I was thinking of doing this for my office. It may be useful to others. It should be easy to do.
When you go into a patient chart, if there are any alert notifications, money to collect, message to give to the patient, labs that must be done…anything that you want to make sure you or your staff are clearly reminded of on the next visit, an alert window would pop up with a list of messages including a delete button, the date and time the message was entered and maybe a link to the encounter where the message was entered.
If there are no alerts, the popup will not pop up and the feature would be invisible to those who do not use it.
Data would be entered through an encounter form. The alert would still be recorded in the encounter even after deleting it as an alert in the popup window.
There could also be a similar popup at the main screen with all patient alerts which can be brought up by clicking a link. This would be similar to the one in the chart but would also include the patient’s name which would be a link into the chart.
I am going to get to work on it because we could really use it in our office.
This sounds a lot like what I already did with patient notes. I.e. patient notes can be specifically addressed to individual staff members, rerouted, closed, etc.
Perhaps what you want is an alternative note destination, one that makes it pop up for whoever opens the patient.
Let’s try to improve on features that already exist, and not have multiple features with overlapping functionality and different interfaces.
This is part of the decision support system that we have discussed previously and for the most part is not a duplication of the existing functionality. The current patient notes works best to document on-going “conversations” such as telephone calls, pharmacy calls etc.
What Dr. Leeds is suggesting are pop that are stored to warn of future events. “Forget-me-nots”. Many of this are general alerts and not assigned to a specific staff member. Such as Dr. Leeds’ example of “this patient owes $780 dollars and is not making any attempt to make payment on this account. The patient needs to discuss a payment plan prior to receiving additional services.
Specific diagnoses in the the problem list should trigger recurring pop-ups on a regular schedule. For instance, any diagnosis of diabetes mellitus, an A1c is due every 90 days. A check on microalbuminuria is due annually. Etc.
Certain regular monitoring events should occur to help remind when this events are overdue.
Females over the age of 18 need annual pap smears up to the age of “x” years. Married women over the age of 45 the event might be set to occur every three years. Women who have hysterectomies for non-gyn cancer related cancers the pop-up could be turned off.
I think this could be a very useful start on a decision support system.
An “Active Alert” from the Clinical Decision Rules engine will produce a pop up when opening a patient screen. Recommend reading through the CDR engine doc for details(Number 3 and number 6 in below page are what to look at): http://www.open-emr.org/wiki/index.php/CDR_User_Manual