Renal PatientView - Admin Help

Renal PatientView is a project of RIXG to give online access to patients' renal results and other information. This page gives information for local RPV administrators about how to use the system.

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 – conventionally 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!
    • Email address is optional but very useful for confirming the email of a patient if they contact you.
    • 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 a warning - 'A patient with this NHS number already exists' - is the patient already registered at your unit? Have you got the NHS number right or have you by accident copied an earlier one into the space? Is this a registration at a second or subsequent unit? If it is a deliberate second registration, it is OK to proceed (see amalgamate data from more than one unit, below).
  • 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.

The most common cause of 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') too, 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 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.

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.

A Unit Admin can see the list of patients for their unit, and their data, and in addition can:

  • Add new patients
  • Add new Unit Users and Unit Administrators
  • Delete patients and Unit Users from the RPV view (note that if you delete a patients’ data on RPV, it is not displayed, but remains on the RPV server unless a ‘Remove’ command is also sent from your local IT system. Read more before doing this!)
  • 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. These are shown at the bottom left on the initial page after logging in.

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 (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”! It is safer to avoid other simple words (e.g. daffodil) too
  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, allow just letters and numbers in passwords, not spaces or special characters or punctuation such as ! - £ @ _ –,.

How to reset a forgotten password

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.

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 they told you about earlier, 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 and they will be referred to their Local Unit Admin. 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.

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. The patient will now see data from both centres in their account. 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; "a patient with this number already exists. Do you really want to ..." (etc). Say 'yes'. The patient's amalgamated records will now appear in your list of patients as well as that of their first unit.
  • You do not need to give these login details to the patient, who already has access to their account, and may indeed be confused to receive a different username and password. Don't print it out!

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 only shows data that it is sent from local IT systems, so 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

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; 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, telling them that the new login replaces their old one (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. 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

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

How to extract 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!]
  • Password unlocked - number of password reset 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.

You can post html into these boxes. Examples:

More questions?