anonymous wrote on Sunday, November 18, 2007:
yes ofcourse, the idea is to contribute to openEMR and make my stuff integrated with that too to make one super system.
Dr. Bowen, thats an interested perspective. Almost a 180 degrees line of thought as far as the encounter capturing is concerned.
So here is my initial take on why we need it template driven.
Eventual goal is to generate Fee Slips or Super Bills from the Options selected in the template itself. This will make for precise encounter form highly consistent with the medical records.
As far as sounding caring and 1-on-1 with the patient… these so called clicks are converted into a prose form using multiple set templates. Soemthing like a "fill in the blanks". This is what is submitted to the Ins companies etc with medical notes are requested by them.
Also: To address the issue of the disadvantage of capturing data
I am working with a specialty right now. In general, the physician works with a limited set of diagnosis and treatments. Say 90% of the ailments are common and oft repeated. It is that remaining 10% which may need special handling. And for that we will always have text fields which will subsequently becoming part of templates/dropdowns. It would be like a self learning tool. That is why i leaned towards the template way.
Also, to explain a bit about the error checking system, currently this is all hardcoded and whenever we come across a rule we just add it to the system. (this is billing related though)
For e.g.
Modifier Check: The code looks for globals by checking for encounters within the last 10/90 days and alerts us to add that in case we have missed.
Missing RPH: If referring physician is missing, it alerts the data entry operator.
Using the Appropriate modifier: such as when to use 50/51/59… All that is hardcoded based oh phy feedback … and so on. We have dozens of such rules which reduce claim errors before hand.
The goal would be to make this a user driven system where the user himself can add rules or create rules on the fly and based on their requirements.
Precert Tracking:Heres the flow till now as we have been using it.
Someone enters into an online form. what they require precert for. Patient/procedure/diagnosis.
This goes into a list to be used by the precert person sorted by date requested.
Color coded for various types so the appropriate person handling can easily view his list./
When clicked, a form with various fields come up including phone number of insurance company, patient details, request details so the precert guy just have to make the call… follow the instructions, determine whether its a no precert required or predet required or whatever and fill in the form. and store it. Once OKed, someone moves it over to the "done list" and sets the appointment.
For tricare, a tricare look alike form is automatically generated in pdf which can be directly faxed.
The reason i was pushing for a template driven objective clickable emr is so we can determine eligibility or medical necessity based on the past data captured (case in point: Anthem medical necessity determination for radio frequency).
