OK, so I am on my 3rd Heineken so if I offend anyone, sorry. Also, there will be some sarcasm.

First....I talked about sticky notes, but we don't always use sticky notes. I hope Jon knows that. This will be the first post as to how WE do things at RVP.

I will have to admit that if my software company hadn't designed File Assistant Pro, I probably would be on the way to UpDox. I had looked at UpDox which had to work with OneBox seven years ago and Andrew Barbash couldn't convince me it worked that well. The latest versions seem very good, and I would highly recommend you look at it closely.

But, our workflow.

We don't have that much of a work flow. It is rather seamless. We send messages in three ways all HIPAA compliant. Instant Message, Outlook and AC messaging.

We never send a chart to someone. We only message. So, when a patient checks in, they are greeted and copays, etc. are taken. They are taken to triage (one area) by our CMA who does the vitals and the subjective. The chart is then sent to me. (OK, the one time we send a chart).

If a referral needs to be made in the room, the orders section is used and it is sent to our referral person. All x-rays and other orders are done by me, printed to the printer on my desk and a label is made using Amazing Labels, which is free and is simply amazing. Ask Steven. The lab sheet is given to the patient or if something needs to be done in house, the lab req and label is given to my MA. If my MA, intuitively knows what the in house lab is, she will print the req and make the label. But, other than that, I do everything once I get the chart including most letters, etc. If a patient needs a letter for school or other excuses, etc. I do it with a template, but if they ignore the 42 inch flat screen TV in the waiting room that asks for those types of things to be done while their chart is open (see 95% of the time), I just ask my receptionist to do it who has templates for all.

Now, if you don't use UpDox and you are a solo practice, then my workflow here is easy and free and very, very, very fast. All incoming faxes which is 98% of our paperwork comes to the server. Since it is on the server it is distributed to everyone's desktop and SharePoint (another day). Since it is in a folder called Inbox, it is automatically in the inbox of F.A.P. File Assistant Pro is a software program designed by our software company which is used by about ten people on here. And, you do have to be a solo practice at this time. Anyway, the fax will be in the inbox of the program and is renamed by the staff. Once named and categorized, I can look at it from any computer and import it. Importing it to the database automatically signs it off at that exam moment in time into the FAP database. These are backed up in multiple ways every night.

Now, this is our only workflow. If I open a PDF, already named by my staff as Smith, John Lab, and it needs some action on it, I click on the email icon which makes it an attachment to an email, I add a subject line, then in the body of the email, I write down what to do. Like: Serum iron is low. Please call patient and put on Niferex and schedule a repeat iron in six weeks. My CMA who functions at a level near a nurse practioner, then does this. It is reflected in Amazing Charts and sent back to me. ALWAYS. She then drags and drops the PDF into Sharepoint and keeps a copy in her email, so we now have three copies with no extra work.

When PDFs are named, sticky notes may be used. Say, it is a transfer, the staff may use a sticky to say, patient had stated last week that they were getting too old, etc.

Anyway, this is basically how it works. It is actually very simple. The instant messages are for things like, so and so is on the phone or I may send a message to get me so and so and call the medical records department for a report we don't have.

Bert
Pediatrics
Brewer, Maine