I hesitate to wade in here. Others who are smarter and more experienced than I have already done their part. The issues are complex and hard to describe concisely. I suspect this is a discussion that would work better face-to-face.

Choc, and Bruce, I believe that a good EMR permits us to maintain our basic workflows with some adaptation on our part. On the other hand, to make things fit to the EMR, sometimes we first have to work to understand the way it is meant to function. Bruce, I don?t think either of you are crazy, and you raise some good points. Maybe it would help to re-envision the way the program functions by comparing it to paper:

Originally Posted by Chock
One question: If I wanted to enter further information on a patient in the sections on past/social/allergies sections on a patient's chart in between encounters, will I have to send the chart to Inbox? I can't send it back to Patient List unless I sign it in which case does it become another "encounter?"
Choc, think of the ?patient list? as the electronic version of your file wall of paper charts. You wouldn?t put a chart back on the wall with an incomplete note, in part because you would never remember that it was unfinished. So you would put it in a pile, or a ?box? of partially done charts. You could keep it in a box on your desk (your message ?inbox?) or you would give it to a staff member to work on (their message box). Only when the note is finally complete would you sign it and put the chart away.

So see a patient and do part of the note. If you have more work to do on it, but want to work on another patient?s chart, hit ctl-s which puts it in your inbox. If you want someone else to work on it, send it to their box. They will later send it back to you when they are done, and you sign it at that point.

I think this next paragraph is the key to avoiding a lot of confusion:
When you want to work on a chart, if you know it is incomplete, look for it in your message box. Open it from there and finish the note. On the other hand, if you aren?t sure if the chart has a partially done note or not, try to pull the chart from the patient list. AC will tell you that you have an incomplete chart; it will tell you that the incomplete (note) chart is in someone?s box. ***Some people think you have no option here and cannot ?back out?; but you do have that option. Usually at that point you do NOT want the version of the note that is about to open. Click ?ok? and the chart opens; the key here is to immediately CLOSE THAT ENCOUNTER. Now go to your inbox and find the same patient?s chart. The version there is the one that you want to work on. Work on it, and either save again, or sign.



Note that wherever the chart is, labs and other reports can be entered by anyone into the imported items area and they are saved to the chart; it is only the unfinished encounter that is in a temporary state.

Choc and solodocmom, are you aware of the way that you can filter and arrange your inbox? You can have it show only messages (since you sometimes don?t want to see charts there)?or only charts. You can also arrange them chronologically or by name (a little annoying since it is by first name, but still helpful). You can also toggle between these choices.

The issue of clearing out your backlog of old messages is perhaps a project for another day (or hopefully Bert, et al have already talked you through that).

Jon
GI
Baltimore

Reduce needless clicks!