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Lowell Kleinman, MD www.drkleinman.com www.old-fashionedhousecalls.com
Originally posted by DrQuit So, how does your EMR specifically allow for variances in workflow between specialties or for an individual who wants to have a specific sort of flow? Lowell
Originally posted by Robert Gleeman [br In my opinion, PrognoCIS can handle most specialty-related workflow issues with selectable templates. PrognoCIS, for example, found several pediatric features, such as interactive CDC Growth Charts and vaccination batch tracking, that could not be handled with templates alone. These pediatric workflow features are now "built-in" features of PrognoCIS, to be used or ignored, but fully available at all times.
quote:Originally posted by sanvas I think I have posted this in the past, but most practices slow down or altogether stop once they have mastered the 'Need' features (basic appointments, Coding, Charting and Billing). I have been guilty of this lately. I have installed my EMR and even though new features have come out, I have not incorporated some of them even though they will clearly help. I am not sure why except that it's easy to become complacent. The auto-updates should be forced :) Lowell Lowell Kleinman, MD www.drkleinman.com www.old-fashionedhousecalls.com | Post Points: 5
Nick Harrington email me or Skype: nickharrington emrupdate.comIf I have seen further it is by standing on the shoulders of Giants" Sir Isaac Newton 1676
Originally posted by azalea_runner I think the standard is the H&P, then SOAP note. If I were a pediatrician doing well-baby exams, however, I would want my growth chart, milestone list, vaccines given, etc AS a template, NOT as separate features where data is tracked. I wouldn't want to enter data on one screen and then click over to see how it plots out. Its great if you have the chart, but how is the office visit recorded in a succinct manner? There are many specialties that use standard "workflow", but require specialized templates. Pediatric and OB are two specific areas where there truly is a specialized need.
quote:Originally posted by azalea_runner Now a question for vendors and physicians alike--what better ways are there to structure workflow to make a visit faster? I think this, too is where a workflow management system applies. There are too many varying approaches to documentation. Some would want to use a flowsheet for a particular problem and others would want to use a SOAP format. An EMR with a workflow management system allows for both styles to be accomodated. Lowell Lowell Kleinman, MD www.drkleinman.com www.old-fashionedhousecalls.com | Post Points: 5
Originally posted by azalea_runner Back to the initial question--workflow. I think the standard is the H&P, then SOAP note. If I were a pediatrician doing well-baby exams, however, I would want my growth chart, milestone list, vaccines given, etc AS a template, NOT as separate features where data is tracked. I wouldn't want to enter data on one screen and then click over to see how it plots out. Its great if you have the chart, but how is the office visit recorded in a succinct manner? Same question with OB. I don't want to enter data on one screen and have it populate a second screen that I then have to view for a complete office visit. There are many specialties that use standard "workflow", but require specialized templates. Pediatric and OB are two specific areas where there truly is a specialized need. Now a question for vendors and physicians alike--what better ways are there to structure workflow to make a visit faster? Example--seeing a diabetic patient for 3 month f/u in primary care--can this basically be pared down to a flowsheet issue--check fasting glucose, check HGBA1c, cholesterol up to date, check wt, BP, Optho appt?, feet OK? No infections? Should you as a PCP restructure your workflow away from a standard SOAP note into more of a flowsheet where all this data shows on one screen?
quote:Originally posted by azalea_runner Now a question for vendors and physicians alike--what better ways are there to structure workflow to make a visit faster? Example--seeing a diabetic patient for 3 month f/u in primary care--can this basically be pared down to a flowsheet issue--check fasting glucose, check HGBA1c, cholesterol up to date, check wt, BP, Optho appt?, feet OK? No infections? Should you as a PCP restructure your workflow away from a standard SOAP note into more of a flowsheet where all this data shows on one screen? Great question I think and although the basis of the question is visit speed, it also brings up important additional implications with respect to how my data can be organized and accessed in such a way as to be fast, provide useful functionality to the end user, help the practice to improve quality of care through adherence to national standards and also maybe provide data on the DOQIT and P4P side of things? If you take your specific example, which is diabetes management, NextGen has added Disease Management templates which are formatted as a flowsheet, much as you describe. Your data is gathered from various data entry locations and displayed on your summary flowsheet screen. Items, e.g. A1Cs, blood glucose, foot inspections, filament testing, etc., that are part of your care plan or critical pathway for this specific type of patient are based on AMA standards, where they exist. Your patient compliance timing can be changed to meet your own needs and requirements, but we start with the AMA standards. As we are a single point data type of system, updating any of the data points in your progress note or on the health maintenance tables will simultaneously update your flowsheet. Also, the data in NextGen is structured data so that it can be output via query and uploaded as part of a DOQIT initiative or for P4P reporting. I don't want to overplay our hand here. We have a great deal of work to do to add all appropriate Disease Mangement templates to all our KnowledgeBases, but the design structure is complete and the Diabetes stuff exists in our Primary Care KB today, is installed and clinically running at real sites and can be seen in a NG demo. Again, sorry for the blatant commercial nature of the post but Azalea Runner did specifically ask for vendor responses. Opus Bob Larson NextGen Healthcare 215-657-7010 Too young for Medicare Too old for women to care My posts reflect my own thoughts and are not intended as an official representation of NextGen Healthcare policy or procedure. | Post Points: 5