Configuring and extending features on the Patient 360 profile
In Pega Care Management, you can configure features on the Patient 360
profile to meet your business needs. Use the Care Management
Configuration page to configure a number of features, from modifying the
patient To-do list to setting the categories of Social Determinants of Health for tracking. The following topics include configuration steps: You can modify the when rule to change the number of days that a patient's discharge
status from the hospital is displayed on the Patient 360 header in Pega Care Management. The default value is 90 days. In Pega Care Management, the patient header is an introductory section of
the Patient 360 view and contains preliminary information about the patient such as name,
gender, date of birth, age, address, and spoken language. There is a SHOW MORE link at the
bottom of the patient header which expands the patient header with more information on it.
You can use these data pages to customize the patient header. In Pega Care Management, you can edit the patient notes in the patient
summary in the header of the Patient 360. You can change the default number of days of 3 to allow a care team member to edit
patient notes in Pega Care Management. After the specified number of days, the notes
are locked and unavailable for editing. For example, your organization might update records for
a period up to seven days. In Pega Care Management, the Patient Risk Score is a
health risk score value for the patient which is calculated based on client-defined
methodology. Different organizations might choose to have different ways of storing and
displaying patient score. Modify the source on the PatientRiskScore data
page to indicate how your organization calculates patient risk scores. Patient risk scores are calculations that are used to identify the risk levels of patients.
Typically, patients are classified as high-, medium-, or low-risk. Additionally, risk scores
are created to review risks in various areas such as readmission risk or future risk of an
event happening in a certain time period, for example, three, six, or twelve months. By consistently using the patient risk score, you segment the patient population into
manageable categories. Low- and medium-risk members might be managed by using email, tests, or
electronic coaching. High-risk members need person-to-person interaction with a care manager.
Risk scores are dynamic and case managers can measure patient progress through the decrease or
increase in their risk score. In Pega Care Management, you can configure the items that you want to display
as recent vital readings in the banner of the Patient 360. Because look-up data pages do not support dynamic class referencing, you need to save the
D_RecentVitals rule in the appropriate implementation-layer
class context so that the data page can fetch the implementation-layer specific data.
Otherwise, the look-up fails and the data page does not return any data. To meet your organization's business needs, you can define additional cases that you
want to display in the patient to-do-list. For example, you might want to add the Discharge
worksheet case. The patient to-do list includes a list of the tasks (cases) that are associated with
the patient. Each record has a Begin button to start the
task. If you leave the task without finishing it, the button label changes to
Continue, which allows you to resume the work where you
left it. Along with the other cases, task cases that occur with a start date in the
next 7 days are also displayed in the to-do list. By default, Pega Care Management displays the following cases in the patient
to-do-list: You can suppress tasks from appearing in the patient task list by modifying the when
rule. Some tasks that appear in the patient task list are not automatically resolved. This
occurs when you create a task and do not select the Auto resolve
check box. For example, you might suppress an email task. In Pega Care Management, some tasks that appear in the patient to-do
list do not require any action. This occurs when you create a task and you do not select the
Auto resolve check box. You might want to suppress tasks such as
Notify Case Owner or Send Email. You can configure the recent activities of patients. For example, this section might
contain events such as out-of-range lab results, phone visits, patient notes updated, home
visit follow-up, incidents and authorizations. A care manager can view the list of
activities and quickly understand the patient interactions. You can choose the items that automatically appear in the Recent activity
section of the Patient 360 profile. This section provides an overview to help
the care manager understand recent interactions with the patient. Based on the priorities of your organization, you can change the order of the events in
the Recent activity section in the CM Care Manager Portal. The
Recent activity section contains events such as out-of-range lab
results, phone visit, patient notes updated, home visit follow-up, and authorization. To fetch the list of recent
activity configured on the configuration page under patient event, use the
D_RecemtActivity data page and the
RecentActivity data transform. For more information, see Data pages and Data transforms. Extending the header status in the member profile in the Patient 360
Patient header data pages
Data page rules for the patient header
Rule name Purpose Parameters D_MemberRecentBarriers Patient active barrier list MemberID D_GetSocialDeterminantsListByMember Patient social determinants of health list MemberID, SDOHCategory, Status D_GetMedicationList Patient medication list- Retrieves the
PegaHC-Data-Prescription instances MemberID D_MemberMedications Patient medication list – Retrieves the FHIR-compliant
PegaHC-Data-PatientMedications entities, the
default data model for medications from 8.4 MemberID D_GetRecentDiagnosisConditions Patient medical history and claim data customerID D_GetNonClaimMedicalHistory Patient medical history and diagnosis information from authorization
and admission cases MemberID, Source D_GetMemberClaims Patient claims MemberID D_DisplayFamilyHistory Patient family history MemberID D_MemberNotes Patient notes added by a care giver in the Patient
summary MemberID D_MemberNotesEdit Update the Patient notes MemberID Configuring the timeframe for editing a patient summary
Changing the setting for locking patient notes in the Patient 360
Changing the source on the Patient Risk Score data page in the Patient 360
Configuring recent vital items for display in the Patient 360 banner
Configuring the to-do list in the Patient 360
Suppressing non-automated resolution tasks in the patient task list in the Patient 360
Suppressing non-automated resolution tasks in the patient to-do list in the Patient
360
Recent activity
Configuring the default settings for the Recent activity section in the Patient 360
profile
Changing the event order in the Recent activity section of the Patient 360
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