Recall Improvements

[jordansparks]

I expect to be posting a new page with an overview of planned recall improvements. If this is a topic of interest to you, check back here later today.

[jordansparks]

http://www.open-dent.com/manual/recallimprovements.html

[drtech]

one thing I have always wanted is for the recall note and next recall due date to appear at the bottom of the progress notes. This way you can see the entire status of the patient when you are looking at the chart and not have to hunt for the note made on the recall status when you are reviewing a patient...

[jordansparks]

You mean over in the patient info window of the Chart module, right?

[drtech]

well, I suppose that would be ok, but I still would like it to show in the progress notes just like an appt, note, or like a commLog copy of the it does now (sometimes it does this). And then be able to double click on it. You could either have the prophy/perio recall listed there by date and the note included just like any other commlog entry.

Think about when your staff is checking out a pt or you are reviewing a pt. If they don't have a next appt, when is the next contact time? (this is where we use the progress notes in the account(where appts show up), so that you can easily see when the pt's next appt is without having to change windows from the account...) We either post a note for the pt on the appt book sometime in the future (and that shows up in the progress notes to easily see) or we rely on a recall date. But currently, you really have no idea when the recall date will next come up without going to the family file and then to see the note that might be included with that recall, you have to open up the list and then double click again to see the note. I think we should be able to specify the main prophy/perio recall to show up all the time in the progress notes at the very bottom. that is your next contact note/date and fits perfectly with the progress (albeit future progress) of the pt.

Just having access to all the recalls on the pt info grid would be one step better though, esp seeing at a glance when the FMX/Pano and/or BW's are due from the chart window. You could set it up to see the next contact date here, but then that falls out of my progress notes idea so that it shows up in the account progress notes too. (That is why I have all the p

[jordansparks]

I don't understand why the clinical staff needs to be concerned with the next recall. They specify that the patient is "done" as far as the planned appointment is concerned, and then the front desk handles recall. As for the recall note, that's for use from the recall list. Why would you need to see that from any specific patient module? Still, I added it to that page.

[drtech]

New Revision: 3057
Log:
Recall list now stays open and can be minimized.[/quote]

Yea!...This will help lots to be able to leave the window open....are you going to be able to jump right to the chart from the list? That would really help!

[drtech]

when I am reviewing accounts (which I do regurally to stay on top of the practice) I go through the aging list and look at each pt. I look for what we did, what they owe us, how we arranged to be paid and or why the account is not paid and then what was the last contact and when do we plan on contacting them again. I do this from the chart and from the account.
I would like to be able to use the recall system to see when the next contact is going to be and what was said the last time we talked with the pt. I don't think we should have any notes that are hidden or not visible from the chart or account (the current recall note) because then you can very easily miss that someone talked to them recently and left a note in the recall note but then can't see it from the account. Very inefficient I think.

What else is the plan to track patients besides the recall list? When you have a pt chart or account up, I think it is very important to know when their next appt is, what was the last thing that was said to them, and if they don't have a next appt, when you are going to contact them again (recall due date).

[jordansparks]

Those contacts and the associated notes are all clearly visible at the bottom of the Account module. They are less obvious to you because you have chosen to put Progress Notes in that location. I still don't think that's an appropriate place for Progress Notes. This is one of many reasons why.

Yes, you can now jump to any module while leaving the recall list open.

[jordansparks]

In the edit recall window, what are all those set buttons doing there? Did you add those? That's not how the program was intended to be used, and I'm going to remove them.

I agree that the status and note should be visible from the Family module, so I'm going to add those.

[drtech]

I added those a year ago or so after we were discussing this. It makes it easy to set the date to the next time you want it to appear on the recall list. Am I missing something here? How else do you reset the date if you are trying to track a recall when you are unable to get a hold of them or you contact them and they are not ready to schedule. This happens all the time. So you agree to contact them again say in three weeks, and then need to set the date to that time, hence the buttons for easy setting of the date. How do you suggest we do it?

If you don't have the progress notes in the account, you can't see the appointments. So how does your staff see if they still need to schedule an appt at check out? That is why I am trying to make it easy to see all that is needed. Also, when someone is working an account, say to follow up, the need to know what was written in the progress notes before calling to see what was stated on the last visit. So, if it isn't in the account, they have to go to the chart. Do you envision it working some other way? How do you handle it?

[jordansparks]

Oh, you've been using that date to move them forward if they want to wait. There's a new field for that in version 6.8. The only reason we ever gave people access to change that date in the first place was for conversions from other software. I suppose your workaround was the best alternative up until now. But the best design is to not change the original due date, but instead make them drop off the recall list for a while. When they pop back onto the recall list, they will still have the older original due date. Looks like I might add your buttons or something similar to them back into that window. But they will affect the new field.

The front desk can easily work off of the Account module and the Appointments for the patient. They do not need to see progress notes. The clinical staff "informs" the front desk clearly and without any ambiguity at all by using the planned appointment. If it's marked "done", then their next appt is the recall. It's simple.

[drtech]

yes, we use the planned appt all the time and I really like that. We schedule half of our appts in the back and even collect money on occasion at the chair too. But if too busy, we send them up front to be scheduled in the traditional way by the front desk staff. What I am saying, is when the front desk is looking at the account to check out with the standard view, there is no way to see if the appt has been scheduled of if they still need to without going to the chart or appt module to check the planned appt. With the future appts showing in the progress notes at the bottom, it is very easy to see at a glance while you are checking the pt out if the appt is already scheduled or not. I am just talking about efficiency. I am trying to have the staff think about the patient as a whole and not break up each task into "departments." The planned appt doesn't really matter to what I am talking about. Does this make since?

[drtech]

great, glad to hear about the new field, that will be even better so you can keep and see when the real due date was and as I understand a new field to when you want them to show up again, sounds good.

[jordansparks]

There is simply not enough space on the screen. So that's why we have different modules. If the front desk it doing appointment related activities like checking to see if they need to schedule an appointment, that activity belongs in the Appts module. I do wish that the other appts for the patient were directly visible without having to drill down to another window. Might add an optional pane for that somewhere.

[drtech]

Yes that would be nice...but my philosophy is no one should be taking to the patient really about anything without having the full knowledge of what has been written before etc, so I still don't see why you don't like the whole progress notes visible in the account. But from what I understand, you think it is too cluttered? It would solve the problem of space on the screen to just show the notes as I suggest...and this includes the commlog that you added a few years ago, so it makes it complete. If you want to filter out to only see the commlog for some reason, then just make it like two buttons to really easy to switch between viewing "all" and only "commlog" visible. Wouldn't that solve the problem and eliminate the need for another pane? Shouldn't the goal be to make everything as complete and efficient at possible? Just trying to make that happen...

[Rickliftig]

This was so tough to visualize in words, but I see where Jordan and David are both coming from. So through the miracle of Microsoft Paint:



My guess is that it is not that simple. This is captured from a 19" screen @ 1440 x900 resolution.

[Rickliftig]

Jordan - Regarding 'Clearing the list' in the Recall Improvements page, rather than fixed rules about clearing thelist, I would rather see flags listed. So the patient would not be dropped, but a flag would indicate things like, owes money, alternates perio, denture patient, pt does not wish recall on regular basis, etc.



Then if you really want to clear, you filter and then delete.

[jordansparks]

You can already do that with the statuses. The improvement is a way to get them off that list for a while. We've simply got to empty that list so that we know we are up-to-date with recall.

[drtech]

Also, I don't know if we need a separate filter or in a different section, but a place to manage patients who fell through the cracks and have recalls due say 6 months ago or 2 years ago we need to contact. How should we handle that? Right now, they too easily fall through if you have your dates set for 2 weeks back or even 6 months back, they eventually a "gone" and forgotten about. Maybe they need to become a red color or something to grab your attention if they are about to go off your list due to dates or something. Not sure that would really help. I don't know what the best solution is, but I wish someone could think of something! I wish we were perfect in communicating with everyone, but it just doesn't always get done....

[drtech]

That is a large res, which works for some and all newer systems, but some of my computers (as well as I am sure lots of other peoples only run at 1024x768) and we need to try to fit everything onto that size.

I think that screen is a great little example of what we need with the films and recall, etc.., trouble again is with screen real-estate. Now the appointments already show at the bottom of the progress notes in the chart, so that part is not really needed. My thoughts are we either need something like the example above in the account and/or just include the progress notes in the account (like I like :p) and that solves the real estate problem. It would require something to go in there about the recall though in the progress notes, which I am not sold on as Jordan says is the best way, just my best idea to combine real-estate problems with what you need to see. All it would take in my mind is one line at the bottom...maybe I will do a little paint action too and demonstrate!

[jordansparks]

Also, I don't know if we need a separate filter or in a different section, but a place to manage patients who fell through the cracks and have recalls due say 6 months ago or 2 years ago we need to contact. How should we handle that? Right now, they too easily fall through if you have your dates set for 2 weeks back or even 6 months back, they eventually a "gone" and forgotten about. Maybe they need to become a red color or something to grab your attention if they are about to go off your list due to dates or something. Not sure that would really help. I don't know what the best solution is, but I wish someone could think of something! I wish we were perfect in communicating with everyone, but it just doesn't always get done....

You need to go back about 3 or 4 years (1095 or 1460 days), not just 2 weeks or 6 months. And if you can get the recall under control, you actually want to go back forever. That's the whole point. When you start going back that far, you will begin to understand why it's so critical to be able to clear them off your list or it will get long. If your settings are correct, they will pop up again every few months or years, depending on your settings. In version 6.8, after a given number of reminders, they fall off the list for good.

[drtech]

And if you can get the recall under control, you actually want to go back forever. That's the whole point.

Exactly...I would love to be able to get it under control and manage it properly...any help would be greatly appreciated...I look forward to these changes and any other discussion to what would make it better...

[jordansparks]

You can start right now by going back farther by default. It's already set up to be able to handle that fairly well. In version 6.8, that will become easier.

[savvy]

I don't understand why the clinical staff needs to be concerned with the next recall. They specify that the patient is "done" as far as the planned appointment is concerned, and then the front desk handles recall. As for the recall note, that's for use from the recall list. Why would you need to see that from any specific patient module? Still, I added it to that page.

Jordan, you are assuming that there is a front desk person that does this.
In my office, everyone, including me, handles this.
I eliminated the dedicated front desk person back when we were using Intellident.
I actually had to re-introduce the position after converting to OD. Primarily because the recall initially sucked the big one.
Now that OD's recall is tolerable, we have dropped the dedicated front desk person again.
I agree that the recall should be highly visible, I'll go so far as to suggest that it appear on almost every screen in the pt chart, or at the very least some manner to access the recall with one click.
For example, my perio office delivers to me a stack of perio pt reports. Each report is scanned into each pt's Image Module.
In order to modify a pt's recall, one must exit the Image module, Enter the Family Module, Select Recall then make the change. If one has a dozen pt reports, one must repeat the process a dozen times. Which equates to 3-4 dozen different screens. It would be great if one could select a pt, go to Image File, Scan Image, Select Recall, Change Recall, Select different pt and repeat....

[savvy]

Also, I don't know if we need a separate filter or in a different section, but a place to manage patients who fell through the cracks and have recalls due say 6 months ago or 2 years ago we need to contact. How should we handle that? Right now, they too easily fall through if you have your dates set for 2 weeks back or even 6 months back, they eventually a "gone" and forgotten about. Maybe they need to become a red color or something to grab your attention if they are about to go off your list due to dates or something. Not sure that would really help. I don't know what the best solution is, but I wish someone could think of something! I wish we were perfect in communicating with everyone, but it just doesn't always get done....

You need to go back about 3 or 4 years (1095 or 1460 days), not just 2 weeks or 6 months. And if you can get the recall under control, you actually want to go back forever. That's the whole point. When you start going back that far, you will begin to understand why it's so critical to be able to clear them off your list or it will get long. If your settings are correct, they will pop up again every few months or years, depending on your settings. In version 6.8, after a given number of reminders, they fall off the list for good.

Why do you want them to fall off the list for good?

The only reasons I can think of are 1) they died, 2) they told you that they are leaving you, 3) mail is returned "no forward address", 4)you want to remove them....and each of these require an intentional act to remove them. Some sort of automatic trigger doesn't set well with me. The trigger goes off, the patient is gone from the list, an you have no idea that it occurred....that doesn't make any sense at all.

[jordansparks]

You certainly don't have to use that option. I have been told that some people would prefer a limit. You don't think there's any limit? If you've sent them a postcard every six months for 10 years, you don't think it might be time to call it quits?

[savvy]

No, actually i don't.
If the notice is delivered and I have no reason, other than I haven't seen the person in my office, that they have left the practice, I'd keep them on.
Granted, 10 years is a long time, but I have had patients take a leave of absence from the practice as long as 7 years and then pop up again. Turns out .....one had gotten all his notices......forwarded to him at the US Mission to NATO.

[Rickliftig]

Granted, 10 years is a long time, but I have had patients take a leave of absence from the practice as long as 7 years and then pop up again..

With my long lost flock it's usually something like,
him:"Hey Doc, remember the last filling that you did on me?"
me: "Yah?"
him: "It broke"
me: "When did it break?"
him: "''bout two years ago. My face is real swelled up. Can you get me in today? (it's always a Friday) - Maybe about 4:00pm? Oh yeah, I gotta be out by 5:00 - plane flight leaves for - (wherever)"

To the practice management gurus that say "this is an opportunity to re-establish the doctor-patient relationship," I say, "Yeah right...."

And of course, they never paid their previous balance from ten years ago!

[drtech]

Jordan,

will this still work well with the new design and getting rid of the date setting buttons?

I have a custom recall called Follow Up, not triggered by any procedure. If we want to follow up on something, we enable that recall and set the date to when we want it to pop up, ie, 1 month, or 2 weeks, etc. Is it still going to be as easy as I had it? I are you going to have easy set buttons somewhere else or how will the date be set?

[drtech]

looking at the recall edit window, now that the buttons are gone, it is not quick and easy to set the "Disable until date" box. You have to manually type in a date. I can of course change this with a dll if you don't like the feature, but wouldn't it be better for everyone to just leave those buttons I had on there and just change what box they effect? That way you can easily disable it for 2wks, 2 months, etc without typing anything. Much more efficient...