Home Forums Discussions General Discussion demographics and instant medical history

Hi Everyone,

so we've been on AC for almost one year now and it's been great, one thing we haven't been able to do is get our patients filling out AC. We have a phressia intake system which should populate the AC demographics by March and are looking at IMH to get the detailed complaint, FH,SH... Is this the best way to go? Using 2 different computer systems, what about an online portal for demographics?

Hi Brett,

Wow! You have been using AC for a year, and this is your first post? Try not to be a stranger. We need fresh ideas and as many users on here as possible. That is what makes AC such a good community.

We use Phreesia pads and love them. Tell me more about the populating of AC demographics. Didn't know about that.

As to IMH, I have played around with that several times, but I and quite a few on here have always found it way too expensive. The part that always made me run away from it was it was extremely hard, if not impossible, to customize. For what they charge per month, it should be highly customizable.

The portal sounds good, but would it be able to self populate as well?

Well, guys, here is where we must part ways. I looked at Phreesia and, as an Internist, I do not like it. What I pride myself in most is my ability to extract from a patient subtle details and information which, I am not convinced, can be managed by branched chain algorithms. Also, the majority of my office visit consists of this face-to-face interaction. I am wary that history programs such as this contribute to the notion that medicine may be practiced by protocols. Perhaps I simply do not fully understand the program and I am open to futher enlightenment.
I have a "Patient Questionnaire", 4 pages in length, which every new patient must complete and every established patient must complete annually. It asks for past, social and family histories, Medicines, allergies, other phsycians being seen, immunization history, mammogram dates, colonscopies, etc. and then has 2 full pages of ROS questions. Every page is reviewed by me in front of the patient. I markup the forms (using pens, one of the last uses for my Bics) adding comments, explanations, and so on. This form is then scanned into imported items.
Rather than asking for only history which has changed, the patient is made to review for themselves at least once a year, their own medical histories. I am constantly amazed how many people do not know what meds they are on, to what they are allergic, or how many other physicians they are seeing that they forgot to tell me about. Everyday, I must remind my front office to specifically ask patients if they still live at such and such address, do they still have Sock-it-to-Me Insurance, is their phone number BR-549? If we just ask a patient "has anything changed?" inevitably it has but they forgot to tell us.
I also believe that having at least this one last papered form helps support any issues an insurance company may have with my otherwise templated EMR. Also, on more than one occasion I have had a patient return to the office with an "attitude" because I did not address their "sore knee" that they supposedly told me about the last time they were in. I can specifically show them on their history form where they neglected to circle
Joint Pain or to use the "Comments" section to tell me about their knee.
So, although I am open to correction, on this I must disagree with Bert.

Leslie

I agree with Leslie, but am ashamed to say I am using IMH and I kind of love it so far. At least I like it a lot I think. FOR SURE I like having a new patient who speaks Spanish complete the initial history with it. (It then populates the AC with text in English!) I read the history and then with my translator I get a history filled in that is PROBABLY better than I could have done myself and is WAY FASTER. For all patients I read what was generated and then go back to the start of the field, type "1-" and list what I believe to be the correct "translation" of the data that was created. If you don't do this you will just have a bunch of garbage.

For example, " Grav -3 1- premature 1-NSVD" I took that to mean the patient had two c-sections? or one? but actually she had 2 NSVD 1 Miscarriage and no c-sect.
It does a good job, not great, but I think it is a plus.

WE ARE JUST STARTING WITH IT, SO MY COMMENTS ARE TO BE TAKEN WITH A LARGE GRAIN OF SALT.

Hey everyone, thanks for the great responses.

The issue we have had since we got AC is the time it takes to document a visit, even with templates it goes very slowly. when we signed up with phreesia maybe 8 months ago, it was because they promised an eventual interface with AC, which should be live in March, that is to say the info entered will actually populate the demographic section of AC. But then we'd like a IMH type program as well.

Our visits take a long time as it is because, as Leslie says, the patients don't know anything, particularly about their last pap, EST...so if some of that time wasted while they recollect can be done in the waiting room instead of at the expense of other patients, that will be nice. Of course all of this is theoretical and I did have a suspicion (Thank you Bert) that IMH would be difficult to customize.

I've already had complaints about the phressia, I guess because it's a computer and people dont want to talk to a bright orange machine (the phressia pads are orange) so if I go and add a laptop where they have to say how long they've had their runny nose and what color is the discharge, will we lose patients?

If you google patient portal amazing charts, the results say AC has a patient portal, but where is it? I never heard about one, and now my IT guy says he can write a program that will populate both fields, (the demographic and the HPI,FH,SH...) and that may turn out to be the best option. I just don't know if he really has the time to do it. So that's where I'm at now,

Bewitched, Bothered, And Bewildered LOL

Brett K

Our office manager talked with a Phreesia representative today and he (the rep) was under the impression that the interface of Phreesia is now possible with AC v4 after the subscriber pays a $250 activation fee to AC. Does anyone know if this is true?

I use the phreesia pads to collect the information, but I have it imported. I personally do not want my demographics done by patients as they mess up the insurance information, put the wrong addresses, contact info, etc. Just try and have them figure out primary and secondary. I also find that my new patients only take me a few minutes to type myself while I talk with the patient and their information would not be in the format I want. Phreesia is more than happy to customize the interview as long or as short as you want - I just wouldn't want my medical history to be only what they put down -- anyone realize how wrong they are until you tease out additional information ? The other issue is that the intensity of service requires that the PHYSICIAN OR PROVIDER obtain the ROS - not the nurse and not some form. You have to at least go over and correct information they put on a form.

I agree with 99% of what you said Steven. I just can't worry about the intensity of server part, though.