Default Procedure Note

[Hersheydmd]

A problem with default procedure notes, is that they don't show up until you mark the procedure complete and click OK. If you want to edit it you have to reopen it and then click OK again. It would make more sense if the default note showed as soon as you created the procedure with a tx plan status. Then when you see the patient you could edit it and mark it complete (which would result in one less entry in the audit log as well).

[jordansparks]

I don't think you're doing it right. You should be marking the entire appointment complete, not individual procedures.

But I do undertand your point. We already have a plan to add the notes to TP procs by changing the appointment to "InRoom" or "StartingTx" or something like that. The plan is that the procedures would remain TP status at that point. They would not convert to C until the end of the appointment when the appointment was then marked completed.

[Hersheydmd]

I don't think you're doing it right. You should be marking the entire appointment complete, not individual procedures.

But I do undertand your point. We already have a plan to add the notes to TP procs by changing the appointment to "InRoom" or "StartingTx" or something like that. The plan is that the procedures would remain TP status at that point. They would not convert to C until the end of the appointment when the appointment was then marked completed.

Jordan,
That would be really fantastic. That would also be very helpful with Prosthetic treatment that spans multiple appointments, because they can be set a "Started Tx" on the first visit, and left that way until completed on the last visit.

With regard to marking appts completed as opposed to individual procedures, I still disagree with you. You don't understand how I work, especially with hygiene patients, where some of the procedures are assigned to the hygienist and some to me in the same appt. I want my hygienist to mark her procedures complete as she types and signs them. I mark my procedures complete (exam, oral cancer screening) after I do and sign them. Sometimes I may not get a chance to examine the patient right away, and the next hygiene patient is waiting. I may tell the hygienist to move the patient into the overflow room, or have them come back to see me another time for the exam. If we would be marking the appt complete, all the procedures attached to the appt would unintentionally be marked complete, even ones that weren't completed. It is too much to ask of the hygienist to be responsible for unattaching MY incomplete procedures from the appt. It is easier if she just marks her procedures complete as she does them and she doesn't worry about the appt. I personally review every procedure note and I personally mark each appt complete at that time. That is how I know if I reviewed them or not.

[drtech]

instead of keeping track if your exam is done by marking it complete, make two new Appt statuses 1)"Need Dr. Exam" 2) "Dr. Exam Complete." Then you go through these in addition to your "Pt arrived" and "Pt Seated" status. This works very well and then you can complete the appt any time during the appt to complete the procedures and still know what needs to be done in a hyg exam.

[jordansparks]

What about marking multiple individual procs complete from Chart module? That wouldn't require extra clicks.

[Hersheydmd]

instead of keeping track if your exam is done by marking it complete, make two new Appt statuses 1)"Need Dr. Exam" 2) "Dr. Exam Complete." Then you go through these in addition to your "Pt arrived" and "Pt Seated" status. This works very well and then you can complete the appt any time during the appt to complete the procedures and still know what needs to be done in a hyg exam.

First of all, it's not just 'exams" that I need to keep track of. It's all visits and notes.
Second, we don't pay much attention to "Pt arrived", "Pt seated", "Pt at frontdesk" etc. The only status that we monitor is confirmed or not, or e-mail sent or not. We're in a small office. We know where the patient is, we don't need to see it on the screen.

What about marking multiple individual procs complete from Chart module? That wouldn't require extra clicks.

How do you mark multiple procedures complete at the same time from the Chart module?

I still don't see what is wrong with typing a note, signing it, and clicking the SET COMPLETE BUTTON to set the procedure complete. Isn't that precisely what the SET COMPLETE BUTTON is for? And where are the extra clicks? Clicking SET COMPLETE isn't any more clicks than clicking OK.
The problem was that the default note didn't appear until after the procedure was marked complete. But according to Jordan that will be resolved in the newest version.

[drtech]

turn on the options to set complete individual procedures from the progress notes in the chart module setup...i asked for that feature long ago and Jordan implemented it until we found it better to do it like Jordan suggests, but your method of working would work well with turning this back on. The risk you run is that you will complete a duplicate procedure than the one actually attached to the appointment and then you will have two of the same completed when you complete the appointment. If you double check everything, like you should anyway, then this will be fine, but does introduce the possibility of errors...

[Hersheydmd]

turn on the options to set complete individual procedures from the progress notes in the chart module setup...i asked for that feature long ago and Jordan implemented it until we found it better to do it like Jordan suggests, but your method of working would work well with turning this back on. The risk you run is that you will complete a duplicate procedure than the one actually attached to the appointment and then you will have two of the same completed when you complete the appointment. If you double check everything, like you should anyway, then this will be fine, but does introduce the possibility of errors...

David,
That is possible but very unlikely, especially since anything attached to today's appointment is colored yellow.
I did not turn on the option to "allow setting procedures complete" from the chart module. We set procedures complete from the PROCEDURE INFO window, when we enter our notes and sign them, not from the CHART module window. I wouldn't want the procedure marked complete until the notes and signature were done.
Since you were the one to request this feature, I am curious what changed your mind?
By setting an entire appt complete first, don't you see a risk that procedures that were tx planned, but not performed will be marked complete. For example a recall appt - exam, x-rays, prophy - where the pt decided they didn't want x-rays this time, but nobody removed the x-rays from the appt, once the appt is marked complete, the x-rays will be marked complete and billed. What if no one catches it?
Also, when entering and signing notes, what is the advantage to clicking "OK" and leaving it as TX PLAN status rather than clicking "SET COMPLETE"?

[Jorgebon]

I guess the preferred method will depend on the particular dentist's habits or workflow. At our office we make changes to the appointment and procedures while we treat the patient. When we finish, we make sure that what's yellow is what we did and we set the appointment complete. Later on I sign the progress notes. I guess I could just as easily edit and sign the progress notes and set the procedure complete at the same time, but I would need a signature pad at each computer. The other thing would be that a lot of procedures we set complete don't have progress notes, such as x-rays. So maybe in my situation setting the appointment complete is better.
Jorge Bonilla DMD

[drtech]

we only attach a note to one of the procedures completed for the day most of the time. This makes it much better to complete the appointment.

The reason we went away form completing the procedures from the progress notes, is that one could be completed and then a duplicate would sometimes get completed later when the appointment was set complete. We found it better to always open the appointment (from the book or the chart) and make sure what you did was actually attached, then complete the appointment. We then always go to the account to make sure no extra procedures were completed before checking the pt out. The notes are then completed on one of the procedures.