JBS
Reisterstown
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#61160
03/14/2014 9:46 PM
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Joined: Sep 2006
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I just did something that I will probably find out is how 90% of you already solved this problem, but if not, let me share:
The problem is getting data from the patient and the home glucose monitor that is in any sense of the word "useful". I don't want the 35 page printout from the obsessive/compulsives who have a glucose meter with a computer interface and software that lists data from thousands of readings over months, and has colored pie charts, bar graphs, and hand written margin notes, (decorated with drops of the patients blood).
I want a snap shot of what is going on. For years I have sent home a hand out, (printed from the orders in AC) that explains what I want and has room for the numbers from ONE DAY for AC and HS. So simple, ? but not. 80% of the time the patients bring back all sorts of OTHER DATA. 10 minutes after eating, or they only eat twice a day, or they eat ?supper? not dinner. (Whatever..)
So at the same time I have wanted to have various things as a PDF available as a template for this sort of problem.
SO: I made a .pdf printout of an Excel Sheet with Glucose vs 24 hours and stored it in our Fax-inbox on the server in a folder called, ?patient forms? where my clever staff keep the blank originals for the MMSE and stuff like that. So I import the BLANK form to the patients imported items, print a copy and put todays date on it, and send him home to record any dam numbers he wants, AC PC HS, before showering, walking the dog, WHATEVER. Just put a dot on this ONE page EVERY time you record a number, ( the more sophisticated patients will be asked to put an X for readings that are after meals). I expect to get back a sheet with one to three months of readings, and a fairly legible curve that will let me increase the morning or evening dose, or recognize (when combined with the HgBA1C) when we need to go to mealtime bolus. I will let you all know if it works out. (if it is a dud, I will insist my XP machine was hacked and I didn?t post this.)
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
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So now I can't post! Ah well. If it was a good idea I will brag about it later.
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
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Joined: Sep 2006
Posts: 531 |
I just did something that I will probably find out is how 90% of you already solved this problem, but if not, let me share:
The problem is getting data from the patient and the home glucose monitor that is in any sense of the word "useful". I don't want the 35 page printout from the obsessive/compulsives who have a glucose meter with a computer interface and software that lists data from thousands of readings over months, and has colored pie charts, bar graphs, and hand written margin notes, (decorated with drops of the patients blood).
I want a snap shot of what is going on. For years I have sent home a hand out, (printed from the orders in AC) that explains what I want and has room for the numbers from ONE DAY for AC and HS. So simple, ? but not. 80% of the time the patients bring back all sorts of OTHER DATA. 10 minutes after eating, or they only eat twice a day, or they eat ?supper? not dinner. (Whatever..)
So at the same time I have wanted to have various things as a PDF available as a template for this sort of problem.
SO: I made a .pdf printout of an Excel Sheet with Glucose vs 24 hours and stored it in our Fax-inbox on the server in a folder called, ?patient forms? where my clever staff keep the blank originals for the MMSE and stuff like that. So I import the BLANK form to the patients imported items, print a copy and put todays date on it, and send him home to record any dam numbers he wants, AC PC HS, before showering, walking the dog, WHATEVER. Just put a dot on this ONE page EVERY time you record a number, ( the more sophisticated patients will be asked to put an X for readings that are after meals). I expect to get back a sheet with one to three months of readings, and a fairly legible curve that will let me increase the morning or evening dose, or recognize (when combined with the HgBA1C) when we need to go to mealtime bolus. I will let you all know if it works out. (if it is a dud, I will insist my XP machine was hacked and I didn?t post this.)
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
Member
Joined: Sep 2006
Posts: 531 |
I just did something that I will probably find out is how 90% of you already solved this problem, but if not, let me share:
The problem is getting data from the patient and the home glucose monitor that is in any sense of the word "useful". I don't want the 35 page printout from the obsessive/compulsives who have a glucose meter with a computer interface and software that lists data from thousands of readings over months, and has colored pie charts, bar graphs, and hand written margin notes, (decorated with drops of the patients blood).
I want a snap shot of what is going on. For years I have sent home a hand out, (printed from the orders in AC) that explains what I want and has room for the numbers from ONE DAY for AC and HS. So simple, ? but not. 80% of the time the patients bring back all sorts of OTHER DATA. 10 minutes after eating, or they only eat twice a day, or they eat ?supper? not dinner. (Whatever..)
So at the same time I have wanted to have various things as a PDF available as a template for this sort of problem.
SO: I made a .pdf printout of an Excel Sheet with Glucose vs 24 hours and stored it in our Fax-inbox on the server in a folder called, ?patient forms? where my clever staff keep the blank originals for the MMSE and stuff like that. So I import the BLANK form to the patients imported items, print a copy and put todays date on it, and send him home to record any dam numbers he wants, AC PC HS, before showering, walking the dog, WHATEVER. Just put a dot on this ONE page EVERY time you record a number, ( the more sophisticated patients will be asked to put an X for readings that are after meals). I expect to get back a sheet with one to three months of readings, and a fairly legible curve that will let me increase the morning or evening dose, or recognize (when combined with the HgBA1C) when we need to go to mealtime bolus. I will let you all know if it works out. (if it is a dud, I will insist my XP machine was hacked and I didn?t post this.)
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
Member
Joined: Sep 2006
Posts: 531 |
I just did something that I will probably find out is how 90% of you already solved this problem, but if not, let me share.
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
Member
Joined: Sep 2006
Posts: 531 |
The problem is getting data from the patient and the home glucose monitor that is in any sense of the word "useful". I don't want the 35 page printout from the obsessive compulsive patient who has a meter with a computer interface, providing a stack of pie charts, bar graphs, and hand written margin notes, (many decorated with drops of the patients blood!)
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
Member
Joined: Sep 2006
Posts: 531 |
I want a snap shot of whats going on. For years I have sent home a hand out, (printed from a template in the "Orders") that explains what I want and provides four spaces for the results of the AC and HS (before breakfast lunch, dinner and Bed time for my IT friends) glucose readings from ONE day. (Sometimes two). So simple, ...but not. 80% of the time the patients bring back a PLETHORA of data, that is anything BUT AC and HS. They only eat twice a day, they eat supper, not dinner. They have 200 results but NO notes of when they are taken. Most of all, they hand me the meter, (which might have the correct time and date in it's clock) and expect me to scroll through and find what I need.
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
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Joined: Sep 2006
Posts: 531 |
So at the same time I have wanted to have various things as a PDF available as a template for this sort of thing.
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
Member
Joined: Sep 2006
Posts: 531 |
SO: I made a .pdf printout of an Excel Spread Sheet with Glucose vs 24 hours and then stored it on our FAX in-box on the server, (in a folder that my clever staff have the MMSE, and other useful forms in). Now I import the BLANK form once to the patients chart under Other, and then print a paper copy when the patient comes in, put todays date on it and send them home to gather data. I want to have ANY dam numbers he can come up with. AC, PC, HS, before showering, walking the dog, eating donuts, WHATEVER. Just put a dot on this ONE page EVERY time you use the meter, all month, (or 2-3 months). The more sophisticated patients may be asked to place an "X" for the readings that are before a meal. I think I will get a fairly recognizable graph that will let me increase the morning or evening dose as indicated and when combined with the A1C will help me identify the patients destined to begin Basal and Bolus dosing.
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
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Joined: Sep 2006
Posts: 531 |
I will let you all know if it works out. (If it is a dud, I will insist my XP machine was hacked and I didn't post this)
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Sep 2006
Posts: 531
Member
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OP
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Joined: Sep 2006
Posts: 531 |
So I initially scribbled this out in Word and cut and paste to post it. No post. Then I typed, "so now I can't post" but it did post. Then I tried posting only a short piece, cut and paste. Still no go. So I re-typed the original in pieces, even some rather too long parts, and it all posted OK. Maybe that is part of the no posting problem?
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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Joined: Jun 2009
Posts: 1,811
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Joined: Jun 2009
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Martin,
It is a bug with non-printing characters that come over when you cut & paste, or with 'special' characters.
Bert stated elsewhere that they are looking to upgrade the board software soon to resolve it; perhaps it was this weekend.
Anyho, he will get it resolved.
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Joined: Feb 2005
Posts: 2,002
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OK, I hate to admit it but this is one feature of Epic that I like. In the patient portal, there are flow sheets for BP and Sugars and Protimes (which are collected at an anticoagulation clinic). The patient just plugs in their readings in real time and they magically appear instantly in the flow sheet in their chart as well as in my In Basket. The BP one is great, the sugar one needs a little more work to allow more options for additional times taken, pre-meal, post-meal, diet record, etc. But all in all it works great and I am not burdened looking at all of those scraps of paper and then scanning those into the system (unfortunately not as nice to work with as is ACs Imported Items) or having staff spend their time entering them into a flow sheet. Patients also like it a lot and I can immediately reply to them via the portal to do this or do that or decrease frequency of testing.
Leslie Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
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