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:
- 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
Extending the header status in the member profile in the Patient 360
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 the header of Dev Studio, enter IsDischargeDuration.
- Open the when rule in the PegaHC-Care-Work class.
- Change the numeric value to equal the number of days for the patient status to display in the header.
- Click Save as.
Patient header data pages
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.
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
In Pega Care Management, you can edit the patient notes in the patient summary in the header of the Patient 360.
- In Dev Studio, click
- On the Care Management Application configuration page, click the Other settings tab,
- 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.
- Click Save.
Changing the setting for locking patient notes in 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 the header of Dev Studio, enter MemberNotesEdit and press Enter.
- Open the report definition rule in the PegaHC-Data-MemberNotes class where the patient notes are captured and saved.
- Click to save the report definition to your implementation layer ruleset.
- On the Query tab, go to the Edit filters section.
- 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.
Setting for locking patient notes 
- Click Save, and then click Check in.
Changing the source on the Patient Risk Score data page in the Patient 360
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 the navigation pane of Dev Studio, click App.
- Enter and search for the PegaHC-Data-RiskScore class.
- Click .
Patient risk score data page 
- Save the data page to your implementation-layer ruleset.For more information, see Data pages.
- In the Data sources section, in the Source list, select how to populate the patient risk score.
- 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:
- Click Save, and then click Check in.
Configuring recent vital items for display in the Patient 360 banner
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.
- In the header of Dev Studio, click .
- Click the Patient events tab.
- In the Recent vitals section, click the plus sign icon to add a row.
- In the Vital column, enter a value for a vital sign and then select it from the list that appears.
- 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.
- 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.
Configuring the to-do list in the Patient 360
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
- In the header of Dev Studio, click
- On the Care Management Application configuration page, click the drop-down arrow at the right of the tabs, and click Patient events.
- In the To do list cases section, click the Add a row icon.
- In the new field, click and press the Down arrow to display a list of class names for case types.
- Click Save. To fetch the cases that are related to a patient, use the D_MemberToDoListCases data page. For more information, see Data pages.
Suppressing non-automated resolution tasks in the patient task list in the Patient 360
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 the header of Dev Studio, enter ShowBeginOrContinue and press Enter.
- In the row where the Type column is labeled When, in the PegaHC-Care-Work-Task class, click ShowBeginOrContinue.
- To save this change to your implementation-layer ruleset, click Save as.
- On the Save as When page, complete the fields.For more information, see When condition rules.
- Click Create and open.
- On the Edit When page, add the task categories that you want to suppress.
- Click Save and then click Check in.
Suppressing non-automated resolution tasks in the patient to-do list in the Patient 360
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.
- In the header of Dev Studio, enter MemberToDoList in the search field, and press Enter.
- In the Report Definition row, in the PegaHC-Care-Work class, click MemberToDoList.
- To save the change to your implementation-layer ruleset, click Save as.
- On the Save as Report Definition page, complete the
fields.For more information, see Report definitions.
- Click Create and open.
- On the Edit Report Definition page, scroll to the Edit filters section.
- 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.
- Click Save and then click Check in.
Recent activity
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.
Configuring the default settings for the Recent activity section in the Patient 360 profile
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.
- In the header of Dev Studio, click .
- Click the Patient events tab.
- 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.
- Click Save and then Close.
Changing the event order in the Recent activity section of the Patient 360
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.
- In the header of Dev Studio, click .
- Click the Patient events tab.
- In the Recent Activity section, in the Display order column, modify the numbers to reflect the order of events for display.
- 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.
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