All Appt, Clinical, CommLog Notes Visible or Just CommLog?

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drtech
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All Appt, Clinical, CommLog Notes Visible or Just CommLog?

Post by drtech » Sun Jul 22, 2007 6:37 am

The chart is the heart of the record for any patient. Routinely, before we call any patients about tx, make them new appts, or reschedule them, we want the person calling/talking to refresh themselves about what is going on with a patient first. This requires visiting the chart and reading the notes.

I find that when you are working from the Recall list, Unscheduled list, or Planned appt list, it is rather difficult to get an complete and accurate picture of the patient with just the CommLog visible. You can't easily bring up the chart and then go back to the list afterwards. (We usually keep two copies of the program open, but then you have to type in the name of the person in one copy to be able to keep the list up on the other copy of OD)

As a solution, I inserted the chart's progress notes into the account and appt edit window where the CommLog was, so you can see everything without going anywhere. (This is in my custom version that I programmed--not yet in the program everyone is using)

Now, the only disadvantage is the same as the advantage, you can see everything now, so it looks much busier. However, I think having a central "log" of all communication is the best way for everyone to be able to actually see what is communicated to the pt. For example: if you can only see the CommLog when looking at a pt's account or appt they are trying to reschedule, you can't really see that note written on last weeks broken appt, or on last visit's clinical note that says patient "wanted to wait until next year to start tx" or whatever.

The main question I have is this, does this sound like something anyone else would be interested in having as an option to show: The same progress notes as in the chart show in the account and appt edit window?
David Fuchs
Dentist - Springfield, MO
Smile Dental http://www.887-smile.com

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jordansparks
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Post by jordansparks » Sun Jul 22, 2007 2:15 pm

This is a continuation of an ongoing discussion that was lost due to the forum malfunction. It's complex. I'm not interested in people posting messages like, "yeah, it would be great to see everything". That's not the point. The discussion is about HOW we do this. Here's what the debate is about. This would show at the bottom of the Account module instead of the Commlog.
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The main problem I have with this is that it is very cluttered. Missing is the usual grid with Commlog and Email entries. Instead, we have nothing more than duplicate information. Clutter. The checkboxes are especially frustrating because they add a high degree of complexity to what we are trying to keep a simple interface.

Now... I didn't consider earlier that this feature would be especially important when in the recall or unscheduled list. But if you do it the way you have it, then you still don't have a central log, because you're missing email. And my goodness that's a lot of clutter with all those checkboxes and all. And way more information than you would need in the grid, with fees and everything else duplicating what is already in the grid right above it.

I do not like the suggested implementation, but I agree with the reasoning for the need. So I see at least 3 ways to go which would include:
1. Add procedure notes to the grid at the bottom of the Account module.
2. Allow flagging certain types of procedure notes as communications rather than purely clinical, and only include those notes in Account.
3. Put the prognotes at the bottom of the Account module like you have it, but get rid of all those checkboxes. Make it a simpler switch between the two views.

#2 is probably the most elegant solution and would require some careful thought about how to encourage the users to split out their discussions with the patient from their procedural notes. #1 would be acceptable, but a little bit of work. #3 is my least favorite. I might be able to tolerate it, but more discussion would be needed about exactly which object types to show.

I consider this feature to be low on our priority list. We're not the ones trying to get it included, and I don't want us to have to spend time on it. Let me try to give you an example of what we're up against. We have many many customers who call us all day long. We simply don't want to have to answer questions about this feature if it seems sloppy. The style of our software is clean and simple. We don't just throw features on the page unless they follow that style. It reflects badly on us. Keep in mind that Nobody but Dr. Fuchs has requested this feature. Nobody.

In situations like this, when there is a disagreement about a feature, we try to develop some consensus before moving forward. When enough people give their opinions about how it ought to be done, we can make a decision one way or the other. It's rare to have very much disagreement about a feature, but it does happen.
Jordan Sparks, DMD
http://www.opendental.com

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drtech
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Post by drtech » Sun Jul 22, 2007 5:58 pm

I might have a different solution altogether.

I still like the idea of central log of all notes(including e-mails like you said I would need to include and the addition of the recall note and any tasks for the pt), but what about this:

Most of what I was talking about involves working from the LISTS. Keeping everything cleaner and less cluttered being the goal, what about adding the ability to launch a copy of the chart module from the ApptEdit window or list (kind of like the recall window, just reworked to include a Tab for the chart along with the account). That way, you could:

1) go right back to where you were in the list when done with that pt
2) it would keep everything cleaner and simpler
3) it wouldn't require any changes to the account grid

Being able to see the prog notes from the recall window was really the reason I wanted it in the account in the first place, so that would eliminate that need. In the account, I would still like to see if the pt has a next appt right on the screen, like I had with the prog notes, but I could instead add a simple indicator that simply says "No Future Appt Scheduled" or "Next Appt Wed, 10-24-07 9:00AM" or something like that.
David Fuchs
Dentist - Springfield, MO
Smile Dental http://www.887-smile.com

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Post by jordansparks » Sun Jul 22, 2007 9:24 pm

My comment about Email was not well thought out. The real solution there is to include email in the Progress Notes. And now that I think about it, my main complaint is that your solution cluttered one of the main modules. If the clutter was buried 3 windows deep inside the recall list, then I wouldn't care at all. So how about if we allow the progress notes, but only if viewing from within one of the appointment LIST windows? And when it shows, there's simply no need to have all the check boxes. Right? Basically, I agree that we need the progress notes visible within each appointment list window. Split window works just as well as a tabbed interface or a popup window.

If we're going to do this, I think it should be the same for everyone. There's no point in giving users an option on this feature. I don't think it should ever show in the main Account module, but it should always show when inside an appointment list. There should be no option to turn it on and off, or flip it back and forth.
Jordan Sparks, DMD
http://www.opendental.com

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drtech
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Post by drtech » Mon Jul 23, 2007 8:15 am

sounds good....just when activated from the lists then, I will work on that sometime soon here.

and for extension of this...what about adding a pt's task list items in prog notes as another object also? Unless I am overlooking something I don't think there is any way to tell if a pt has a task attached to them.
David Fuchs
Dentist - Springfield, MO
Smile Dental http://www.887-smile.com

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Post by jordansparks » Mon Jul 23, 2007 9:09 pm

You're right. Tasks don't really show outside the task list itself. So many object types... But it kind of seems like low priority, doesn't it? I mean aren't there other higher priorities with tasks? Like having the task lists be assignable to a specific user and popup in a startup window for that user? Or developing an instant messaging system with inboxes that more closely ties together tasks, patients, email, and messages? All of those things seem more important than showing a task for a patient within their progress notes.
Jordan Sparks, DMD
http://www.opendental.com

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