AVS Testing Checklist

1. Instantiation of the AVS from the CPRS Tools menu

a) AVS should open up on the same screen as CPRS (if multiple monitors are being used).

b) AVS should display the name of the user currently logged into CPRS along with the facility name.

2) CCOW patient context switching

a) AVS should bring up the same patient currently open in CPRS.

b) AVS should automatically switch patients to reflect the selected patient in CPRS.

3) Patient identification

a) AVS should display the name, SSN, and DoB (age) near the top-left of the screen.

b) The patient name should also be displayed in bold in the header of the AVS document itself.

4) Patient encounters

a) AVS should list the last 60 days of patient encounter locations in a drop-down (combo) box.

b) AVS should auto-select the encounter that is the closest match to the current date/time.

c) Selecting a new encounter and clicking the Refresh button should cause the AVS to display information relevant to the selected encounter.

5) AVS refresh

a) Clicking the Refresh button causes the AVS to refresh for the same patient and encounter.

b) AVS should automatically refresh the same patient and encounter information every 3 minutes.

c) AVS should display the last refresh date and time near the top-right of the screen.

6) AVS header

a) A header is displayed in the top-left of the AVS document which by default should list the patient name, the visit date, the date generated, and the name of the facility.

b) The header template can be modified in the AVS Admin Settings interface (see #19 below).

c) The visit date should reflect the date of the selected encounter.

d) The VA logo should appear in the upper-right of the AVS document.

7) "Today's Visit" section

a) The "Clinic's Visited" subsection should reflect the clinic locations and times of each encounter scheduled for the current day.

b) The "Providers" subsection should reflect the providers for each encounter scheduled for the current day.

c) The "You Were Diagnosed With" subsection should reflect a list of the patient's diagnoses from the selected patient encounter.

d) The "Vitals as of This Visit" subsection should reflect the values of any vital signs collected  the current day (if available).

e) The "Immunizations" subsection should reflect the immunizations that were administered to the patient for the selected encounter.

f) The "New Orders From This Visit" subsection should reflect the orders that were created in the context of the selected patient encounter (see # 8 below).

8) New patient orders

a) AVS should display orders placed in the time window of 30 minutes prior to through 3 hours after the currently selected patient encounter.

b) Orders that should be displayed include medications, lab, imaging, consult, and text.

c) AVS should not display discontinued, expired, discontinued/edit, canceled, and lapsed text and lab orders.

d) New orders that are created while AVS is in session should display when AVS auto-refreshes.

e) AVS should use the translation engine to replace text in the orders with more patient-friendly text according to entries in the Translations grid of the AVS Admin Settings (see #19 below).

9) "Important Notes" section

a) The "Upcoming Appointments" subsection should list appointments for the patient from the following day over the next three months (this is configurable for the facility; see #19 below).

b) The "Instructions" subsection should reflect custom comments entered by the provider into the Instructions dialog (see # 10 below) and/or Krames HealthSheets (see #14  below).

10) Patient instructions

a) Clicking on the Edit Instructions button should open up the Patient Instructions dialog box where comments may be free-text entered.

b) The Patient Instructions dialog box should allow the user to customize the font and formatting of the comments.

c) The Patient Instructions dialog box should allow the user to customize any Krames content that was inserted into the AVS.

d) AVS should display the content entered or inserted into the Patient Instructions dialog box exactly as it appears in the dialog itself.

11) "My Ongoing Care" section

a) The "Primary Care Provider" subsection should display the patient's primary provider or "Unknown" if no provider is registered for the patient.

b) The "Allergies (Reactions)" subsection should list the patient's allergies with a comma-delimited list of reactions in parentheses by each allergy.

c) The "My Current Medications" subsection should list the patient's active medication list along with the sig, # refills, last fill date, and expiration date (if available).

d) This section should also display the Lab Results and Clinical Charts if those subsections are enabled and data is available (by default these subsections are turned off (see # 13d below).

12) Footer

a) AVS should display at the bottom of the document any facility-wide, clinic, and provider disclaimers as well as footer text as configured in the AVS Admin Settings interface (see #19 below).

13) Edit AVS

a) AVS should allow the user to edit the content of the AVS.

b) AVS should open the AVS Editor in a pop-up window in response to the user clicking the Edit AVS button on the top toolbar.

c) The user should be able to add, modify, delete, and style content in the AVS Editor.

d) Upon clicking the Update button the content that is displayed in the AVS document should reflect any changes made in the AVS Editor.

14) Options

a) Clicking on the top toolbar button labeled "Options" should display a drop-down list of menu options that allow the user to customize certain parts of the AVS.

b) AVS should allow for setting the font size (Normal, Large, and Very Large) of the AVS document.

c) AVS should allow for displaying lab results (the default is not to display) from the last one week, one month, or three months.  If displayed, lab results should appear in the "My Ongoing Care" section.

d) AVS should allow for displaying various clinical charts in the form of line graphs (the default is not to display).  The clinical data that may be displayed in chart form (if available for the patient) include BMI, BP, Cholesterol, Creatinine, eGFR, HbA1C, HDL, HGB, LDL, Platelets, Pulse, Triglycerides, and Weight.  These values that are displayed in the graphs are from the past one year.

e) AVS should allow for turning subsections on or off in the AVS document.  The sections that may be displayed or hidden include Clinics Visited, Providers, Diagnoses, Vitals, Immunizations, Orders, Appointments, Instructions, Primary Care Provider, Allergies, Medications, Clinical Charts, and Lab Results.  By default, Clinical Charts and Lab Results are turned off.

f) AVS should allow the user to include all clinical services information in printouts of AVS documents.  If this option is selected then when an AVS is printed, the clinical services information should be printed as well.  The clinical services list may be edited using the AVS Admin Settings interface (see #19 below).

g) AVS should allow the user to select specific clinical services from a list in which to include with the AVS when printed.  This option is available when the user clicks the "Options"..."Clinical Service Descriptions"..."Select Clinical Service for inclusion in printouts" menu item.

h) AVS should allow the user to prevent other users from editing the current document.  If this option is selected then other users can access the sheet but may not modify or add custom comments or change any of the options set by the primary provider.

15) Krames

a) AVS should allow users to search Krames StayWell HealthSheets and select documents for printing or inclusion in the AVS document itself.

b) AVS should open the Krames interface in response to the user clicking the Krames button on the top toolbar.

c) AVS should automatically search the Krames database for articles based on the patient's ICD-9 diagnosis codes.  The titles of any articles that are returned by Krames are displayed in a list on the left side of the screen.

d) The user should be able to do a custom search by clicking on the New Search button on the Krames interface.  The Krames Search interface allows the user to search by keywords (with a boolean AND or OR), MeSH codes, ICD-9 codes, CPT codes, and select the language of the articles returned by Krames.

e) The user should be able to click on an article title (not the checkbox) and have the content of the article displayed.

f) The user should be able to click the Print Content...Print Entire Document menu option to print the entirety of a selected article.

g) The user should be able to click the Patient Instructions...Insert Entire Document to insert the entirety of a selected article into the Patient Instructions section of the AVS.

h) The user should be able to use the mouse cursor to select all or part of the content of the article and click the Print Content...Print Entire Document menu option to print the selected content of the currently displayed article.

i) The user should be able to use the mouse cursor to select all or part of the content of the article and click the Patient Instructions...Insert Selected Content menu option to insert the selected content of the currently displayed article into the Patient Instructions section of the AVS.

j) The user should be able to select one or more article titles by checking the checkboxes associated with the articles and then click the Print Selections button to print all selected articles.

k) The user should be able to minimize the Krames interface by clicking the double-up arrow button on the Krames title bar, and restore the Krames interface by clicking on the double-down arrow button.

16) Note creation/VistA Imaging upload

a) AVS should allow the user to create a TIU stub note with auto-generated text indicating that the patient has been provided with a copy of the AVS by clicking on the Note button on the toolbar and selecting the Create Note menu option.

b) This feature should auto-create the note in TIU with the boilerplate text and then administratively close the note (so it doesn't need to be electronically signed).

c) This feature should also upload a PDF copy of the AVS to VistA Imaging.

d) The user should be able to simultaneously print a copy of the AVS to the default printer and create a note/upload to VistA Imaging by clicking on the Note button followed by the Print Document & Create Note menu option.

e) Clicking on either of the aforementioned menu options should display a prompt that explains what this option will do and allowing the user to proceed by clicking Yes or cancel by clicking No.

17) Printing

a) AVS should allow the user to print to a Windows printer (i.e. a printer in which device drivers are installed on the PC) by clicking the Windows Printer menu option under the Print button on the toolbar.  This option should bring up the Adobe PDF Print dialog that allows the user to select the printer and choose other print properties.

b) AVS should allow the user to print to a network printer and select the printer from a list pulled from VistA.  This option is accessible from the Print...VistA Printer menu.  

c) Clicking on the VistA Printer option should bring up a dialog with a list of printers, with the ability to search for a printer by entering in the first few letters of the printer name into the "Printer Name" edit box and clicking the Search button.  This action should filter the list that is displayed in the list to only those printers that partially match the search text.

d) Clicking the Reset button on the dialog referenced in (b) and (c) above should clear the filtered list of printers and display the default list.

e) Selecting a printer in the list of printers obtained from VistA and then clicking the Print button should result in the AVS document being printed to this printer.

f) Selecting a VistA printer and checking the "Set this device as the default printer" and then either clicking Apply or Print should set the selected printer to the default.

g) Clicking the Default Printer menu option under the Print button on the toolbar should either print to the default Windows printer or to the default VistA (network) printer, if a default VistA printer was selected.

18) PDF

a) AVS should allow the user to display a PDF version of the AVS document in a pop-up window by clicking the PDF button.

b) From the PDF displayed in the pop-up window the user should be able to print to the default printer (either a Windows printer or VistA/network printer) by clicking the Quick Print button, or to a Windows printer through the PDF print dialog by clicking the Print button.

19) AVS Admin Settings

a) In response to clicking the admin button (small button with gear icon in upper-right of screen) AVS should open up the AVS Admin Settings dialog in a pop-up window.  This dialog has four tabs:  Services, Translations, Disclaimers, Header/Footer.

b) A list of clinical services may be composed from the Services tab.  A new service may be added by clicking the Add Service button, followed by entering the service name, location, operating hours, phone, and comment into the grid row and clicking the Update button.  The information for a service may be edited by first double-clicking on the row corresponding to the service to be edited, making any changes, and then clicking the Update button.  A service may be removed by first clicking on the service row and then clicking the Remove Service button.  The data in the services grid may be sorted by clicking on the column headers.

c) AVS collects location names and order texts and displays them in a grid in the Translations tab.  The user should be able to type in alternate text for the source string by clicking on the cell in the Translation column and then entering in substitute text.  The user should be able to search for a source string by entering in a partial text string into the search edit box and click the Search button.  A filtered list of source strings should appear in the grid.  The data in the translations grid may be sorted by clicking on the column headers.

d) The Disclaimers tab on the AVS Admin Settings screen should allow the user to enter in a facility-wide disclaimer that gets displayed at the bottom of each AVS, as well as a disclaimer for a specific clinic and for the current user.  To enter a disclaimer for a clinic, the user should type in the name of the clinic and select it from the list and then enter in the disclaimer into the text box.

e) The Header/Footer tab should allow the user to edit HTML that gets displayed in the header section of the AVS (top left of the AVS document).  The user should be able to use any HTML element along with any of the string replacements displayed in the Optional String Replacements grid to the right.  The user should also be able to enter in custom HTML for the footer.  Any changes made are reflected in the Preview window at the bottom of the screen.

20) Help

a) The user should be able to access online help by clicking the help button located in the upper-right of the AVS screen (question mark icon).  This should result in a separate browser window opening up with the help contents displayed.