After visit summaries

Discussion in 'Feature: Requests and Planning' started by laumansm, Sep 27, 2008.

  1. laumansm

    laumansm New Member

    I would like to see some sort of function that allows us to generate "After visit summaries" (AVS). An AVS shall include certain data elements such as vital signs, diagnoses, labs and xray ordered, as well as instructions that I hadn write and/or that are taken from my plan. Maybe that functionality already exists?



    Marius
  2. Graham

    Graham Developer Staff Member

    There is a Medical Summary available.

    In Patients/Consults and with the current encounter expanded, click on [Docs] and then click on the first option. If gsview is working, then click on PS-Template.
  3. laumansm

    laumansm New Member

    Yes, this is kind of what I was thinking of, with the exception that I cannot add my own notes/modify the text. Would be great to push this note to Word instead of pushing it to GSView
  4. Graham

    Graham Developer Staff Member

    Well, it would be easy enough to add export to Word functionality, but you have to give me a good reason.

    What we are doing is creating a report ... so I don't understand why you wish to add more text and not place it in the medical record. So, my initial thought is that any extra text you want added should be placed inside the encounter text, and then you do the push to whereever.
  5. laumansm

    laumansm New Member

    The reason I was thinking of a way to manipulate the data for an after visit summary is that I frequently give my patients handouts with a summary of my recommendations yet put these into different words than I use in my medical documentation. Maybe that's just me. For efficiency's sake, I should use the same text in both documents, though. Also, I do not necessarily want my patients to have the subjective and objective paragraphs on their handouts.



    I guess, what I am aiming at here is the possibility to generate a template that is reusable and contains the data that I want it to contain e.g. today's dx, plan, vital signs, current meds, certain meds. I could make templates (kind of like reports) for all kind of situations: AVS, lab summaries, referral letters, prescriptions, lab requests, blank patient letters, all from the same function. I have seen this kind of functionality in 3 other EHR and found it very useful. I can elaborate on this if you wish.
  6. Graham

    Graham Developer Staff Member

    I'll see what I can do then.

    However, this will make the automated uploading of such a document to a patient portal more difficult because what you want uploaded is different from what is in the notes.
  7. Graham

    Graham Developer Staff Member

    Synapse uses PostScript templates for this type of functionality. I would have to extend the dialect a little - but we could use that.

    The current templates are:

    1. Letter to GP/Consultant
    2. Letter to patient
    3. Lab or radiology request ( with or without diagnostic details )
    4. Prescriptions
    5. Superbills
    6. List of medications

    you can see and modify these templates in Settings/PostScript Templates, and you select which ones you wish to default to in Settings/User/PostScript/Templates

    The Medical Summary template isn't modifiable ( yet ) though it could be. It's basically a header, followed by all the selected text from the check boxes.

    One would also have to decompose the visit into SOAP ( well, it is already if you choose that documentation method .. and I don't )
  8. laumansm

    laumansm New Member

    Yes, I think this is about what I envisioned. I haven't found out yet how to call these templates in order to print them. Additionally, I am not sure yet what data tags I can use in the templates in order to include today's dx, medx etc.



    Looks very promising. I will look further into this.



    Marius
  9. Graham

    Graham Developer Staff Member

    basically in most situations where you print, you have a postscript printing option... and that's when these templates are invoked.

    In most cases, there is little point in offering different templates at print time and so the choice is just defined in your preferences. The exception is when printing letters .. and then you can select any of the different templates that have been defined.

    So, I have some letter templates that switch to different size fonts and so forth.
  10. laumansm

    laumansm New Member

    That makes sense. I just found http://compkarori.no-ip.biz:8090/Documentation_Index/PostScript_Template_Language



    In my current EMR, I have 5 or 6 different templates that I use, not more. These are basically reflected in the choice of templates that Synapse offers.



    Still, it would be nice if there was an option to modify the text easily after generation of the ps file e.g. by pushing it to Word or some other text editor (Wordpad?) instead. But maybe that's just me.


    Marius
  11. Jason

    Jason Developer / Handyman Staff Member

    Neat idea ... printing out the key patient information for that visit so the patient can understand what just happened to them !

    I certainly see an important trend here ..... we need a new Template for "Medical Summaries". I see Great Need for this:

    (1) After Visit Summary

    (2) Pre Op Summary

    (3) Changing Doctors Summary

    (4) Insurance Summary

    (5) Whatever Situation Summary ...




    I would find a PUSH TO Word Feature very helpful. Printing to Word is a feature I use a great deal already. Being able to edit and touch up the Final Document is a great bonus for many reasons.

    (1) Many things I put in the Diagnoses are not entirely appropriate for other doctors or other sources to know about. "Keep monitoring for Depression". "Very anxious". "Husband is worried about her mood". Or whatever.

    (2) When doing patient summaries I often add in which doctor they are seeing for certain diagnoses (ie. so one doctor knows which other doctors the patient sees.).


    (3) I like to make my documents look awesome. Word is great for adding images, Bolding on the fly, adding a colour Header, chopping up a document exactly as you want it, adding a digital signature ... and many other last minute things you want to do before you [FAX] [PRINT] ! A weakness of Synapse thus far (and many EMRs) is formatting of PRINT / FAX documents. Word would promptly eliminate all that.

    Note: Your need for some "Patient-language" that does belong in the Visit/Consult note ..... could easily be added to the Word Document with some Macro Text. Word has KILLER formatted Macro Text ability.


    (4) sometimes the patient's address changes ... and I just want to delete it.

    There are soooo many great examples how: PRINT to Word = Power and Flexibility.

    The idea you can create a pre-made Template for every situation is simplistic.

    Interestingly enough I find that my intermediate step of Printing to Word before printing the final document has great clinical value. I seem to come up with some super important information about patients at times as I read through what Synapse pumped out to Word. I will save these files to the patients Windows (aka "Paperport") directory because of how great they look and I will even often reuse the documents. To get the Networked Folder URL (for me: p:\patients\D\Doe, John I use the [Xplr] button to pop the directory up and then I just copy the URL of the folder and use it in the Save As ... dialog box in MS Word ! I would much prefer that Synapse generates a Word File in patient's directory ... pumps it full of data .... so I dont need to go through this process.


    Note: one thing that would be great for "Print to Word" would be to have a Synapse Specific default Word document template which is different from my usual default Word Document template (Normal.dot)


    Flexibility = Tremendous Power.


    [quote user="laumansm"]

    I guess, what I am aiming at here is the possibility to generate a template that is reusable and contains the data that I want it to contain e.g. t
  12. Jason

    Jason Developer / Handyman Staff Member

    Another suggestion: I would like the ability to PUMP <u>almost everything</u> about the patient into a Word Document. From there, I could easily delete what I dont want in ....

    Actually while on the topic ... it requires many different printings to send a copy of a patient's file to another doctor ( a patient moves and is changing doctors, or they go to a nursing home). I would love to provide a copy of "EVERYTHING" to the Next Doctor. I would touch up the Word Document and send that but I would also send a PDF which I would generate from Word .... ie with FreePDF XP. I would put both on the CD... with all their important .pdfs (consultant notes, MRIs, LabTests, etc. etc.).


    Note: it is also very "Consultant" biased that the Docs Button is only available when Printing a Consult. The majority of my [Docs] (ie. Patient Summary) needs are not based around one encounter, but on the patient as a whole ! Make the [Docs] button available everywhere !
  13. Jason

    Jason Developer / Handyman Staff Member

    I dont want to make you salivate too hard... but I would like you to read this thread where I make a case to Graham to produce end user customizable Popups / Summaries of exactly what you want ... but more for customized displays to help you make clinical decisions.
  14. Graham

    Graham Developer Staff Member

    On the diagnoses tab, the [Print] button brings up a Medical Summary that can be exported to Word.
  15. Graham

    Graham Developer Staff Member

    I've added the Medical Summary to the [docs] button and added an option to add the encounter text.




    [​IMG]
  16. Graham

    Graham Developer Staff Member

    So, Marius, does that Medical Summary -> Word do what you need?
  17. laumansm

    laumansm New Member

    Yes, this is very much what I envisioned. Awesome. Marius
  18. laumansm

    laumansm New Member

    [quote user="Jason"]

    I will save these files to the patients Windows (aka "Paperport") directory because of how great they look and I will even often reuse the documents. To get the Networked Folder URL (for me: p:\patients\D\Doe, John I use the [Xplr] button to pop the directory up and then I just copy the URL of the folder and use it in the Save As ... dialog box in MS Word !

    [/quote]

    You can add yoru own directories in the "Save us" dialog, at least n XP Professional. See http://www.simplehelp.net/2007/07/28/how-to-set-custom-shortcuts-in-the-windows-xp-save-as-dialog-box/

    This works for me. On that note: some documents such as WORd documents are not automatically saved in Synapse. If I e.g. save a document in the "Paperport" directory, can I access these from within a patient's chart?

    Marius
  19. Graham

    Graham Developer Staff Member

    No .. because they're external documents.

    I don't recommend using Paperport, Word etc. because they are not tied into Synapse's document management system.
  20. Jason

    Jason Developer / Handyman Staff Member

    It depends on what you mean "Access".

    You can always access a Patient's entire "PaperPort"/"Windows Explorer" directory by clicking the [Xplr] button.

    Then to open the File you created, just click on it.

    As pictured below, you can "Look Behind" the consult popup and acess [Xplr].

    It might be quite handy to have [Xplr] accessible via a Function Key popup, if you do it alot.

    Attached Files:

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