Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 We recently stumbled on something useful. We have recently started some chronic disease management.To readily identify who has diabetes prior to the visit we have been printing out a patient summary on every patient the day before their visit. It was an easy way to plan ahead who needs what. Our patient summary lists the patient demographics along with a problem and meds list. Our ma soon discovered that it was useful to have the patient review this when they arrive to make sure that their address and insurance information is accurate. We then noticed that the patient was also reviewing the diagnosis and meds lists for accuracy. When I saw the patient they were telling me any meds they had gotten from the specialist that I didn't know about. We also give a copy of the patient summary to the patient after the visit to any one who is travelling or anyone who wants one. I would like to start giving people a flash usb drive with their summary in pdf format to keep with them on their keychain in case they end up in the er. We will probably start this next year. By the way I am finding chronic disease management both rewarding and disappointing. I love improving the care of my patients but I am disappointed at myself at all the patients I am discovering that have fallen through the cracks. Larry Lindeman MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2006 Report Share Posted November 10, 2006 Patient summary We recently stumbled on something useful. We have recently started some chronic disease management.To readily identify who has diabetes prior to the visit we have been printing out a patient summary on every patient the day before their visit. It was an easy way to plan ahead who needs what. Our patient summary lists the patient demographics along with a problem and meds list. Our ma soon discovered that it was useful to have the patient review this when they arrive to make sure that their address and insurance information is accurate. We then noticed that the patient was also reviewing the diagnosis and meds lists for accuracy. When I saw the patient they were telling me any meds they had gotten from the specialist that I didn't know about. We also give a copy of the patient summary to the patient after the visit to any one who is travelling or anyone who wants one. I would like to start giving people a flash usb drive with their summary in pdf format to keep with them on their keychain in case they end up in the er. We will probably start this next year. By the way I am finding chronic disease management both rewarding and disappointing. I love improving the care of my patients but I am disappointed at myself at all the patients I am discovering that have fallen through the cracks. Larry Lindeman MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2006 Report Share Posted November 10, 2006 As an aside, docs in my community are required by hospital bylaws to attend staff meetings & serve on committees as part of being on their medical staff. I think I’m also required (or at least strongly encouraged) by insurance companies & my malpractice carrier to have staff privileges somewhere. So, I am surprised that so many said on the poll that they attend no staff meetings. Maybe they are all “courtesy staff” rather than “full active”? Patient summary We recently stumbled on something useful. We have recently started some chronic disease management.To readily identify who has diabetes prior to the visit we have been printing out a patient summary on every patient the day before their visit. It was an easy way to plan ahead who needs what. Our patient summary lists the patient demographics along with a problem and meds list. Our ma soon discovered that it was useful to have the patient review this when they arrive to make sure that their address and insurance information is accurate. We then noticed that the patient was also reviewing the diagnosis and meds lists for accuracy. When I saw the patient they were telling me any meds they had gotten from the specialist that I didn't know about. We also give a copy of the patient summary to the patient after the visit to any one who is travelling or anyone who wants one. I would like to start giving people a flash usb drive with their summary in pdf format to keep with them on their keychain in case they end up in the er. We will probably start this next year. By the way I am finding chronic disease management both rewarding and disappointing. I love improving the care of my patients but I am disappointed at myself at all the patients I am discovering that have fallen through the cracks. Larry Lindeman MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2006 Report Share Posted November 10, 2006 From Drain, I've been talking about giving patients access to their records for years. If we can trust a pin number and a card to get access to our bank accounts, why can we not trust the same system to give access to our own medical records. I mentioned this in the first cohort call I was part of. The problem is, there is not an access system built into any EMR I know of, that would allow for that access to happen. Maybe we should purchase whatever system the banks use for their account information, and copy the medical record into that as if it were bank account information (joke). The point is, the technology is out there, the software is out there, and the only thing that is missing is the will to do it. I believe ( in my personal paranoia) that the current health care system is very uncomfortable with the patient reading the medical record any time they want to because we might not like to hear what the patient thinks about our opinions. Now, these people pay us for what we do and write, and so I believe the record belongs to the patient and only secondarily to me. I'd love to hear what other people think about this. Joanne Holland, the MD from Drain, Oregon wrote: Patient summaryWe recently stumbled on something useful. We have recently started some chronic disease management.To readily identify who has diabetes prior to the visit we have been printing out a patient summary on every patient the day before their visit. It was an easy way to plan ahead who needs what. Our patient summary lists the patient demographics along with a problem and meds list. Our ma soon discovered that it was useful to have the patient review this when they arrive to make sure that their address and insurance information is accurate. We then noticed that the patient was also reviewing the diagnosis and meds lists for accuracy. When I saw the patient they were telling me any meds they had gotten from the specialist that I didn't know about. We also give a copy of the patient summary to the patient after the visit to any one who is travelling or anyone who wants one. I would like to start giving people a flash usb drive with their summary in pdf format to keep with them on their keychain in case they end up in the er. We will probably start this next year. By the way I am finding chronic disease management both rewarding and disappointing. I love improving the care of my patients but I am disappointed at myself at all the patients I am discovering that have fallen through the cracks.Larry Lindeman MD Everyone is raving about the all-new Yahoo! Mail beta. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2006 Report Share Posted November 11, 2006 I would define interoperability between EMRs as the ability to take an entire patient record from one EMR and import it in electronic format automatically into another EMR, so that a user in the second EMR would be able to immediately access it and use it. We are a long way from achieving that. I think the " CCR " project is a good attempt to provide a format for exchanging data between EMRs in such a manner. On the other hand, there are many " least common denominator " formats that are so common in our offices, hospitals and homes that any EMR should be able to dump a patient's entire record into any of these formats. You should be able to print out a patient's entire record on paper, or fax it to somebody, or email it (securely, of course, in deference to HIPAA). Everybody has PCs with a web browser, so you should be able to burn the record onto a CD in HTML format so it can be read by any computer with a web browser. The same type of HTML record on a USB drive or memory stick on a necklace is also a good idea. Sort of like a modernized MedicAlert bracelet, only with much more information. This got me thinking, MediAlert bracelets were very popular a few years ago. They were very popular as gifts. Why not have patient's families buy a memory stick a memory stick necklace with the medical records as a gift? A possible income stream for the IMP office? :-) > > > > Patient summary > > We recently stumbled on something useful. We have recently started > some chronic disease management.To readily identify who has diabetes > prior to the visit we have been printing out a patient summary on > every patient the day before their visit. It was an easy way to plan > ahead who needs what. Our patient summary lists the patient > demographics along with a problem and meds list. Our ma soon > discovered that it was useful to have the patient review this when > they arrive to make sure that their address and insurance information > is accurate. We then noticed that the patient was also reviewing the > diagnosis and meds lists for accuracy. When I saw the patient they > were telling me any meds they had gotten from the specialist that I > didn't know about. We also give a copy of the patient summary to the > patient after the visit to any one who is travelling or anyone who > wants one. I would like to start giving people a flash usb drive with > their summary in pdf format to keep with them on their keychain in > case they end up in the er. We will probably start this next year. By > the way I am finding chronic disease management both rewarding and > disappointing. I love improving the care of my patients but I am > disappointed at myself at all the patients I am discovering that have > fallen through the cracks. > > Larry Lindeman MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2006 Report Share Posted November 11, 2006 I would define interoperability between EMRs as the ability to take an entire patient record from one EMR and import it in electronic format automatically into another EMR, so that a user in the second EMR would be able to immediately access it and use it. We are a long way from achieving that. I think the " CCR " project is a good attempt to provide a format for exchanging data between EMRs in such a manner. On the other hand, there are many " least common denominator " formats that are so common in our offices, hospitals and homes that any EMR should be able to dump a patient's entire record into any of these formats. You should be able to print out a patient's entire record on paper, or fax it to somebody, or email it (securely, of course, in deference to HIPAA). Everybody has PCs with a web browser, so you should be able to burn the record onto a CD in HTML format so it can be read by any computer with a web browser. The same type of HTML record on a USB drive or memory stick on a necklace is also a good idea. Sort of like a modernized MedicAlert bracelet, only with much more information. This got me thinking, MediAlert bracelets were very popular a few years ago. They were very popular as gifts. Why not have patient's families buy a memory stick a memory stick necklace with the medical records as a gift? A possible income stream for the IMP office? :-) > > > > Patient summary > > We recently stumbled on something useful. We have recently started > some chronic disease management.To readily identify who has diabetes > prior to the visit we have been printing out a patient summary on > every patient the day before their visit. It was an easy way to plan > ahead who needs what. Our patient summary lists the patient > demographics along with a problem and meds list. Our ma soon > discovered that it was useful to have the patient review this when > they arrive to make sure that their address and insurance information > is accurate. We then noticed that the patient was also reviewing the > diagnosis and meds lists for accuracy. When I saw the patient they > were telling me any meds they had gotten from the specialist that I > didn't know about. We also give a copy of the patient summary to the > patient after the visit to any one who is travelling or anyone who > wants one. I would like to start giving people a flash usb drive with > their summary in pdf format to keep with them on their keychain in > case they end up in the er. We will probably start this next year. By > the way I am finding chronic disease management both rewarding and > disappointing. I love improving the care of my patients but I am > disappointed at myself at all the patients I am discovering that have > fallen through the cracks. > > Larry Lindeman MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 Thanks . I know when it is an e maill from caldwell that the topic is technical.. But see where we all get stuck then is not just the interoperability flash drive thing( and someone told me not that I have checked it out that now you cna get flash drives from medic alert just like you could get bracelets) is that we do not have a computer terminal in every ER cubilce. That is actually why paper still works for patietns. I agree a flash drive / a cd / and credit care swiper thing -a - ma - bob or a password proteted site all work . I really think this needs to be pushed becasue it si so possible and realitively low cost to institue in any one of these fashions and it would reduce errors and oincrease saftry yes? EVEN if each c9ommuity did different things or statewide we got something going? May be I should just get a bar code tatooed onto my wrist a nd they can scan me when I am admitted. Patient summary > > We recently stumbled on something useful. We have recently started > some chronic disease management.To readily identify who has diabetes > prior to the visit we have been printing out a patient summary on > every patient the day before their visit. It was an easy way to plan > ahead who needs what. Our patient summary lists the patient > demographics along with a problem and meds list. Our ma soon > discovered that it was useful to have the patient review this when > they arrive to make sure that their address and insurance information > is accurate. We then noticed that the patient was also reviewing the > diagnosis and meds lists for accuracy. When I saw the patient they > were telling me any meds they had gotten from the specialist that I > didn't know about. We also give a copy of the patient summary to the > patient after the visit to any one who is travelling or anyone who > wants one. I would like to start giving people a flash usb drive with > their summary in pdf format to keep with them on their keychain in > case they end up in the er. We will probably start this next year. By > the way I am finding chronic disease management both rewarding and > disappointing. I love improving the care of my patients but I am > disappointed at myself at all the patients I am discovering that have > fallen through the cracks. > > Larry Lindeman MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2006 Report Share Posted November 13, 2006 Be careful on the CCHIT recommendation - conversations with small EMR companies indicate this is a private company ( i.e. NOT AAFP CHIT) that is charging tens of thousands for the "certification." Small EMRs may try to fight back against this brand of "certification.""So now there is no realistic hope of interoperability" look up CCHIT.org. They are an organization that was created to certify emrs to have a platform for interoperability. They have already certified 20-25 emrs. Not a perfect system, but many emrs have been written for this interoperability for some years now, and the presence of a certification body obviously pressures the others to comply. Not everything will be shared, just core data like med lists, problem lists, etc. <jantonuccifchn (DOT) org> wrote: Patient summaryWe recently stumbled on something useful. We have recently started some chronic disease management.To readily identify who has diabetes prior to the visit we have been printing out a patient summary on every patient the day before their visit. It was an easy way to plan ahead who needs what. Our patient summary lists the patient demographics along with a problem and meds list. Our ma soon discovered that it was useful to have the patient review this when they arrive to make sure that their address and insurance information is accurate. We then noticed that the patient was also reviewing the diagnosis and meds lists for accuracy. When I saw the patient they were telling me any meds they had gotten from the specialist that I didn't know about. We also give a copy of the patient summary to the patient after the visit to any one who is travelling or anyone who wants one. I would like to start giving people a flash usb drive with their summary in pdf format to keep with them on their keychain in case they end up in the er. We will probably start this next year. By the way I am finding chronic disease management both rewarding and disappointing. I love improving the care of my patients but I am disappointed at myself at all the patients I am discovering that have fallen through the cracks.Larry Lindeman MDCheck out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2006 Report Share Posted November 13, 2006 Be careful on the CCHIT recommendation - conversations with small EMR companies indicate this is a private company ( i.e. NOT AAFP CHIT) that is charging tens of thousands for the "certification." Small EMRs may try to fight back against this brand of "certification.""So now there is no realistic hope of interoperability" look up CCHIT.org. They are an organization that was created to certify emrs to have a platform for interoperability. They have already certified 20-25 emrs. Not a perfect system, but many emrs have been written for this interoperability for some years now, and the presence of a certification body obviously pressures the others to comply. Not everything will be shared, just core data like med lists, problem lists, etc. <jantonuccifchn (DOT) org> wrote: Patient summaryWe recently stumbled on something useful. We have recently started some chronic disease management.To readily identify who has diabetes prior to the visit we have been printing out a patient summary on every patient the day before their visit. It was an easy way to plan ahead who needs what. Our patient summary lists the patient demographics along with a problem and meds list. Our ma soon discovered that it was useful to have the patient review this when they arrive to make sure that their address and insurance information is accurate. We then noticed that the patient was also reviewing the diagnosis and meds lists for accuracy. When I saw the patient they were telling me any meds they had gotten from the specialist that I didn't know about. We also give a copy of the patient summary to the patient after the visit to any one who is travelling or anyone who wants one. I would like to start giving people a flash usb drive with their summary in pdf format to keep with them on their keychain in case they end up in the er. We will probably start this next year. By the way I am finding chronic disease management both rewarding and disappointing. I love improving the care of my patients but I am disappointed at myself at all the patients I am discovering that have fallen through the cracks.Larry Lindeman MDCheck out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2006 Report Share Posted November 14, 2006 You are right, it looks like MedicAlert does have a USB flash drive medical record on a keychain. http://www.medicalert.com/E-Health/ It looks like they have a way for the patient to upload and store information about themselves on their server and any time changes are made, they can also update their own USB flash drive. The other comment about IT people not allowing these USB drives to plug into hospital computers because of security concerns makes me wonder. Has anybody had any experience with someone showing up at their office or hospital ER with their medical record on one of these? Would you feel comfortable plugging it into your PC to read it? Or would you be afraid of catching a virus from it? of the outpatietn docs in my community however are never at the > > hospital meetings and do not see each other.So no dialogue about > > this area. > > > > I have broached to a consortium we have here called Th e Healthy > > Community Coalition, the idea of personal health records. Where larry > > says he wants to give patins a flash drive, my thought was get a > > grant to enroll people into putting phr info into a password protected > > site ( already availbale free on the internet at MYPHR.com) I HAVE HAD > > A GOOD RESPONSE ABOUT THIS AND THERE WILLBE A MEETING UPCOMING SOON TO > > SEE IF THIS hOPSITALS AREA CAN WORK ON THIS. oops caps lock. > > > > aLSO i HAVE BROACHED THIS TO THE TERTIATY CARE CENTER mAINE MEDICAL > > CENTER AND THEY HAVE RESPONDED QUITE cREATIVLY AND POSITIVEL;Y Darn > > that stupid caps lock button I am gonna excise it...Their idea had > > been to to credential me into their coutesy staff thus getting me > > access to their emr.The only holdup has been cost I cannot afford > > their dues at the momment! > > Why can't more docs do this ? That is If the systems are separate OK, > > but, what if any given doc only had to access two or three local > > hospitals systems.. we could make that work. > > In Whatcomb Co Washingotn an intiative was started to use PAPER > > -remember that stuff - and each patietn owned and brought with them to > > the doc their own record with meds/problems etc. > > > > I think much more can be done and done now and simple widespread > > iniatives like this would do an enormous amount to imporve care > > empower cpatietns and reduce errors. > > > > Larry thanks for bringing this up I just think this is a critical > > topic and who better than Practice improvement IMPs to press this > > forward? > > > > > > Patient summary > > > > We recently stumbled on something useful. We have recently started > > some chronic disease management.To readily identify who has diabetes > > prior to the visit we have been printing out a patient summary on > > every patient the day before their visit. It was an easy way to plan > > ahead who needs what. Our patient summary lists the patient > > demographics along with a problem and meds list. Our ma soon > > discovered that it was useful to have the patient review this when > > they arrive to make sure that their address and insurance information > > is accurate. We then noticed that the patient was also reviewing the > > diagnosis and meds lists for accuracy. When I saw the patient they > > were telling me any meds they had gotten from the specialist that I > > didn't know about. We also give a copy of the patient summary to the > > patient after the visit to any one who is travelling or anyone who > > wants one. I would like to start giving people a flash usb drive with > > their summary in pdf format to keep with them on their keychain in > > case they end up in the er. We will probably start this next year. By > > the way I am finding chronic disease management both rewarding and > > disappointing. I love improving the care of my patients but I am > > disappointed at myself at all the patients I am discovering that have > > fallen through the cracks. > > > > Larry Lindeman MD > > > Quote Link to comment Share on other sites More sharing options...
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