I treat them all as consults, list the Dr. name in the subject line, even if it is my name, (my dictation, all the hospital stuff in one spot.) This is why we need the "magic buttons" or Filters.
The chart remains "SOURCE ORIENTED" as Dr. Weed complained about it in 1968. You want to organize it by "Problem" but there are things that overlap. The CXR done during the hospitalization is important to your understanding of the hospital case, but you are likely to look at the CXR in the coming year when you are doing the annual exam on this patient who smokes or who had a Breast Cancer 5 years ago. So where should it be filed?
I propose we will have the best chart when it can be filed by source, (the staff put it in without medical insight) so no time is lost. Then the complicated ones will we sorted out with filter keys, (think of postem notes). You will tag EVERTHING about the hospitalization on one key, but the CXR will also get a key for Breast CA and one for Smoking. Then when you consider the patient and their smoking problem, you will see the CXR done during the hospitalization. Likewise for the other Dx.
Where ever you see a Filter Key, (postem note) (It will appear as a symbol anywhere in the chart that you have placed it)you can click on that filter Key. If you are in the PMedHx you can click them there, of anywhere they exist. When you do click the key it takes you to a NEW PAGE that it Temporarily pulls together from all the places you stuck a key (postem note). You see this one snapshot of that condition all gathered into one page. When you close it, all the pieces go back where they belong.
On the CXR there will be multiple keys, click the Breast CA key, then that page assembles, click the tobacco abuse key and the CXR, PFT and visits that you have tagged regarded quiting all come together.
Wouldn't this be cool?
