Well, guys, here is where we must part ways. I looked at Phreesia and, as an Internist, I do not like it. What I pride myself in most is my ability to extract from a patient subtle details and information which, I am not convinced, can be managed by branched chain algorithms. Also, the majority of my office visit consists of this face-to-face interaction. I am wary that history programs such as this contribute to the notion that medicine may be practiced by protocols. Perhaps I simply do not fully understand the program and I am open to futher enlightenment.
I have a "Patient Questionnaire", 4 pages in length, which every new patient must complete and every established patient must complete annually. It asks for past, social and family histories, Medicines, allergies, other phsycians being seen, immunization history, mammogram dates, colonscopies, etc. and then has 2 full pages of ROS questions. Every page is reviewed by me in front of the patient. I markup the forms (using pens, one of the last uses for my Bics) adding comments, explanations, and so on. This form is then scanned into imported items.
Rather than asking for only history which has changed, the patient is made to review for themselves at least once a year, their own medical histories. I am constantly amazed how many people do not know what meds they are on, to what they are allergic, or how many other physicians they are seeing that they forgot to tell me about. Everyday, I must remind my front office to specifically ask patients if they still live at such and such address, do they still have Sock-it-to-Me Insurance, is their phone number BR-549? If we just ask a patient "has anything changed?" inevitably it has but they forgot to tell us.
I also believe that having at least this one last papered form helps support any issues an insurance company may have with my otherwise templated EMR. Also, on more than one occasion I have had a patient return to the office with an "attitude" because I did not address their "sore knee" that they supposedly told me about the last time they were in. I can specifically show them on their history form where they neglected to circle
Joint Pain or to use the "Comments" section to tell me about their knee.
So, although I am open to correction, on this I must disagree with Bert.
Leslie
