Add Result / Inbox Tweak: review on paper to cut down on INBOX items.

Most of my paper comes on paper, not by fax. I get alot of medication requests by fax.

I'm assuming there are a lot more Rx request faxes than other faxes, so hence my suggestion on .tiff prescreening. What's your workflow for the stuff arriving in the mail? Are you using a high speed scanner to pdf them, and send to cache-listener?

My mail stuff is the problem.

Especially because I don't currently use HL7 Labs, I get so much paper each day. I want to "Quickie" triage things on paper with my nurse and myself. My INBOX will really be just for things I want to review or my staff things I definitely need to review. Right now it is an inbox for everything that is scanned and that is just too much.

The paper will also help me leverage my staff more effectively. I am planning on using a yellow highlighter to

- highlight med changes and get my staff to enter the changes.

- highlight new diagnoses to add to the patient's chart

- highlight new surgeries to add to the patient's chart

- highlight new ticklers to add to the patient's chart

- highlight new Social History to add to the patient's chart

If it is in the inbox, I have to do it myself.

I don't mind marking up the documents with a highlighter .. because they don't show on scans, and I just shred paper anyway.

I figure this is maximizing the benefits of paper when I have the document in paper format and then getting rid of it so I don't need to maintain paper charts.

This would save me lots of time and data entry.

Explain again why you don't have HL7 labs? I wouldn't cope with all the paper if I had to scan all my results.

I will re-pursue formal talks with the Lab, but they don't need the business so they dont care about me.

They kept insisting that they cannot certify what their results will look like in Synapse, so they won't send me the electronic data.


Wait. I have a great idea. I really like the online lab results so for 75% of my labs I could review it online.

25% come from other labs where I have no digital access.

If I had a way of diverting incoming labs from my inbox, I could review them online and not need to review in my inbox.

I still need the ability for Importing to NOT go in my INBOX.

This online labs reviewing should also satisfy them that I am viewing their results as they see fit.

Maybe you could use chickenfoot as well to search the lab's website for a particular patient's labs as you are in that patient's file in synapse.

After you have reviewed a patient's lab results on the lab website, do you then download a pdf of it to synapse cache-listener?

Maybe a new incoming folder could be invented, similar in function to (in my case) /hyalafax/faxout called something like /EMR/Server/already_reviewed. Files in this folder would go straight to patient's synapse record without passing through doc's INBOX. Maybe the reviewer's name could be added to the initial file name, so synapse would know which provider it belongs to.

This is a very unusual position to take. What if you told them you were using some common ca emr? Or, were using Mirth?

Heh. Only vendors can actually contact the labs to hook this stuff up. I am going to stick out like a sore thumb when I pursue this. I know a guy who worked with me on the Provincial EMR standards committee and he used to work with the Lab I want to integrate. Hoping he can pull some strings.

Your lab is crazy if they want to certify each EHR that wants to receive HL7. It is supposed to be a standard.

What they need is a little competition ...

Indeed.

Labs here have "no" competition whatsoever.

I think the labs are somehow more profitable if they do less testing for some weirdo reason.

The request was to be able to send some things I have already seen to the patient's chart (without the need for me to review it in the INBOX).




I think this is a very MD-friendly feature that most EMRs would not have.

The workaround suggested was to file some things I don't want to re-review into another doctor's name.

I made a doctor called zAlready Reviewed, but for patients with myself as their PHCP .... the doctor reverts from zAlready Reviewed to me when I [F3] switch to their name. Thus 90% of items filed need to have the Doctor switched from me to zAlready Reviewed.

So the issue is ....

(1) I really agree with the items going to their MAIN doctor by default (good idea).

(2) We need a way to file items without going in the doctor's inbox.

I think the simple [For Review] [File in Chart] paradigm is a good method. Maybe add a good [x] Urgent tag and it'll be great !

I plan on handling urgent things on paper myself.

B49 now has the "default doctor" over riding the PHCP setting so that should solve that problem.