CCHIT - Problem List

bradymiller wrote on Tuesday, January 26, 2010:

hey,

So, we can’t default the new explicit item to ‘none’ then, correct.  If so, I’d suggest (similar to smoking) having a mechanism (via clinical alert summary widget) to remind physician/staff to place none vs an issue for them then (or else, you’ll likely be less than 80% on the MU.

Need for above mechanism is what has me confused my about the meaning of this sentence, Sam. If , indeed, this needs to be explicitly set, then it’s not a emr issue anymore, it’s a individual practitioner issue (how we can claim MU, then???). For exmaple, if one bad practitioner in a group doesn’t fill this stuff out, they will fail CMS.

-brady

bradymiller wrote on Tuesday, January 26, 2010:

To repeat more clearly,
  We need to ensure adding an explicit ‘none’ is needed. If not needed, this mechanism alone the has potential to cause many OpenEMR instances to fail MU.
-brady

blankev wrote on Wednesday, January 27, 2010:

For what it is worth,

some fields could have as DEFAULT “Don’t forget to ask” or “To be asked”, might be more appropriate than required.It is obvious to ask certain questions and sometimes there is no time to fill in very field related to every aspect of important medical information.

I like Sam Bowen’s remark and it is clear. But somehow I have the impression that many doctors and practinioner nurses would like to ask every question but decide to leave some questions till next visit.

Pimm

tmccormi wrote on Thursday, January 28, 2010:

I have actually implemented some versions of that kind of logic, “must select something here” .   MU requires that provide a mechanism for recording the various data items, not that we enforce a Physician’s business practices.

There (as Sam says) are plenty of places where true and false must be explained and unselected means “I didn’t look there”.  CMS rules require this for Review of Systems…

-Tony

bradymiller wrote on Thursday, January 28, 2010:

The issue is this though. If we create this mechanism (need to explicitly state or choose ‘none’ and place in a field), are we shooting practices in the foot (if their practitioners don’t select ‘none’ or an item in >80%, they don’t fulfill MU).
-brady

blankev wrote on Thursday, January 28, 2010:

Could this be done with:

global.php

with the mind set on “I do want MU always to be in place” or MU “can be in place but I sometimes have no time to fill every requiered field”?