Home Forums Discussions Problems Flow Sheets

How are you monitoring data in AC that have traditionally been on flow sheets?

Right now for my diabetics I have a spread sheet that I can just glance at to see who needs what and who is not at goal. But it's not within AC.

I'm also trying to figure out how to manage my coumadin pts, but I'd really like to keep it within their chart in AC.

Using the tracked data fields on the summary sheet does not allow me to make specific comments about dosages, instructions etc.

Thanks,

You make an Excel spreadsheet on your desktop. On it you make a Problem list and lab sheet, etc. Anything you want on your "face sheet." You can put a flow sheet, acute and chronic problem list, whatever. Save this somewhere your receptionist or whoever puts in the new patients can readily find. Make SURE you keep an extra copy on a CD or something.

Using Excel to make a flow sheet allows you 1,000 times more flexibility. Every patient is different so you could using different sheets, but I would recommend using the sheet/tab feature at the bottom. So the template could have a tab for diabetics and their lab flowsheets. You could have a tab for your coumadin patients, etc. The tabs can be renamed and made different colors, etc. We use page one for the problem list, etc., since AC doesn't truly have a PROBLEM list but a running list of diagnoses. You can add meds or anything you like on the first sheet. We put consultant visits, etc. You can put links to files and/or links to websites. You could place a link to his or her email if you want to send results or reminders. You could link to a certain Word template to write a letter.

If you really want to utilize it as well as possible, I would recommend hiring an Excel guru to help set it up. Excel is a VERY powerful spreadsheet and database program. So, you could allow it to add and average your HbA1Cs or do the same with your INRs, etc. You can do all these things yourself, but I found having an expert set it up made it look extremely clean and much more helpful. Plus, she kept the template version since I knew I would end up deleting mine.

Oh, and of course, you can delete sheets and add sheets on the fly. So by importing this into a patient's chart, simply clicking on the ImportedItems tab will bring up your flowsheet.

Then, when a new patient comes in (John Smith, DOB: 8/8/78), you enter him into those spots on the flow sheet. Have your receptionist import this into the patient's chart.

I label it the following way for maximum exposure. You can do it anyway you like:

Under Item Type: I write Face Sheet
Under Item Subject: I put in a "." This makes for the smallest icon area. You can put in the name or whatever, but I like a period. I click sign off and leave the comment section blank.

When the nurse opens the chart, she opens the imported item Excel sheet and minimizes the chart. When I walk in the room, with the screen closed, there is all the info I need. The cool thing is I can open it as an Excel, save it, and send it to consultants.

Hope this helps. Let me know.

Cheers!

Hi Bert,

I've read this a few times now...and it seems overly complicated to me...is there an example I can see somewhere on the web?

I already use a spread sheet for my diabetics...gives me an at-a-glance look at all my pts with DM. I used the format suggested at http://www.aafp.org/fpm/20060400/47usin.html . Of course, that has all diabetics, so it's not appropriate to import into charts.

Once you have imported your spreadsheet into someone's chart, how to you add to it? For example, if I'm tracking someones INR, I need to make adjustments. Do you simple import an updated spreadsheet each time?

If you are using a spread sheet for so much data (face sheet and the like), why use AC?

Sorry if I'm just not getting it...it's Monday

Barbara

That's OK. I will give you a little more info this evening.

By the way, I have no idea why it is not saving. What I would suggest until you figure it out is to write it out, then copy and paste it to a word document, save that, then add it. This way when you look for it, if it's not there, you can copy and paste it back. : )

Hi Bert,
Me again, your fix seems to have worked to get me around the firewall issue.
The flow sheet/problem list issue is one of AC's major shortcomings and has kept me wedded to my paper charts. Do you think your excel guru might be willing to work with me long distance to make flow sheets for me and coach me on how to use them with AC? That would be approaching a dream-come-true.
Thank you again for taking the time to share what you know.
Lisa

Lisa,

Sorry, it took me so long to get back to you. I hate taking this long. It's simply another issue with this board. I can never get the Notify to work. It should work by default and allow you to turn it off if necessary. Most people post in a thread that interests them, so most would want to know if there are any other comments. Unfortunately, it seems like all of the posts now are become negative. Only a couple of yeras ago, you couldn't find a negative comment on here. I hate to say it, but I truly think Jon has lost touch with his customers. The nice thing about AC has always been the community of providers who use it, support it and talk to each other on here. Try finding that on Logician.

I am glad that fix is working for you. I am now about 70 for 75 with it. Sometimes I get lazy and just do it the old way and I get blocked, and I do the system, and bang, right through.

You know what kills me sometimes, though, is the lack of response to posts. I guess they are read and either used or not. For instance, you were the only one who responded to the workaround for the firewall things. There was a Control-N problem (sorry Rainy) that was hurting some people, because they were accidentally hitting and wiping out their HPI etc. I think Hockeyref had the biggest issue with it. I have to admit, I must have smallere hands, because while I use it, I have never hit it by mistake. Anyway, just for fun, I researched it and found this perfect answer for it for about $20.00. No response. I have seen 20 downloads of my AmazingMeds.mdb pediatric database. No response. I don't want this to come across like I am pouting but it would be fun to know how things work for others.

OK, enough raving and ranting. Yes, I will talk with my guru and see what he/she can do. I also use Experts-Exchange a lot. I actually subscribe since I ask SOOO many questions. The experts there are incredible and can answer any question. A lot of them do freelance work. It also is not that hard to do it, and I could even help you with it or do a startup. But, let me check with my sources.

It's so fun to watch these go through all the time. I am almost tempted to not copy them first. Even with a long post as this one. But, I still copy them. Most of the time, it is still there if the firewall or ghost host comes up. But, there are times it is gone. Vinny said this is a new board, but I have to admit, I see nothing new about it. And, again, why does Vinny have to do all of Jon's work. Jon should come on and talk about it. I will tell you a story some time in PM. Oh, and you're welcome.

Oh, one more observation. Why is it taht with almost 900 members, the average amount of online providers on the boards is one? There are alwasy more anonymous users.

Bert,
First off, Nancy has some of the smallest hands and fingers ever to play bass for a heavy metal band. She really used to play this large trapazoid shaped Aria Pro II with RotoSound String (the ultimate in bass player finger torture) with these small little fingers and held up a very strong, melodic, and solid bottom in our old power trio; "Ice Nine". Now you know our dark past.... but her name is Nancy and I bet she uses the capital "N" more than most. But please don't feel disheartened, it really was very nice of you to suggest your fix. Nancy and I are a bit hesitant to use add on programs with AC, seeing that we're not totally sure where we stand with AC tech support and Jon after our big falling out over the "numbers thing" in the financial section.

Also, I think the reason there are so many anonymous users are because some people just come to the board and see if anybody has posted anything new or interesting. Then if they care to respond to something, then they bother to deal with the double log in to get on and make a comment. Goodness knows that is what I do frequently. We can't do live chat right now, so why bother logging on if you're not going to write something, right?

But yes I agree with you that Jon and AC have certainly lost contact with the customer base. One of the other regulars here, warned us all to be careful for what we wish for as we kept asking for more and more cool and interesting features. AC has grown and the culture is changing. Perhaps that was inevitable but I for one sure wish it could have kept more of it's original flavor all while growing and refining; but that may be a bit too unrealistic. Again you know how I feel about the almost stealth change in the EULA and how the old one used to be worded compared to the one that is there today.

But as long as folks like you and all the other regulars keep up the more positive exchange of ideas and pitching in to assist one another, we can still retain a bit of that old AC culture ourselves, even if the home base has changed. We're stronger with you than without you..... Sorry I couldn't resist. lol.

Hockeyref,

I certainly didn't mean that to be directed at you, although it would be hard not to when I used your name, lol. But, I figured you wouldn't mind. You should feel free to use it though because it wouldn't at all be a third party program. Just works on the computer as a whole so that combo would never work for AC.

I actually went back and tried to delete that entire paragraph as I thought it did sound a like lot sour grapes but it was too late to edit. I think I was just very tired. I do wish I would get more feedback from users on certain suggestions even if they don't work. It's just helpful to know.

Bert,
I know you were not dissin' me. Actually at times I'm sort of feeling the same way you do. I like and miss the "community feeling" of old AC. I guess I still belong back in Burlington VT or with you in Maine even if I was born and breed down in "The Bronx". Let's Go Rangers and Yankees!

And you are right, it is hard to tell what is getting thru and what is being sluffed off, whether by fellow users or by Jon and AC, which at times can be demoralizing for a guy like yourself who likes to pitch in. Although not well written, I really was writing as a form of support and confirmation for you and your feelings. And to explain to all what I believe is really happening. We have gotten what we wished for.... Can we have our cake and eat it too? I'm not too sure. Be well.
Paul

Hi Bert,
I can appreciate your frustration about lack of response, from Jon and from other users. I only started using AC late last year and have been disappointed in it; I initially wrote a post with some of my complaints/wishes but it didn't seem as if others had the same concerns, and when I've looked at the user boards over the past few months, many of the topics have not been the ones that interest me. So it didn't seem worth my time to get involved. I tried to respond to Vinnie when I read that he was going to see Jon, but I was blocked by the firewall problem you later solved for me. So that's why this particular 'member' has been silent. If your excel guru can work with me to set up flow sheets and a true problem list, I'll be much happier and more engaged with AC.
On the issue of the prescription function, I like the one on Relay Health (www.relayhealth.com) a lot. Aetna has sponsored the first 3 months of subscription to that site and I've been very impressed with their database; it actually has all the information I need, including generic availability, whether the medicine is pills or tablets etc. And it does e-prescribing. It claims to have formulary info but that seems to be incomplete so far. I keep wishing that AC could link with it or have a similarly well developed medication database.
Anyway, I appreciate all the time and effort you put into sharing your expertise with the rest of us.
Lisa