Home Forums Discussions Problems Decision Support

Why does AC does not automatically recognize decision support or HM items? Perhaps I am using it wrong? Ex. BMI, BP, Smoking, A1c, aspirin etc. are HM items which even if done are not recognized. One has to go into each item separately and document the date and finding (it does not import) for the alert to reset. Is this the way it is supposed to work or I am doing something wrong. When I painfully do go through all these it adds two lines for each alert I cleared in the plan. I think these have to be tracked as part of MU, isn't it? How is everybody else handling this task. Please advise.

Anil,

I am not so sure I can help you as I am not so well-versed on this. Maybe someone else can. I do know that AC is SUPPOSED to be looking into making changes in the near future as to ideas the users have. We have heard that before but we do have Chris now. I feel bad because even with a good road map, MU has taken up a lot of time. I do think v7 got us off track.

I do want to say that I don't believe in the newbie status, and I don't consider you a newbie. I think you are a new user finding issues that older users may have glossed over or forgotten and it is important to bring up again, even if it is a workaround.

I have read all your posts, and I admire your pointing out things that could be better. And, they are well constructed questions, not complaints. So keep asking and keep being provocative. Maybe try to come up with some ideas and workarounds on your own as well.

OK, I admit it, I just want some cardiology tips. Unfortunately, my patients are all under 18.

Hi Anil,

I should be careful at your catching me if you have that many posts in such a short time. We are lucky here in that most posts are taken seriously and will receive many comments. As far as lab importation, I would start a thread just on that; very non-specific. Many users here use lab importation and could help as to the logistics.

Not to brag, but I have posted many, many times on the power of using an Excel sheet for lab or histories, etc. I have always pushed for a very detailed face sheet that comes up when you click on the chart. It would be very helpful to peruse through the diagnoses, PMH, problem list, medications and allergies prior to moving to the recent encounter. Sometimes I diagnose a heart murmur four times and am almost ready to refer when I either notice it in the PMH or the parent embarrassingly tells me their child has been seen. If a patient has an ASD that I am following to see if it heals by itself vs possible surgery (which has occurred a few times in my career), I don't find that to be PMH as much as an ongoing problem.

As far as Excel goes, it is much like Word in that, we probably use about 5% of what it is capable of doing. If you use Excel a lot by importing in an Excel template you have made into your patient's chart (I am guessing into II -- where you open from there), then you may wish to consider hiring someone to improve it. There are many, many on the net you could work with. They may allow you to set it up in such a way that data and statistics would be rather easy to get and even happen automatically. Excel is a VERY powerful spreadsheet, and I have used it a lot. But, I cannot come close to its full potential without a consultant. I should say I have not used it enough to do this, but I would highly recommend it.

Dear Anil,

Welcome to the Board.

In response to your original query, the Decision Support feature is a little confusing at first. To see how it works, check out the Help section. Search in AC Help under "Use The Health Maintenance (Decision Support) Module."

In my use of DS I find it a helpful reminder especially for somewhat obscure recommendations like checking for AAA which is only for men who have every smoked between 65-75. Before using AC I never remembered to do this. With AC I'm doing much better.

The other nice thing is the ability to enter customized recommendations for DS within the Administration section. I have added several things not in the standard USPSTF advice.

Once you get used to using DS it's very quick to go through. You can also delegate some or all of the task to a medical assistant.

With best wishes,

John

Hey John,

Thanks. Can you be more specific as to how to find the Module? Like which Help section?

Thanks!

Well, at the moment we aren't handling the task. But I did play around with HM and it seems that you are correct in your assessment "One has to go into each item separately and document the date and finding."

In the Help Window in AC (which can be accessed by pressing F1), if you search for the topic "meaningful use" you can find out how AC can help you achieve MU.

As an example of the things you'll find there, I'm posting this:

I don't believe that you have to enter in BMIs and weights and BPs into HM. The data is being tracked in the chart. Additionally, I'd recommend making your own "results" templates for HM to handle patient counseling documentation.

Bert,

You asked where I found "Use The Health Maintenance (Decision Support) Module." Look in Help>How Do I... It's 3rd from last of the items in that section.

John

Thanks a lot everyone. This looks daunting to track so much. But would keep on working. I will keep you guys posted.

Dear Anil:

While I do use DS/HM and find it helpful in my care of patients, don't feel you have to use it "just because it's there." Use of Decision Support (at least at this point) isn't required for MU. If you find DS helpful, use it; if not, ignore it. Focus on getting AC working well for you in the basic task of documenting patient encounters. Once you're comfortable with that, then perhaps add things like DS.

As you know from your own experience, the transition from paper records to an EMR is a HUGE CHANGE in how we do our jobs as physicians. Give yourself time as you make the transition. As the saying goes, "Rome wasn't build in a day."

John

Anil,

I have a partner who has been using eCW for several years. We are 9 solo practitioners sharing overhead and under one roof, and we all respect the others autonomy of practicing, so we do not tell the other how to practice. However, I think he has some interest in switching to AC at some point. So I would be interested as time goes if you would be willing to comment on the pros and cons of each EHR--AC vs eCW. Thank you for your posts, as they are extremely insightful.

Sure. The only caveat is that my knowledge of ecw is old, I think it was like 2006 or something. They may have evolved since then.