DocM,
I was just suggesting (guessing?) ICD-9 because you could perhaps assign the ICD-9 to your magic button. Then anywhere you insert that same number like in the imported lab as I suggested, now it links back to the magic button you previously assigned to it. But I see your picture clearer now too, now that you have added to the original post. But as a P4P tool, some way of using ICD-9 (f'ing 10 still being considered?) would bring it all full circle for that purpose.
I would still want to find a way to get one lab or image linked to more than one button, Dx or ICD-9. Here is a lab with multiple tests on it and so it speaks to cholesterol, diabetes and goodness knows what else. So the ablility to have such a thing link to multiple Dx's seems to be very important here, especially in Primary Care where folks are seeing lots of issues in one very complex patient and encounter.
But your idea of breaking it out, in this completely more issue based format certainly hold lots of merit for further examination and experiments. It must be hell for you guys with old fashioned paper charts, flipping back and forth madly. Even with tools like AC, clicking back and forth between screens must get very frustrating at times. Especially when all you really want to do is be able to see this and that at the same time so you can relate this to that or what have you.
I still see P4P as a labor managment issue that can only be solved by either returning to the old model of trust the doc, especially the primaries, or, by collective bargining. Funny how back when docs could slow down and only see a handful of patients a day to make a decent doctor's living, nobody had any concerns about "performance". But now after years and years of the facsist Henry Ford cranking up the assembly line so to speak, NOOOWWW, they want to bitch about performance???
Isn't that what almost killed Detroit with high speed and low quality control. You really can't have both. Back in my old business as a stagehand, there were the non-union houses whee things were always hurry, hurry, and then there were the union houses where we might have gone at what seemed to be a somewhat slower pace, but there were a lot less injuries, breakage of expensive equipment, and a whole lot less "re-do's" if you catch me drift. "Nobody re-do like we do." Real quality of outcomes will save lots of money but only in the real long run and none of these SOB carriers really care about that. And it means paying a lot more for the lowly office visit at the PCP's office because this is where the rubber meets the road. Why do Office Visits have some of the lowest relative value units of all things. And then even your own IPA's and PO's multiple this insult by having contracts that pay a higher percentage of Medicare for procedures than for OV's. This is all just smoke and mirrors to pick your pockets.
Anyway, Where was all their concern about outcomes while they were all stuffing the fat faces and pockets with all of our money? To this day where is their concern about outcomes as the swap patients back and forth every enrollment period and have MA's and PA's supervise licensed physicians? BULLCCHIT! That money belongs to patients and doctors for good pay for good care, not for some greedy-@$$ Ivy League MBA to pad his golden parachute. Give me a break.
Have a great night. I need to go home...
Good Night and Good Luck,
Paul
