Oh, WRMD!

For several years, Devin and Rachel have been working with OWCN to modify WRMD for use with oil spills, and this year, the Oiled Wildlife Rehabilitation Medical Database (OWRMD) made its big debut. So far, OWRMD has been used for two single-animal spills, and the recent Cuyama River Incident.  The very first spill patient input was a Bell’s Sparrow.  Cuyama was the first “big” test of the system…

OWCN Blog – Oh, WRMD!
https://owcnblog.wordpress.com/2020/08/17/oh-wrmd/

Read the full article on the OWCN Blog

It’s been an honor and a pleasure to work with the Oiled Wildlife Care Network (OWCN) over the past several years. OWRMD has developed into an amazing program that advances the care and documentation of California’s oiled wildlife.

Classification Tagging

A few weeks ago we introduced the Circumstances Of Admission field to help you tag your patients with any and all reasons the patient was admitted to your hospital. The reception for this field has been very positive and we thank you for your feed back. However there are still two items we want to address:

  1. How do you tag patients with what’s clinically abnormal?
  2. What if you want to use tags that are not available?

Diagnostic Classification Terminology

Very soon we will be adding two new classification tagging fields: Clinical Classifications and Categorization Of Clinical Signs. The fields will help you tag your patients with the abnormal physical exam findings by body system and what caused the abnormal physical exam findings.

So there will be 3 classification categories:

Circumstances of Admission (ex: Cat interaction, Vehicle collision, …)
— Why did the rescuer bring me this animal?

Clinical Classifications (ex: Physical injury, Neurologic disease, …)
— What are the physical exam findings by body system?

Categorization Of Clinical Signs (ex: Trauma, External parasites, …)
— What caused the abnormal physical exam findings (Clinical Classifications)?

The Clinical Classifications and Categorization Of Clinical Signs fields can be found with the Diagnosis field.

Reminder: If you want to use the Classification Tagging fields, go to Settings and choose Classification Tagging under the WRMD settings box. From the Classification Tagging settings page you can activate these new fields.

As of the date of this blog post, the Clinical Classifications and Categorization Of Clinical Signs fields DO NOT have an automatic tagging feature like the Circumstances Of Admission field does. In the future we will add that feature.

Additionally, if you want to see a list of all the terms for each category and their hierarchical organization, you can view that on the Classification Tagging settings page. We are working on a list of each terms definition that will be made available from the Classification Tagging settings page as well.

Custom Terms

The terms in each category are meant to encompass, at a baseline level, the most common situations encountered in wildlife rehabilitation. For example, the Clinical Classifications category only classifies to the body systems, not to each individual organ or body part. You may use the terms in the classification tagging fields as-is or you may now also add custom terms for specific classifications that your hospital encounters. Your custom terms must be assigned to an existing root or leaf node of the terminology hierarchy. For example, you could use the Circumstances of Admission term “Cat interaction” or add the custom term “Feral cat” under Cat interaction in order to track that detail.

That’s It!

We hope you enjoy the new fields and are having a safe year!

Flexible Analytics

With the release of the new Circumstances of Admission field we are very excited to also release a completely updated Analytics section. The older analytics section was nice but frankly kind-of rigid. It didn’t allow users to modify or tweak the graphs in order to see the information they wanted. In the updated Analytics section, all that changes. Our motivation for a new Analytics section was to answer the question:

Can the analytics be flexible enough to allow users to discover answers to their own questions?”

ps: we think the answer is yes

The Five Ws

The Analytics section has been organized around the Five Ws (Who, What, Where, When and Why). Additionally, all the filters that you can apply are designed to adjust the Five Ws so that you can narrow down the data into only what you want.

Patients (Who)

The Patients sections is all about who your patients are. Such as, what are your most prevalent patients by common name, how many patients were in your care, how many species have been admitted and a whole lot more. There are pages summarizing your patients by many different taxa categories such as, common name, taxonomic class, biological group and endemic status. There are also pages summarizing your patients by many demographic and health indicators such as age, sex, attitude, body condition, dehydration and mucus membranes. The details of each category can be viewed to see their changes in over time. There is also a taxonomy tree map to visualize your patients grouped by their taxonomic ranks.

Origin (Where)

The Origin section is all about where your patients are found at. You can see the most prevalent cities and states you receive patients from and there is now a map page that plots where your patients are found at. The map will cluster patients together within a close geographic area to help you visualize groups.

Circumstances of Admission (Why)

Perhaps the most exciting section is Circumstances of Admission; ie why are your patients brought to your hospital. There is an overview of your patients most frequent circumstances of admission and all your circumstances of admission grouped by their the root circumstance. You can also see the totals of each circumstance of admission as well as the percent of each circumstance of admission compared to each other. And of course, circumstances of admission over time to illustrate their fluctuations seasonally. And, after popular request, there is now a survival rate for each circumstance of admission including their first 24 hours of care compared to after the first 24 hours.

Disposition (What)

The disposition section is about what happened to your patients at the end of their care. There’s an overview page with the totals of each disposition as well as graphs illustrating when each disposition occurred. There are also specific graphs for released and transferred patients, include the type of release (or transfer) and the release (or transfer) rate of your survived patients. Of course you can see the survival rate of your patients and the percentage of each disposition. There is also a map that plots where your patients are released (or transferred) at.

Dates (When)

We’ve also greatly expanded your ability to modify the date range to render the analytics within. Not only can you change the date range but you can also compare to previous date ranges and group your data by different time frequencies; ie Day, Week, Month, Quarter, Year. (Grouping dates by bigger time frequencies is perfect when looking at data over large time periods)

Segment the Data

Analytic Segments

By default the graphs show data for all your patients, but what if you want to see analytics for a unique segment of your patients? For example, what if you only want to see data for your birds, or raptors, or perhaps all patients from a particular city, or even only patients that were poisoned? No problem!

Just click on the box labeled All Patients and choose which segment of your patients you wan to see.

Want to compare multiple segments of patients? Again no problem. You can choose up to three segments to create your graphs with.

Future Plans

In all honesty it is difficult to describe all the features and functionality of the new Analytics section, simply because of how much you can do with it. Even with this amazing release we are already planning improvements. Soon, we hope to allow you to save favorite graphs into one convenient place. We also want to create the ability to have even more specific segmentation; for example, render the charts for only “songbirds that also had an interaction with a cat”

We are very interested in any charts that you may generate at your own hospital. If there are any useful charts that you think we are missing PLEASE TELL US and share your charts with us ([email protected])! Additionally if you are not able to “discover answers to your own questions” PLEASE TELL US. There may be some tweaking that we need to do.

A Word of Caution

Looking at your analytics can be extremely fun and interesting, however I would like to express a word of caution. It is very easy to read to far into what the analytics are showing you. In other words, don’t let the analytics let you jump to conclusions. Let the analytics confirm, deny or improve your questions. If you see anomalies in the analytics that might indicate something important, or maybe just the result of bad data that needs correcting.

Other than that enjoy the new Analytics!

Circumstances Of Admission Tagging

Our First Goal: Keeping WRMD Simple

When we first conceptualized WRMD we set some very basic rules and milestones that we wanted to stick to. The first was that WRMD must be as simple as possible so that any wildlife rehabilitator could use it no matter their background or resources. Every time we make a change or add a new feature we still ask our selves “will this benefit our community of users or slow them down? ie: is this the WRMD way.”

Very soon we will be introducing a new feature in WRMD that officially takes WRMD into our second goal; benefitting from all the incredible data you collect on your patients!

Our Second Goal: Benefitting From The Data

In WRMD, you can collect information about who your patients are, where your patients come from, what condition they were in when admitted and what their final outcome was. However, although there are ways to record why a patient was found and admitted, it has always been a little bit difficult to do that. Definitely not in the “WRMD way.” In a forthcoming update, that will change. We are introducing a new field called Circumstances Of Admission that will allow you to tag your patients using predefined terms for any and all reasons the animal was brought in.

The new Circumstances Of Admission field can be found underneath the Reasons for Admission field with all the other Intake related data. Additionally, with each term you choose you can indicate if the circumstance is suspected or confirmed.

But That’s Not All!

You may be excited by this new field but also concerned that you now need to record in multiple places why your patients are admitted. Additionally you may be concerned that you need to go back and update all your past patients. If that’s how you feel then we agree with you.

In keeping with the “will this benefit our community of users or slow them down?” spirit, we wanted to make this new field as powerful as possible but also as simple as possible. With that being said, over the past year we have been developing and training a machine learning application to interpret what is written on your patient records in order to automatically tag your Circumstances Of Admission for you, so you don’t have to.

You and your users can still describe the reason for admission in regular human language. After you have admitted your patient, the Circumstances Of Admission classifier application will use the patients Common Name, Reasons For Admission, Notes About Rescue and Care By Rescuer fields to predict which Circumstances Of Admission tags best fit. You may still manually add or remove terms if needed.

Because of the automatic tagging, the Circumstances Of Admission field will be hidden by default. This way everything will appear the same and you won’t need train your volunteers or staff on the changes.

If you want to manually use the Circumstances Of Admission field, there is a setting under General WRMD Settings to show the Circumstance of Admission field.

Retroactive Tagging

As part of training and validating the Circumstances Of Admission classifier application, we have already tagged the majority of all patients admitted in WRMD over the past year and plan to retroactively tag past patients so that you don’t have to. The Circumstances Of Admission classifier application is not only a huge timesaver for you in realtime, it also has the amazing benefit of going back in time and automatically tagging your older patients. Additionally any imported patients can be automatically tagged in a matter of seconds.

It Gets Better!

With the introduction of the Circumstances Of Admission field we are also releasing a major update to the entire Analytics section of WRMD. One blog post is not enough to describe how powerful the new Analytics section is, but to give you an idea of our motivation, we want to answer the question: “Can the analytics be flexible enough to allow the user to discover answers to their own questions?”

In the new Analytics section you can see what your most frequent circumstances of admission are, what their survival rate is and how often they occur over time. To learn all about the new Analytics section read this blog post.

Thanks!

We really hope you use and appreciate the Circumstances Of Admission field. This was an important missing part of WRMD and one that we have been working long and hard on to make simple and amazing.

Just Some Foot Notes
  • The Circumstances Of Admission terms are based of the Clinical Wildlife Health Initiative terminology with some modification and additions.
  • A complete list of all the Circumstances Of Admission terms and their definitions will be made available.
  • The Circumstances Of Admission classifier application is still learning and it may occasionally make incorrect predictions. Please do your part and correct any mistakes for us and help teach the classifier.
  • We know that the data that you collect is amazing and powerful but we are not in the business of taking, selling or using that data without your permission and understanding.

Wild Hope Magazine

Hello friends! We are very excited and honored to have been featured in an article in Wild Hope Magazine.

If you are not familiar with this fantastic magazine then definitely check it out! They feature inspiring stories from around the world about preserving Earth’s biodiversity co-created by naturalists, conservationists, wildlife rehabilitators, veterinarians, biologists, ecologists, nature writers, photographers, and artists.

Our article: “Helping Hands, Wildlife Rehabilitators Around the World are Using Information Technology to Save the Lives of Our Wild Neighborscan be read online in its entirety. It shares how important WRMD is to the wildlife rehabilitation community and how valuable the wildlife rehabilitation community is to advancing One Health.

Please support Wild Hope Magazine as they continue to share field notes and images from nature’s front lines!

PS: Thank You Kathryn Arnold!

Early 2020 Updates and Important Information

Now That Most Of the Reporting Is Done..

December and January are two of the busiest months for WRMD. Reporting takes its toll on everybody. We  work really hard to make sure that everybody’s reports are functioning correctly and that giant reports are not crashing our servers, which has happened a few times. Every year or two we have to upgrade our servers to handle all of the activity that happens this time of year, and we  will be upgrading again soon. Thank you for your patience. 

NWRA Symposium

WRMD will be attending the NWRA Symposium this year in South Padre Island, Texas – Feb 25-29. If you are also attending we would love to meet you! Bring any and all questions, concerns, comments and feedback to us, or just come by and say hi.  We will also be presenting on Thursday morning from 8:30-9:30AM and hope to see you there!

We are especially looking for feedback for our proposed new Husbandry extension. If you have been waiting patiently for this extension please come and chat with us. We are looking for suggestions and advice on recording husbandry information.

Analytics

Devin, our developer, has been working extra hard to improve the Analytics section of WRMD. We want our users to be able to view their data in whatever way they need. All I can say is that what he is creating is absolutely beautiful! Seriously, the graphs are like artwork and the information they provide is invaluable. Devin  is doing everything he can to get it done so he can unveil it during our presentation at the NWRA symposium (fingers crossed). Things to look forward to!

M-Opinion & the Migratory Bird Treaty Act

The Migratory Bird Treaty Act is under attack and birds need you to speak for them. The language within this 100+ year old treaty has been scrutinized and recently a new proposed regulation change is underway. The M-Opinion  proposes to redefine the meaning of the “incidental take”. The change effectively allows anybody who “accidentally” destroys, kills, or harms any MBTA protected bird, nest or egg to do so with no penalty. An example of this would be an oil spill where birds are not intentionally harmed. Currently, oil spillers have to pay a price for this. The M-Opinion would make it so they could get off scot-free. The same would be true of a tree-trimming company did not intend to wipe out an entire colony of herons and their nests. They may now experience no repercussions. On a smaller level, we may no longer be able to tell the public that removing a nest that has baby birds in it is illegal. We all know how devastating this could be to all MBTA protected birds. USFW has finally opened this up for public comment and we need to comment this until they have no more space on their server to hold all the comments. Spread this far and wide. We only have until March 19, 2020. Let’s do everything we can to stop this change. https://www.regulations.gov/document

A Great Question From a User

This is from a new user and it inspired me to write this blog:

“I have just one more question as well. I am using the program for our intakes only. We are a larger facility and still growing and the rehabilitation staff have a paperwork system that works really well for them as far as exams, feedings, vet visits etc. Does utilizing your system just for what we need hurt us in anyway? I was not sure if I just used it for intakes and out comes and used our paper system for the rehab side of things if that would be an issue in anyway.”

Here is our response: 

We designed WRMD so that it could be used any way you want and need. Most wildlife rehabilitation organizations that have existed for 10 years or more started with paper records, which is completely fine. However, one of the big reasons we developed WRMD was to create a tool that can save institutional knowledge in a useful, easy-to-search format. When we ask, “What medication did we give that patient 5 years ago that worked, because we now have a similar situation?”, we can easily and quickly find the answer in WRMD. With paper you really can’t do that. So much information is lost on paperwork. On the flip side I do think that it can work great for many tasks such as husbandry charts or prescription forms that can be written on and checked off. WRMD provides many paper forms within our “Paper Form” extension that, when used, translate nicely into the digital format of WRMD. 

We have found that the normal progression of our WRMD users is to start small. Many rehabilitators just add in their intakes and dispositions to get the reports and basic stats they need. Once they get used to using WRMD and can navigate more easily, they slowly start to incorporate its’ other features. Features like the Prescriptions extension can automatically calculate the dose your patient from the last recorded weight once you add information into your Prescription Formulary. In order to do that you need to use Locations and record in weights. If you use the Rechecks feature, a daily calendar is automatically generated for you on a daily basis, but you have to add in these rechecks.  All these little features help save you time that could be used on animal care instead of paperwork and calendars.. How you use WRMD is up to you. We support you, whatever way you decide to use WRMD. Our first priority is to make things easy for our users, and everything else comes later.

– Rachel Avilla

Introducing the Prescription Formulary

Over the past few months we have been working hard on an exciting update to the Prescriptions extension. Today we are happy to share with you the Prescription Formulary: a faster and more reliable way to write your most common prescriptions.

What Is A Formulary?

A formulary is a list of medication prescription protocols that may contain information on approved dosage, route, frequency, duration and more. Formularies are a helpful tool to guide a user to prescribe a recommended and safe prescription. You might be familiarly with this formulary: https://www.amazon.com/Exotic-Animal-Formulary-James-Carpenter/dp/0323444504.

How Does the Prescription Formulary Work in WRMD?

If you are using the Prescription extension, then you are familiar with filling out each field of the prescription form to write your prescriptions. Now with the Prescription Formulary, you can define the values for a prescription that should be auto-populated when choosing a particular medication from your formulary. This will not only make it faster to write a prescription, it will also help you and you coworkers to follow consistent medication protocols.

In settings, when your Prescription extension is activated, the Prescription Formulary link will be in the Extensions box on the left column. After you click on Prescription Formulary you can click the green plus icon to add a new formula.

Next; fill out the displayed form for the formula you want to create. Remember that a formula is used to create a prescription so your formula should be named something that represents what its prescriptions would be used for. For example, if you give all cat caught song birds clavamox, you might name it Cat caught clavamox for songbirds. You can then fill out all the default values of the formula that you want autofilled in a prescription. You can also specify that you want the prescription’s dose to be automatically calculated based on the patients most recent weight. If you want the prescription to start on the same day it’s written, then check the indicating checkbox and provide the number of days the prescription should run for.

Formula for Cat caught clavamox for songbirds
Formula for Cat caught clavamox for songbirds

After you have created your formulas you will see them listed on the settings screen. You can always edit them later if they need to be updated.

Formula list
Formula list

Now For the Exciting Part!

Now on a patients prescriptions page when you type in the Drug / Medication field, WRMD will search your formulas matching the text. You can then click the formula name to fill out the prescription!

Using the formula for cat caught clavamox for songbirds

Of course, you’re not required to use a formula to write a prescription. Additionally you can modify the values of the prescription after the formula has populated the fields.

What About Veterinarians?

In addition to the Prescription Formulary we are integrating veterinarians into prescriptions. In case you did not know, WRMD allows you to keep a list of the veterinarians you work with. As a Super Admin in the settings area, click the veterinarians link under the Account heading on the left sidebar. When adding or updating an existing veterinarian you can now indicate which user the veterinarian is.

Now when writing a prescription you will see a list of your veterinarian(s). If a veterinarian is logged in and is writing a prescription, their name will be automatically selected from the dropdown list.

What Do You Think?

We love your feedback so please tell us what you think! Don’t forget to click the Ask For Help link on the top right of WRMD to reach out to us. WE ARE HERE FOR YOU.

We’re Hiring a Technical Writer!

Organization Description

The Wild Neighbors Database Project is a 501(c)3 non-profit organization which supports international wildlife rehabilitation by developing online data management software and helping implement its use worldwide. Through the continuing development of data management software, including WRMD, we are enabling wildlife rehabilitators to collect, manage and analyze data from their patients, so that together we can continue to improve our best practices and make a difference in all wild lives.

Reports To

The Technical Writer will report to Rachel Avilla, Customer Relations Manager.

Job Overview

This position will be responsible for creating content for the WRMD knowledge base. We are looking for a person that can take the detailed and nuanced technical attributes of WRMD and distill them down to conceptual and task-based documentation that any end user can understand and use.

This is a contracted job until the project is completed. After that point the contract may be extended for maintenance of the knowledge base and to help answer daily questions that come through WRMD’s forum.

Responsibilities and Duties include but are not limited to:

  • Developing and writing user documentation on how to use WRMD’s many features.
  • Developing and applying uniform style guide for the formatting, approval, presentation, and release of technical documents.
  • Help create online video tutorial screencasts that compliment the written tutorials.
  • Create a glossary of WRMD terms and uses.
  • Write descriptions and overviews of WRMD’s extensions.

Qualifications

  • Two years of experience working in wildlife rehabilitation.
  • Experience using WRMD.
  • Excellent technical writing skills.
  • Experience with WordPress.
  • Proficiency with computers and learning new software.
  • Ability to be a self-starter and take a project and run with it.

Budget

The Wild Neighbors Database Project has a budget of $10,000 for this project. Payment plan will be negotiated depending on skills, output of work and timeline.

How to Apply

Please send a cover letter, resume, and an example written tutorial of any WRMD task to [email protected]. We will be accepting submissions until October 15, 2019.

Generating Reports

Last week we had to make a change to how reports (including rechecks) are generated in WRMD. Over the past few days we have been making adjustments to fix issues with this change.

We Need Your Feedback!

In all our tests and through our monitoring of errors and server loads it appears that this new system is working. However , we still want to hear from you and address any issues. If you are having any troubles please reach out to us. We are here for you! Email us at [email protected] or send us a Help request in WRMD.

Devin Dombrowski

New Reporting System

For a very long time I (Devin) have been annoyed with how reports were created in WRMD. Starting from the layout of the Reports page, through the inability to customize reports for my own needs. Well, as of today all that is changing.

We are Excited to Release a New Reporting System into WRMD

This new reporting system has some very simple goals.

  1. To simplify the processing of finding the report you want to produce.
  2. To create more flexibility around the formats of the reports.
  3. To allow you to customize what the report is reporting on.

Favorite Reports

Finding a report should not be a chore. Your most commonly used reports should be on top of the list, so we created a feature for that purpose. Reports will now be listed in groups instead of being tiled all over the screen. And, to make your life easier, you can now star a report as a Favorite! By doing this, those reports will be put on top of the list.


Report Formats

Reports can now be generated in multiple formats. The most basic format is just to see a preview of the report on your screen. When you click on a report you will be taken to a screen to preview the report and from there you can choose to print the report as a pdf or email the report. Now, many reports will have the ability to export the data directly to Excel!

Report Filters

The best part of the new reporting system are the filters. For a long time people have asked for the ability to adjust what a report, reports on. For example, limiting the date range to a specified time frame instead of an entire year or excluding certain species taxonomies if you don’t rehabilitate all classes.

A very simple example of this are the annual reports. Each annual report has a filter for a given year that it should report on.

USFWS Wildlife Rehabilitation Annual Report has 1 Filter: Year


Many reports will now have multiple filters like the Disposition by Species report!


Generated Reports

Once you create one of these reports it will be saved in the Generated Reports page for 14 days. If you think you want to permanently save this report, we suggest saving the PDF that is created to your computer.


Adding these filters were not just for our users, but also to help us manage the reports on the backend. Previously, we had to create multiple reports for what was essentially the same information but with slight variations. For example the Prescriptions Due report existed four times with slightly different pre-set filters. Now we can maintain one Prescriptions Due report but use the filters within the report itself to adjust what the report, reports on.

Still to Come…

Customized Reports: This capability will allow you to save a specified search and then report on the specific dataset you wish to see. This will be available in the near future.

Filters you suggest: If there is a filter that you would like to see added to any of the reports, that would be a valuable addition, please let us know.

We hope you appreciate this update. It has been a lot of work for the past few months and we think it’s going to be the beginning of a wonderful and powerful new feature of WRMD. If you have any feedback or suggestions then please tell us either by email or in by clicking Ask for Help in WRMD.