Home Forums Discussions General Discussion Reporting notes to peers

Sending out a report to the primary and other consultants is good medicine and good business (advertising).

I see the list of referring doctors in the demographics tab, but I don't see a way to set up AC to send a progress note. Am I missing something?

Is there a way to automatically send the progress note to the primary and other consultants?

How do you do this?

Alright, all of you UpDox users, speak up on this!

There is no way to automatically send a letter to a referring provider or consultant in AC. I use UPDOX and this is how I write a letter to a consultant.

Right click the patient name in the patient list and chose "Print Notes & Letters". Next choose the encounter date you wish to include. Then I click "Consultants Only" in the Letter Writer area then click "Compose Letter". From there I write my letter and you can include such things as meds, PMH etc by clicking appropriate areas to the left of the letter.

When I'm done, I then click "Preview". AC then asks if you wish to save a copy of the correspondence to the chart. I select "yes". A copy is now saved to the patient chart and this brings up the preview of the letter I just wrote. From there I print it to UPDOX and fax to the consultant. If needed, I can open the patient chart and print to UPDOX appropriate labs, radiology reports etc and attach this to the letter I'm faxing to the consultant.

Go to "File" on the progress note, then "print progress note", then "print preview" and choose your fax printer. I send mine to my Brother MFC. My list of contacts is kept in the PC-Fax Address book.

Thanks,

I think keeping a current list of providers is right up there with updating meds and allergies.

I imagine I would keep a list of a patient's providers as part of the HPI or Plans that would carry over to each visit. Staff would check each progress note after signed off and use UpDox/PC-Fax to send the note to each of the other doctors listed on the note.

If you would do something else to minimize staff-hours, let me know.

Dan,
This is one area where specialists have a different preference than primary care providers.
One important thing to do is to go to this setting:
Edit...My preferences...User preferences (you can also get here from the main page with ctrl-U). Click the "documentation preferences" tab and look for the radio button "Print Note/Letters: Don't show the print/letter window after signing the chart". That button should NOT be checked.

This means that as you finish each note, the "print note/letter screen" that Leslie and Marty refer to will always come up. If you don't need to send a copy of the note, you close the screen, but the default is to remind you to do so.

I also put a list of referring docs (who gets the cc: ) at the end of the note, as a reminder of to whom to send it.

So you sign your note and the "print/letter" screen pops up. Go to the right side (#2) and click the down arrow, which lets you select the format for your note. I only use one of two choices: "Detailed large note with header", or "SOAP note with header". (One of the idiosyncracies of AC is that you can print the same note in different formats; sometimes you can control the output and sometimes you cannot. Here, you have limited control: I generally use "detailed large" for an initial note, and "SOAP" for a follow-up).

From here, there are several choices. First, a word about what I have decided to dub "The Grauman conundrum" (since he first described it; to me, anyway). Simply stated, the conundrum is that as EMR's become more and more efficient, a higher percentage of the clerical work seems to fall to the provider. So as you stated, you can sign the note and send it to a staffer who then faxes it. But it becomes so easy (and to some degree, satisfying) to immediately fax it yourself, that you may chose that route.

A good option is to set your default printer to "Updox". So after finishing the note, you select the "Detailed large" or "SOAP" format, and then click "Print to default printer". A copy of the note is now in the Updox practice workspace. If you have put "cc: Dr. Spock" at the bottom of the note, your staff knows that when they see your notes in the workspace, they fax it to him. This makes the contact list in Updox important since that is what they will be using for faxing. It has a pretty good "self-complete" function.

There are other options. Leslie describes one that works well. I have a set-up that allows me to receive faxes in Updox without them counting towards my monthly total. That is a topic for another day. One upshot is that I have a fax modem and often use that to send my notes (these also do not count towards my quota. I know what you are thinking: "what a cheapskate"). Anyway, "Faxtalk" is my default printer and I just hit "print", choose the referring provider from the contact list that pops up, and the fax is sent.

Leslie,
I adopted your method and use a Brother MFC. One annoyance is that the contacts in the address book are only stored on the computer where they were entered, not shared with the other computers on the network. Do you know if there is a way to copy them to other machines?

Yes. Pull up your PC Fax address book on each of the computers. Go to settings, (or right click on "properties"), address book, address book file, and choose the file you want. I have my address book shared from my network so, browsing to it from each computer and selecting it, it defaults to that file. That way, you can change or add to it on the server's book and not each computer.

Also, Donna, if I remember correctly, when I first set it up this way,I just copied and pasted the address book file from one of the computers to a new shared file on the server.

Thank you, Leslie!

I used to use to letter writer. Found it to be a waste of time. I hate the way the letters look in IE when you open it. After talking to my consultant, what they really want is my office note. Most don't even bother to read my letter. So...
at the bottom of my note, before I save the note, I write:

cc: Dr. Awesome guy who sent me this patient

Enclosed: copies of labs / xrays / op notes for Dr Awesome

Then I print to updox.

My staff checks updox, reads the bottom of my printed note, prints labs / xrays / op notes for Dr. Awesome and attaches to my notes and faxes to Dr. Awesome, usually before patient leaves the office.

Done.

In the future, when I open I note I can see that I faxed my note and whatever I enclosed. So I know what Dr. Awesome knows. We cool, like ice T.

Dr. Awesome thinks I am Dr. Cool Later when Dr. Awesome and I meet in the hospital we "bump" fists and all is well.

If I forget to write cc: I just I added it on updox.

Great summary, Gerado. As an Internist, that's all I really want to see too. I do not need any fancy cover letter stating how wonderful the patient is and how appreciative you are to see them for me. Just the facts, Mam.