Home Forums How to make a flowsheet or facesheet for AC

I gave up on open office for a face sheet. It was crashing AC when I imported it and it was too many steps. I also use excel for a diabetes registry. I would love to hear how you link it to individual patients in AC.

Bill

Hi Bill, I use Excell for a single "Flow Sheet" which I have loaded on the server as the blank form, and I retrieve the blank for any patient I want to use it for. It has the usual 3 sheets in the form for Excell so I laid out the first page as a diabetic flow sheet with all of the criteria that "LUMETRA" uses when they review a chart. (The local Medicare reviewer.) I don't use most of those topics, but I felt that having those ready might be handy.

On the second page I have set up a simple flow sheet for warfarin which uses Excell to tally the dose and calculate the average daily dose in a line (the week). This makes a good tool for following the results of changes in the dose.

The third page I use for whatever might come up, to follow sed rate or other things. (But lipid results and treatment and creatinine are on the LUMETRA / Diabetic page so I keep them there.)

To the point: I have the blank on the server, stored in a folder labeled imported items with the title CMGDflowsheet.

In the patients chart under "Imported Items" click 'Import - File - Browse' and find the server on the network and the file labeled "imported items" and then "CMGDflowsheet". Click on it and store it in "Other" labeled, "Flowsheet - warfarin" or "Flowsheet - Diabetes"

Then from the patients imported items, go to 'Other' and RIGHT click on the flow sheet. Select 'Open with the default program'. THIS WILL OPEN EXCELL AND A COPY OF THE BLANK FLOW SHEET. The first time I open it, I add all the identifiers to the flow sheet, Patients full name, Date of Birth and Amazing Charts number.

When I am finished working with it, I simply EXIT Excell. It will ask "do you want to save the changes? Say 'yes'! IT IS ALREADY RENAMED BY AC AS AN AC FILE, so your blank is unchanged. The next time you open AC you can again Open the flow sheet and the changes will appear as you left them, BUT THIS IS STILL A WORKING SPREAD SHEET and totals will change etc as you continue to work the pages.

NOW THE PROBLEMS. #1 you can't keep a part of your medical record that is subject to changes that are not time and date stamped to keep the record pristine. IMHO this flow sheet is like the scrap of paper we have all kept loose in the chart and is a 'work sheet' and is IMHO NOT a part of the medical record. That's my story and I am sticking to it. This is ONLY true if EVERY single thing on the flow sheet appears else where in the chart, as mine does. The lab results, changes in Rx and conversations with the patient are ALL recorded in the regular parts of the chart. The flow sheet is NOT documentation, it is only an organizer that saves me time in recalling where we have been.
#2 CCHIT is not likely to allow this. I DO NOT know it this is still going to work on version 5 (CCHIT certified) but I doubt it, so don't get to deep into this. My anticipated work around will be to label the page IN EXCELL with the AC number, then recall it from EXCELL, use it, send it to the FAX writer and import the printed copy to AC, and save the changes in EXCELL. That will be cumbersome, but still lets me use my Coumadin counter which I really like.
#3 ah heck, this post is so long nobody will still be reading it by #3.

I read it But I am confused. Once imported into your Imported Items folder, why is the Excel sheet no more a documentation than is any other imported item?

Leslie

Yes, and just for more information, you can add sheets and also default the number of sheets you wish. You can rename them and change colors. Thanks for a good post Martin. As a tip, you can just keep a new sheet on your desktop and slide drag it in to the left pane.

When we used them a lot our secretary just put them in with all the demographics. You can time and date stamp them, but in order to secure the sheet so no one can change it, I would recommend hiring an Excel expert. I played around with it, but it was just too frustrating.

Martin, are you saying that CCHIT will not allow imported files?

Not sure I understand what you mean.

thanks,

Tim

I am currently trying to compare using Excel to enter data on a patient (e.g. diabetic labs) vs. the AC tracking entry in the summary sheet. Could I have some input on which is better? Also, if I enter data into Excel would I be able to compare across patients? E.g. if I wanted to search the database for how many patient's had A1c below 7. Would this be easier to do in the data tracking on the summary sheet?
Would appreciate any input.
Thank You,
Romi

Ouch! I am so sorry that I didn't respond sooner. Got a little distracted and missed this, glad it got bumped.
In my example when I import an excell spread sheet it is handled as an .xlsx file. When you try to open it, it returns to Excell to open it. When it is open in Excell it is a "living" document and YOU CAN MAKE CHANGES. I don't believe that will fly with CCHIT, but I am neither an IT person nor any sort of expert on CCHIT. To be legit, and what you would do if this was a paper chart, you must PRINT the spread sheet and then save it. Of course you can import the printed, (dead, permanent, unalterable) files into your chart.

In the past I, (like many of you) used pages that allowed multiple entries that often were not dated. The Problem list was one. I once testified in a case to defend a cardiologist, and because my first entry for alcoholic cardiomyopathy was undated on the problem list the judge would not allow that I had proof of the pre-existence of this condition. A CCHIT record would (I hope) not allow that sort of thing. In my current use of excell I do double entries, EVERYTHING on the spread sheet is in AC in the conventional (and unalterable ) manner. But the spread sheet allows me to see it at a glance, and to allow the system to help me calculate the dose.

To answer RomiB, neither will do what you want really at this point. The excell spread sheet is not a part of AC and you can't search it. The summary sheet in AC is very good for flu shots, but cumbersome for lab values.

I cling to the belief that when the big pieces are done, (CCHIT nad the PM portions) Jon will be able to return to some of these bells and whistles that we all dream of.
Martin

Hello Everyone. I am new to Amazing Charts and was doing some research on the "Flowsheet Problem". I really like the Excel solution - however, I'm not really sure where to get started. Would anybody be willing to share any of their excel templates as an example?

Many Thanks,

Samantha

Bert will you weigh in here. I would be delighted to have anyone use my two pages, but I don't really know how to link the page to the forum. In the meantime, Samantha if you will send me a private message with your e-mail address I will send what I've got.
The first page is the guidelines from "LUMETRA" (an acronym for some agency that has the contract for reviewing Medicare in Calif.) On that page there is A SPACE to put everything I am aware of that they audit for. I DO NOT use it for that, but I use it to list the lipid therapies, and diabetic agents and the resulting lab values. It is of some slight value for this.
The second page I use for coumadin, and on it I log the INR, the dose of coumadin, and the daily totals, including any extra doses, (IE, 5, 5, 5, 7.5, 5, 5, 7.5) The spread sheet then automatically shows the total, 40 mg and the daily avg. 5.71
For me this makes it simple to see when to increase by another 1/2 pill or change to 6 mg daily etc.