Home Forums Discussions General Discussion Late night musings......

I am looking for potential answers to 2 questions.......none may exist, but I gotta ask them nonetheless.

1. Is there some sort of file/list that outlines the "new/improved/changes" from previous versions to 6? I am the sole support person for our staff that includes front office, an infusion center (5 nurses), a wound care clinic, a physician and 2 medical assistants. Daily I am asked to problem solve or trouble shoot some sort of issue from one of these divisions. I am trying to compartmentalize pieces of information that would impact each of those departments so it becomes bite size and specific to their areas. It would make my task much easier as we make the move to version 6 to do the retraining/updating in this fashion.

2. We have been hit with an audit from 2 large insurance companies that want copies of our patients entire chart. Until yesterday one of our front staff was printing these to the tune of 300 or so pages each. Seems a bit counterintuitive for a "paperless" system, no? I was able to determine that I could send the insurance company a disk with the required information for each patient. My problem now is that I am not sure how best to do the export of the chart so that I can burn it to a CD? It appears in our version (5.09) that everything gets printed in an html format?

Any and all help is greatly appreciated.

thanks........Sky

Sky,

About printing records - someone- perhaps Wendell, laid out a method using a PDF printer that you can then print to as a single document.

If you use UpDox you can then go one better and send it to them via secure message so that you get read confirmation and secure the communication.

I owe you a visit on one of my runs up/down 15/3945; just isn't warm enough out there for me yet.

I use PDFill (available free at PDFill.com) and go in and print all office notes to that and make a file - then I go into imported items and using pdfill tools I merge that file and all imported items under that pt. account number, which makes one large PDF file that I can burn to disk.

Definitely go the paperless route when sending records. That would be a lot of wasted paper and staff time.

I use Updox...Steven's idea is the way to go if you don't have Updox or Adobe.

Sky,
1. Here is the link to the version changes in 6. By the way, the list is long but worth a viewing, IMHO, by V6 users. Here are a couple little examples that surprised me:

• Added ability to merge 2 patients into a single patient
  
• Added ability to completely configure decision support rules[HM], including by: medication, diagnosis name, diagnosis code, gender, and/or lab name and value
  
• Improve keyboard tabbing through demographics
  
• Can now enter Resolved and Inactive diagnoses with prior dates
  
• Can import Practice Documents into patient's imported items
  
• Added ability to Delete and Modify orders
  
• Can print encounters by date range
  
• And my personal fave, "corrected issue where Alka-Seltzer can have an interaction with itself"

2. Do NOT forget your own rights in these audits! You may very well be contractually required to provide the charts, and if so, you should do so. But for starters, you are probably NOT required to provide them for free. Charge your usual record fee, which of course for a 300 page chart could be substantial. Do you REALLY need to print all of the imported items? You may simply be required to provide copies of your own notes; remember, they are not providing care for the patient, just auditing your notes.

3. As Steven and Indy point out, use Updox or a free pdf printer to print the past encounters to a folder to be placed on a disk. If you are going to include imported items, it is often easier to navigate to the II folder on your server and simply drag and drop the patient's II folder (put it in the same folder where you just put the encounter pdf). This is especially faster if the patient has a lot of imported items. In this situation, I would not take the time to combine them all into one pdf; let the insurance functionaries go through the patient's chart and open each pdf, one at a time to read them. That is, unless you have a warm, fuzzy feeling for the insurance company and want to go the extra mile to make their life easy, like they have done for you over the years.

Sky,

First off, check your insurance contracts. If they do not specifically say it is your responsibility to copy and send the chart, don't do it! Mine say I have to make the chart available for review. So, when they want me to send copies I tell them they are more than welcome to send someone to my office to review the chart onsite (which is how it used to be done "back in the day"). If they say they cannot do that then I tell them there is the normal copying charge if they want me to send it to them. Pay me and I will send it.

I send basically imported items and progress notes and vaccine records.

Attorneys always have what they call "work product." I obviously keep the patient messages, but I don't print the entire chart or the messages go along with them. I just go to visit history and click on progress notes and print the notes.

In pediatrics, there are just way too many bizarre and frustrating requests. The parent calls and says, "We can't do that brain MRI on Tuesday, because he has a kick boxing match."

We just can't help but vent and make comments that a patient shouldn't read.

I use a program called PDF redirect and it will merge all of the documents together. It is a lot simpler in V6, they are automatically merged, but imports are not.

I agree with charging them for copying records.

I do not mail, only fax. I only do a merged document to make it easier to fax. Let them burn 300 pages of fax paper not me!!!

Anyone know how to do this?

I think they have to have similar DNA.

This only works for merging duplicate charts into one.

I always use an exorcist for this kind of thing.

I use this.

What happens when you merge a patient with hypothyroidism with one with hyperthyroidism?

For the morphing or the bat?

Bert, you thyroid?

Jon, too witty for me. Gotta explain.

hypothryroid + hyperthyroid = euthyroid

Hence, "Bert, euthyroid".

The joke was a bit of a stretch.

Oh I got it now. Maybe the first sign of rabies is losing your ability to pick up on puns and humor.

Ya know.....it just fills my heart with joy to not only find the answer to lifes (well OK, AC's) pressing problems, but to find myself engaged in HUGE fits of laughter doing it. I so appreciate that I am not the only one with a twisted sense of reality. My kinda people.

thanks so much for the direction and answers. I am sure I will have many more as I continue working with v6.

OK but seriously, back to my original question.

HOW DO YOU "MORPH" 2 CHARTS TO ONE??

I have a number of charts where there are one or two entrys on one number and the rest on another. When I find them I usually notate in the yellow section to "DO NOT USE THIS CHART USE THE OTHER ONE"

It would be great to be able to merge them. Next question would be how to find them quickly. Not sure how to create a search for that.

Why couldn't you just do phone number, dob, address, last name, first name, etc.

Wendell, you could save time changing your notation to just Code Red!