab - Report Ready and Delete OptionA report ready message appears for 6 seconds on the portal page when the report has been built and is ready to be printed (Figure 52)A red icon (Figure 52) appears over the Report Builder icon when report builder is closed to indicate that a report is ready to be printedFigure 52: Report Ready Message and IndicatorOnce a report is created, it is available on the Patient Reports tab for 72 hours. After 72 hours, the report expires, is removed from the Patient Reports tab, and can no longer beaccessed.Open a report:Click the report name in the Report column of the Patient Reports tab (Figure 51) -OR-Click the Contents link in the Status column of the Patient Reports tab to open a list of the records included in the report in the Report Contents window (Figure 51) -OR-Click the blue, hyperlinked report name in the Report Contents window (Figure 53)Figure 53: Report Contents WindowDelete a report:Select the checkbox to the left of the report name on the Patient Reports tab (Figure 51)Click the Delete Selected buttonClick OK to confirm deletion (Figure 54)Figure 54: Delete Reports Dialog BoxPrintingThe data list of a widget in either minimized or expanded view, the details window of a widget, and reports created in Report Builder can be printed.To print the data list of a widget in either minimized or expanded view click the Print icon on the desired widget’s toolbar.To print the details window of a widget, click the Print icon on the details window’s toolbar. To print a report created in Report Builder, click the Print icon within the report window.Each report generated using Report Builder includes this disclaimer: The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws.Widget FunctionalityThe following subsections detail the functionality in a sampling of the widgets available in JLV.Patient Demographics WidgetThe Patient Demographics widget displays a summary of the patient’s non-clinical, personal data. The widget appears in the upper left section of the Patient Portal (Figure 55). The tabs above the patient’s name provide a demographics summary for each site (VA, DoD, or VHIE) the patient has visited.Figure 55: Patient Demographics WidgetThe Patient Demographics widget provides additional functionality and displays:Clicking the patient's name opens details in a standalone windowClicking a Connection Status icon opens the connection status details in a separate windowClicking the Flags icon above the tabs in the widget opens clinical flag details in a new windowA warning icon displayed on one or more tabs within the Demographics widget is an indication that the patient is not registered at that VA site or DoD facility.Patient Flags and AlertsIf the patient has one or more clinical warnings, alerts, or flags in their record from VA and DoD sites, the Flags icon is displayed next to the Patient Name tab, above the Demographics widget, on the Patient Portal (Figure 56).The Patient Flags and Alerts details window opens and displays by default when the Patient Portal opens, if there are warnings associated with the selected patient.Figure 56: Patient Flags IndicatorClick the Flags icon to open the Patient Flags and Postings details window (Figure 57). The window displays a list of alerts and flags within the patient’s record. If the patient’s record does not contain any clinical warnings, the Flags icon is not displayed.Figure 57: Patient Flags and Postings DetailsRace Data Terminology NormalizationRace data from VA and DoD sources in the Patient Demographics widget is normalized. Hovering over the Race information displays the standardized name and code for the race classification, normalized to the Centers for Disease Control (CDC) standard (Figure 58).Figure 58: Standardized Race DataDemographics from Community PartnersWhen users enable the Include Community Data setting and VHIE patient data is displayed, the Patient Demographics widget displays color-coded information.The blue circle represents data retrieved from a VA systemThe orange square represents data retrieved from a DoD systemThe purple hexagon represents data retrieved from VHIE sourcesPlease Note: VHA users can see the Include Community Data option, but it is not yet active. It will be enabled in a future release.Viewing Third-Party Insurance InformationThird-party payers and insurance information is available from the Patient Demographics widget. Click the Insurance link in the Demographics widget. A new window (Figure 59) opens with the following insurance information:Health Plan Type? Member IDHealth Plan Name? Subscriber IDStandardized Insurance Type? Subscriber Date of BirthPlan Effective Date? Subscriber’s Relationship to InsurerPlan Expiration Date? Health Plan Mailing AddressSite? Health Plan Contact InformationGroup NumberFigure 59: Insurance InformationUse the scroll bar in the window to view the columns not seen within the default window size.The data in the Standardized Insurance Type column is normalized to the X12 Health Insurance Type standard. Hovering over entries in this column display the standardized name and code for the insurance type.Documents WidgetThe Documents widget (Figure 60) includes documents from multiple clinical domains, including radiology reports (exams), progress notes, outpatient encounters, consult encounters, discharge summaries (inpatient notes), questionnaires, and Health Artifact and Image Management Solution (HAIMS) records. HAIMS records retrieved by JLV include scanned paper records, imported paper records, scanned non-radiology images, and imported non- radiology images, displayed in chronological order by the document date.Figure 60: Documents Widget, Minimized ViewDocuments Widget DataThe minimized view of the Documents widget displays the following information:DateDescriptionProviderImageSiteOutpatient encounter records displayed in the Documents widget may have a details link enabled in the Date column. Where available, click the link to open a Details window for records of this type.The Description column displays the document title, where available. Click a hyperlinked entry in the Description column in either the minimized or expanded view of the widget to open the document.A camera icon in the Image column of the Documents widget indicates that one or more images are associated with that record. Clicking the camera icon opens the VistA Imaging Viewer in a standalone window and displays the associated image(s).Click More >> in the minimized view of the Documents widget to open the expanded view (Figure 61). Information in expanded view includes:DateDescriptionStandardized DescriptionProviderProvider SpecialtyLocationStatusImageSource SystemSiteFigure 61: Documents Widget, Expanded ViewViewing DocumentsClick a hyperlinked entry in the Description column in either the minimized or expanded view of the Documents widget to access additional information for a listed record. Depending on the record type, the additional information may open in either a details window or a separate browser window. Figure 62 displays outpatient encounters details, accessed through the Documents widget.Figure 62: Details View of a DocumentViewing DoD Sensitive DataJLV masks the display of sensitive records in the Documents widget. The record is masked with the tag **Sensitive**. A user may view the data, but the action is audited each time the sensitive DoD record is viewed.After clicking the hyperlink in the Description column for a sensitive record, JLV notifies the user that they will be audited. This message is triggered each time a user clicks a sensitive record. After the user selects the purpose of viewing the record and agrees to be audited, the sensitive data appears in Details view, but the record remains masked in the minimized and expanded views of the widget.Display and Filter OptionsDisplay and filter options within the Documents widget include:Click a column title to sort records by that columnIf a user sorts a column that appears in both minimized and expanded views of the widget, the sort is saved to the user profile, and appears in subsequent JLV sessionsIf a user sorts a column that is only available in the expanded view of the widget, subsequent JLV sessions display the default widget sort, or the last sort saved to the user profile.Use the Quick Date Range Selector, or the Start Date and End Date calendars, to specify the date range of records to be displayed within the widgetIf the information you expect does not appear in the widget display, use the Start Date and End Date filter options to expand the date rangeWhen a date range filter is applied in an open widget, the date range is displayed in the widget headerOpen or close the filter options by clicking the date range in the headerClick the Column Settings icon on the widget toolbar to show or hide columns within the widgetCheck/uncheck the column names that appear in the pop-up dialog box, then clickApplyUse the Filter by Description dropdown to redraw the widget and show only the records for the selected description(s) (Only available in expanded view)Use the Filter by Standardized Description dropdown to redraw the widget and show only the records for the selected description(s) (Only available in expanded view)Use the Filter by Provider Specialty dropdown to redraw the widget and show only the records for the selected provider type(s) (Only available in expanded view)Use the Filter by Location dropdown to redraw the widget and show only the records for the selected location(s) (Only available in expanded view)Use the Filter by Site dropdown to redraw the widget to show only the records for the selected site(s)Terminology NormalizationTerminology normalization in the Documents widget is provided through the following columns:The Description column displays the name of a note or document in the patient recordHovering over an entry in this column displays the standard used for terminology normalization for the clinical domain (Logical Observation Identifiers Names and Codes [LOINC]) and the standardized LOINC name and code for that documentThe Standardized Description column displays the standardized name for the corresponding entry in the Description column, mapped to the LOINC standardIn addition to the standardized name, hovering over an entry in this column displays the standard used for terminology normalization for the clinical domain (LOINC) and the standardized code for that document.The data in the Provider and Provider Specialty columns, in both the minimized and expanded views of the widget, is normalized to the National Uniform Claim Committee Taxonomy (NUCC) standardHovering over entries in these columns displays the standardized name and code for the providerFigure 63 highlights a document mapped to the LOINC standard. The standardized name and code are displayed in the hover text over the record in the Description column.Figure 63: Standardized Name and Code–Documents WidgetCommunity Health Summaries and Documents - VAThe Community Health Summaries and Documents - VA widget displays the patient’s VA VHIE community partner information, including Continuity of Care Documents (CCDs) in C32 and C62 formats, and HL7 Consolidated-Clinical Document (C-CDA) structured documents available for the patient. The information in this widget is sorted by the title of the entry listed in the Document munity Health Summaries and Documents - VA Widget DataData displayed within the Community Health Summaries and Documents - VA widget includes:DateDocumentSourceThe purple hexagon beside entries in the Source column denotes the source of the data is outside the VA.Figure 64: Community Health Summaries and Documents - VA, Minimized ViewThe Site List icon on the toolbar in the Community Health Summaries and Documents - VA widget (Figure 64) generates a list of community sites where the patient has been seen.Click the Site List icon to open the full list of community sites where the patient has been seen. The site list content is gathered from the widget's Source column and the sites where the patient was seen, but no document was generated. Click Close Site List to remove the full site list from the widget display.Viewing VA Community Health Summary DocumentsThe Community and Health Summaries and Documents - VA widget is rendered only in minimized view. Instead of an expanded view, the selected document opens in a new browser window (Figure 65).Figure 64 shows health summary records available from the Document column in the Community Health Summaries and Documents - VA widget. Clicking a hyperlinked entry in the Document column opens the document in a separate browser tab (Figure 65).1136063112544Multiple documents can be opened in separate browser tabs for simultaneous viewing and printing.Figure 65: Community Health DocumentMilitary Health System (MHS) GENESIS WidgetThe MHS GENESIS widget displays the documents in patient records from the MHS GENESIS system. The information is displayed in reverse chronological order by date.MHS GENESIS Widget DataThe minimized view of the MHS GENESIS widget includes the following orders information:DateDocument TitleDocument TypeSiteFigure 66 highlights the MHS GENESIS widget in minimized view. There is no expanded view for the widget; instead, the CCDA document selected opens in a new browser window (Figure 67).Medical CCDs, Dental CCDs, and aggregate CCDs with blank entries in the Date column for the record appear first in the widget by default.Figure 66: MHS GENESIS WidgetViewing MHS GENESIS DocumentsClick a hyperlink in the Document column in either view of the MHS GENESIS widget to display a Consolidated Clinical Document Architecture (CCDA) document (Figure 67) in a new browser window.Figure 67: CCDA DocumentTroubleshootingThe following subsections provide information about troubleshooting common errors in JLV.For how to information within JLV, please see online help. To see JLV training videos and access additional JLV training materials, please visit JLV Resources.Special Instructions for Error CorrectionJLV utilizes access control and authentication services to limit access to registered, authorized users. When enabled, JLV validates a user against information retrieved from their Smart Card. If you are having trouble logging in to JLV, and have used the correct URL for your agency, please review the following before contacting the ESD:Users with any CAPRI patient selection restrictions will not be able to log in JLV. Instead, they will see this message on the JLV Login page:Figure 68: Login Error - CAPRI Patient Selection RestrictionsVHA users:Have accessed JLV using the VHA URL ()Have entered their existing CPRS Access and Verify codes correctly in the fields on the JLV Login pageHave selected a site from the Site dropdown list on the JLV Login page (Most users must specify the individual facility name or their parent healthcare system name)VBA users:Have accessed JLV using the VBA URL ()Have entered their existing CAPRI Access and Verify codes correctly in the fields on the JLV Login pageLogin Page Error MessagesTroubleshooting steps for error messages received at the login page are provided in Table 6.Table 6: Error Messages and Resolution StepsError MessageResolution StepsAccess denied. You are not an authorized userWHAT? You see the error message Access Denied. You are not an authorized User.WHY? There is a PIV card processing problem; the wrong security or an invalid security certificate was selected; or you are not an authorized user. FIX IT:Close your browser windowReinsert your PIV card and relaunch JLVSelect a certificate that is not expired, and specifies Issued by: Veterans Affairs CA B1If unsuccessful, contact the ESDCould not save User ProfileWHAT? You receive the error message Could not save User Profile.WHY? The error occurred during PIV authentication. It is typically a PIV card processing problem, or the wrong security certificate is chosen.FIX IT:Close your browser windowReinsert your PIV card and relaunch JLVSelect a certificate that is not expired, and specifies Issued by: Veterans Affairs CA B14.) If unsuccessful, close all open IE windows/tabs, then open IE and try JLV againNot a valid ACCESS/VERIFYCODE pairWHAT? You see the error message Not a valid ACCESS CODE/VERIFY CODE pair error at the login screen.WHY? 1) JLV could not match your Access and Verify codes to the site selected in the dropdown, or 2) A username and password were entered instead of Access/Verify codes.FIX IT:VHA users must select the parent VistA host site for their facilityReenter your Access and Verify codes (CAPRI codes for VBA users, CPRS codes for VHA users)Page cannot be displayedWHAT? You receive a Page cannot be displayed error when launching JLV.WHY? The JLV URL requires certain IE settings.FIX IT:1) Click the Tools menu (press ALT+X) in IEError MessageResolution StepsSelect Internet OptionsWhen the dialog box opens, click the Advanced tabScroll down in the list until you see the Secure Sockets Layer (SSL) 2.0 setting, and ensure it is NOT checkedEnsure that the Transport Layer Security (TLS) 1.0, 1.1 and 1.2 settings ARE checked5) Click OK to close the dialog box, then relaunch JLV (The page should load)Smart Card requiredWHAT? You see the error message Smart Card Required.WHY? Your Smart Card was not read by Windows Security and JLV before opening the JLV URL.FIX IT:Close all browser sessions and browser-based applicationsReinsert your PIV card, and relaunch the JLV URLIf unsuccessful, close all open IE windows/tabs, then Open IE and try JLV againVERIFY CODE mustbe changed before continued useWHAT? You receive the message VERIFY CODE must be changed before continued use at the login screen.WHY? Your CPRS or CAPRI VERIFY CODE has expired.FIX IT:Open CPRS, VistA, or CAPRI (VBA users)Select the Change Verify Code checkbox on the sign-on dialog before clicking OKYou will be prompted to create a new Verify codeOnce your Verify code has been changed for CPRS or CAPRI, relaunch JLV and the new code will be recognized immediatelyThe JLV button in CPRS does nothingWHAT? Clicking the JLV button in CPRS does not open JLV. WHY? You are likely using Google Chrome as your default browser. FIX IT:Click Start menu, then select Default Programs in the right paneClick Set your default programsClick Internet Explorer in the list, then click Set this program as default.System Error MessagesTable 7 summarizes system messages that may be presented to JLV users.Table 7: System Error MessagesMessageDescriptionNo Message displays, but behavior occurs: The browser window does not allow the user to scroll to widgets, or access the JLV icons on the portal pages.Access JLV using IE 11. Use a monitor with a minimum screen resolution of 1024 x 768. Set the browser zoom feature to 100%. If browser display issues continue, log out of JLV, close the browser window, open a new browser window, and log in to JLV again.Warning: An error occurred while attempting to retrieve VistA Imaging Viewer URL.Either VistA Data Service or VistA Imaging Exchange is offline, and JLV is unable to retrieve the necessary dataMessageDescriptionobject to launch a VistA Imaging Viewer instance within JLV.MVI Message: There are no patients found using the current parameters.No patient records were found using the information entered in the Patient Search dialog box. Reenter patient identifiers in the Patient Search dialog box fields after verifying the accuracy of the informationMVI Error: Patient not found with search elements entered, please provide additional patient identifying information and search again.No unique patient is found with the identifiers used in the search. Click OK to return to the Patient Search window and provide additional patient identifiers, like the full first name or DOB.MVI Error: Your query yields too many results. Please modify your search parameters to narrow the search.JLV adheres to VA guidelines and blocks search results when a search request yields more than 10 patients.Modify the information in the Patient Search dialog box using additional patient identifiers to reduce the number of results.MVI Error: Application Reject. There was an error attempting to process your query.Please modify your search parameters and try again.There may be one or more errors in the Patient Search dialog fields. Validate the patient identifiers and try the search again. If problems persist, there may be an error between MVI and the Defense Enrollment Eligibility Reporting System (DEERS).You do not have authorization to view this record. Security regulations prohibit computer access to your own medical record.VA security regulations prevent a user from accessing their own medical records.You do not have authorization to view this record. Your SSN is missing from the NEW PERSON file. Contact your ACP Coordinator.Per VA policy, JLV does not allow access to patient records if the JLV user’s SSN is not in their VistA profile.An error occurred while attempting to retrieve the document.Occurs when something goes wrong when JLV tries to retrieve a selected document.An error occurred while attempting to display the document.Occurs when JLV tries to receive a document, but has trouble converting the document to a viewable format.Your patient selection is limited. To access electronic health record data, please log into CAPRI.Some VBA users have patient or site restrictions attached to their profile. Log into CAPRI to view patient records.Connection Status alert or error displayed in the Community Health Summaries and Documents - VA widget:One or more data sources could not be connected; some entries will not appear. orError: DAS Query failure. HTTP error.These messages appear when the VA VHIE service is not available. If either message persists for more than 5 minutes, contact support to report the connection error.Error displayed in Community Health Summaries and Documents – VA widget:Connection Error – No DataJLV was unable to retrieve data from eHX.MessageDescriptionErrors displayed in the Community Health Summaries and Documents - VA widget: An error occurred while attempting to retrieve the document.orAn error occurred while attempting to display the document.These error messages may appear when a user attempts to view a document, but JLV is either unable to retrieve it, or is unable to convert the document to HTML.VA VHIE Server Error MessageTable 8 details an error that may be presented to JLV users, related to the display of VA VHIE data.Table 8: Community Health Summaries and Documents - VA Widget Error MessageMessageDescriptionAn error occurred while attempting to retrieve the document.These messages may occur when you try to view a - VA widget, but JLV is either unable to retrieve the document, or JLV is unable to convert the document to HTML.orAn error occurred while attempting to display the document.Acronyms and AbbreviationsTable 9 lists the acronyms and abbreviations used throughout this document, and their descriptions.Table 9: Acronyms and AbbreviationsAcronymDescriptionCAPRICompensation and Pension Record InterchangeCCDAConsolidated Clinical Document ArchitectureCCOWClinical Context Object WorkgroupCDCCenters for Disease ControlCPRSComputerized Patient Record SystemDEERSDefense Enrollment Eligibility Reporting SystemDOBDate of BirthDoDDepartment of DefenseEDIPIElectronic Data Interchange Personal IdentifierEHRElectronic Health RecordseHXeHealth ExchangeESDEnterprise Service DeskGUIGraphical User InterfaceHAIMSHealthcare Artifact and Image Management SolutionHL7Health Level 7IDIdentificationIEInternet ExplorerIENInternal Entry NumberIPInternet ProtocolJLVJoint Legacy ViewerLOINCLogical Observation Identifiers Names and CodesMHSMilitary Health SystemMIMiddle InitialMVIMaster Veteran IndexNUCCNational Uniform Claim CommitteeOITOffice of Information and TechnologyPDWSPatient Discovery Web ServicePIVPersonal Identity VerificationSSLSecure Sockets LayerSSNSocial Security NumberTLSTransport Layer SecurityUIUser InterfaceURLUniform Resource LocatorVADepartment of Veterans AffairsAcronymDescriptionVBAVeterans Benefits AdministrationVHAVeterans Health AdministrationVistAVeterans Health Information Systems and Technology ArchitectureVHIEVirtual Lifetime Electronic Record ................
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