We here at MedPeds are all new users to AC. Making a transition from paper charts.
I need some direction, some ideas:-
In my paper chart I wrote-in pertinent pt data on a paper template, and kept in on the inside front of the chart. It has clinically useful info that served as a snapshot of my pt. It included
last colonoscopy dates
last mammo date
last PSA date and value
Last ECHO/STRESS; and briefly findings
Last PFT date with FEV & FEV/FVC
This was a very helpful page to glance at before I wrapped up a visit, and could see if they were up to date on the age appropriate screenings etc. or what was the last EF on the ECHO.
WHERE DO I PUT THIS INFO IN AC?
So it is just as easy to glance and update?
Any ideas?
Thanks
Ness

This topic has come up many times and I used to do this but stopped for awhile. Personally, I have always felt that AC should default to a GOOD face sheet with promblem list and such.

There really isn't a good one. It's simple to do, especially if you hire someone that is really good with Excel. Obviously, you can do it yourself, but the formatting can really be nice if you get someone really good with Excel. There are plenty of places on the Internet to find someone you can send the document to.

Anyway, you take an Excel sheet and you put all of your data with headings, etc. that shows what you want to see. There would be a place for each patient name and some demographics, etc. A template would be kept at the reception area and everytime you get a new patient he/she would fill in the initial name and demographics and import it into that patient's chart. When, you pull the chart in the room, you go to the Imported items and open the Excel sheet in its own format. You can use as many tabs as you wish. You can use Tab 2 for confidential information if you wish. You can also copy a copy, put it in a folder, zip it and send it with records to a consultant. You can even use a whole worksheet to type your note.

It works even better if your MA triages in the room, as he/she can open the Excel sheet and have it sitting right in front of you. Some of us like to open it and go over it with the patient and see if they agree.

If you enter certain labs (say PT/PTT/INR) or glucose levels, you can easily use Excel to add them, average them, do whatever you like. Let me know if you have questions.

I put that in Past Medical History. It is medical history in a sense and if you put it there it will be available on every visit if you follow the convention of opening a new visit while preserving the PMedHx, FamHx, and SocHx. You will begin to use the drop down menu on the Assessment as the real Problem List and the Past Med History becomes a nice place for the rest.

Incidentally I will be mentioning a tip that I use for colonoscopy results. The problem on all of these tests is finding a reliable means of remembering to order the next one. Colonoscopy is the worst since the follow up might be anything from 1 to 10 years. I use a phrase with intentionally fractured English to allow the free text search function to find only the items I am searching for. If the colonoscopy was was done last month and the patient was told to have it repeated in 5 years my entry would be a single run on sentence with the details, who did it, where, the date and the path report. Then I put the statement, "Told Return 2015" I use this same statement for any test that needs to be repeated in 2015. (common for things to be repeated in one or two years, only colonoscopy comes to mind for such a long interval). So in January of each year we use the free English text to locate all the charts with the statement, "Return 2010" or next year "Return 2011" etc. In Jan.of 2015 we will find that guy and his colonoscopy, no problem.

Oh, little Earthquake just now. Gotta love So. Calif!

Martin, we have also been putting those items in the PMH and using the yellow note area for reminders. When I import an item, I also expound on it a bit, like "colonoscopy with tubulovillous adenoma". We have not started exploring the health management function, but that seems to be the logical place for most of the reminders. Are you using it? Does it work?

I also put these in the PMH under a templated heading called "Interventions". Here are listed things like colonoscopy, mammogram, bone density, vaccinations, etc. It is so much easier for me to look at it here when I open a chart than to switch screens. I do have an Excel sheet for diabetics which also lists eye exams, etc. I use the yellow reminders for things like when the next colonoscopy or repeat CT is due.

I guess the Excel sheet is dying a slow death. If it were ever alive to begin with. I just find that PMH is too small to do what medpeds is trying to accomplish. But, it sounds like a great idea that works for everyone here.

If you have Version 5, there is a new "Health Maintenance" section. I'm not sure if anybody has really gotten into using it yet, but it seems pretty neat for those general screening reminders like colonoscopy, mammography, cholesterol screening or PAP.

You can add your own rules (I haven't played with this too much) and even have them respond to a specific diagnosis, or selected risk factors. It would be neat to be able to add your own risk factors, but that is, perhaps for a future version.

The reminders show up in the health maintenance section, and you can have your staff input when their last screening was done and any notes (ex. normal, abnormal).

While we get acclimated to the Health Maintenance section, we put this info in the PMHx section for now.

- S.K.

Does anyone have experience with the Health Maintenance section they'd like to share?