Home Forums Discussions General Discussion What does the patient get

I was told that the privilege of medicine is the value you can add to another persons life, but that the business of medicine is to make the patient feel they got enough value out of the encounter such that they are happy to leave the exam room before your next appointment.

I'm one of those doctors that needs all the help I can get, so I like to hand out things to the patient, exercises, drug info, care instructions after procedures. These things get added to patient note I print out in the exam room when the progress note is saved. It includes a picture of the patient, a list of their providers, meds, allergies, and emergency contacts as well. If I start a medication, there are boilerplate instructions to ask the pharmacist for a printout of side effects and cautions. If we stop a medicine there are instructions to dispose of the old pills. It kills trees, but people really like it.

What does a patient get to see on the Updox portal after a visit? What can you put there, and more importantly, what can go there automatically from AC after a visit?

Dan,

Nothing is automatically sent to Updox via AC. You can pretty much put anything you want on the portal: lab results, medication instructions, handout info. You just have to send it to the portal.

My suggestion is make a dummy patient (ours are John Doe & Jane Doe). Use your own email address and send something to yourself via the portal. That way you can see how the patient would interact with the portal.

Thanks Marty,

Is there a summary of the visit that AC can produce that I can manually send to the portal?

Isn't there a meaningful use requirement for a clinical summary? Is that for a patient's total history in my office or is that a summary of the last visit?

I was hoping I could put every visit's clinical summary on the portal, that would be something I would like my doctor to do for me.

Feedback appreciated,

dan

I have sent a summary of every visit to any patient willing to receive it through the portal. After doing this exclusively for about 6 mos, I find that I write the PLAN as if I am giving instructions directly to the patient. It is a great place to document my expectations regarding use of meds/exercises or f/u appts/labs/xrays. My staff has put many of our hand-outs into the practice documents. I then print those to updox and send it along with the patient summary. I also send the CCD which will include old lab results (though only from the Quest interface). We can send copies of anything through the portal. The patients 100% approve!

Thank you Catherine,

Can you or someone describe the contents of the summary besides the Plans?

Chief Complaint?
ROS?
Past Medical History?
Family History?
Social History?
List of Meds?
List of allergies?
Vital Signs?
Assessments?

Thanks,
Dan

Dan, those note sections are exactly what is in your not, No brevity, no summation, just the text of the note section (or allergies or med list)

Thanks again Roger,

I'm using the holiday weekend to do some coding for a better fit.

dan

You get a Holiday Weekend??

Yes,
The way holidays are designed to work is that hard-working people don't get them. Which puts me in the other group.

I think the requirement of a patient summary, for 50 % of the patients, is one of the worst requirements for meaningful use. Not that a patient summary is bad, but having a printout with every diagnosis, every med they have been on, etc, is overwhelming to the patient. I still print in out, preview it, print it to the portal, print it to the amazing charts immunization database, whatever... Patients are more that welcome to receive it, but most don't want it.

I agree, Ken. The current patient summary is way too confusing, with all the old medications and diagnoses on it. Is there a way to print out something more focused, that the program will still count toward MU?

No there is not a way to print out more focused information. Those are MU requirements.

One way around it is to "Print Preview" then close out all the windows. This records in AC as having been printed. It's up to you to actually print to paper, or print to PDF, or not print it out at all.

It's kind of stupid that a law forcing us to use EHR (key word "electronic") is also forcing us to waste billions of sheets of paper nationwide by printing these ridiculous patient summaries that are completely not helpful for anyone.

Actually, here is what the CMS rule says should be on the summary:
" the patient name, provider's office contact information, date and location of visit, an updated medication list, updated vitals, reason(s) for visit, procedures and other instructions based on clinical discussions that took place during the office visit, any updates to a problem list, immunizations or medications administered during visit, summary of topics covered/considered during visit, time and location of next appointment/testing if scheduled, or a recommended appointment time if not scheduled, list of other appointments and tests that the patient needs to schedule with contact information, recommended patient decision aids, laboratory and other diagnostic test orders, test/laboratory results (if received before 24 hours after visit), and symptoms.

The EP must include all of the above that can be populated into the clinical summary by certified EHR technology. If the EP's certified EHR technology cannot populate all of the above fields, then at a minimum the EP must provide in a clinical summary the data elements for which all EHR technology is certified for the purposes of this program (according to ?170.304(h)):

Problem List
Diagnostic Test Results
Medication List
Medication Allergy List"

A lot of verbiage, but it isn't a bad list of things to have a patient go home with. AC chooses to do this as a CCD, but actually there is apparently no such requirement, nor is there a need to list every medication they have ever been on or every diagnosis they have ever had.

Awesome info. I hope AC sees your post and will consider NOT including all the "inactivated" items.

I agree. One of the main reasons I rarely print out this CCD is because of all the INACTIVE junk. I too hope AC will trim this down.

I agree that I hope they catch this thread and consider it. I don't think that the AC realize how cluttered this becomes for an elderly/frail patient over a 3-4 year span. I understand that they briefly made the inactive Diagnosis actually go inactive at one time, and when some users objected to this, it was reverted to the current form where active and inactive all still show, I am sorry I missed the time it was 'fixed'. I would love to have the inactive remain invisible until they are called back up. The clutter in these fields makes it mostly useless as it is now.
mts