Back to Basics

Discussion in 'Bugs & Issues' started by DrO, Jan 8, 2007.

  1. DrO

    DrO New Member

    Back to basics!!

    1- There is no way to get a simple query! I tried to get a list of my female patients who are older than 65 and got
    "sql error in sql-report". If I want to know who lives in zip code 33614, I do housecalls, I have to go to my excel file, Synapse can't help me!

    2- How can you know who is due for a visit/a follow up appointment? Forget tags, you have not explained how to use them!!

    3- At present, the program does not allow us to enter the reason why a medication was stopped. Clicking on the "Old Medications" brings up a pop up for refills!! Entering "diarrhea" on the text area (before delete) shows on the Script area M:diarrhea. This needs to be fixed!!

    4- We are not in full or adequate control of the SOAP area. I like "denied" when the patient denies SOB.
    Most older patients are seen for chronic conditions. These diagnoses are already in the database. There should be an easy way to apply these "Tags" to the Subjective. For instance:

    F/U for multiple chronic problems: COPD (496), DM( 250.00), HBP(401.1), CAD (414.00), Hyperlipidemia (272.4)
    Diabetes (250.02)<----last ICD-9 code used. FBS has remained WNL, 14d ave 109, PP 14d ave 156. Asymptomatic.
    HBP (401.1) taking his meds, denies CP, palpitations, headaches, dizziness. BP has been controlled( pharmacy readings).
    Hyperlipidemia (272.4) On Lipitor 10 mg. Refers that he is not feeling well, weak, aches and pain in calves and muscles (myalgias) , asthenia since he started Lipitor.

    "The status of >= 3 chronic conditions is enough for a HPI that can result in a "high level visit" depending on the other parts of the Evaluation and Management"

    I can use DNS8 to enter the note, but the main reason to use an EMR would be lost!! Of my patients on Lipitor I would never know how many presented with myalgias or asthenia.

    These mundane problems should be addressed, now that we "know" how to format a PostScript report.

    DrO
  2. Jason

    Jason Developer / Handyman Staff Member

    "Back to Basics"

    I've been feeling the same way for a while now.

    I, as you, have a list of what might be called "more core issues". Certainly Synapse has added a massive number of features over the last 3 months. Massive. I would agree that some areas were added before others were "finalized".

    Case in Point: Linux distro, and forthcoming OSX version.

    I'll try to round up my list of "core issues" - and I would encourage everyone to make a similar list. It would be interesting to see what items we have in common.
  3. Graham

    Graham Developer Staff Member

    Try this ..Click on Example-1, then change the age to 65, gender to female, and remove the "contains" arthritis.

    run the report .... be prepared to wait ... and Synapse will be blocked until the query completes.
  4. Graham

    Graham Developer Staff Member

    Tags are nothing to do with followups. If you want to know who is due .. just look at the appointment scheduler.

    Tags are for searching for patients where the visit contains certain text .. ie. a type of free text search.
  5. Graham

    Graham Developer Staff Member

    Click on the Medication - use the Delete button, fill in the reason, and the medication is gone.

    Use the Medication History popup ( or button in the consult editor ) to see the reasons and dates.
  6. Graham

    Graham Developer Staff Member

    Not entirely clear what it is you want here. In the consult editor, if you click on a diagnosis, that gets inserted into the text.

    If you want to know about the number of asthenic lipitor patients ...you would have to stop the medication and give the reason as asthenia.
  7. Graham

    Graham Developer Staff Member

    Hmm. Clicking on a diagnosis puts it into the assessment field ...

    Have to think on this.

  8. DrO

    DrO New Member

    Most elderly patients have multiple chronic illnesses. Thus, Mr.Smith comes in for F/U of his multiple problems: DM,HBP,Hyperlipidemia, Arthritis,COPD,CAD, etc. The status of these conditions is of import. The visit might address a new problem, an exacerbation of an existing problem, or the F/U of multiple chronic problems.

    The Diagnoses have been incorporated in Synapse, but they are not accessible to be entered in the text.

    I would like to have a template that addresses these chronic conditions and their status. The manner in which Synapse is currently dealing with Templates does not allow us to do so.

    Perhaps expanding my previous example might help:

    F/U for multiple chronic problems: COPD (496), DM( 250.00), HBP(401.1), CAD (414.00), Hyperlipidemia (272.4)
    Diabetes (250.02) <----last ICD-9 code used, Diabetes was uncontrolled the last time he was seen!


    Status of chronic conditions:

    Diabetes: FBS has remained WNL, 14d ave 109, PP 14d ave 156. Asymptomatic.
    HBP: taking his meds, denies CP, palpitations, headaches, dizziness. BP has been controlled( pharmacy readings).
    Hyperlipidemia:On Lipitor 10 mg. Refers that he is not feeling well, weak, aches and pain in calves and muscles (myalgias) , asthenia since he started Lipitor.


    This hx is a high level hx!!



    I would like to be able to design a template like the CC: template. It produces a "pro" output. I would like to be able to control the "hidden" text.

    Can you do it?

    DrO
  9. Graham

    Graham Developer Staff Member

    I'm currently working on integrating the enterprise fax server Hylafax into Synapse, but if you leave your template ideas here ( or another topic ), I'll catch up later on and see what can be done.

    See Sam's ideas/requests here and see what you guys come up with.

  10. Graham

    Graham Developer Staff Member

    See here for some new ideas on templating.

  11. Jason

    Jason Developer / Handyman Staff Member

    [quote user="Graham"]

    See here for some new ideas on templating.

    [/quote]

    Looks good.

    How much work would it take to make the macros "more robust" (ie. 1 window) ?
  12. Jason

    Jason Developer / Handyman Staff Member

    Oh BTW, Back to Basics isn't feature adding, it's making the core even more robust. [:)]
  13. Jason

    Jason Developer / Handyman Staff Member

    [quote user="DrO"]

    Most elderly patients have multiple chronic illnesses. Thus, Mr.Smith comes in for F/U of his multiple problems: DM,HBP,Hyperlipidemia, Arthritis,COPD,CAD, etc. The status of these conditions is of import. The visit might address a new problem, an exacerbation of an existing problem, or the F/U of multiple chronic problems.

    The Diagnoses have been incorporated in Synapse, but they are not accessible to be entered in the text.

    I would like to have a template that addresses these chronic conditions and their status. The manner in which Synapse is currently dealing with Templates does not allow us to do so.

    Perhaps expanding my previous example might help:

    F/U for multiple chronic problems: COPD (496), DM( 250.00), HBP(401.1), CAD (414.00), Hyperlipidemia (272.4)
    Diabetes (250.02) <----last ICD-9 code used, Diabetes was uncontrolled the last time he was seen!


    Status of chronic conditions:

    Diabetes: FBS has remained WNL, 14d ave 109, PP 14d ave 156. Asymptomatic.
    HBP: taking his meds, denies CP, palpitations, headaches, dizziness. BP has been controlled( pharmacy readings).
    Hyperlipidemia:On Lipitor 10 mg. Refers that he is not feeling well, weak, aches and pain in calves and muscles (myalgias) , asthenia since he started Lipitor.


    This hx is a high level hx!!



    I would like to be able to design a template like the CC: template. It produces a "pro" output. I would like to be able to control the "hidden" text.

    Can you do it?

    DrO

    [/quote]

    Q: DrO, does the new macros with the *diagnoses* help you at all ?


    Attached Files:

  14. Graham

    Graham Developer Staff Member

    Multi-select ?

    Let me see what I can do about that.

  15. Jason

    Jason Developer / Handyman Staff Member

    The selections would be separated by commas ?

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