EMR Integration
Introduction
Integrating Premie BiliRecs (PBR) into your Electronic Medical Record (EMR) is fairly simple. A programmed weblink embedded in the EMR launches the webpage, directly importing the infant's current total serum bilirubin level and post-menstrual age at time of sampling. No protected health information is transmitted. The webpage opens directly to the treatment recommendation for the patient's age.
Integration
For Epic customers, the preferred integration method is through the Epic Showroom listing for Premie BiliRecs. From there, your organization can request access to the app and enable SMART on FHIR-based launch within your system.
Your Epic Technical Coordinator can assist with the necessary setup to allow clinicians to launch PBR directly from within Hyperspace. This integration automatically passes the necessary patient information to PBR without manual input.
Alternatively, Epic customers may choose to implement PBR using a basic GET/POST approach as described below. However, use of the official SMART on FHIR launch method is recommended when possible.
GET/POST Integration
Integration is accomplished by passing the required data to the PBR website via a query string. PBR can alternatively accept the same data fields via HTTP POST, if preferred. Below is the template for that query string and a description of each of the
- days:
- The patient's Post-Menstrual Age (Gestational age + Chronological age), specified in days, at the time of blood sampling
- total:
- The laboratory observation for Total Serum Bilirubin
- units:
-
(Optional) The units of measure, set to
"us" for milligrams per deciliter (mg/dL) or "si" for
micromoles per litre (µmol/L)
Defaults to "us" if not passed
Optionally, you may pass multiple days and total fields as arrays to have PBR display the trend over time of the patient's Total Serum Bilirubin levels. The recommendation will be based upon the most recent measurement. Refer to the last example below to see how this is achieved.
The results are only valid for laboratory observations in children with a Post-Menstrual Age equal to or greater than 27 weeks (189 days) and less than 35 weeks (245 days). Although the PBR results screen will throw an error if the submitted age is outside these boundaries, it is advisable to include logic to prevent the creation of the weblink for patients that do not fit this criteria.
Examples
For a patient with a Post-Menstrual Age of 28 weeks and 5 days and a Total Serum Bilirubin of 13.5 mg/dL, the URL would be:
https://pbr.stanfordchildrens.org/?days=201&total=13.5For a patient with a Post-Menstrual Age of 32 weeks and a Total Serum Bilirubin of 256 µmol/L, the URL would be:
https://pbr.stanfordchildrens.org/?days=224&total=256&units=siFor a patient with a Post-Menstrual Age of 32 weeks and a Total Serum Bilirubin of 14.2 mg/dL, the URL to show their trend over time would be:
https://pbr.stanfordchildrens.org/?days[1]=195&total[1]=16&days[2]=204&total[2]=16.2&days[3]=223&total[3]=12&days[4]=239&total[4]=10.6