Home Forums Discussions General Discussion New templating feature in current Beta

Hi Folks,

There's a new feature in the current beta test code that some of you might be interested in, especially if you strive for readability in your notes. Built into the template system there are now a number of macros, which when the template text is brought back to the chart note are interpreted based on the patient's demographic information. All of these start with a percent sign, so that the parser knows they're key words. The list so far includes:

%TITLE - Prefix - Mr, Mrs, Dr. etc from patient demographics
%FNAME - Substitute the patient's first name
%LNAME - Substitute the patient's last name
%AGE - patient's age
%him - if male says "him" if female says "her"
%he - if male says "he" if female says "she"
%his - if male says "his" if female says "hers"
%Him - same as %him but first letter in caps. Same with %He and %his

Here's an example. The template says:

%FNAME appears to be doing well, and we will keep %him on %his current regimen for now. %FNAME was given refills as above, and was instructed that these medications should be taken only as directed. %He was advised to call or return to the office if %his pain is not controlled with %his current medications, or if %his condition changes.

Notice the keywords. For patient Fred Test, the resulting text comes back to the chart note as:

Fred appears to be doing well, and we will keep him on his current regimen for now. Fred was given refills as above, and was instructed that these medications should be taken only as directed. He was advised to call or return to the office if his pain is not controlled with his current medications, or if his condition changes.

For patient Trisha Jones, the result would be:

Trisha appears to be doing well, and we will keep her on her current regimen for now. Trisha was given refills as above, and was instructed that these medications should be taken only as directed. She was advised to call or return to the office if her pain is not controlled with her current medications, or if her condition changes.


The feature makes templated text a little more "personalized".

Any thoughts?

Vinny

Dr. Meyer:

We have v 3.6.9beta. I cant find a way to do what you described. When we right mouse clik in any field the templates screen opens up, then where do I go to do what you suggested?

Yes very much interested. Show some light please.

Regards.

I got it now. Works like a charm.

This makes AC go into the realm of artificial intelligence.

Thanks a bunch.
I have posted at Emrupdate.com about this.
http://www.emrupdate.com/forums/thread/64510.aspx

Hi Joseph,

I read the thread at emrupdate.com. Do you think this would be better if pronoun replacement was automatic and the pronouns didn't require the "%" ? This would be a pretty easy change to make in the parser that handles this. What do you think?

Glad you like the new feature :-)

Vinny

Dr. Meyer:

% sign is fine with me. I guess once the template is set- we usually do not change that too often.

Can you introduce more and more features like this. For me this is truly amazing.

Best regards.

I just posted about this the other day. Now if they make more fields available!?!

See my posts and other suggestions here:

http://www.amazingcharts.com/ub/ubbthreads.php?ubb=showflat&Number=1085&page=1#Post1085

See #13.

Hi Joseph,

Can you think of any other macros besides the ones that are there? If the data is available, I'll format the code and send it to Jon to add.

Vinny

Hi Dr. Meyer:

New ones:

time: minutes, hours, days, weeks, months, years
febrile: febrile, afebrile
test result: positive negative inconclusive

I have an article:
http://www.aafp.org/fpm/20010500/33elec.html

This being a new concept for me: I have to explore this further.
We do use shortkeys.
http://www.shortkeys.com/

Regards.

Hi Joseph,

How well does Shortkeys work with Amazing Charts? What mode are you using it in? (Prefix or suffix?) Can you give me some examples of substitutions you're using??

I'm drowning in delinquent chart notes - and typing EVERYTHING that isn't templated. We've written a new templating system which uses Treeview controls instead of lists, so templates can be organized into folders. Drag and drop works, as do most features dictated by the Microsoft interface standard for a Treeview control. Is helping, but still WAY too much typing.

We're looking at adding the ability to have choices within a template which could be pointed and clicked on. Means adding controls to a form in visual basic dynamically in a control array then parsing the events and substituting the text as the buttons are clicked. We have that working as a stand-alone piece of code, still with a ton more work to do on it.

Of course, no guarantee it'll ever see the light of day - it's Jon's product, and inclusion of features is totally up to him.

Shortkeys reminds me of the feature my partner and I miss most from Logician Internet - the ability to have fast inline macros. I just downloaded the demo and will play with it tomorrow. Heck if they're willing to do bulk licensing maybe Jon would consider licensing and bundling it in the next version.

Regards,

Vinny

Vinny,

I have been using Shortkeys for almost as long as I have been using AC because I missed this feature from my previous EMR (SoapWare). In fact, I may have been the one to make the original recommendation for it on this forum. I think it is terrific and it has made my charting so much easier. For instance, if I have performed a complete exam or routine physical, I can type 'dt' and it comes out "I discussed all of the tests and labs with the patient and answered all questions". 'dhi' comes out "I discussed routine health issues with the patient including routine health screening, safety issues, advanced beneficiaries......" 'dtob' is "I discussed the health risks associated with the patient's use of tobacco and advised them to stop. We discussed some of the options for this". 'dsc' is "I discussed the importance of having a screening colonscopy with the patient and we will make arrangements with a gastroenterologist of their choosing."
So on and so on. And, of course, just using even the smaller macros, like 'w' for "with", 'sev' for 'several" is very time saving. The program is inexpensive and is a one-time only fee. There is some learning curve associated with it but if an old fart like me can learn it, I am sure you can too. I highly recommend it.

Leslie Strouse, M.D.
Internal Medicine, Solo

Hi Dr. Meyer:

As L Strouse mentioned above- we use shortkeys in same fashion.

Pts INR is 2.3. I email to nurse-
ccc-continue current coumadin dose
ddd- reck in 4 weeks

utis- please inform patient that she has UTI
meds- will fax meds to her pharmacy. Let me know.

etcc..

I noticed that the %TITLE, %LNAME %FNAME does not work in letter section.

Is there something you could do to fix this?

Regards.

I'm really glad to see this feature finally in AC. I submitted this as a suggestion to Jon about 3-4 years ago, and it really humanizes the note. Until now, I've done all my templates in gender-neutral phrases, which can be pretty cold. This now makes the note more "dictation-like".

Another field that might be useful is sex, as in "male" or "female" or more formal "Gentleman" or "Lady". An example: "Mr. Johnson is a 46 year-old gentleman who presents today...".

The most exciting aspect of this goes far beyond simple substitution. Fully implemented scripts with simple decision trees embedded into templates will make it possible to generate complex integrated notes with a wealth of data instantly.

Another idea I'm waiting to see is "linked templates". Selecting one template for the HPI, for example, would automatically select and enter another template in another field, such as Physical Exam and/or Diagnosis codes. Selecting the "Flu" linked HPI template could automatically fill in the physical exam, diagnosis and plan fields.

Keep up the great work!
Chester Lapeza, MD

I love this! Up to now I had two versions of each template. I guess I am going to have to delete one now! These macros do not work with the letters created with amazing chart yet? At least they do not work for me. I agree with Gentleman/Lady recommendation. How about %weight %bloodpressure %pulse, etc. I would love %weight change from last visit.

Hmm.. How about Lady or Gentleman if over a certain age and Boy or Girl if under a certain age? Your thoughts? This would be like 8 lines of code for me to add - an easy hack.

Thank you for your comments on my work. Please let Jon know you use this feature.

Vinny

I added this because I HATE getting notes from other practices or writing notes that are obviously templated. Neutral gender and impersonal sounding text.. when we're taking care of PEOPLE.

I, too, had multiple versions of templates in order to do this, and was very clunky to use.

Tell other users if you find this useful, and share your templates if you have cool ones!

Thanks,

Vinny

Dr. Meyer:

Does this macros work in letter writing section. I tried a few times and it would not work in letter writer.

Can you fix this?
Regards

This would also be useful in the Addendum section.

%TITLE does not seem to work for me. Anyone else?

Oops My bad. The macro is %Mr not %TITLE

Sorry about the mixup.

V.

Shouldn't be too hard to add the parser code to the letter write section.. I'll take a look at this and forward a patch to Jon if he's interested.

V

How about...?
%man
%male
%gentleman

I truly hope this feature is included in future versions and expanded to letters and addendums as well.

Great idea! I'll try to work up a patch for this to send to Jon.
I'm working on bringing this to letters, but it's not as easy a patch as I thought it would be. I'll keep the group posted as to progress. %man, %gentleman are great ideas. %male should be already there.

Regards,

V.

I tried the %male and could not get it to work although the other templates are working

Umm. that's because I haven't added it yet. I have to patch the template parser to add it, then send the patch to Jon, and then he has to look it over and incorporate it into the main source code tree, then release it in a later beta...

I plan on adding a few more of these to the parser and sending an updated patch to Jon soon..

V.

VINNI
It happened!!! It took TWO years, but I finally emptied by inbox! Down to zero charts. I'm going to start working on the templates. My understanding is that the following symbols only work on the progress notes section of the chart. I have the following:

%Mr
%FNAME
%LNAME
%AGE
%him
%he
%his
%Him

are there others?