Configure Vitals Reference Ranges

athenaClinicals

This page allows you to configure what values are considered normal for vitals based on a patient's age so that athenaOne can alert you when a patient's vitals are outside this range.

 

On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — History/Intake, click Vitals Reference Ranges

 

 

 

To configure vitals reference ranges for your practice, you must have the Clinicals Admin: Reference Ranges permission. (This permission is automatically assigned to you if you have the Clinicals Admin role, unless your organization creates and assigns its own roles.)

 

 

If your organization creates and assigns its own roles (using Local Roles on the Users page) to members of your organization, an administrator must do one of the following:

  • Update your local role to include the new Clinicals Admin: Reference Ranges permission; or,
  • Assign the Clinicals Admin: Reference Ranges permission to you on the Users page.

 

 

  1. Display the Configure Vitals Reference Ranges page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — History/Intake, click Vitals Reference Ranges.
  2. If you see the You have no configured vitals reference ranges message at the top of the page, review the set of evidence-based vitals reference ranges and then click Accept & Publish or Edit Ranges.
  3. If you chose Accept & Publish, no further action is needed.
    Note: You can edit the published reference ranges for your practice at any time.
  4. If you chose Edit Ranges, click Edit next to the vital that you want to modify.
  5. Edit the reference ranges for that vital as necessary.
    • If the same reference range applies to patients of all ages, select The normal range for this vital is the same for all ages at the top of the section, and then enter the minimum and maximum values for the vitals range.
    • If there is no maximum age, you can leave the maximum age range box blank.
    • If you hover over a row, the delete icon appears.
    • You can add a row by clicking Add reference range at the bottom of the section.
    • You cannot enter the same value for the minimum and maximum age range or vitals range. For example, you cannot enter an age range of 8 years to 8 years.
  6. Click Done.
  7. Repeat this process to edit all vitals as necessary.
  8. Click Publish.
    athenaOne displays a message to indicate whether the publishing was successful.

Note: You can edit the published reference ranges for your practice at any time. Users can see changes made to reference ranges in the audit history.

 

 

Enabling Abnormal flags for out-of-range vitals

Before your practice can see Abnormal indicators for out-of-range vitals, a practice manager must review the reference ranges that appear by default on the Configure Vitals Reference Ranges page and then either accept and publish or edit and publish the reference ranges.

 

After a practice manager publishes a set of reference ranges, the ranges are effective for all patients and providers in your practice. Abnormal indicators then appear next to all current and historical vitals that are out of range. For more details about Abnormal indicators for vitals, see Abnormal vitals indicator in the Vitals Section help topic.

Vitals you can configure

You can configure reference ranges for only the following vitals:

  • Blood Pressure
  • Temperature
  • Pulse/HR
  • Respiration Rate
  • Oxygen Saturation

Note: Abnormal indicators do not appear for other out-of-range vitals.

 

 

A team of on-staff clinicians at athenahealth used the following sources to select reference ranges for vitals based on a patient's age:

  • Ball, J. W.; Dains, J. E.; Flynn, J. A.; Solomon, B. S.; and Stewart, R. W. (2019). Seidel's Physical Examination: An Interprofessional Approach 9th edition. Elsevier Health Sciences.
  • Vital signs: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from https://medlineplus.gov/ency/article/002341.htm.
  • Vital Signs (Body Temperature, Pulse Rate, Respiration Rate, Blood Pressure). (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/vital-signs-body-temperature-pulse-rate-respiration-rate-blood-pressure.
  • Hafen, B. B. and Sharma, S. (2018). Oxygen Saturation. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK525974/.
  • Kleinman, M. E., Chameides, L., Schexnayder, S. M., Samson, R. A., Hazinski, M. F., Atkins, D. L., ... & Hickey, R. W. (2010). Pediatric advanced life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Pediatrics, 126(5).
  • Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., ... & Gidding, S. S. (2017). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140(3), e20171904.

 

 

 

No, at this time you can set normal ranges for vitals based only on a patient's age.

 

 

 

Where Abnormal indicators appear

If a vitals reading is outside the normal range for the patient's age, athenaOne displays an Abnormal indicator next to the vital in the:

More specifically, athenaOne displays Abnormal indicators in:

  • Vitals item of Intake check list
  • Intake documentation
  • Review step of encounter
  • Vitals tab of patient chart
  • Vitals flowsheet — in both the table and graph views
  • Problem-based flowsheets
  • Exam documentation
  • Intake section of patient briefing

Where Abnormal indicators do not appear

athenaOne does not display Abnormal indicators in:

  • Encounter summary
  • OB episode
  • PT episodes
  • Quality tab
  • Chart export
  • Care plan
  • CCDA
  • Report Builder
  • External APIs

 

 

 

Yes. After a practice manager configures what values are considered normal for vitals based on age, you will see Abnormal indicators for out-of-range vitals in both athenaOne and the athenaOne app.

 

 

 

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