Renal PatientView - Admin Help

Renal PatientView gives online access to patients' live renal results and other information. This page gives information for local RPV administrators about how to use the system. For more information about RPV, see www.renal.org/rpv.  Shortcut to this page:  bit.ly/rpvadminguide

RaDaR is integrated with RPV from 2013. It allows patients to choose to share their data with Disease Registries. For more info about RaDaR see: www.rarerenal.org

2013 changes - Local admins  received messages about one or two issues round about the appearance changes in March 2013.  Further info was also posted in news items on RPV and at the RPV blog (sorry not all trusts allow access) at renalpatientview.blogspot.co.uk.  We think new issues are resolved now but do get in touch if necessary.

This page was last updated on April 29th 2013 to record changes to email verification, a link to info about how to add a patient to a Rare Disease Group, and to note minor changes to procedure when you add a patient at a second or subsequent centre.  Comments about safe emailing updated to add info about secure messaging option in future.

Some units don't have an automated data link to RPV. If not, headings with an asterisk* are not relevant:

How to enrol a new patient

We've found that with practice this process takes about 6 minutes per enrolment, including addressing and sealing envelopes.

1. Flag the patient in your local renal IT system to initiate ‘sends’

  • Check you have a completed enrolment form – store it in an agreed location. (Click here for enrolment forms and letters that can be modified for your own unit)
  • Check patient has NHS number in system (CHI in Scotland).
  • Check EDTA diagnosis code entered (treatment code probably OK already). If not, remind clinician, but it may be that the patient doesn’t fit one.
  • Go to PatientView menu in your renal IT system and complete it. RPV status should be made INCLUDE. (Other options include REMOVE to wipe all data from server - see below before doing this).
  • Click on ‘re-send’ to initiate a ‘push’ of this patient’s data before the nightly automated run (the exact command may vary with different systems). Info is then be encrypted and sent on. For Proton systems this is usually undertaken by a ‘gateway PC’ at scheduled intervals (variable but often set to be hourly).

On first send, the last 10 items under each heading are included. On each subsequent send, the most recent 10 items values under each heading are sent again, allowing error corrections to be transmitted. For letters, there is no retrospective sending - only letters after enrolment are sent. There is a mechanism to manually send any old data.

2. Tell the RPV server, and get initial passwords

    • Log in to www.renalpatientview.org as a unit administrator (Tip: use the Tab key to go to the username space, and then on to the password space) and click on Add Patient. Regular unit users do not have access to this, only unit admins. You are shown a number of options including
      • Add Patient
      • Patients in Unit – search for a patient or view the list of patients, by leaving search fields empty.
        • See the info presented for them by clicking on their number.
        • ‘Edit’ by clicking on their name, enables you to re-issue a password if they forget it, and various log functions (see below).
        • Check the 'show GP' box to show GP logins.
  • Complete the Add Patient screen as follows:
    • Username – eg surnameab or surnamefirstname. Try surnamefirstnameNumbers if the system tells you the name is taken (e.g. smithjohn1946 or smithjp1946).
    • Name – Firstname Surname e.g. John Smith
    • NHS number = CHI number in Scotland. This must match the one in your local system and it must be the NHS/CHI number, no other number will do! Although RPV will accept other numbers, after a warning, it relies on this number being the same on data from all units or other sources to generate a unified record. 
    • Email address is optional but increasingly valuable.  From mid 2012 RPV has been automatically emailing this address and asking the user to validate it. In 2013 the timing of this moved to first login.  You can see which email addresses have been validated when you look at a patient's login (Search for patient in unit - click on the patient's name).
    • Renal Unit – you shouldn’t have any choice here, just your own unit.
    • Don't check 'dummy patient' unless this is a fictitious patient that you are using to test the system. Dummy patients are excluded from stats, can't change passwords, and won't get a Transplant status.
    • If you get the warning  'There is already a patient registered on RPV with that NHS number. Please carefully check the details of that patient, then you can choose to add the existing user to your unit. '- this suggests that the patient has already joined RPV at another unit.  If it is a deliberate second registration, it is OK to proceed (see amalgamate data from more than one unit, below). No new login is generated but they now appear on  your list and can see data from your unit merged with others. 
  • Then click ‘Add'
  • The server will return an initial password on a screen that is suitable for you to print out to send to the patient along with a ‘Welcome Patient’ letter and a blue info leaflet
  • Then click GP password – print out screen and send the initial password to the GP with a ‘Welcome GP’ letter and a blue info leaflet

If a patient’s results don’t appear on RPV

The RPV server looks for info at intervals so it won’t look different immediately, but updating should usually occur within at the most a few hours of your clicking ‘re-send’. At busy times this delay may be longer.

Occasionally files are corrupted in transit or during encoding and fail to reach the server. If you still don’t see updated info, try a manual ‘re-send’ and test again later, and/or go to check the log files (see below).

The most common cause of initial failure is mistyping of NHS number. Note that under the ‘Patients In Unit’ option of RPV, you can click on the patient's name to edit the number, the patient's name, and to reset passwords etc. You will need to alter the GP’s entry too (when searching for the patient, check 'show GPs'), the GP username is the same with the suffix "-GP", e.g. username-GP.

If these don’t solve the problem, or if data showing on your local IT system are missing or different on RPV, in the first instance check the files that you are sending - see log files below. There is now also a mechanism to send emails to a unit's RPV email address (the one listed under Renal Units as the RPV contact email address) when files are received but don't work. If you find that files are failing repeatedly contact the liaison person for your RPV interface. For Proton systems this is usually Vitalpulse. If possible coordinate all communication through one 'chief admin' in your unit.

If multiple patients data fail to appear on RPV

Assuming this used to work but now doesn't, the most common causes of this are in local hospital IT systems

  • Gateway PC switched off (some units use an intervening PC to marshall and encrypt XML files)
  • Firewall changes; necessary port closed by Trust making change and not telling you, or installing new PC without necessary changes, etc

Alternatively your local system is not generating and/or sending the files.  There should be a log function in the system that you can check.  If this shows a problem, contact your IT system supplier.  If none of the above, contact us

How to add patients to Rare Disease Groups

This is covered in the RaDaR admin guide at bit.ly/radaradminguide  - you can do this as an RPV admin from May 2013.

How to register members of staff with RPV

Types of staff user

A Unit User can see the list of patients for their unit, and their data, but cannot add new users or edit any details. Most of your staff users will be in this category. From May 2013 these users will also be Radar Professional users who can add an RPV patient to Radar (see bit.ly/radaradminguide) and enter data into Radar

A Unit Admin can do the same as a Unit User, and in addition can:

  • Add new patients to RPV
  • Add new Unit Users and Unit Administrators
  • Remove patients from their Unit and delete Unit Users from  RPV. Read more before removing a patient!)
  • Edit details (email addresses, names, NHS numbers) of patients and staff users
  • Edit the Unit details listed under ‘Contact’
  • Re-issue passwords if users have forgotten them. Send these to the user's registered address unless you are certain that you have their correct email address, or that any email has come from them.
  • Track the usage of any account (see how to use the log functions)
  • Add news items that can be seen by all patients and/or staff users.
  • Extract statistics on usage in your unit (more below on this).

Enrolling a new staff user

  • Click on Unit Users and enter their details.
  • Choose the user type (Unit User, or Unit Admin) as described above (usually Unit User).
  • Print out and hand them their login details. They will be forced to change the initial password.
  • IMPORTANT - Ensure that Staff users have read and understand the Staff Info leaflet, and that new Unit Admins are fully aware of their extra responsibilities as listed on this page. For Admins, a short training session is advisable to ensure understanding.
  • Password security is particularly important for staff users. There is a password strength checker when you create your first, or change it. (see box)

A NOTE ON PASSWORDS

Simple words or numbers are easy for machines or people to guess. Avoiding this is particularly important for staff passwords. Here are some simple ways to make it more difficult.

  1. Do not share your password. The correct way to show someone else a patient’s data is for the patient to share their password.
  2. Don’t make it easy to guess, so not less than 6 characters and not 123456 or 777777, and certainly don’t use “password”! Do not use simple words (e.g. daffodil) at all.  
  3. Using a mixture of numbers and letters makes it much safer, e.g. daff271odil (daffodil + 271)
  4. Using a mixture of capitals and ordinary letters is even better, e.g. dAff271oDil – this would be a very difficult password to guess, and not impossible to remember.
  5. Changing your password from time to time is wise. Certainly do that if you think that someone else may know yours.
  6. Most systems, including RPV, limit special characters or punctuation that you can use.  It will tell you. 

How to reset a users forgotten password

Note that users can reset their own password using the "Forgotten Password?" link under the login box, IF

  • They know their username AND
  • They have an email address recorded in the system

Find the patient on your list. Click on the patients name (the head of the column shows 'edit' in brackets). On this page you can edit details including name, email address, and NHS number if you got it wrong at first. Clicking on 'Reset Password' will generate another printable page with an impossible nonsense password again.

Often it it turns out to be the username that the user got wrong, not the password, so send them both.

IMPORTANT: If dealing with queries like this by email or phone, make sure you confirm that it really is the patient contacting you, e.g. by checking that the email address is the one recorded in the system, or ringing them to check.

How to unlock a password
Users have a limited number of attempts to get their username-password combination right, and if too many attempts are made, their login will be locked . When you click on 'Edit' (click their name after searching for them), unlock password will appear. You will presumably also need to send a new password and remind them of their username as usual.

The number of attempts allowed is quite high, but the limit is in place to prevent robots from brute-force attempts to gain access to data.

Email a patient safely
In many regions the NHS frowns on the use of email communication with patients, sometimes (and beyond requirements of any law) even when the content is not sensitive. However if patients choose to email you, and you want to reply directly:

  1. only send data to an email address that is confirmed in their RPV record, or call them first to make sure it's them.
  2. try not to include any personal info (about their diagnosis. etc) - or at least none that they haven't already mentioned.
  3. ask them to confirm in their reply that they are OK with using email, "as the NHS does not recommend using email for sending sensitive data". Patients get a similar caution when entering data into the contact form on RPV, but it is useful to ensure that the email trail includes a statement like this.

Note that in 2013 we will be piloting Secure Messaging within RPV, and if/when this is fully implemented emails will not need to include any sensitive data.  You (and patients) will get an email to say there is a message for you, and you will have to login to read it on the secure server.

How to send and receive messages to and from patients within the system

This feature will be piloted during 2013 and if successful made available to all units, but units will be able to choose when to implement it.

How to amalgamate data from more than one unit

Data sent from different centres carrying the same NHS number will be combined in a single record. A patient can see all data displayed in one record regardless of its origin. However the patient is only visible to staff from a unit they enrol in unless you take extra steps, and of course data only travels from units where the data-sending has been initiated in the local renal IT system.

  • You should have the patient's request to send data from your unit on a signed enrolment form even if they have already enrolled in another unit.
  • Flag them (or whatever you call it locally) in your local renal IT system to initiate sending data to RPV. However, you will not yet see them on your list of patients.
  • To make them appear under your unit as well as their original unit, go to the RPV server and make them a second login. You should receive a warning; "There is already a patient registered on RPV with that NHS number. Please carefully check the details of that patient, then you can choose to add the existing user to your unit. " If the details are right, say 'yes'. The patient's amalgamated records will now appear in your list of patients as well as that of their first unit.
  • No new login is issued, the patient should already have access to their account, though it can be useful to check that it's working for them.  

When transplant data is missing or wrong

Transplant status comes from UK Transplant based on matching of NHS numbers to patients registered on RPV. We are aware that NHS number is not recorded in 100% of UKT records, so a subsidiary matching process checks surnames, dates of birth etc. So an absent record may be just not fully recorded, and not matched. However errors are likely to be genuine mismatches of what you (or the patient) thought was recorded at UKT. Either way, the solution is to check the UKT record first - often it is Transplant Coordinators who can do this, but this varies from unit to unit. If you find it is correct, let us know. There is information on this for patients (and anyone else) in the 'explain this' link next to Transplant Status.

Note that a patient whose transplant has failed and who has returned to dialysis will be correctly listed as 'transplanted' until they are made active or suspended on the list again, or their record is removed from the list.

How to correct an error

RPV mostly shows data that it is sent from local IT systems, and that data cannot be corrected on RPV, it must be changed locally. Static information such as demographic data are overwritten each time data is sent, so changed telephone numbers etc should be overwritten promptly. For timed data, on each data transmission the last 10 items under each heading are sent. If there is correction of an error on your local renal IT system within this time window, the value will automatically be corrected on RPV, because data with the same date and time (e.g. a urea value from 10.10.07 at 1123h) will overwrite previous values for the same variable at that date and time. This mechanism will occasionally fail to correct errors:

  • Very old errors will fail to be corrected automatically even if corrected on your local system. You will need to intervene manually. There will be a date-range option in the RPV menu of your local renal IT system which permits sending of data from any day or range of days. Re-send data for the date(s) on which you want to transfer corrections. They will overwrite the previous data for that day in RPV, as long as the times of the new data are the same.
  • However if the error was in the date or time of the item (e.g. a blood pressure was recorded for the wrong month or year), and showed a time when no data was actually collected, this will not be corrected automatically, although you could alter the data to "000" or similar by altering it in your local system. Contact the RPV administrators if you need to erase this kind of error.

How to remove a patient's data from RPV

Note that we propose to change this mechanism during 2013.  Announcements will follow.

Because RPV can create a unique record that cannot easily be regenerated, we ask that you get patient's written instructions if they ask to have their data completely removed from RPV. A suitable form is available here. Then do ...

  • Not this:When you are logged into the RPV server as a Unit Admin, and go to 'Edit' (click on the patient's name in the list, or after searching) you have the option to 'Delete Patient' . Note that this only deletes the patient's login, it does not remove their data from the server. If you create a new login for the same NHS number, the data becomes visible again. This is the option to use if a patient moves to another unit, but not if the request is to remove all their data from the system.
  • But this:To delete their data from the server entirely, you need to send a 'Remove' message from your local renal IT system. You will have local instructions about how to do this for your system. Note that this will delete all data stored under their NHS number; even data sent from other units. This is not the option to use if they are simply changing units.
  • If any patients taking this step are registered in more than one unit, they need to formally de-register in this way in each unit that they are registered in, otherwise new information will be uploaded to the server from units they are still enrolled at.

I want to alter a patient's login name

Did you accidentally create an embarassing one? The only way to do this is to create a new login with the correct username. First delete their previous login as in the section above, under the first bullet point where it says 'Not this' (as explained there, this does not remove data from the system, only the login). Then create the new login. You will have to give them one of those difficult initial passwords again.

Mrs Nephron is moving to another unit

If you are the unit they are leaving -after you know that they have a new login at their new unit, you should go to the RPV server to delete the patient's login at your unit. Do not send a 'Remove' signal from your local renal IT system (see 'How to remove a patient's data'), instead just inactivate data sending ('remove the RPV flag' in Proton). If they can't use RPV at their new unit, they may want to continue to see their old record at yours, perhaps hoping their new unit will join RPV soon, so don't remove their access without asking them first.

If you are the new unit - the patient should fill in an enrolment form again and you should register them as usual, but don't give them a new login.  Their old one will continue to work.   Note that when you create their login you will get a warning that the patient is already on the system, are you sure you want to go ahead - yes, you should check the box to go ahead. They will see data amalgamated seamlessly from the two units. See also how to amalgamate data from more than one unit.

My patient crosses borders and has both an NHS number and a CHI number

We were afraid you'd ask that, but we are now ready for it. It is a manual process to associate identifiers, please contact us.

How to use the log functions

When you find a patient on the 'Patients in Unit' page, to the right of the patient's name are a number of possible logging queries

  • log shows all activity for any account, by NHS number (defaults to last 1 month but you can alter that), including password changes, logins, data uploads - this is often too much info for what you want.
  • activity gives activity of a given user, by username (what has user X been doing)
  • views identifies who has looked at a specific record (who has looked at the record of the patient with this NHS number)
  • data shows when data uploads have been received, and from where, to check when RPV has received data for a specific account.  You can examine the data files received in the last month - this is valuable if trying to trace a problem.  

Note that 'Views' (who views each account) is shown just from Feb 1st 2007. The others have older records.

How to extract usage statistics

When logged in as Unit Admin click on "Renal Units'

  • Edit enables you to alter the info shown about your unit including contact info
  • Stats shows a table summarising activity during each month. "Patient Count" is the number enrolled at the beginning of each month. By the end of the month, when the other columns are filled, it is modified by adding the number enrolled, and deducting the number removed, to fill the Patient Count at the beginning of the next month.

It is possible to obtain more detailed data about number of logins from Superadmins.

What the table columns show:

  • Patient Count - on the first of the month
  • Logons total logons
  • Unique logons - number of patients who logged on during the month
  • Patient view - [I don't know!]
  • Patient add - new logons issued
  • Data load - number of updating files received
  • Unique data load - number of records updated at least once
  • Password change - ? patients changing, or admins?
  • Password locked - [is empty?] should show what it says
  • Password unlocked - number of passwords unlocked by Admin
  • Patient data removed - number of records 'wiped' because of death or patient request

How to add News items

Short items, articles or notices can be added to the site to announce anything that might be of interest to a unit's patients and/or staff. News items are of three types

  • Visible to users from your unit only. Local Unit admins can create these items and choose whether to show any message to staff users, or to patients, or to both.
  • Visible to users from all units. Superusers (system administrators) can post these items and choose whether to show any message to staff users, or to patients, or to both.
  • Visible to everybody. Superusers (system administrators) can post these items which are shown to everybody without logging in, on the home page of the website.

Click on "News Edit" to add, edit and delete news. Click on "News" to view items. Note that the news articles do not expire, they need to be deleted manually.  HINTS:

Make the title Short, Enticing and Local - so "Could you comment on transport in York?" rather than "NHS Kidney Care requests responses to national transport survey".  More examples: "Edinburgh results problem".  "Young and on dialysis? Can we hear from you?" Make the content easy to read too.  Change your items from time to time, and please remove old news items regularly!

You can post html into these boxes. Examples:

  • To make text bold, use the tags <b></b> like this: a <b>heavy</b> emphasis would come out as: a heavy emphasis. Similarly, the tags <i></i> for italic and <ul></ul> for underline.
  • Make a link as in this example: <a href="http://www.renalpatientview.org">text you want shown for the link</a>, would come out as text you want shown for the link, ... Don't forget to include both http:// AND the double quotation marks around the URL, both are needed.

How to show a Splash Screen

The splash screen is shown once when you log in as a patient.  It is suspended in new RPV (March 2013) as its code broke something.  We are probably going to use the messaging system to replace it rather than restore it in its previous form.

I'm getting 'failed file upload' (or similar) emails, help, how do I stop them?

In 2012 we began to introduce a system for alerting local admins to a variety of problems, including when files were received but could not be uploaded to the server.  A couple of times transient failures at the RPV server have led to hundreds of these going out (sorry), but more usually the problem is in the construction of the XML in the file, or in its encryption.  These faults, if recurrent, have to be corrected at your end.  An example is a result with a date in the future.  Contact your IT supplier if the problem isn't obvious.  There is info in the email about the type of problem identified. 

More questions?

*Apologies that a couple of these sites are at locations that some Trusts and NHS Boards like to block.

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