TOWER, How to use the Stel dashboard

Log-in

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To login, go to data.stelhealth.com (see on the right)


Click on “Login with Hospital credentials”, you'll be redirected to a screen to log in with your hospital username and password.

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Then complete the dual-authentication step:

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Once you complete the hospital log in process, you will be redirected back to Stel homepage which will display this for a second or two.

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And finally automatically redirected to the main page of the website.

Reviewing all patients (main page of the dashboard)

The main page of the dashboard shows a simple card for each patient. The goal is to have a quick overview of all of the patients.
You can filter “Show issues only” to only see patients with Out of bound alerts, or Missed Schedule alerts, and you can Search for a patient name, or MRN, or Hub number with the search bar.

The cards are ordered to show the most recently updated patients first.

The patient card

On every card, you can see the patient main information (name, phone, MRN)
Here on this card we can immediately see a lot of other information about his RPM status:

  • The HUB ID associated to the patient is 821C5

  • The HUB is NOT connected (RED), below a second example show a hub connected (green)

  • Is “paused” meaning possibly in medical setting, or in vacation, and therefore won't transmit vitals. Below you can see an active patient (no paused label)

  • The patient missed their set schedule for both BP and weight

  • The last measurement of each kind, value, and date is indicated on the card

  • The weight gain or loss is indicated

  • The BP risk status (hypertension, normal) is indicated

  • The patient has a Note attached to his card (see the “comment” icon in blue next to the HUB ID)

    • Click on this icon to see the note, the note is saved automatically or when clicking save

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Another example here:

  • the patient is not on pause

  • the patient has no alerts

  • the hub is connected

  • the patient has no Note attached to his card

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Patient Page overview

Following the “Vitals” link on the card we arrive to the patient page you arrive on the patient page

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On this page it is possible to see:

  • the patient information (top left) like on the card's top section

    • name, mrn, phone, HUB id, HUB connected/disconnected

    • A “settings” link that can bring you directly to the patient setting page

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Patient engagement:

  • number of minutes of engagement during the month

  • button to “pause” the monitoring of a patient (on vacation, in medical setting)

  • Create a Note for the patient without any kind of engagement time

  • Create a note with engagement time for the patient

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Details of how to create notes and pauses in the dedicated sections

Latest vitals Weight and BP

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Calendar: This show you an overview of the measurements, notes, “pause status” of a patient along time. You can from the calendar edit existing Notes, Pauses and go back months in the past to see a patient evolution.
See detailed section Calendar

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The vitals: this section with graphs shows the latest values received.

  • to dismiss a value from the graph (it will still be in the summary), you can use the “close” icon on the top right of a measurement card. This is mostly if you think the data is incorrect (incorrect BP usage or weight measurement)

  • weight graph: show you the weight graph based on the most recent measurments and the current baseline, and +/-5 bounds around the baseline, In the card section you can also see the delta between a measurement and the previous value

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BP graph: shows you the BP trend of the Systolic, Diastolic and BPM based on the most recent measurements. The graph background represents the “hypertension” level. See “Hypertension Level” addendum

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Creating Notes

Warning, this may change to include more options in March 2019
In the Patient Details Page, in Patient Engagement section

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You can create a note that counts patient engagement time in the period summary using the “Log Care Time” option.
You can create a note that does not count any engagement time using the “Create Note” option.

You will have a simple form prompting you to enter

  • a note (at least 5 characters long)

  • [log care time only] a time in minutes

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Notes will then show on the calendar view, the note is created on the calendar at the time and date of creation.
IF you want to change the notes time day, see Calendar Usage

Creating a Pause

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When a patient monitoring is “paused” (meaning we do not expect the patient to send any data) the patient should be marked as such.
The goal is to avoid considering the patient as NON compliant if the monitoring is stopped on purpose.
You can do this by clicking on the “Pause Monitoring” button in the Patient Engagement setting in the Patient Page.
The reasons for a patient to be paused are listed below.

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In case you use “Other” you need to type a comment for the reason of the Pause, if you use one of the preset options you do not have to add such a comment.

When creating the pause you can select the starting date of the pause, you can not select the end date right away, you'll be able to do this after in the Calendar Usage section
Once the pause is created it will show up in the Calendar, see Calendar Usage to see how to edit the pause.

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Calendar Usage

Modifying a note

To modify a note, simply click on it in the calendar view.
You can from there “read” or “delete” or “edit” a note. You could edit:

  • the text

  • the logged time (for notes that log patient engagement time)

  • change the date and time of the note

If you decide to delete a note, it will be gone completely, and will not show in the end of period summary.

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Modifying a Pause reason or starting date (or deleting the pause)

To modify a pause, simply click on it in the calendar view.
You can from there “read” or “delete” or “edit” a pause. You could edit:

  • the reason for the pause (and the comment if the reason is “other”)

  • the starting date of a pause

If you decide to delete a pause, it will be gone completely, and will not show in the end of period summary.

Resume monitoring / END pause

You can also “end the pause of monitoring”, or “resume the monitoring”. This means that the patient is supposed to be taking his measurements and we will count his adherence.
To do this, simply click on the pause in the calendar and then on the “Resume Patient (end Pause)” button. The date for the end of the pause will be set to the moment you click this button, but you can modify this afterward by editing the pause again.
Pauses that are not ended keep extending until the patient is resumed.

Pause title in the calendar

The pause in the calendar look slightly different, with an end date when the pause as been ended, and without if not.

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Pause with a start and end date

 
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Pause with only a start date.

 

Adding a new patient

Adding a new patient is a process:

  1. Not detailed in this document: pre-existing step to validate that the patient is eligible, and that the patient signed a consent.

  2. Get the MRN, name, and phone of the patient

  3. You are now ready to create the patient in Stel dashboard

  4. Not detailed in this document: Process to set the hub (usually done by paramedic) at the patient's home

The add a patient page is a simple form used to create a new patient in the Stel dashboard. Clicking add patient opens a form. Simply fill it with the patient information.

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Once this is filled click Validate new personal information, you will then be redirected to the patients settings page for initial setup.

Patient Settings Page

Modify patient information

  • modify the patient information after the patient was first created

  • add “tags” to easily see on the main page some quick information about the patient, such as the practice

 
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associating hubs

Associate a HUB ID to the patient (the HUB ID is unique to each HUB device and will ensure the association between a device and a patient, this number is on the label of the hub and is made of 5 or 6 characters, numbers and letters).

When you first create a patient, there is no hub in “registered”

You need to type at least 5 character of the HUB ID to be able to add it, a button Validate will appear if the HUB is available.
If the hub is marked as “already used” or non existent, this means this number is not in your inventory.

Once the device is associated to the patient, this will look like this

DISASSOCIATING hub

You may need because of a disenrollment or a hub replacement to remove a hub from the patient.
To do this, go in the patient Setting page, and find the card of the HUB using the HUB ID in “Registered Hubs” section.

Click the “Remove” button on the card of the HUB which will return the hub to the “Inventory” Patient of your group.

Schedule

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This section sets the schedule of a patient (for instance everyday between 4AM and 10AM is the default) to measure each vital.
It is possible to specify different schedules for blood pressure and weight and specify that the patient will not take measurement on some days of the week.

Non compliance with this schedule will trigger alerts that will show on the patient card in the main page or the patient page. See the Alerts Section
Once the device is associated to the patient, this will look like this

DISASSOCIATING hub

You may need because of a disenrollment or a hub replacement to remove a hub from the patient.
To do this, go in the patient Setting page, and find the card of the HUB using the HUB ID in “Registered Hubs” section.

Click the “Remove” button on the card of the HUB which will return the hub to the “Inventory” Patient of your group.

Bounds

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This section is used to set the weight and blood pressure baseline and bounds
Non compliance will trigger an alert describing the out of bound measurement for the patient's weight or blood pressure

The checkbox “active” means the bounds will be checked on the upcoming measurement.

The section Temperature is not useful if you did not distribute thermometers.

Alerts

As we have seen in the sections “Patient Settings” it is possible to set alarms of two types:

  • Out of schedule if a patient misses a scheduled measurement

  • Out of bounds if a patient's blood pressure or weight is too high or too low

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Alerts will show on the pane page patient card, OOB (bounds) in red and OOS (schedule) in yellow

 

To dismiss/resolve an alert simply click on it and select how you solved this alert:

  • outreach (there was successful outreach to the patient, maybe to check his wellbeing if OOB, or to ask him to take his measurements if OOS)

  • Outreach voice message (same as outreach but the patient did not answer and a message was left

  • No outreach: no outreach was needed

The way you resolve the alert will be saved in the system to be used in the period summary in the future or statistics.

The way you resolve the alert will be saved in the system to be used in the period summary in the future or statistics.

Billing

To bill a patient period of care you need to generate his report.
Go on the report page: data.stelhealth.com/reports

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On this page search for the patient card (you can use the search bar at the top)

  1. Type the CSN in the field of the card

  2. Select the period (start and end date)

  3. click Generate Summary

Review the summary

  1. Select Print to PDF to export the document

  2. You then have to upload this document within Epic (see documentation from TOWER)

Note, here is a sample of this report Report View _ VHOMELYN summary 2019-01-19

Addendum

hypertension levels

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