Home Forums Discussions Problems How to find a list of patients in AC that have never been seen

Issue:
I am often referred patients. Not all of then show up. It would be nice to be able to send a letter to referring physician that their patient did not show up. Currently I keep an excel spreadsheet with name of patient, referring doctors, attempts made to contact, etc. This requires double data entry.

I have looked in advance search options and there is a category called schedule, but the only options available are:
"Not seen in x months (without upcoming appt)
months since last seen
weeks until next visit
months until next visit

When I choose the first option I get pretty much every patient in database, including patients already seen and those never seen.
Too big of a list to be useful

I though about combining with another field such as demographics -> ID and select the last x new accounts made, but there is no option for this. only option available under ID is =. It would be nice if it had options for <>

Is there a way to track this in AC? I would love to hear what other users have done.

Gerardo

I am going to assume that you make these charts in advance. And, you put in the demographics, etc.

The part I don't understand is what no shows you want to pull up? All no shows today? (Which would simply be in your schedule for that day). All no shows from a certain time frame prior to a certain date. Generally, if I want to pull up certain charts later I enter data ahead of time into certain fields. I would enter Asthma into Misc 3 and then search for Asthma there and all patients in the study would pop up. It would be easy to do a date by entering 030415. But, I would be using the operator =. There are many fields you can populate to search for. But, I guess I would need to know more about what you are trying to do.

Sorry.

Gerardo, it looks like you have been using AC for a long time.

Some time ago, I was trying to do the same thing. I had figured out a way but had forgotten. Your posting made me go back and figure out what I had done.

Under schedule/months since last seen put in a high number (I tried 199) this should give you all those never seen. Unfortunately, some will be those referred 10 years ago. But this should create your list.

Hi. Do you know how long you've been using AC? This is what I do in v6.3.3. I use the Not seen in last x months criteria with >= the number of months we have used AC. So if I search for patients not seen in last >= 45 months, I get the patients that have no encounters saved.

The only issue might be that since he has been on the board since 2004, he will probably need to use a number > 144 and then get many referrals done in 2005-2010 that are somewhat irrelevant at this time.

I still don't understand why the search is even necessary. Sending letters (I get these, and they are helpful) is a great idea. But, why worry about going back so many months? You just came up with the idea. Why not bite the bullet, and just start fresh.

Patient A is scheduled for today, and they no show. Or you get patient who cancels or re-schedules. You then have a very current patient that your referring doctor would want to know. I think if I got a letter that a patient who was scheduled in January didn't show, I would be frustrated that I just found out.

I like the idea so I can go inactivate all the patients I have never seen so my active list is right - I get dozens from ones I see in the ER and want to download labs so I can review them, particularly cultures.

This seems like something that AC's built-in reporting system should easily do, but that does not appear to be the case.
As Bert points out, I would imagine that you have little interest in identifying patients who missed in the distant past. Further, you want them to disappear off the list as time goes by.

Gerardo, it looks like you invest some significant effort in trying to contact these patients as well as keeping track of those attempts, so you might consider the following:
Create a series of flags.
1= missed appointment
2= missed appointment, called patient
3= missed appointment, letter written

At the end of the day, have someone set a flag "1" on each patient who does not show.
At the end of the month (or whenever) run a report "flag=1" to create your list.
As the patients are called and not reached (so you need to take the next step in follow-up), as the staff goes down the list they change the flag to "2".

A but cumbersome, but I would expect this is less effort than maintaining a separate spreadsheet.

Just found another problem with my method now that I'm inactivating all these patients.. the "without upcoming appts" part of the rule does NOT work. So my list shows new patients who have appts scheduled too. Well, I have to open each pt chart first to look for upcoming appts, then inactive ones that don't.

We also use the flags like Jon does. After I clean up all these old no shows we can be more diligent about inactivating new patient no shows more regularly.

If on the main screen you bring up the pt name - in the lower left it will show if they have upcoming appt - then open/inactivate. I went through and found I have about 600 pt with no history of an appt - going to make this a project for off hours for employees to inactivate them.

thanks!

Remember that I have been using AC since 2001 and have over 30K patients. Also, I depend on referring docs to send me patients. Those docs would probably like to know if their patients were seen. There is an issue of liability here. If you refer someone for a colon cancer and they don't show up... and no one follows up... well...

bottom line, it is just good patient care. I need to know if the patients that have been referred have been seen.

If a referral is received in my office I make a chart. If I make a chart, then I expect that patient to be seen, otherwise that patient could be "lost to follow up." with a cancer... or with obstructive jaundice... or with breast cancer... or with type II diabetes and morbid obesity and a1c of 15... or with barretts esophagus and high grade dysplasia... or with blah blah blah.

Gerado,

I continue to think about this. I am a bit behind the eight ball, because I do not use the AC scheduler. I do not know if you have to use this, but when I run a query on not seen in x amount of months, nothing returns.

But, going back to your first post, you state that you get a list, but it includes those who have already been seen.

I think this is where you would have to use another identifier like the word notseen or not seen in a misc. field such as Misc. field 3. You could then run the first query along with AND demographics misc field 3 = notseen. This would bring up all those patients not seen within a certain amount of months. Of course, once the patient was seen you would have to remove that. If they had a f/u, you would have to enter followup in a misc. field and do the same.

Something tells me this won't work, but I am trying.

Something to have fun with. This query lists all patients that have demographics entered but no encounters but also have an appointment in the future from the current date/time. The query shows the patient ID, last name, first name, date added to demographics, and date of any future appointments from the current date/time (which means a patient may be listed more than once if they have more than one future appointment).

Wrote this in 5 minutes and I'm a little tired so it the query may need tweaking, but, like I said, fun place to start.

James:

What sorcery is this and how do you make it work? In advance search? Pray tell!

I need all patients that have demographics entered, no encounters, and no appointments in the future.

I was going to comment on this:

James is assuming you know how to download SSMS for your version of SQL Server, know the username and password and know how to enter to query.

All of these things are not overly difficult. To be fair, downloading SQL Server Management Studio via Google is straightforward, a little tougher with 2012 as it is bundled in other software -- but there. Hate to talk about the username and password on here, but there of those who can help. And, you basically copy and paste the query into the query window.

You can always PM James or go through my guy who will do all of this for you.

Since I am on the thread and helping, I just want to give an opinion. Sorry, that is why I am not well liked by all. Too opinionated.

The things you are asking for would be helpful for all. But, you have found it lacking as you come across them. Others, like myself, in my everyday use find things. So, with 8,000 users, they must get tons of questions. Throw all the government bullshit in there.

So, we need you on. Bear with them. It must be difficult when I am asking for lbs and kgs at the same time. And, please quit making me delete the "why window" when I inactivate a medication.

Bert:

I am a little confused... but that is the typical state of mind for me.
Regardless, I appreciate your help, and willingness to help.

I am learning a lot. Keep it coming.

I got some homework to do.

Any time.