Home Forums Discussions General Discussion Our Second Day Live with File Assist Pro!

Now not to take away from the last few stand up jokes, but it is time to get back to the main point of this thread... Reporting on how things are going to FAP, so in the words of John Cleese: "And now for something completely different."

Bert,
I was talking to my brohter Mike, he himself and program debugger and engineer by trade. He is currently working at a company that makes the ultimate version of a demographics page and relational database. It is a custom program for folks who have to track Humana Resources (Freudian slip there?) type data. So like I said imagine the ultimate in demographics data including what benefits, which family members do and don't belong with any given benefit you get the picture...

So Let's talk about a problem we had with FAP. We have a number of good old Italian families. Now what does ever Italian male patrioarch have to have, a first born son, and with most of these first born sons, come two family member with "Identical Names" right down to the middle intitial sometime. So for a great example, we have two patients father and son, (and we almost got Grandpa too!!!) Michael J. Pizzano (the last name has been changed to protect the innocent and make for a bad joke).

So the younger son went into AC at chart number of approx. 525 and dad got dragged into the practice by mom, (Go get your cholesterol check and finally see Dr Blake!!! Or Else!) months later at chart number 900 or so. But try and I might, no matter how I try to highlight either of the two names, the scan always goes into the son with the lower chart number. FAP needs a better way of differenciating who is who...

Well now back to Brother Michael (my Michael, not the Pizzano's). His program also set up data by people and can even TIE families together (HINT, HINT Jon and AC) but the very first layer of the program the first level of data is the EMP number, thier version of a chart number, for employee number and now no matter what no matter how many different people with the same name go in, with the program always looking for that EMP or Chart number it will always go to the correct chart or file no matter what (as long as human error is not the case).

It is my brother humble but professional opinion that Special Ed probably tapped into the names first or just the names and that the chart number is not the first and most important level and determiner of who is who. The first Table I believe you guys know it as... So Special Ed needs to make sure that the chart number and not the name is the first highest up the food chain table...

Bert, does this make sense? Can you guys do this and tune the data post facto to correct for this???

Welcome to being a software developer Bert. Now you know how Jon feels...

I will pass this along. As I was telling another user, Ed used to stop by here every night (annoying as hell) but things got done. Now, it is hit or miss. I need to wake him up a bit. He's not a baby, so I can shake him. I think he has been rather sick lately.

And while we are at it, I really need to get your practice out of the license and mine in there, just in case any authorities come along soon...

HockeyRef, Bert,

This is a database design issue:
1) The system must assign each user with a uniqueID. Don't use the SSN, just in case, in the rare instance, the SSN changes. The UniqueID NEVER CHANGES no matter what changes about the patient.

Oh and while you are at it, add a PatientName History table also. This table is automatically populated using a TRIGGER, every time there is a change to the patient's name. It includes the name that was changed, the PatientID, and a datestamp for the change. This way no matter how many times Elizabeth Taylor gets married, you can find her under any name.

2) To tie people to each other, you need 3 tables:
a) 1 the User/Patient Table with the UID
b) the PatientRelationTable. This table usually has 4 columns which hold the
RelID - the PK for the row
PatientID1
PatientID2
RelationshipID - identifies the relationship between Patient1 and Patient2

3) RelationsResolver Table this table takes into account the two patient and their sex from the initial entry and resolves the reverse relationship.

Now you have to also design a view to automatically handle the reverse of the relationship for example:
If Patient1 is the man and the child of Patient2. That automatically makes Patient2 the father of Patient1, and Patient1 the son of patient2 You do not need to store that reverse relationship in the database, rather just construct a view that will generate that for you.

...just musing along!!!

George,
This is great, just the kind of great stuff a guy with your understanding brings to the table (pardon the pun there). Thanks so much for your professional understandings and insights.

Bert,
So can you and Special ed do this for FAP please. I have a small but growing file of things like the Michael J. Pizzano family that can't be scanned... Thanks

Also bert, with this understanding might you be able to pass this along to Jon so we can start quickly tieing our families together? What I really want and I think you said you wanted this too, was to be able to have the computer remind you of all the non-same named family members in these families were mom has had kids with two or three different last names. Still important to tie them back to the mom as well as to each other as sibs...

Also just nice on a social level to be able to see it quickly before a visit and it reminds you that smith, jones, humperdink are all sibs and related back to mom who is Cleese.

Bert & George,
I gather if Bert and Special Ed tapped into the AC chart numbers so that both systems used the same unique identifying number that one, that would be OK to start with and that two, it would probably make life (program life, not user life) kind of easier between the two programs because both systems, both programs see all patients via the same numbering system??? Does that make sense to you guys? I'm I asking this clear enough???

If such is not the proper or best way to go about it, then I would still like the user, interface side to appear that way for less human error even if I must be designed differently on the inside....

Thanks much,
Paul

Hockey, I don't think that would necessarily be a good solution. AC has issues when trying to find a patient who has changed her/his name. This means there is not a name history table. And what you would be dealing with is yet another set of "legacy" issues.

The best way to do this is for FAP to have a column called XSUID which stands for
External System UniqueID - this stores the value of the AC or any EHR's Unique ID in a separate column and FAP stores its own UniqueID. That way it does not matter what changes come to AC, FAP will work independent of AC.

But I do not work for either of these companies, and any advice given here is caveat emptor.

On tying a family together:

Hockey, if you take a look at the following page:
http://www.visualizedata.info/cms/admin.aspx

You will see the same concept of "famlies/generations" in a self-referencing (recursive) data table.

If you expand "Grandmother Smith" and on down you will see the generations. If you click the "Preview Menu" you will see them presented in a Linear Menu.

Each level in the heirachical table represents a "generation." There are 4 levels table.

Grandmother
|____Mother
|____Son
|___Daughter

I enjoy software development so much, because there are so many constructs that already exist that we can apply very easily if we, developers, just open our eyes.

Gee,
You need to move to New England for all of us....

HockeyRef,

Software development is today a global affair. Companies hire and work with developers in Bangalor, India, Jakarta, China. There is no reason a developer in Arizona can't build things for people in New England.

I knew you were going to say that!

New very interesting "bug" to report. Are ya ready Bert???

Well I'm at the old tower scanning, renaming and sometimes importing documents from today and over the weekend just a while ago. Meanwhile, Nancy is sitting at her laptop reviewing things in FAP that are in the watch box previously scanned.

So check this out, I hightlight a new scan so I can properly name it and in the middle of clearing the name from the bottom so I can enter a new proper name the darn thing bounces me back down to the bottom of the list, to the last name in the watch box that is in there in alphabeticaly order, and "W" last name in this case. I am no longer highlighted on the code only named doc I just scanned and selected at the top, now I'm at the very last really named at the bottom of the watch box!

This keeps happening as Nancy is reviewing things in the watch box and importing them while I'm trying to scan and rename other docs for her review. I was just about ready to throw the darn monitor or scanner across the room when I hit me that her operations were causing this "bounce effect" in the middle of my renaming operation. AAAAAHHHHH!!!! This needs to be addressed. One person's operation on one computer shouldn't screw up another person's operations on a second or third one and visa versa. Wow this was driving me up the wall.

So once we figured it out I had Nancy go back to charting for a few minutes while I finished scanning in the last of the days papers, but still this is weird and certainly puts a crimp in things. Now we are P2P not a server set-up like Bert and I wonder if how one is networked might affect the behavior of the program and database. Not sure at all, I'm just throwing that out there as a reminder to the programer developer....

Have fun with this one buddy,

Paul

The posts on this forum have been invaluable to me. Thanks to Bert, my IT guy has me set up with a server and RAID (don't know the number), and AC running on 9 computers. The Scansnap S510 was just set up yesterday and I've been playing with the bundled software which includes Adobe 8 Standard, Rack2 Filer Lite, and a reader whose name I don't remember. Based on what's been posted here, it sound like Rack2 might function in a similar manner to File Assistant Pro with Libraries, Cabinets, and File Binders. It's easy to set up and use, but it does have built in storage limitations, and if FAP is more generous in that area, I'd rather use that. I am wondering, however, if FAP will work with the upcoming SQL version of AC. If the answer is "yes", how do I purchase FAP?

Thanks, y'all, for providing such a wonderful resource in this UB.

Kathleen Lewis, MD
Family Practice

Kathleen,

Let me answer that in a private message or email.