Wow! Didn't see the post two above! Good thing there is email. OK, caveat. This is black and white and just having fun and giving opinions. So, no offense ahead of time.
I gather you have devised a "face sheet" system for yourself, external from Amazing Charts, which demonstrates that you appreciate the value of having a problem list. You apparently just don't care for Amazing Charts way of doing it, and obviously don't mind doing double-entry to maintain it to your personal standards. There is absolutely nothing wrong with that; I just see an opportunity to automate that process here, and Amazing Charts is soooo.... cloooooose to perfection.
No, I have no external method. The only external methods are FAP (wicked fast) and a possible Excel sheet. I don't even go there much. OK, so an admission. I would say in the last four years, I have looked at the summary sheet maybe eight times. Seriously. I won't count the immunizations, which is the only reason, I would look there. Never inactivated a problem. I'm not really upset with AC's version; I just think it isn't helpful -- to me -- anyway. I'm not much into face sheets, but at least AC prints a good one. I agree having diagnoses in a running continuum can help, but that is also the way the visit history is configured when I remember to change the chief complaint to the diagnosis. There isn't much thought into how it is designed.
Our medical students are mercilessly beated down
when they screw up Problems with PMH, etc. A few years back, The POMR became the thing with the assessment and plan based on this. Patient comes into the hospital with three major problems and we deal with them. We don't deal with the appy he had ten years ago. So, to me anyway, there are major differences between PMH, Problem list and diagnoses such as an ear infection. In peds, the problem list is much shorter and the diagnosis list probably much longer. I don't know completely how to look at both the visit history (would look better as diagnoses) and a list of diagnoses. But, that is where I can see OM, scraped knee, OM, bronchits, OM, OM and go wow, this kid needs an ENT consult. And, one could easily argue that chronic OM would be an actual problem for this kid.
I wish there were a way to have these lists on the first sheet, but there probably isn't enough room. I have always wanted the summary sheet (if it were set up correctly) to come up first, forcing me to know a lot of this child already. I could go there when I went in the room, but being lazy I don't. I do know that the administrators at the hospital after ten years came up with a brilliant idea that has cut back delinquet computer charts by around 80%. Instead of the computer opening directly to the flow sheet where we all want to go, it opens to the Inbox. It is then easy to see your charts that need to be signed. They have also made the next sheet an incredible summary sheet. Very good design with what I believe will be better patient care.
I also trust my biller to come up with the right codes way more than the Access databases we have now. Some times it is nice to compare, but for the most part, that three inch thick book is just much more accepted by Anthem and Aetna than the codes we have now. I love the 786 and 786.00. I, for one, have never thought of Adam's idea until the other day. But, it is a good one. But, we all use the program differently; I have never inserted a diagnosis with the dropdown button and I have NEVER inserted an amount or a refill amount in a script using the dropdown fields. Just prefer typing I guess.
But, I get no benefit from the diagnosis going into the problem field. A single case of conjunctivitis or a mild ankle sprain just isn't a PROBLEM for me. And, the typed in diagnosis does show up in the assessment field on the progress note.
And, yes AC was heading toward something near perfection, but then the Johnny Quest factor (this should pull Paul into the discussion, lol
). That's my silly way of talking about the huge emphais on the interfaces such as Quest. A lot of people, maybe even myself but less so, are really looking forward to the PM. And, it may be great. But, it does take away from working on the little bugs or making more preferences.
