Here is a classic example. When you print a lab requisition, the documentation in the chart is:
ORDERED/ADVISED: - Custom Order (CBC
ESR
CMP
LDH)
Why do we need Custom Order?
Why is CBC on the first line?
Why do we need parentheses?
I don't see a "custom order" lab order test. And I tried placing all sort of orders, and they seem to have printed out fine. Am I missing something?
Yes. You are missing something, lol. Lab orders section. Far right tab. Type in customer orders. And, before we had this convoluted lab section, we had a simple one. It did the same thing.
For whatever reason, whenever I add a custom order, and then use the "Print Orders" button in the Orders window, the order requisition form generated has a blank "requested studies" area. But I've digressed. We were talking about how orders get documented in the chart.
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"Why do we need Custom Order" && "Why is CBC on the first line?" && "Why do we need parentheses?" - Short answer, MU/structured data requirements. Long answer. Each Order that is logged in the program is supposed to correspond to a
single "real" life order. All orders should have a corresponding CPT code if possible. Let's face it, tracking data is valuable, and I imagine it only becomes feasible after a certain amount of codification. However, there are situations in which codifying a value(s) is not appropriate/possible or [too cumbersome AND not justifiably so] or just a pain: enter the Custom Order that you can make with free text. However, it's important to differentiate Custom Orders from codified orders. Why? It makes the life of auditors/external reviewers easier.
RECAP/EXPANSION
So why does "Custom Order" have to be there? && "Why do we need parentheses?" For clarity in the eyes of others. And I imagine there are some users that find the parentheses helpful. The parentheses serve to isolate the text.
"Why is CBC on the first line." Because some of the programers had 1 order per 1 real-life order in mind whenever they wrote that code. If you only have 1 order, then you don't run into that problem. Yet, AC provides us with the option of using templates in the Other tab of the Orders window; they do this to help us reduce our clicks; it is an invitation to put multiple labs/orders in a single order. They probably could have added a little bit of code to bump the starting line 1 line down, just for the Other Orders templates; however, that kind of spoils the consistency/uniformity of how templates function. If you want to bump the line down yourself, you can always add an extra "." and "enter" at the beginning of every Order template. That would produce something like this:
ORDERED/ADVISED: - Custom Order (.
CBC
ESR
CMP
LDH)
(Unfortunately, just adding an enter to the template will not work.)
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What I wrote above is what I imagine the developer thinks about this. Supposition. Personally, I agree with the you on the "tell the program to put the first lab two lines down" point. However, I don't see too much harm from "Custom Order" and the "()."
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Mario, you must remember that as an Office Manager, you have much less of a reason to write a script. I am not sure if you are an MA/Office Manager, but even if you are, my guess is I would write 15 scripts to your one. Without using the script writer, it is hard to comment on whether it is distracting or not.
My guess is that the number of scripts you write compared to the number of scripts I write approaches infinity. You make a fair point.
Keeping things smaller and less obtrusive makes them less distracting and allows for other windows/boxes to be enlarged and show more. The only reason it should ever need to be red, would be if it turned red if there were an allergy listed. As it is, the red contributes nothing. And, are you really going to tell me you need the time. Why not add seconds?
I never argued that the utility of the allergies feature was its saving grace; I just said I didn't find the allergies feature that distracting. I have already conceded that I have little authority when it comes to determining how distracting it is.
Why stop at seconds?
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For example, you will have a hypertension template that goes "Patient denies headache, syncope, SOB, epistaxis, chest pain or peripheral edema." All very tidy and right-clickable. But, when Mr. Y comes in, and you ask, and he says he gets occasional nose bleeds in dry weather and his ankles swell a little at the end of a long day of standing at the parts counter, what do you think happens? It is "pretty much negative", so you go ahead and use the template. It is going to take as long to edit as to just do properly from scratch.
I think that templates exist best as lists. For a hypertension template, I'd use some variation of the following:
Hypertension Symptom Checklist:
[n]=patient denies symptom
1. peripheral edema-
2. chest pain -
3. epistaxis -
4. headache -
5. syncope -
6. SOB -
For that patient, it would turn out like this:
(filling this out quickly requires you to use the arrow keys on the keyboard quite well; also, notice how I cascaded each line so that pressing the "down" arrow will take you the end of the next line)
Hypertension Symptom Checklist:
[n]=patient denies symptom
1. peripheral edema- ankle swelling after a long day of standing
2. chest pain - n
3. epistaxis - occasional nosebleeds in dry weather
4. headache - n
5. syncope - n
6. SOB - n
