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:

• Extending the header status in the member profile in the Patient 360
• Patient header data pages
• 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
• Recent activity

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. The default value is 90 days.

1. In the header of Dev Studio, enter IsDischargeDuration.
2. Open the when rule in the PegaHC-Care-Work class.
3. Change the numeric value to equal the number of days for the patient status to display in the header.
4. Click Save as.

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.

Data page rules for the patient header

You can edit the patient notes in the patient summary in the header of the Patient 360.

1. In Dev Studio, click Care ManagementCare Management Configuration.
2. On the Care Management Application configuration page, click the Other settings tab,
3. In the Timeline to edit the patient sumary (in days) field, enter the number of days in which you can update the patient summary note.
4. Click Save.

You can change the default number of days of 3 to allow a care team member to edit patient notes. 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.

1. In the header of Dev Studio, enter MemberNotesEdit and press Enter.
2. Open the report definition rule in the PegaHC-Data-MemberNotes class where the patient notes are captured and saved.
3. Click Save AsSpecialize by class or ruleset to save the report definition to your implementation layer ruleset.
4. On the Query tab, go to the Edit filters section.
5. In the Condition B row, in the Relationship list, click a relationship and enter the number in the Value field that meets your organization's needs.

   

   

6. Click Save, and then click Check in.

1. In the navigation pane of Dev Studio, click App.
2. Enter and search for the PegaHC-Data-RiskScore class.
3. Click Data ModelData PageD_PatientRiskScore.

   

   

4. Save the data page to your implementation-layer ruleset.
   For more information, see Data pages.
5. In the Data sources section, in the Source list, select how to populate the patient risk score.
   For example: If the patient risk scores come from an external system, you might select a connector or a data transform.
6. Based on the Source method that you select, update the fields to describe how you are getting information or calculating information for the patient risk score.
   For more information, see the following topics:

   • Data Transforms
   • Updating and generating records for REST integration
   • Data pages
   • Activities
7. Click Save, and then click Check in.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. Click the Patient events tab.
3. In the Recent vitals section, click the plus sign icon to add a row.
4. In the Vital column, enter a value for a vital sign and then select it from the list that appears.
   For example: You might enter Glucose.
5. In the Display name column, enter the name that you want to display for the vital sign.
   The value in the Code column is filled in.
6. Click Save and Close.
   To fetch the recent vital signs from the configuration page, use the D_RecemtVitalsProfile data page. The parameter is MemberID. For more information, see Data pages.

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:

• Prior authorization
• Admission
• Admission notification
• Program referral
• Task
• Case conference
• Visit
• Discharge Plan
• Concurrent review
• UM Case
• Incident
• MTM

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. On the Care Management Application configuration page, click the drop-down arrow at the right of the tabs, and click Patient events.
3. In the To do list cases section, click the Add a row icon.
4. In the new field, click and press the Down arrow to display a list of class names for case types.
   For example: If you are adding Discharge worksheet case, select the PegaHC-Care-Work-DischargeWorksheet class to display the discharge worksheet cases on the patient to-do list.
5. Click Save.
   To fetch the cases that are related to a patient, use the D_MemberToDoListCases data page. For more information, see Data pages.

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.

1. In the header of Dev Studio, enter ShowBeginOrContinue and press Enter.
2. In the row where the Type column is labeled When, in the PegaHC-Care-Work-Task class, click ShowBeginOrContinue.
3. To save this change to your implementation-layer ruleset, click Save as.
4. On the Save as When page, complete the fields.
   For more information, see Creating a When rule.
5. Click Create and open.
6. On the Edit When page, add the task categories that you want to suppress.
7. Click Save and then click Check in.

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.

1. In the header of Dev Studio, enter MemberToDoList in the search field, and press Enter.
2. In the Report Definition row, in the PegaHC-Care-Work class, click MemberToDoList.
3. To save the change to your implementation-layer ruleset, click Save as.
4. On the Save as Report Definition page, complete the fields.
   For more information, see Report Definition rule form.
5. Click Create and open.
6. On the Edit Report Definition page, scroll to the Edit filters section.
7. In the F4 row (.CMTask.pyCategory in the Column source column), in the Value column, enter the name of the task that you want to suppress.
   Enclose the name of the task in quotation marks.
8. Click Save and then click Check in.

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.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. Click the Patient events tab.
3. In the Recent activity section, select the check boxes in the Loaded by default? column to represent the items that you want to automatically display in the patient Recent activity section of the Patient 360 profile.
4. Click Save and then Close.

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.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. Click the Patient events tab.
3. In the Recent Activity section, in the Display order column, modify the numbers to reflect the order of events for display.
4. Click Save.
   To fetch the last engagement filters, use the D_GetDefaultLoadRecents data page. For more information, see Data pages.

   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.