Home Forums Discussions Problems CCD is Completely FUBAR!

We have just started exporting/printing the CCD as we attempting to meet criteria for meaningful use. Thanks to another thread, I started looking closely at the CCD, to see exactly what information we are providing to our patients and colleagues when we provide them with the CCD (either printed or exported).

Imaging my surprise when I see that nothing, and I mean absolutely nothing, from the "Plan" section of each encounter is included with each encounter in the CCD. WTF? Do the developers of AC think that the plan section is not important to the patient or other physicians? This section includes the starting and stopping of medications, the orders for labs and rads, and other very important parts of the record. The fact that this is not included in the record boggles my mind.

For now I will type everything in the assessment box, and cut the information from the Plan box to ensure that it is included in the CCD.

Does anyone know why this is, or have a better work around?

Aren't the CCD and the CCR supposed to be "standards" published by, oh, a couple different organizations. It may be that the "Plan" section is not listed as a required part of the "standard" that they set out to meet. Sometimes IT "standards" don't include things that seem common sense to have from the user standpoint. This seems especially true in the healthcare industry.

I'm not making an excuse for it not being there. I'm just saying this could be a reason. They may have been trying to meet the required "standard" and at the time just didn't think about things that are/were not requirements that probably should be.

You're probably right. It's just frustrating to see what I consider an integral part of the chart not included when information is shared. IMO, the CCD should be the same as sharing of printed notes, and should contain all the information. For now I'm just typing everything into the assessment block.

In the newest versions of AC you have a lot of flexibility in choosing what is included in your CCD - the latest plan is an option to include. This is in 6.5.5 and above.

i do think it has to do with requirements - much of the information in the CCD is useless for what we as physicians think should be included - but the feds did not care what was medically needed it was just up to the bureacrats.

One of the things we noticed was that the med list were not always updated on the CCD sometimes it was sometimes not. I brought this to AC attention and I think they are working at correcting but if you forward the chart and then reopen and print the CCD the med list is updated.

Actually, you can only include the plan from the most recent encounter, and it's not included in the encounters section of the CCD. If I have referred a patient to another provider and am providing my last three months of notes, it's important that provider be able to see all of each encounter, not limited documentation.

NeuroDawg-

Have you been printing out the instructions to patient letter (button located in bottom right hand corner of patient encounter when the chart is open)? I do this for almost every patient encounter after I type instructions to the patient in the plan. This will print out a list of what ever medications are prescribed electronically at the time of the visit, list all immunizations such as a flu shot, given at the time of the visit (provided they are entered in the decision support section), orders for lab, x-ray and follow-up and whatever freehand information I wish to provide the patient. I print this along with the CCD. As noted by others, one main problem of printing the CCD why you still have the chart open is that the medication list is not updated.

I see that you registered on the user board in 2009. I am curious as to why you are finally starting the meaningful use journey at this time as opposed to earlier. It is an arduous task. The people at Amazing Charts were very helpful to me when I went through this.

Doctor Mel,

We are doing the task now, because we weren't originally going to do it. The effort wasn't worth the money. But we learned this year that there will penalties in the future for not doing it. So we figured we'd like to avoid the penalties, and since we're going to do it to avoid the penalties, we should try to get some money from the government now.

No, I don't print the clinical summary via patient letter. We find it too time consuming, and to count for MU the CCD has to be attached. We simply print the CCD at the end of the day, to a null printer. We have a notice at our front desk, notifying patients that if they want a clinical summary of that day's visit to let us know and one will be made available to them within 48 working hours. So far, no one has taken us up on the offer. We do have patients who want the electronic access, and for that we send the CCD to the Updox Patient Portal. We are also using the CCD to sent all data to other specialists when we refer a patient.

For now, we just make sure that anything we want to be included in the CCD into the assessment box.