SynapseDirect for neurologists Q & A

Re: Date input field

I see what the issue is.

You are talking about archiving old records.

I am talking about scanning day to day stuff.



Converting paper charts to an EMR is incredibly time consuming for the doctor and the scanner/filer.

All of my old items are in the patient's paperport directory. (and are named with what they really are).



Zola, Lou Ann - GDC - Dr. De J - Pap normal - August 2005.pdf

Zola, Lou-Ann - XRay - LSpne - Mild Deg Disc Disease, Mechanical changes - Jan. 19,05.pdf



These are reports and whatnot I've seen regarding the patient (while under my care) but before I started archiving with Synpase.




The other issue is the transfer files (old files from their old doctor).

I did two things

(1) if there was time I went through the patient's old chart. I made piles for all the relevant things. I usually put all the old labs in one big pile (I threw out the old labs that were useless). Sometimes I made a different pile for labs I felt were "key". I often made a pile for the patient's most recent pap smear. I made a pile for the most recent EKG and put the old ones together in one pile. I put patient's cardiology stuff in a cardiology pile (consults, stress tests, echos, etc). For patient's with multiple consults from the same specialist, I usually grouped those together. I put all imaging together often. Except for special imaging (ie. MRI spine shows MS, etc). Because I consider this "doctor triaged" scanning, I threw out really useless stuff and shredded it.

(2) when there isn't time, my secretary either did one of two things.

- put the entire transfer chart into sections: (1) consults, (2) labs, (3) EKG, (4) imaging, (5) doctor notes, (6) most importantly .... Patient Summary.

Because it is time consuming, I suggest just putting all old records in the PaperPort directory and not importing them to synapse.



Many doctors just make a clean break from paper charts, don't import anything, and ONLY get the paper chart when needed.

One option is to get your secretary to scan everything into the patient's paperport directory. Name all the documents .... EKG.pdf MRI head.pdf ... etc. Mass Add the patient's name to the beginning of all the filename (with an external program). Once it is finished by the secretary, you can review it and import the files you want to import and leave the rest. [Add New] [Open PPort File].

Re: Date input field

Much more time is saved by :

(1) not scanning what doesn't *REALLY* need to be scanned.

(2) coming up with a system for your staff to do all the work they can.

(3) getting the right scanner.

(4) realizing it's not possible to archive old charts during the busy day.

(5) putting everything in the patient's paperport directory is much faster than attaching it.



Think long and hard before you embark on "scanning and filing" every patient's old chart. Quite possibly for the hardest 100 patients you might *NOT* scan their charts and just use the paper charts.


Q: I've always wondered if it is worth it to have a section in the EMR for each patient that describes what was done with patient's old files, etc.

Re: Date input field

Try drag and drop to a tree structure of 40,000 patients ...

Re: Date input field

You could have third party software synch up your patient's paperport directories to all your offices. Consider it an interesting backup method, with benefits.

Every EMR does a very bad job of migrating old charts. It is a difficult task.

It is hard to figure out what is reasonable when migrating from paper to paperless charts. Difficult decisions are required.

Re: Date input field

This is my point ... when you have a few patients, you might think that using a tree structure is faster.

But once the numbers build up .. it becomes way slower to navigate a tree.

Which is why PaperPort becomes unusable after you have a few patients as the tree navigation is so slooooooowwwwwww.

Re: Date input field

Re: Date input field

Don't understand.

You already can choose from the buttons for correspondence, and various type of labs .. what exactly is the functional difference from selecting from buttons as opposed to selecting from the labels on a tree?

Re: Date input field

PS - work that is deferred to tomorrow never ever gets done.

Re: Date input field

PPS: an interval viewer is useful, but has the big drawback usually of being limited to viewing only one file at a time.

Say you had two MRI scans you wanted to compare. With an internal viewer you have to keep switching between them. With an external viewer, you bring up both images on a different monitor ( if you have multiple monitors ).

Which is more flexible?

Re: Date input field

I know, but you still have to get to that patient somehow to open his document tree. (analogous to F3 last first searching)

The problemof gettingold scanned files into any EMR is a challenge. Any method of batch importing is beneficial.

Q: are you sure that you really want to import a document without a date and no metadata ? If the document is that unimportant, why import it at all ? When you have 30 imported "Labs" exactly how are you going to find the one you want / need ?

Assuming this is a goodidea, Graham, is it possible to make a different [Addresults] dialog window that more corresponds to the needs of "initial batch importing of data" where you don't need to specify anything other than what it is (lab/consult/EKG/whatever). And allow for dates to be changedlater and keep the option open for adding metadata asneeded ?

I'd seriously consider using paperport to do this. Dump everything in Paperport and then add things as you need them.

One thing to remember, you want access to charts from remote locations, how did you do that with Paper ?





Very complicated stuff.

Time is money and I say never mind importing old stuff. Just file it in the patient's paperport directory

Re: Date input field

I don't think there's much to be gained by dumping anonymous documents into the patient file in Synapse.

So, at present I won't support it.

Re: Date input field

Anonymous ? heh. It has what it is

Re: Date input field

All dates in Synapse are dd-Mmm-yyyy

Or, dd/mm/yyyy

When adding a patient, and so far, only there, the date format mmddyyyy is supported.

Dropping the century digits eg. 19 from date fields was the cause of the y2k problem. Since it is possible that users want to record historical medical data, without the century digits, Synapse will not be able to interpret the dates correctly.

In some countries ( Taiwan for example ), the Gregorian calendar is not used. There the current date is actually 15-Feb-0096.


The y2k problem also arose because software was in use for much longer than intended. It would be nice if Synapse were still in use in the years 2100 and following ..., and since I don't think I'll be around to fix it back, I think I would prefer to keep the century requirement.

Re: Date input field

Try this ...

Adds alternate date formats - for results eg. 01-Jan => 01-Jan-2007, and 31-01 => 31-Jan-2007

ie. it tacks on the current year with a "-" if it only see dd-Mmm, or dd-mm-

Should work for Taiwan as well ...

Re: Date input field

Oh ..you have to use <enter> on the add result date field to make this work.